Department of Reproductive Health and Research/Human Reproduction Programme, World Health Organization, Geneva, Switzerland.
School of Public Health, University of Washington, Seattle, WA, USA. Now with Department of Reproductive Health and Research/Human Reproduction Programme, World Health Organization, Geneva, Switzerland.
Glob Health Sci Pract. 2018 Mar 30;6(1):128-136. doi: 10.9745/GHSP-D-17-00285. Print 2018 Mar 21.
BACKGROUND: Despite international recommendations and supportive evidence, there are few examples of scaled-up and sustained programs to provide adolescents with sexuality education. Moreover, despite acknowledgment that building community support and responding to resistance are key challenges, there is a lack of detailed discussion on specific programmatic strategies to address these issues. OBJECTIVES: This article reviews the work of 2 organizations-Aahung and Rutgers Pakistan-that are successfully implementing large-scale sexuality education programs in Pakistan, collectively reaching more than 500,000 students. This review aims to answer the following questions: (1) How did Aahung and Rutgers Pakistan work to understand Pakistani society and culture and shape their programs to build community support? (2) How did Aahung and Rutgers Pakistan overcome resistance to their efforts? METHODS: We reviewed program documents and publications, synthesized key themes, identified questions of interest, and engaged key informants from Aahung and Rutgers Pakistan's leadership. RESULTS: The success of Aahung and Rutgers Pakistan was grounded in their readiness to understand the nuanced context within the communities, collaborate with groups of stakeholders-including parents, school officials, religious leaders, media personnel, and adolescents themselves-to ensure support, and stand up to forces of resistance to pursue their goals. Specific strategies included working with communities to select content, tactfully selecting and framing issues with careful consideration for sensitivities, engaging adolescents' influencers, strengthening media presence, showcasing school programs to increase understanding and transparency, and choosing opportune times to introduce messages. CONCLUSION: The successful strategies used by Aahung and Rutgers Pakistan to promote adolescent sexual and reproductive health through sexuality education can inform programs worldwide. Additionally, the programmatic weaknesses identified can guide future planning and action by Aahung and Rutgers Pakistan. We call on other programs to continue sharing challenges, specifically related to resistance, with sexuality education programs in order to develop a toolbox of additional strategies for community uptake.
背景：尽管有国际建议和支持性证据，但很少有扩大规模和持续进行的方案为青少年提供性教育。此外，尽管认识到建立社区支持和应对抵制是关键挑战，但缺乏关于解决这些问题的具体方案策略的详细讨论。
目的：本文回顾了 2 个组织——Aahung 和 Rutgers Pakistan——在巴基斯坦成功实施大规模性教育方案的工作，这两个组织的工作共同覆盖了超过 50 万名学生。本综述旨在回答以下问题：（1）Aahung 和 Rutgers Pakistan 如何努力了解巴基斯坦社会和文化，并调整其方案以建立社区支持？（2）Aahung 和 Rutgers Pakistan 如何克服对其努力的抵制？
方法：我们审查了方案文件和出版物，综合了关键主题，确定了感兴趣的问题，并与 Aahung 和 Rutgers Pakistan 的领导层中的主要知情人进行了沟通。
结果：Aahung 和 Rutgers Pakistan 的成功源于他们准备了解社区内微妙的背景，与包括家长、学校官员、宗教领袖、媒体人员和青少年本身在内的利益相关方团体合作，以确保支持，并抵制阻力以追求目标。具体策略包括与社区合作选择内容，谨慎考虑敏感性问题，巧妙地选择和框定问题，争取青少年的影响者的支持，加强媒体存在，展示学校方案以增加理解和透明度，并选择适当的时机介绍信息。
结论：Aahung 和 Rutgers Pakistan 通过性教育促进青少年性与生殖健康的成功策略可以为全球方案提供信息。此外，确定的方案弱点可以指导 Aahung 和 Rutgers Pakistan 的未来规划和行动。我们呼吁其他方案继续分享与性教育方案相关的挑战，特别是与抵制有关的挑战，以便为社区接受制定更多策略的工具包。
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