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Reducing Age-Related Barriers to Sexual Health Services

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Reducing Age-Related Barriers to Sexual Health Services Reducing age-related barriers to sexual health services Learning to change policy toolkit For civil society organisations, youth activists, parliamentarians and journalists ACKNOWLEDGEMENTS 1 CONTENTS Acronyms ....................................................................................................................................................... 4 Glossary ......................................................................................................................................................... 6 Why this guide? Who should use this guide? How to use it ................................................................ 9 Why this Guide? .......................................................................................................................................... 9 Age of Consent Legal Review in 22 Countries............................................................................................ 10 Ethical, Social, Cultural (ESC) desktop review ............................................................................................ 10 Barriers Preventing Adolescents’ Access to Sexual and Reproductive Health Services (SRHS) ................. 11 The Reducing age-related barriers to sexual health services: Learning to change policy toolkit .............. 11 Who should use this guide? ...................................................................................................................... 12 How to use the guide ................................................................................................................................ 12 Module 1. Starting your Learning Journey ............................................................................................ 15 What will be covered in this Module? ....................................................................................................... 15 What is Advocacy?..................................................................................................................................... 15 Advocacy as a learning activity .................................................................................................................. 18 Check you understand key parts of this module ....................................................................................... 20 Module 2. Understanding AoC, Youth Services and Treatment ............................................................ 21 What will be covered in this module? ....................................................................................................... 21 Adolescents and sex .................................................................................................................................. 21 The most at risk adolescents (MARA) in your country ............................................................................... 22 Age of consent (AoC) law and access to sexual and reproductive health services (SRHS)......................... 26 What are sexual and reproductive services? ............................................................................................. 28 Check you understand key parts of this module, what do the following acronyms stand for: .................. 32 Module 3. Understanding the problem to develop a strategy.............................................................. 33 What will be covered in this Module ........................................................................................................... 33 Who are the people to involve? ................................................................................................................ 33 Understanding the complexity by systems using systems thinking ........................................................... 38 2 A systems approach to journalism............................................................................................................. 51 Check you understand key parts of this module: ...................................................................................... 53 Module 4. Prioritising responses to improve SRHS access for adolescents .......................................... 54 What will be covered in this module ........................................................................................................... 54 What does the ideal AoC legislative environment look like? ..................................................................... 54 What is the goal? ....................................................................................................................................... 55 What resources do you need? ................................................................................................................... 60 What is the time frame? ............................................................................................................................ 60 What can we use as grounds to advocate? ............................................................................................... 62 Who are the people to target? .................................................................................................................. 67 Source mapping ......................................................................................................................................... 71 What do you need them to hear? ............................................................................................................. 73 What are the best channels for communication ....................................................................................... 78 Check you understand key parts of this module: ...................................................................................... 95 Module 5. Implementing and monitoring the project ................................................................................. 96 What will be covered in this module: ........................................................................................................ 96 Monitoring and Evaluation ........................................................................................................................ 96 The watchdog role of journalism ............................................................................................................. 101 Advocacy Resources .................................................................................................................................. 103 References ................................................................................................................................................. 107 3 ACRONYMS AIDS Acquired Immune Deficiency Syndrome ANC Antenatal Care AoC Age of Consent ART Antiretroviral treatment ARV Antiretroviral ASRHRS Adolescent sexual and reproductive health and rights services CD4 CD4 cells or T-helper cells are a type of white blood cells that fight infection, and their count indicates the stage of HIV or AIDS in a patient ESA Eastern and Southern Africa EVA Especially vulnerable adolescents FSW Female Sex Worker GDP Gross Domestic Product HCT HIV Counselling and Testing HIV Human Immunodeficiency Virus HPV Human Papillomavirus HTC HIV/AIDS testing and counselling IDU Injecting drug users LGBTI Lesbian, gay, bisexual, transgender, intersexual MARA Most at Risk Adolescents MSM Men who have sex with men NGO Non-governmental Organisation PEP Post-exposure Prophylaxis PMTCT Prevention of Mother-to-Child Transmission PLHA People Living with HIV/AIDS 4 PLWHIV People Living with HIV PrEP Pre-exposure Prophylaxis STI Sexually transmitted infections SRHR Sexual and reproductive health and rights SRHRS Sexual and reproductive health and rights services SRHS Sexual and reproductive healthcare services STI Sexually transmitted infection UNAIDS Joint United Nations Programme on HIV/AIDS UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund WHO World Health Organization WSW Women who have sex with women YFS Youth-friendly services 5 GLOSSARY Abortion or termination of pregnancy – the medical process of ending a pregnancy so that it does not result in the birth of a baby. Depending on how many weeks you have been pregnant, the pregnancy is ended either by taking medication or by having a surgical procedure. Antenatal care – care received by a pregnant woman during her pregnancy. Adolescent – the United Nations and its agencies define an “adolescent” as an individual in their second decade of life (between 10 and 19 years of age), with a “young adolescent” being defined as one aged 10- 14 and an “older adolescent” aged 15-19. Age of consent – Age of Consent in this document is used both to talk about age of consent to sex and to medical treatment, including access to contraceptives; HIV counselling and testing, termination of pregnancy. Awareness raising – increasing people’s recognition that a problem exists or familiarity with a policy proposal. Bisexual – romantic attraction, sexual attraction, or sexual behaviour toward both males and females, or romantic or sexual attraction to people of any sex or gender identity. It also refers to a person that experiences such attraction. Briefings/presentations – making an advocacy case in person through one-on-one, group meetings or conferences. Communication campaigns (also public communication campaigns) – communication to influence the knowledge, attitudes and behaviour of people. Such campaigns may have positive political, social, environmental, and health outcomes1. Constituency
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