In May 2020, the Journal of Sexual and Reproductive Health Matters published our systematic review titled: A systematic review of…
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Science in Five episode 105 is titled Growing up informed – Sexuality Education: Click Here…
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This short video contains my reflections on WHO, on my 30 years as a WHO staff member, and my reading of the evolution of the adolescent sexual and reproductive health field and WHO’s response to it.
One of the highlights of my work in 2020 was the blended learning certificate course (e-learning with mentor and peer support) which we ran with the Geneva Foundation for Medical Education and Research, UNFPA and FP2020. We have worked with the Foundation to run an eight-week e-course on ASRH for over ten years. This year, the course content was adapted to include COVID-19 and ASRHR. Modules One and Two of the course covered lessons learned and experiences gained in improving the ASRH in the 25 years since the International Conference on Population and Development; and priorities to build on the progress made for the next 25 years. Module Three addressed the effects of COVID-19 on the lives of adolescents, and specifically on their SRH. It featured presentations by Gender and Adolescence Global Evidence, Population Council, Guttmacher Institute, WHO, and the African Population Health Research Centre. Module Four addressed approaches to ensuring the continuity of SRH information and service provision to adolescents in the context of the COVID-19 crisis, as well as case examples for each of the eight SRH interventions listed in the Guttmacher-Lancet Commission Report. Over 300 participants from over 50 countries undertook the course. Participants included representatives from Ministry of Health, UN agencies, NGOs, and academia. Watch the video on youtube
The changing world of adolescent sexual and reproductive health and rights
The world in which adolescents live has changed dramatically in the last 25 years and the response to their sexual and reproductive health and rights has evolved in important ways. A new supplement in the Journal of Adolescent Health celebrates gains, confronts barriers, and identifies key areas of action for countries and key stakeholders to build on progress in the critical decade ahead. The four published articles were developed by technical teams at WHO and UNFPA, along with governments, academia, civil society, and funding organizations. They were co-authored by young people from six regions around the world. In this video the six young coauthors of the paper have put together the key messages they took away from the four articles and would like to share.Featured Article
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Good progress in a number of areas of ASRH, but there is much more that needs to be done
Sexual and Reproductive Health, 2023 – Download PDF
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Commitment, Concessions and Compromise: Experiences of building support for and addressing resistance to sexuality education from Nigeria. (1)
This paper describes and analyzes efforts led by the Nigerian Government and its partners to build support and to anticipate and overcome resistance to the delivery of the national school-based sexuality education programme (the Family Life and HIV Programme) in the country: Click Here…
Nigeria is one of the few countries in sub-Saharan Africa in which a national government-led school-based sexuality education programme has been scaled up nationwide. The scale up of this programme has been described elsewhere (2), but the strategic support-building and resistance-overcoming effort has not. That is the gap that this paper seeks to fill. (This is part of a body of work on learning from and with countries).
This paper is timely for two reasons. Firstly, opposition to sexuality education is not new. What is new is that the opposition is increasingly being orchestrated by well-funded organisations especially in North America, which in addition to communicating misinformation are providing financial resources to willing individuals and organizations in low- and middle-income countries to extend their work. In the face of this growing opposition, the efforts of Nigeria provide both and inspiration and practical approaches in overcoming this. Secondly, the paper will contribute to the animated public discourse that is under way in the country. Here is a statement by civil society organizations in Nigeria, pushing back on the statement and actions of the newly appointed Federal Minister of Education: Click Here…
References:
1. Chandra-Mouli V, Adebayo E, Watson K, Esiet A, Plesons M. Commitment, Concessions and Compromise: Experiences of building support for and addressing resistance to sexuality education from Nigeria. Open Health, 2022, 3, 155-167. Click Here…t
2. Chandra-Mouli V, Huaynoca S, Yaqub Jr N, Denno D M. Scaling up comprehensive sexuality education in Nigeria: from national policy to nationwide application. Sex Education, 2013.14, 2, 191-209. doi: 10.1080/14681811.2013.856292. Click Here…
I am pleased to announce the publication of a paper which takes stock of twenty years of progress in Ethiopia:
Akwara E, Worknesh K, Oljiira L, Mengesha L, Asnake M, Sisay E, Demerew D, Plesons M, Shirka W, Hadush A, Chandra-Mouli V. Adolescent Sexual and Reproductive Health and Rights in Ethiopia: Reviewing progress over the last 20 years and looking ahead to the next 10 years. 2022. 19, 123.. Click Here…
The paper makes the following points
1. Over the last two decades, political, economic and social developments, and national and development policies and programmes have contributed to changes in ASRHR.
2. Substantial changes have occurred in a number of health outcomes, harmful practices, health behaviours, health service use, and social determinants in the first two decades of the 21st
3. As we look to the next ten years, Ethiopia must build on the progress made, and move ahead understanding and overcoming challenges and making full use of opportunities.
