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Module 16: Reproductive Health Services for Adolescents Comprehensive Reproductive Health and Family Planning Training Curriculum MODULE 16: REPRODUCTIVE HEALTH SERVICES FOR ADOLESCENTS Participant’s Manual Judith Senderowitz, Cathy Solter, and Gwyn Hainsworth Pathfinder International June 2002 Revised 2004 © 2002 Pathfinder International. Any part of this document may be reproduced or adapted to meet local needs without prior permission from Pathfinder International provided Pathfinder International is acknowledged, and the material is made available free of charge or at cost. Please send a copy of all adaptations from this manual to: Technical Services Group Pathfinder International 9 Galen Street, Suite 217 Watertown, MA 02472 Funds for the development and production of this Comprehensive Reproductive Health and Family Planning Training Curriculum were provided by the United States Agency for International Development (USAID) and the Melinda and Bill Gates Foundation under the African Youth Alliance (AYA) project. The views expressed are those of Pathfinder International and do not necessarily reflect those of USAID. Participant’s Manual Table of Contents PARTICIPANT HANDOUTS x 0.1: Defining Participant's Expectations of the Course.........................1 x 0.2: Suggestions for Effective Feedback..............................................2 x 0.3 RH Services for Adolescents Training Schedule............................3 x 0.4: Where Are We? and Reflections ...................................................4 x 0.5: Reproductive Health Services for Adolescents Pre-Test...............5 x 1.1: Adolescent Reproductive Rights ...................................................8 x 3.1: Gender Role Case Studies............................................................9 x 3.2: Decision-Making/Predicting Consequences..................................10 x 4.1: Small Group Discussion Topics ....................................................11 x 4.2: Clarifying Sexual Values ...............................................................12 x 4.3: Lines to Practice the Clarification Technique ................................13 x 5.1: Reproductive History Form............................................................14 x 6.1: Sexual Safety Questionnaire.........................................................16 x 6.2: Talking About Condoms................................................................18 x 7.1: Adolescent Contraception .............................................................20 x 7.2: Selection Guidelines for Contraceptive Methods...........................30 x 7.3: Immediate and Underlying Causes of Misconceptions ..................47 x 7.4A: Rumors and Misinformation about COCs ...................................49 x 7.4B: Rumors and Misinformation about IUDs .....................................52 x 7.4C: Rumors and Misinformation about Condoms ..............................55 x 7.4D: Rumors and Misinformation about DMPA...................................56 x 9.1: Role Plays and CBT Skills Assessment Checklists for ARH Counseling ....................................................................................60 x 9.2: Role Plays for ARH Counseling ....................................................85 x 9.3: Counseling Cue Cards ..................................................................86 x 11.1: Sexual Abuse Truth or Myth........................................................102 x 11.2: Roleplay ......................................................................................103 x 11.3: Case Studies...............................................................................105 x 11.4: Observer Roleplay Checklist .......................................................106 x 13.1: Clinic Assessment of Youth-Friendly Services ............................107 x 13.2: Action Plan ..................................................................................123 x 13.3: Reproductive Health Services for Adolescents Post-Test ...........124 x 13.4: Participant Evaluation Form ........................................................127 CONTENT x Unit 1: The Nature of Adolescence .....................................................127 x Unit 2: Adolescent Vulnerabilities, Risk-Taking Behaviors, and Their Consequences........................................................................133 x Unit 3: Adolescent Behavior and Life Skills.........................................138 x Unit 4: Communicating with the Adolescent Client .............................142 x Unit 5: The RH Visit and the Adolescent Client...................................153 x Unit 6: Safer Sex and Protection for Adolescents ...............................158 x Unit 7: Contraceptive Options for Adolescents ...................................163 