2FINAL_SHAPE-INTRODUCTION PDF

SHAPE 1 INTRODUCTION  Sexually Healthy and Personally Empowered Adolescents FOREWORD The 2013 Young Adult Fertility and Sexuality Study (YAFS 4) showed that, young Filipinos between the ages 15-24 undergo chang...

SHAPE 1 INTRODUCTION  Sexually Healthy and Personally Empowered Adolescents FOREWORD The 2013 Young Adult Fertility and Sexuality Study (YAFS 4) showed that, young Filipinos between the ages 15-24 undergo changes in the body at the onset of adolescence, sometimes as early as eight (8) or nine (9) years old. Adolescents and young people are composed of those who are in and out-school-youth, who are dating, or in their first jobs, getting married, being first time (single or married) parents), and needing to build a life for themselves or for their families. Our young people are in that phase of being curious, seeking and deciding whether or not to enter the doors that beckon, and whether or not they find good fortune within depend on their readiness for these life challenges. It has been 20 years since the Adolescent Health and Development Program (AHDP) was established. It is still going strong and we see the need to let it grow stronger. The prototype training modules, Sexually Healthy and Personally Effective Adolescents (SHAPE) Adolescents, were first developed in 1997, and are meant to support the main concerns of AHDP, which, essentially, is to help prepare young people for personal, social and global responsibilities especially as they are in transit during this time from childhood dependency to adulthood independence. These modules have been reviewed, pre-tested among users and clients, revised, updated and repackaged into four (4) training modules. One (1) introductory part includes this foreword, identified users, and how to use the modules. Both materials are conveniently designed to serve as easy tool and reference of trainers in addressing the adolescents’ concerns. INTRODUCTION 2 SHAPE POPCOM invites and strongly encourages all institutions, government or private, that are involved in training programs for adolescents to use these five (5) SHAPE modules. We hope that through SHAPE Adolescents, we can effectively show ways that would enable our youth to realize and accept the good that they can do for themselves and as members of the larger society as they grow to be responsible and personally effective. Congratulations to those directly involved in the conceptualization and development of the SHAPE Adolescent training modules. Personally, may I say that you did a pretty good job. Mabuhay tayong lahat! DR. JUAN ANTONIO A. PEREZ, MPH Executive Director 3 INTRODUCTION  Sexually Healthy and Personally Empowered Adolescents A MESSAGE FROM THE DEPARTMENT OF EDUCATION Our warmest greetings to the Commission on Population (POPCOM) on the development of Sexually Healthy and Personally Effective (SHAPE) Adolescent training modules. Your multispecialty approach in support of the Adolescent Health Development Program (AHDP) is truly significant in the establishment of a well-rounded system in making the delivery of sexuality education proper and relevant. The Department of Education (DepEd) integrates and ensures age-appropriate, developmental, and culture-sensitive sexuality education for learners in the K to 12 Basic Education Curriculum. We integrate sexuality education in the curriculum through natural and purposive means. Natural integration means it is taught as part of Science, Health, Araling Panlipunan and Edukasyon sa Pagpapakatao subjects. Purposive integration, on the other hand, is done through Mathematics and Language subjects, through analysis and statistics, and grammar and vocabulary enhancement relating to issues on teenage pregnancy, premarital sex, and sexually transmitted infections. But more importantly, we see the need to integrate human rights principles in sex education that would correct the stigma attached to teen pregnancy and enable young girls who get pregnant under very unusual circumstances to return to school. DepEd acknowledges your invaluable contribution in ensuring that our teachers and school officials are well-informed to properly guide the youth in sex-related problems and threats and to achieve our collective vision of quality, accessible, relevant, and liberating basic education for all. Thank you and congratulations! LEONOR MAGTOLIS BRIONES Secretary INTRODUCTION 4 SHAPE A MESSAGE FROM THE DEPARTMENT OF HEALTH The youth nowadays are exposed to various sexual risks, such as sexually-transmitted infections (STls), the Human Immunodeficiency Virus (HIV), unintended and repeated pregnancies, and health hazards brought by choice of lifestyle and unprecedented pace of change. Teenage pregnancy is a major social and health concern. The 2017 National Demographic Health Survey conducted by the Philippine Statistics Authority shows that one (1) out of 10 young women aged 15 to 19 years old had begun child-bearing. This alarming situation can be associated with the limited access to correct and meaningful information and level of awareness of the youth about reproductive health and sexually transmitted infections. This is critical in the youth’s holistic development and formation from childhood dependency to adulthood independence. This Sexually Healthy and Personally Empowered (SHAPE) Adolescents’ toolkit will aid us in our response to the challenge of developing healthy, empowered, and responsible adolescents. Through competent facilitators and trainers, we are confident that young learners will be able to grasp the appropriate knowledge and skills that will develop their competencies for adaptive behaviors to maintain and protect their health during this crucial transition stage. We need to shape the youth of today to become responsible citizens of tomorrow so we can build a high-trust society where individuals, adolescents and families thrive in vibrant, culturally diverse, and resilient communities. To carry forward the objectives of this toolkit, we urge all our national and local partners, health workers, community volunteers, and training facilitators involved in youth programs to use this material to further the Adolescent Health Development program. 