It charts the impressive progress that the country made in the Millennium Development Goals era, and the somewhat faltering progress in the first five years of the Sustainable Development Goals era, and the challenges and opportunities to build on this.
The paper was coauthored by a writing team comprising of Ethiopian Ministry of Health staff, academics, NGO staff, UN agency staff and two young people (who were selected based on their involvement in ASRH work, supported to make the best contribution they could, and acknowledged/paid for their contribution).
This article highlights that although there has progress in the areas of adolescent sexual and reproductive health and rights that have received attention and investment, this is uneven both between and within countries.
Chandra-Mouli V, Neal S, Moller A-B. Adolescent sexual and reproductive health for all in sub Saharan Africa: a spotlight on inequalities. BMC Reproductive Health. 2021. Read More…
The state of adolescent menstrual health in low- and middle-income countries and suggestions for future action and research
This paper is a report of a global meeting convened by WHO. At the meeting experts considered nine domains of menstrual health – awareness and understanding; stigma, norms, and socio-cultural practices; menstrual products; water and sanitation; disposal; empathy and support; clinical care; integration with other programmes; and financing – and answered the following five questions:
1. What is the current situation?
2. What are the factors contributing to this situation?
3. What should the status of this domain of adolescent menstrual health be in 10 years?
4. What actions are needed to achieve these goals?
5. What research is needed to achieve these goals? Read More…
Trends in adolescent first births in sub-Saharan Africa: a tale of increasing inequity?
Neal S, Channon A A, Chandra-Mouli V, Madise N. Trends in adolescent first births in sub-Saharan Africa: a tale of increasing inequity? International Journal for Equity in Health, 2020, 19, 151
Two key messages from the paper are: “ Adolescent first births are more common among women who are poorer, and live in rural areas; early adolescent first births before 16 years of age are particularly concentrated in these disadvantaged groups. Progress in reducing adolescent first births has also been particularly poor amongst these vulnerable groups, leading to increasing inequity.”
This paper builds on similar studies in Asia and Latin America.
Five key messages emanating from this body of work are:
- In the 25 years since the International Conference on Population and Development, the level of adolescent child bearing has shown an impressive decline.
- The decline in adolescent child bearing has been uneven across continents, across countries, within countries, and within communities. In some countries, the rate has remained unchanged or has even increased.
- In all countries, some groups of adolescents are being left behind. While some attributes of those who are left behind are similar across countries, others are not. What this means is that some of the factors contributing to adolescents being left behind are situation specific.
- National averages mask these disparities. Data collection, analysis and use should move from the national to the subnational level, to identify which groups are being left behind and why.
- In terms of what needs to be done, it is not about doing more of the same. It is about addressing the differing needs and problems of different groups of adolescents with approaches tailored to their needs. Read More…
Systematic review on peer education on sexual and reproductive health directed at young people in India
In May 2020, the Journal of Sexual and Reproductive Health Matters published our systematic review titled: A systematic review of the evidence on peer education programmes for promoting the sexual and reproductive health of young people in India.
The key messages of our review are that both the content and the delivery of peer education on sexual and reproductive health directed at young people in India vary greatly; there is little attention to quality in designing and delivering peer education; and the outcomes of peer education initiatives are mixed. Read More…
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Systematic review on peer education on sexual and reproductive health directed at young people in India
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Progress in adolescent sexual and reproductive health and rights globally between 1990 and 2016: what progress has been made, what contributed to this, and what are the implications for the future?
In April 2020, the Journal of Sexual and Reproductive Health Matters published the above commentary which was in response to…
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What a thrill to see
@ChandraMouliWHO
get his Gold Medal Award from the @WAS_org. www.x.com/liannegonsalves/status/1720777737244164226?s=20
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I joined WHO in 1993. My first work trip was to Uganda. Now 30 years later I am back in Uganda for the FP2030 Anglophone Africa focal points meeting. What a blessing to be back here, to reconnect with old friends & to see the adolescent contraception field growing stronger. pic.twitter.com/2Vot5FBND8
— Dr. V. Chandra-Mouli (@ChandraMouliWHO) June 6, 2023
In today’s world, it’s hard to see the good news through the bad. But, in the world of Adolescent Sexual & Reproductive Health, our collective efforts have led to important progress in 5 areas of girls’ lives. And while we have much work to do, this momentum is worth celebrating. pic.twitter.com/pdxcGmRTHQ
— Dr. V. Chandra-Mouli (@ChandraMouliWHO) January 31, 2023
🎉Congratulations to our dear colleague @ChandraMouliWHO, awarded this year’s Outstanding Achievement in Adolescent Health and Medicine by @SAHMtweets! Hear from Chandra about his longstanding work on adolescent #SRHR, and positive changes along the way🥇 https://t.co/omKsoHnmeR pic.twitter.com/s0J2UdA3fF
— HRP (@HRPresearch) August 9, 2022
The following tweet commemorated International Youth Day 2021 with the launch of a 50 country profiles:
Today is the International Day of Youth! These country profiles from @WHO share disaggregated data on sexual and reproductive health issues which affect adolescents worldwide https://t.co/8Y8KNO2DGV #InternationalDay4Youth2021 #SRHR pic.twitter.com/gwPxnh5uP5
— HRP (@HRPresearch) August 12, 2021
The state of adolescent menstrual health in low- and middle-income countries and suggestions for future action and research
#Menstrualhealth is increasingly seen as a #publichealth issue linked to #humanrights and the #SDGs but challenges remain. This report from the @WHO & @HRPresearch global #research collaborative meeting on #menstrual health in #adolescents is rich reading: https://t.co/jzFa1Ayq4C pic.twitter.com/I3D89Qhjmg
— HRP (@HRPresearch) February 12, 2021
The fourth webinar in our “Connecting Conversations” series discussed the value of acknowledging missteps and learning from them to adapt and improve our work.
