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Promote, Prevent, Influence Reija Klemetti Eija Raussi-Lehto Promote, prevent, influence The action programme for the promotion of sexual and DISCUSSION PAPER reproductive health in 2014–2020 14 | 2018 Discussion paper 14/2018 Reija Klemetti & Eija Raussi-Lehto Promote, prevent, influence The action programme for the promotion of sexual and reproductive health in 2014 – 2020 © Authors and National Institute for Health and Welfare ISBN 978-952-343-092-1 (online publication) ISSN 2323-363X (online publication) http://urn.fi/URN:ISBN:978-952-343-092-1 Helsinki, Finland 2018 Foreword The action programme for the promotion of sexual and reproductive health in 2007–2011 by the Ministry of Social Affairs and Health was the first sexual and reproductive health action programme in Finland. The intermediate assessment of the action programme was carried out in 2009, and the final assessment seminar was held in December 2011. Both the intermediate assessment and the seminar conclusions stated that significant reforms in sexual and reproductive health promotion had been carried out during the programme implementation in Finland. Nevertheless, there was still a lot to do, and thus the action programme was updated according to the original plan. The updating task was given to the Sexual and Reproductive Health Unit (SELI) of the National Institute for Health and Welfare. In addition to the SELI unit, numerous internal and external experts took part in the updating process (Appendix 1). During the updating process, the SELI department convened two meetings, inviting organisation representatives in order to discuss the action programme from their point of view. After that, the action programme was further developed, taking account the valuable feedback received from the organisations. In addition, the SELI unit heard the experts that took part in the preparation of the previous action programme. The National Institute for Health and Welfare received total of 50 advisory opinions, and the action programme was finalised accordingly. The updating of the action programme was carried out at the time when the social and health care structure reform was still under preparation. Therefore, the division of responsibilities was difficult. Suggestions for optimal choices as project actors were made in common meetings of the National Institute for Health and Welfare and the Ministry of Social Affairs and Health. The action programme on sexual and reproductive health promotion will be implemented as a part of the re-structuring of local government services and development and reform of preventative municipal services. Furthermore, the National Institute for Health and Welfare recommends that municipalities will take advantage of the action programme when drawing up action and financial plans for the forthcoming years. The action programme combines all the goals of the sexual and reproductive health promotion work in Finland for the next few years and presents proposals for action in order to reach these goals. In addition, the programme deals with the gaps in the sexual and reproductive health research and gives proposals for research topics. The action programme is intended for social and health care management, staff, organisations of the industry and other key cooperation partners, as well as for persons of trust. Furthermore, the target group consists of sexual and reproductive health researchers, universities, research institutes, universities of applied sciences and sponsors of researches, teachers and students in the social and health care field, as well as health education teachers at basic education, general upper secondary education and vocational institutions, and those providing their education. We extend our warm thanks to all those who were involved in the updating process and gave their opinions. Cooperation is the best way to promote sexual and reproductive health and, consequently, the health and welfare of the whole nation. In Helsinki, 17 March 2013 Marjaana Pelkonen Ministerial Adviser, Ministry of Social Affairs and Health THL – Directions 14/2018 3 Promote, prevent, influence Contents Introduction ............................................................................................................................................................. 7 2. Sexual and reproductive rights ..................................................................................................................... 16 Sexual and reproductive rights as concepts .................................................................................................................... 16 International conventions ................................................................................................................................... 16 3. Sexual and reproductive health awareness at national level and sexual and reproductive health behaviour ............................................................................................................................................................... 20 Level of awareness and monitoring it .............................................................................................................................. 20 Sexual and reproductive health behaviour at national level ...................................................................................... 21 4. Sexuality education: education, guidance and counselling ...................................................................... 27 Sexual and reproductive health education at national level ...................................................................................... 27 Sexual and reproductive health education, guidance and counselling ................................................................... 28 5. Sexuality education .......................................................................................................................................... 32 Children and adolescents ...................................................................................................................................................... 32 Sexual and reproductive health services for young people ....................................................................................... 34 Young adults ............................................................................................................................................................................. 39 Adults .......................................................................................................................................................................................... 41 Elderly population................................................................................................................................................................... 43 Special needs groups .............................................................................................................................................................. 46 6. Multiculturalism .............................................................................................................................................. 52 Need for services among traditional minorities ............................................................................................................ 52 Increasingly multicultural Finland .................................................................................................................................... 53 Special issues affecting sexual and reproductive health of people with foreign origin ................................... 54 Health and welfare research ................................................................................................................................................ 57 Issues to be taken into account when planning service systems .............................................................................. 58 7. Pre-conception health, care and counselling .............................................................................................. 63 8. Involuntary childlessness ................................................................................................................................ 66 9. Gestation period ............................................................................................................................................... 71 10. Childbirth and the postnatal period .......................................................................................................... 76 Trends in childbirth and childbirth care ........................................................................................................................... 76 Antenatal training and delivery planning ........................................................................................................................ 77 Childbirth and immediate postnatal care ......................................................................................................................... 78 Shorter hospital stays and early postnatal discharge ................................................................................................... 81 Identification and treatment of postnatal depression ................................................................................................... 82 Postnatal examination and prevention of postnatal depression................................................................................ 83 11 Contraception .................................................................................................................................................
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