5 INTRODUCTION  Sexually Healthy and Personally Empowered Adolescents The revitalized Philippine health sector agenda, now called FOURmula One Plus, puts our youth at the top of everything that we do in the Department of Health (DOH). Being the primary steward of the nation’s health, we believe that our success can only be measured by the well-being of our fellow' Filipinos and how well the health system responds to their needs. May the users of this toolkit find opportunities to continue learning lessons from it in order to forge closer partnerships and strengthen cooperation among the different sectors and stakeholders for a healthier Filipino adolescent. DR. FRANCISCO T. DUQUE III, MSc. Secretary of Health INTRODUCTION 6 SHAPE A MESSAGE FROM THE DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT The Department of Social Welfare and Development (DSWD) has been a staunch advocate of the full implementation of the R.A. 10354 or the Responsible Parenthood and Reproductive Health (RPRH) Law. The Agency and the Law acknowledge the pivotal need to provide the youth, couples and families with improved and greater access to correct information and services on Reproductive Health. We believe that it will help to empower the poor, disadvantaged and vulnerable sectors in society towards improved quality of life. The Agency also ensures that the reproductive health concerns are integrated in the implementation of our programs such as Pantawid Pamilyang Pilipino Program (4Ps) to address the increasing number of teenage pregnancies and teenage motherhood among our youth-beneficiaries that exacerbates poverty. On this, we would like to commend the Commission on Population (POPCOM), together with the men and women, who are behind the development and production of the Sexually Healthy and Personally Empowered (SHAPE) Adolescents Toolkit. This training package will serve as a guide to our trainers and learners to acquire correct knowledge, attitude and skills on Adolescent Sexuality and Reproductive Health (ASRH). In fact, our agency utilized the SHAPE as reference during the production of Population Awareness and Family Life Orientation (PAFLO) manuals. 7 INTRODUCTION  Sexually Healthy and Personally Empowered Adolescents We highly recommend the use of these Modules by social workers, development partners, outreach workers, community workers and others who shared the same passion in developing the young generation who are future leaders and nation builders. Together, let us embody the “tunay na malasakit, maagap at mapagkalingang serbisyo” to our youth through this initiative. ROLANDO JOSELITO D. BAUTISTA Secretary INTRODUCTION 8 SHAPE A MESSAGE FROM THE NATIONAL YOUTH COMMISSION The National Youth Commission, tasked to uphold the rights and welfare of our youth, lauds the Commission on Population (POPCOM) for the timely development of Sexually Healthy and Personally Empowered (SHAPE) Adolescent Modules - a toolkit for facilitators on Adolescent Sexual and Reproductive Health (ASRH). We see the significance of the SHAPE Adolescents toolkit because it integrates life skills with personal and social issues of the youth for both sexual and non-sexual risks. Through this, we can effectively disseminate appropriate, accurate, and vital information that would enable our youth to realize their maximum potential and make positive life choices. We congratulate every one behind this project for recognizing the vital role of the youth in nation-building. Our work in promoting and protecting the physical, moral, spiritual, intellectual and social well-being of the “Hope of our Nation" will surely not put in vain. We enjoin all the trainers and facilitators to use this module as a guide in the conduct of their trainings and activities for adolescent health and development. Again, congratulations! RONALD GIAN CARLO J. CADERMA Chairperson and CEO National Youth Commission 9 INTRODUCTION  Sexually Healthy and Personally Empowered Adolescents Adolescence is the period when boys and girls undergo enormous physical and psychological changes to become adults - a natural and healthy period in life. It is a time for boys and girls to grow and develop to their full potential in preparation for adulthood. However, many of them go through this period experiencing sexual and reproductive health problems like unwanted pregnancy as a consequence of early, unsafe or unprotected sex. 1 For this reason, ensuring the health and well-being of adolescents remain a key development concern in the country. The Adolescent Health and Development (AHD) component of the Philippine Population Management Program (PPMP) coordinated by the Commission on Population (POPCOM) is one of the country’s responses in pursuing the overall objective of contributing to the improvement and promotion of the total well-being of young people. In particular, the AHD program aims to reduce the incidence of teenage pregnancy through adolescent sexuality and reproductive health education and services. This new Sexually Healthy and Personally Empowered (SHAPE) Adolescents resource material is the Commission on Population’s latest addition to the Adolescent Sexuality and Reproductive Health (ASRH) learning package. It makes use of the Comprehensive Sexuality Education (CSE) both as a principle and as an approach. As an approach, the CSE enables the adolescent learners to: a. acquire accurate information on human sexuality and sexual and reproductive health (SRH) in the context of human rights; b. explore and clarify values, adopt positive attitude towards SRH, and develop self-esteem, and respect for human rights and gender equality; and c. develop and practice life skills that allow them to nurture respectful and productive relationship with family members, peers, friends, and romantic or intimate partners. Sexual and Reproductive Health of Today’s Adolescents Adolescence is a time of sexual exploration and expression. As their bodies change and mature, many adolescents develop an interest in sex and begin to have sexual relations. The consequences of unprotected sex in adolescents include too early and unwanted pregnancy, and sexually transmitted infections, including HIV.2 1 World Health Organization (WHO). Orientation Programme on Adolescent Health for Health-care Providers: Handout, New Modules. 