A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it.
A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it.
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DOI：
10.1186/s12978-017-0347-9
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发表时间：
2017-07-20
影响因子：
3.4
通讯作者：
Say L
中科院分区：
文献类型：
--
作者：
Chandra-Mouli V;Parameshwar PS;Parry M;Lane C;Hainsworth G;Wong S;Menard-Freeman L;Scott B;Sullivan E;Kemplay M;Say L
青少年的健康和权利日益得到承认，并被列为全球议程的优先事项。这为我们提供了一个“前所未有”的机会来解决青少年避孕问题。这是及时的，因为目前有大量青少年无法获得和使用避孕药具。从研究证据和方案经验来看，我们显然需要以不同的方式行事，以满足他们的需求/实现他们的权利。在本评论中，我们呼吁在几个关键领域采取行动，解决青少年长期无法获得和使用避孕药具的问题。我们必须摒弃“一刀切”的做法，摒弃“只使用避孕套”的思维定式，摒弃针对青少年的单独服务，摒弃忽视药房和商店的吸引力，摒弃一次性培训，使卫生工作者对青少年友好。我们努力扩大青少年获得优质避孕服务的机会，同时必须努力培养他们使用避孕服务的愿望和能力，并始终如一地这样做。为了做出这些改变，必须在几个层面上采取行动。这包括制定健全的国家政策和战略、有监测的强有力的方案执行、定期方案审查和执行情况研究。此外，高质量的数据收集、分析和传播必须是我们所有努力的基础。在我们向前迈进的同时，我们还必须认识到，在那些带头增加青少年使用避孕药具的国家中，大规模和持续的方案具有积极的范例，并从中吸取教训。这一历史上史无前例的时刻给了我们一个真正的机会来带来变革性的变化，特别是在事关重大的情况下。
Increasingly, the health and rights of adolescents are being recognized and prioritized on the global agenda. This presents us with a “never-before” opportunity to address adolescent contraception. This is timely, as there are enormous numbers of adolescents who are currently unable to obtain and use contraceptives. From research evidence and programmatic experience, it is clear that we need to do things differently to meet their needs/fulfil their rights. In this commentary, we call for action in several key areas to address adolescents’ persistent inability to obtain and use contraceptives. We must move away from one-size-fits-all approaches, from a ‘condoms-only’ mind set, from separate services for adolescents, from ignoring the appeal of pharmacies and shops, and from one-off-training to make health workers adolescent friendly. Our efforts to expand access to quality contraceptive services to adolescents must be combined with efforts to build their desire and ability to use them, and to do so consistently. In order for these changes to be made, action must be taken on several levels. This includes the formulation of sound national policies and strategies, robust programme implementation with monitoring, regular programmatic reviews, and implementation research. Further, high-quality collection, analysis, and dissemination of data must underlie all of our efforts. As we move ahead, we must also recognize and draw lessons from positive examples of large scale and sustained programmes in countries that have led the way in increasing contraceptive use by adolescents. This unprecedented moment in history gives us a real opportunity to bring about transformational change, particularly when there is so much at stake.