World Health Organization, Geneva, Switzerland.
Family Planning 2020, Washington, USA.
Reprod Health. 2018 Jan 30;15(1):17. doi: 10.1186/s12978-018-0457-z.
BACKGROUND: We thank Bijlmakers et al. for their interest in our article, "A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it", and are grateful for the opportunity to respond to their four key assertions. RESPONSE: First, we fully agree that sexual rights are controversial, which we discussed in depth in our original article. However, we reaffirm that there is global consensus on adolescent contraception as evidenced in part by recent data emerging from FP2020 on 38.8 million additional modern contraceptive users, the Global Goods and commitments emanating from the 2017 FP2020 summit, and their translated actions at the country level. Additionally, we clarify WHO's working definitions of sex, sexual health, and sexuality, and introduce WHO's newly released Operational Framework on Sexual Health and its Linkages to Reproductive Health. We welcome and agree with Bijlmakers et al.'s second point, which elaborates on the barrier of restrictive laws and policies. To address this barrier, we describe examples of resources that can help programmes understand the political/social context that drives these laws and policies at national and subnational levels, and identify programmatic gaps and best practices to address them within specific political/social contexts. We also welcome and agree with Bijlmakers et al.'s third point, which reiterates that discomfort around adolescent sexuality is a major barrier for sexuality education. In response, we point to four relevant reviews of CSE policies and their implementation, our original article's description of three programmes that have successfully addressed inadequate teacher skills, and our ongoing work on documenting strategies to build an enabling environment for CSE and deal with resistance. Lastly, we wholeheartedly agree that the harmful policies noted by Bijlmakers et al. are damaging to international efforts to improve adolescent SRH and rights. We argue, though, that these policies alone will not undermine efforts by countless other stakeholders around the world who are working in defence and promotion of adolescents' SRH and rights. CONCLUSION: Despite the many valid obstacles noted by Bijlmakers et al., we truly believe that this is "a never-before opportunity to strengthen investment and action on adolescent contraception".
背景:我们感谢 Bijlmakers 等人对我们的文章“加强青少年避孕投资和行动的前所未有的机会,以及我们必须做些什么来充分利用这一机会”的关注,并感谢他们有机会回应我们的四个关键观点。
回应:首先,我们完全同意性权利是有争议的,我们在原文中对此进行了深入讨论。然而,我们重申,全球范围内对青少年避孕问题达成了共识,这在一定程度上可以从 FP2020 最近公布的新增 3880 万现代避孕方法使用者的数据、全球商品以及 2017 年 FP2020 峰会的承诺及其在国家一级的转化行动中得到证明。此外,我们澄清了世界卫生组织关于性、性健康和性的工作定义,并介绍了世界卫生组织新发布的性健康业务框架及其与生殖健康的联系。我们欢迎并同意 Bijlmakers 等人的第二点,即阐述了限制性法律和政策的障碍。为了解决这一障碍,我们描述了一些资源,可以帮助方案了解在国家和国家以下各级推动这些法律和政策的政治/社会背景,并确定在特定政治/社会背景下解决这些问题的方案差距和最佳做法。我们也欢迎并同意 Bijlmakers 等人的第三点,即重申对青少年性行为的不适是性教育的主要障碍。对此,我们指出了四项关于性教育政策及其实施情况的相关审查、我们原文中描述的三个成功解决教师技能不足问题的方案,以及我们正在进行的记录建立性教育有利环境和应对阻力的战略的工作。最后,我们完全同意 Bijlmakers 等人指出的有害政策对改善青少年性健康和生殖健康及权利的国际努力造成了损害。不过,我们认为,这些政策本身不会破坏世界各地无数其他利益攸关方为捍卫和促进青少年性健康和生殖健康及权利而开展的工作。
结论:尽管 Bijlmakers 等人指出了许多合理的障碍,但我们确实相信,这是“加强青少年避孕投资和行动的前所未有的机会”。
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