x Unit 8: STI/HIV and Adolescents ........................................................167 x Unit 9: Counseling the Adolescent on Safer Sex ................................173 x Unit 10: Sexual Identity and Orientation..............................................178 x Unit 11: Sexual Abuse ........................................................................180 x Unit 12: Pregnancy, Birth, and Postpartum Issues .............................188 x Unit 13: Providing Adolescent Services ..............................................202 ACRONYMS LIST .............................................................................................205 BIBLIOGRAPHY ...............................................................................................207 Module 16/Participant Handouts Participant Handout 0.1: Defining Participant's Expectations of the Course 1. What do you hope to accomplish during this course? 2. Do you anticipate any difficulties during this course? 3. While you attend this training, what will you be missing at home? For example, having a young baby at home or a sick family member. 4. While you attend the training, what will you be missing at work? For example, there is no one to cover your position or certain work will not be completed. 5. How do you think this training will help you at work? Pathfinder International 1 Adolescent Curriculum Module 16/Participant Handouts Participant Handout 0.2: Suggestions for Effective Feedback DO x Ask a question when you have one. x Feel free to share an example. x Request an example if a point is not clear. x Search for ways in which you can apply a general principle or idea to your work. x Think of ways you can pass on ideas to your subordinates and co-workers. x Be skeptical–don't automatically accept everything you hear. x Participate in the discussion. DON'T x Try to develop an extreme problem just to prove the trainer doesn't have all the answers. (The trainer doesn't.) x Close your mind by saying, "This is all fine in theory, but..." x Assume that all topics covered will be equally relevant to your needs. x Take extensive notes; the handouts will satisfy most of your needs. x Sleep during class time. x Discuss personal problems. Pathfinder International 2 Adolesc Module 16/Participant Handouts Participant Handout 0.3: Reproductive Health Services for Adolescents Training Schedule Time Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 9:00 am – Opening "Where Are We?" "Where Are We?" "Where Are We?" "Where are We?" Where Are We? 10:30 am Introduction and Unit 4: Unit 6 continued Unit 8 continued Unit 11: Unit 13: Providing Pre-test Communicating/ Sexual Abuse Adolescent (1 hr, 45 min.) Counseling (4 hrs, 15 min) Services (4 hrs, 30 min) Assessment (1/2 day) 10:30 am – Break Break Break Break Break Unit 13 10:45 am Assessment continued 10:45 am – Introduction Unit 4 continued Unit 7, Unit 8 continued Unit 11 continued Unit 13 1:00 pm continued Contraceptive Unit 9: Counseling Assessment Unit 1: Nature of Options on Safer Sex continued Adolescence (3 hrs, 40 min) (3 hrs, 45 min) (2 hrs, 45 min.) 1:00 pm- Lunch Lunch Lunch Lunch Lunch Lunch 2:00 pm 2:00 pm – Unit 1 continued Unit 4 continued Unit 7 continued Unit 9 continued Unit 11 continued Unit 13 3:30 pm Unit 2: Adolescent Unit 12: Assessment Vulnerabilities and Pregnancy, continued Risk-Taking Birth, and (55 min) Postpartum Issues (2 hrs, 40 min) 3:30 pm – Break Break Break Break Break Break 3:45 pm 3:45 pm – Unit 3: Adolescent Unit 5: RH Visit and Unit 8: STIs/HIV Unit 9 continued Unit 12 continued Unit 13 continued 6:00 pm Behavior Adolescent Client (3 hrs, 25 min) Unit 10: Sexual Reflections (1 hr, 55 min) (1 hr, 15 min) Reflections Identity and Reflections Unit 6, Orientation Safer Sex Protection (1 hr, 10 min) (1 hr, 40 min) Reflections Reflections * The schedule above reflects 9-hour days to accommodate approximately 40 hours of training time. Alternatively this training can be done in 6 and half days with the facility assessment being conducted on the last day. Pathfinder International 3 Adolescent Curriculum Module 16/Participant Handouts Participant Handout 0.4: Where Are We? and Reflections Where Are We? Starting each day with "Where are We?" is our opportunity to share insights, clarify issues, resolve problems, and review the previous days' material we need to remember so that each of us can get the most out of the course and each day's experiences. Reflections After a full day of activities, we need to take time to look over what we have done and examine what it means to us individually. The "Reflections" activity is an opportunity for the trainers and Px to share feedback on the training activities and to identify areas that need reinforcement or further discussion. Therefore, each day, selected Px (housekeeping
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