Youth.now PREPARING CARE PROVID IN ADOLESCENT SEXUAL AN REPRODUCTIVE HEALTH A Resource Guide forTrainers, Educators and Facilitators 4> 0 The Futures Group International GOJ / USAID JAMAICA ADOLESCENT SEXUAL & REPRODUCTIVE HEALTH TRAINER RESOURCE BOOK (TRB) The Jamaica Adolescent Reproductive Health Activity (Youth.now) is a five-year project funded by the U.S. Agency for International Development (USAID) Jamaica Mission under contract # 532-c-00-00-00003-00. Youth.now is implemented on behalf of the Ministry of Health (Jamaica) by the Futures Group International in collaboration with Margaret Sanger Centre International (MSCI) and Dunlop Corbin Communications (DCC). 2-4 KING STREET KINGSTON JAMAICA 2002. i ACKNOWLEDGEMENTS This manual and resource guide was developed over the span of two years. In that time, many individuals and organizations contributed their time and expertise to their development. We would like to thank the educators, child development specialists, representatives from health care agencies that serve adolescents, and curriculum development specialists who participated in the Curriculum Development Workshop and provided valuable insights and experiences to the process. The individuals representing the Ministry of Education (Dr. Delores Brissett), University of the West Indies (Mrs. L. Williams), West Indies School of Public Health (Ms. Ivy Limonius), Heart Trust NTA (Ms. Clover Barnett, Ms. Jacqueline Phinn, Ms. Carmen Brown), Red Cross Society of Jamaica (Ms. Lois Hue), Jamaica Association for the Deaf (Ms. Shirley Reid, Ms. Karen Bailey), Ministry of Health (Mrs. Lola Ramocan), USAID (Ms. Sheila Lutjens, Ms. Jennifer King-Johnson), and the Futures Group International (Ms. Cate Lane, Ms. Mary Beckles, Mr. Hilton Grace) participated in conceptualizing the manual and its content. We are also grateful for the expert guidance in the early stages of the development provided by our colleagues, Mrs. Shirley Oliver-Miller and Mr. Errol Alexis from Margaret Sanger Centre International of Planned Parenthood of New York. Funding for the development for this manual was provided by the USAID Mission in Jamaica. We are grateful to Ms. Lilieth Williams of University of West Indies Advanced Training and Research in Fertility Management Unit for preparing the first draft, and to Mrs. Lola Ramocan for producing the final document. We can only ask that as the manual and-resource guide are used, you, the users, will share your comments and recommendations for improving their subsequent versions. ii CURRICULUM DEVELOPMENT COMMITTEE Dr. D. Brissett The Ministry of Education, Youth and Culture, Jamaica Mrs. L. Williams University of the West Indies, Mona Campus, Jamaica Ms. I. Limonius West Indies School of Public Health clo MOH, Jamaica Mrs. C. Barnett Human Employment and Resource Training/ National Training Mrs. J. Phinn Agency (HEART TRUST/NTA, Jamaica). Ms. C. Brown Ms. L. Hue Red Cross of Jamaica Ms. S. Reid The Jamaica Association for the Deaf Ms. K. Bailey Mrs. L. Ramocan Ministry of Health, Jamaica. (MOH) Ms. S. Lutjens United States Agency for International Development (USAID) Ms. J. Knight-Johnson Ms. C. Lane Ms. M. Beckles The Futures Group International/ Youth.now, Jamaica. (TFGI) Mr. H. Grace Consultants: Mrs. S. Oliver Margaret Sanger Centre International (MSCI), New York, USA - Mr. E. Alexis Dr. P. Russell Brown The Futures Group International/ Youth.now Chief of Party iii Abbreviations and Acronyms 0 ABBREVIATION MEANING ABBREVIATION MEANING A.I.D.S Acquired Immune N.G.Os Non-Governmental Deficiency Syndrome Organizations A.S.R.H Adolescent Sexual and O.H.T Overhead Transparency Reproduction Health P.I.D. Pelvic Inflammatory C.O.R.A Center for the Orientation Disease of Adolescents P.W.P Participatory Workshop F.S.H Follicle Stimulating Process Hormone S.E.S Socio Economics Status G.A.T.H.E.R Greet Ask Tell Help Explain Return S.E.S.P Social and Economic Support Programme G.O.J Government of Jamaica S.T.Ds Sexually Transmitted H.I Hearing Impaired Diseases H.I.V Human Immune S.T.Is Sexually Transmitted Deficiency Virus Infections I.C.P.D International Conference TFGI The Futures Group on Population International Development T.M Trainers' Manual L.H Luteinising Hormone T.R.B Trainers' Resource Book M.O.E.Y.C Ministry of Education Youth and Culture T.S.S Toxic Shock Syndrome M.O.H Ministry of Health U.S.A.I.D United States Agency for International Development M.R. Mental Retarded V.I.P.P Visualization In M.S.C.I Margaret Sanger Centre Participatory Planning International F/GOJUSAID/ARSHTM-07-02 iv Overview of the ASRH Training Programme The Futures Group International, with funding from the USAID, and in collaboration with the Ministry of Health (MOH) in Jamaica, the Margaret Sanger Centre International (MSCI), Dunlop Corbin Communications (DCC) and JHPIEGO launched an Adolescent Reproductive Health (ARH) Project called Youth.now. Youth.now supports the ongoing efforts of government and non-government organizations to address the health and social issues associated with early unintended pregnancy and sexually transmitted infections including HIV among adolescents 10-19 years. Youth.now endeavours to improve access to quality reproductive health and preventative services and to combat improve adolescents' and providers of care to adolescents' knowledge and skills related to reproductive health. In order to bring about the needed changes in knowledge, attitudes and practices of adolescent service providers and care givers, which will support improved health- ASRH and positive life choices, an Adolescent Sexual and Reproductive Health (ASRH) Training Programme was developed to train trainers in the first instance. Trainers are expected to use this material to train adolescent care providers. To facilitate training, a Trainer Manual (TM) and a related Trainer Resource Book (TRB) were developed. Materials were developed through consultations with educators, service providers and facilitators. During consultative workshops, participants identify topics in six areas deemed essential to training trainers in adolescent sexual and reproductive health. The suggested topics are: FIGOJ/ASRH/TRB-07-02 v 1. Sexuality 2. Reduction of sexual risk taking behaviours 3. Sexually transmitted infections (STIs) 4. Unplanned pregnancy 5. Abortion 6. Sexual abuse 7. Encouraging healthy lifestyles and positive health-seeking behaviours. (Youth. Now Report, p.1). The Trainer Manual was developed from materials compiled and written by the Advanced Training and Research in Fertility Unit, UWI, Mona. The manual outlines the aim of the training programme, suggested organization of workshops, content materials, methodologies for training participants, references to additional material support and presentation tips. The manual covers the following topics: 1. Introduction to Adolescent Sexual and Reproductive Health 2. 'Youth-Friendly' Health Services 3. Introduction to Adolescence 4. Reproductive Anatomy & Physiology 5. Contraceptive Technology In Adolescence 6. Promoting Healthy Lifestyles During Adolescence 7. Nutrition, Eating Disorders and Personal Health Care 8. Introduction to Sexuality 9. Sexuality and Gender Issues 10. Counselling Adolescents 11. Sexually Transmitted Infections 12. Substance Abuse 13. Crisis Issues 14. Care of Adolescent During Pregnancy and Childbirth F/GOJIASRH/I'RB-07-02 i 15. Abortion 16. Homosexuality, Bisexuality, Lesbianism and Heterosexuality 17. Evaluation of Training Programme, Trainer Manual and Trainer Resource Book Each topic is addressed within the following format: Session Topic Recommended Time Session Objectives Materials Advance Preparation Activities , with References to TRB pages Session Review/ Evaluation Reference NB. In some casesthere areadditionalresourcematerials. The training manual begins with an Introductory Session (Session One) where the Visualization in Participatory Planning (VIPP) is introduced as a part of the workshop process. VIPP Principles and rules are introduced and their use is recommended to ensure an atmosphere of warmth and to encourage the highest level of participation. Emphasis is placed on evaluation which is informal and qualitative, using the Mood & Feeling and Matters Arising Charts at the end of each session and Plus (+) Delta (-) at the end of the programme. Instruments for the evaluating the TM and TRB are included in the respective document. Facilitators are requested to complete these instruments and submit to Youth.now for analysis. The data/ information gathered will be used to improve the content and presentation and develop a revised TM and TRB. The Trainer Manual and Trainer Resource Book have been developed as a guide for the trainer/ facilitator and are intended to be used with much flexibility. The trainer/ F/GOJIASRH/TRB-07-02 vil facilitator can, and should, modify activities, tips and suggestions and also use others, which may be more relevant to participants and the training objectives, to stimulate discussion and participation. It is recommended that the manual is implemented in its entirety. The 18 sessions should take approximately 54 hours, or nine days with two sessions per day. The following table gives a recommended outline for scheduling the entire training programme: F/GOJ/ASRHI/TRB-07-02 vi I Ss ionDa Hor Ssio Hor 0OA Two: Day l\ One: Day 1 2 'Youth Friendly' Health 4 6 Introductory Session Services Three: Day 2 Four: Day 2 4 Reproductive Anatomy and 2 6 Introduction to Adolescence Physiology Five: Day 3 Six: Day 3 Contraceptive Technology