The Policy Process

Students participate in the Health Competent School Initiative after-school program at an elementary school in Mafraq, Jordan. The program promotes fitness, nutrition, non-smoking, and hygiene. © 2006 Basil A. Safi/CCP, Courtesy of Photoshare Youth reproductive health (YRH) policy consists of expressions or statements that address the reproductive health needs or problems of young people. The reports and policy briefs in this section of the Toolkit provide key information on the pressing needs of young people in low- and middle-income countries.

Decision makers should ensure their YRH policies adhere to the following guiding principles:

Acknowledge gender differences. Policies should recognize that boys and girls may have different reproductive health needs and thus require different program strategies. At the same time, it is important for policies to recognize that differential treatment for boys and girls can be a barrier to YRH care.

Acknowledge the needs of marginalized sub-populations. Policy should pay particular attention to marginalized groups such as young refugees, street children, and sex workers. Youth in these situations are among the most vulnerable of all young people to risk taking and sexual coercion and abuse.

Be consistent. Laws and policies affecting YRH should be consistent across sectors and from one document to the next. Currently, too many countries have a scattershot approach to YRH policy, with the result that policies lack consistency and often contradict each other. Age of consent is one reflection of this contradiction, with many countries having different age of consent for marriage, consensual sex, HIV counseling and testing, and employment.

Promote access to information and care. Young people, especially those who are sexually active, need access to a variety of reproductive health and HIV services. Researchers have found that youth-friendly services generally share the following traits:

  • Providers are trained to communicate with youth in a respectful and nonjudgmental manner.
  • The facility has policies of confidentiality and privacy for youth.
  • The facility has convenient hours and location for young people, as well as a nonthreatening environment.
  • The fees are affordable.
  • Youth participate in developing policies and implementing services through an advisory board, as peer educators, and in other roles.

Promote youth involvement. Policy should acknowledge the importance of meaningful involvement of youth at all stages of policy and program design, implementation, and evaluation. Still, the YRH field is grappling with cost-effective approaches to involving youth, and there are legitimate questions about the value of such efforts.

Reinforce the interconnectedness of YRH. Policy should make clear the connection among the various key elements of YRH. Young people's vulnerability to risky sex and other unhealthy behaviors is tied to a host of individual, family, and community factors that influence young people and are closely related to economic and educational opportunities. Reinforce the connection between policies that help to both prevent unwanted pregnancy and prevent HIV/STI infection.

Respect culture. Policy should acknowledge the cultural context for YRH and assign roles to parents, teachers, and other influential adults. YRH programs often face resistance because they challenge deeply held cultural beliefs about sex, parenting, and the roles that men and women play. The success of YRH programs depends largely on recognizing these underlying beliefs, understanding how they manifest themselves as barriers, and employing a range of culturally sensitive strategies to address these obstacles.

Segment the youth population by age and life stage. Policy should recognize that young people differ according to age and life stage. Sexually inexperienced 11-year-olds require a different approach from married 19-year-olds. Similarly, a married young person might have very different needs from an unmarried sexually active young person of the same age.

Treat youth as assets, not problems. Policy should recognize and promote young people as a positive force for economic and social development, not exclusively as a problem group that must be addressed.

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