2006:B-16. 2 World Health Organization (WHO). Orientation Programme on Adolescent Health for Health-care Providers: Handout, New Modules. 2006:C-7. INTRODUCTION 10  SHAPE Early and Unwanted Pregnancy When an adolescent girl becomes pregnant, she is at risk of complications during pregnancy and delivery. Her baby is also at risk of health problems, even death. As a consequence of early childbearing, adolescent mothers are often unable to continue schooling and fulfill their aspirations and dreams in life. Adolescent fathers also face some of the issues that adolescent mothers do. They face the challenges of early fatherhood and the outcomes of lack of emotional maturity to handle relationships. The lack of knowledge and skills, poor access to contraceptive methods, and vulnerability to coerced sex put adolescents at high risk of unwanted pregnancies and sexually transmitted infections and irreversible or life-long social consequences. The 2013 Young Adult Fertility and Sexuality Study (YAFS4) reported that in the past decade, the proportion of older adolescent females (15-19 years old) who have begun childbearing doubled. This is primarily because of the rise in the number of both male and female adolescents (15-19 years old) who engaged in premarital sex [ one (1) in every three (3)] and whose sexual activities are mostly unprotected against unwanted pregnancy and sexually transmitted infections including HIV. Moreover, the study found that the youth in general, which include the older adolescents (15-19 years old), has poor knowledge about risk of conception and most of them acknowledge their lack of knowledge about sex.3 Figure 1. Percent of adolescents (10-19) who have begun childbearing 13.6% 6.3% 2002 2013 Source: Young Adult Fertility and Sexuality Study, 2013 3 University of the Philippines Population Institute (UPPI) and Demographic Research and Development Foundation, Inc. (DRDF). 2013 Young Adult Fertility and Sexuality Survey. 2014 11 INTRODUCTION  Sexually Healthy and Personally Empowered Adolescents Figure 2. Percent of adolescents (10-19) who have engaged in pre-marital sex 32% 23.2% 2002 2013 Source: Young Adult Fertility and Sexuality Study, 2013 Sexually Transmitted Infections At the time of first sexual contact, adolescents often lack knowledge about sexuality and reproduction. Generally, their first sexual engagement is unprotected which places them at risk of getting sexually transmitted infections (STIs) and unwanted pregnancy. When left undiagnosed and untreated, STIs will continue to afflict them in their adult life and may lead to certain health conditions such as pelvic inflammatory disease, ectopic pregnancy, and eventually, infertility. The children they bear may have are also be at risk of damaged eyesight and poor general health condition. A female also runs the risk of getting the virus that causes cervical cancer if her first sexual activity was in early adolescence.4 HIV and AIDS Young people are vulnerable to HIV infection because of risky sexual behavior, substance abuse, and lack of access to information and prevention services. Many young people do not know that HIV is a threat to them but many do not know how to protect themselves from acquiring HIV infection.5 4 World Health Organization (WHO). Orientation Programme on Adolescent Health for Health-care Providers: Handout, New Modules. 2006:C-10. 5 Department of Health (DOH). The Growing HIV Epidemic Among Adolescents in the Philippines at http://www.doh.gov.ph/node/5783. INTRODUCTION 12 SHAPE Among the most affected young populations in the country today are young males who have sex with males, young males who have sex with both males and females, young sex workers, and young persons who inject drugs. Their sexual initiation starts during adolescence. Furthermore, they have low knowledge about HIV and low perception of risks of having HIV infection. Finally, they have poor access to HIV information and services. Sexual Violence Adolescent girls usually lack the power, confidence, and skills to refuse to have sex. Girls are most often raised to become submissive females, while boys are raised to become dominant males. These gender roles and norms make it difficult for a girl to say no to sex. Consequently, sexual violence such as sexual abuse, coercion, and rape, becomes a tragic reality that affects young people. Sexual violence can result in unwanted pregnancy and STIs including HIV, in addition to long lasting psychological consequences. Table 1 below suggests that the first sexual activities of Filipino youth, which include older adolescents (15-19 years old), are mostly non-consensual - that there are many of them who did not want sex to happen but were somehow or actually forced into it. Moreover, Table 2 shows there are adolescents whose first sexual intercourse happened against their will. Table 1. Youth’s Reasons for Having Sex Women Men Reasons for Having Sex % % Wanted to happen that time 34.6 46.5 Did not want but went along with it 27.2 21.4 Did not plan but happened anyway 33.8 31.2 Happened against will 4.5 0.7 Source: YAFS4 13 INTRODUCTION  Sexually Healthy and Personally Empowered Adolescents Table 2. Forced at First Sexual Intercourse Percentage Whose First Number of Women Who Age at First Sexual Sexual Intercourse was Have Ever Had Sexual Intercourse Forced Against Their Will Intercourse