Adolescent reproductive health in Myanmar

This project provides formative research to support the delivery of life-skills education and hygiene improvements through monastic schools in Magway, Myanmar.

Objective

Adolescence is a critical transition in the life course, during which foundations for health and wellbeing in adulthood, and that of the next generation, are established.

This period is defined by rapid biological, cognitive and psychosocial development, encompassing not only the physical changes of puberty but also the development of values, norms and identity related to relationships and gender.

Such changes bring new health needs and risks, and therefore a heightened need for informaton and services related to sexual and reproductive health.

Comprehensive reproductive health education is the cornerstone of improving adolescent reproductive health.

In order to make healthy, responsible decisions, young people need accurate information about puberty, reproduction, relationships, the consequences of unsafe sex, and how to avoid HIV, sexually transmitted infections (STIs) and unintended pregnancy.

They also need the skills and confidence to be able to deal with peer pressure, negotiate safe and consensual relationships, and navigate the health system to access services.

Reproductive health education programs that address these components have been demonstrated to have a positive impact not only on knowledge and attitudes, but also contribute to safer sexual practices (such as delaying onset of sexual activity, reducing the number of partners, and increasing condom and contraceptive use) and can also prevent the negative consequences of unsafe sex.

In addition to a need for comprehensive reproductive health education, there is increasing recognition of the impact that menstrual hygiene management (MHM) practices can have on health, education and psychosocial outcomes of adolescent girls.

While globally there is an emerging body of research into MHM and the impact of menstruation and MHM practices on girls’ health and psychosocial outcomes, there are still significant knowledge gaps, particularly in relation to school settings.

Adolescents account for almost 20 per cent of Myanmar’s population (an estimated 10 million adolescents aged 10-19 years). These young people are just entering their reproductive years, however understanding of their reproductive health needs remains very limited.

Timeline

2016–2017.

Approach

There is currently a paucity of national survey data and smaller sub-national studies describing reproductive health knowledge and attitudes of unmarried young people.

One qualitative study conducted among out-of-school youth reported that few had accurate and comprehensive understanding about puberty, reproduction and reproductive health, despite many already engaging in sexual activity.

There are no published studies examining reproductive health knowledge, attitudes or needs of school-going adolescents that could inform the delivery of quality reproductive health education in school settings.

This formative study aimed to improve understanding of the reproductive health information needs (included those related to puberty and menstruation) of adolescents in Myanmar, explore the implementation of reproductive health life-skills education and improve understanding of current MHM practices and impacts in school settings.

It was anticipated that the research findings would contribute to the development and implementation of projects to improve LSE and MHM in school settings in Magway.

The findings of this study would be of relevance to LSE and WASH in schools policy and programming nationally.

The aims of this study were to:

• understand the quality and implementation of LSE through the monastic Education System in Magway
• understand current MHM practices, their determinants, and impacts among adolescent girls in Magway
• identify opportunities to support the delivery of quality LSE and improve MHM in monastic schools.

Specific objectives were to:

• describe adolescents’ knowledge and attitudes related to reproductive health
• examine the current implementation of LSE through monastic schools, including coverage, content, and challenges impacting on delivery
• identify adolescent girls’ MHM practices, their determinants and self-reported health, social and educational impacts
• determine the extent to which available WASH facilities support MHM in monastic schools.