On WORLD CONTRACEPTION DAY let us commit to learning from our mistakes.
1/5 Why we must STOP using one-size-fits-all approaches to reaching adolescents with contraceptive information and services: https://t.co/9C1gBVF2Ka@HRPresearch @FP2020Global @fprhknowledge @IYAFP— Dr. V. Chandra-Mouli (@ChandraMouliWHO) September 25, 2020
In March 2020, I tweeted a call to young people worldwide by WHO’s Director General Tedros Gebreyesus:
An important reminder about COVID 19 to young people from WHO’s Director General: “You are not invincible”
And a plea be part of the solution: ‘ … the choices you make… could be the difference between life and death for someone else” pic.twitter.com/iTdlNrCTxZ— Dr. V. Chandra-Mouli (@ChandraMouliWHO) March 29, 2020
In July 2020, I tweeted a similar call to young people in the USA by a leading infectious diseases expert Anthony Fauci:
Echoing a call by WHO’s DG, Anthony Fauci, a top infectious diseases expert said to young people in USA: ‘You have to have responsibility for yourself but also a societal responsibility that you’re getting infected is not just you in a vacuum. You’re propagating the pandemic.’ pic.twitter.com/OsjcR29wPX
— Dr. V. Chandra-Mouli (@ChandraMouliWHO) July 21, 2020
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Featured Tweet – July 2020
In March 2020, I tweeted a call to young people worldwide by WHO’s Director General Tedros Gebreyesus: https://twitter.com/ChandraMouliWHO/status/1244356963758202883?s=20 In July… -
Featured Tweet – June 2020
On the 28th of May, the world commemorated Menstrual Hygiene Day, with the theme ‘It’s time for action’. This tweet…
The Palgrave Handbook of Critical Menstruation Studies
This open access handbook, the first of its kind, provides a comprehensive and carefully curated multidisciplinary genre-spanning view of the state of the field of Critical Menstruation Studies, opening up new directions in research and advocacy.
It is animated by the central question: ‘“what new lines of inquiry are possible when we center our attention on menstrual health and politics across the life course?” The chapters—diverse in content, form and perspective—establish Critical Menstruation Studies as a potent lens that reveals, complicates and unpacks inequalities across biological, social, cultural and historical dimensions. This handbook is an unmatched resource for researchers, policy makers, practitioners, and activists new to and already familiar with the field as it rapidly develops and expands.
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This story about me and my work was published by Exemplars in Global Health, to mark the International Day of the Girl: . Read More
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This blog piece was published on World Population Day, 2022. It sets out the missed opportunities for improving access to and increasing uptake of contraception by adolescents, and recommends that actions countries could take.
Chandra-Mouli V, Lane C, Jackson H. Getting to what works in adolescent sexual and reproductive health: FP2030 commitments can help, FP2030, July 2022. Read More
This newsletter draws attention to a neglected area of project evaluation.
Chandra-Mouli V, Igras S, Plesons M. Bridging the gap for post-project evaluations of adolescent sexual and reproductive health projects: Guidance from WHO. Health Policy and Planning Debated. June, 2021. Read More
Chandra-Mouli V, Kagesten A. Realizing gender equality: Are gender transformative interventions the answer ? Medicus Mundi Schweiz, 155, 2020
This newsletter poses and responses to four questions. It then sets our five implications for action.
1. Why is gender inequality important to address?
2. What do we mean by gender transformative approaches and how common are they?
3. What do we know about the feasibility and impact of gender transformative approaches to improve adolescent health?
4. What are the implications for the future ?
First, we need evidence on the long-term impact on actual health outcomes.
Secondly, we need to tap into the influence of such initiatives on the broader community norms that young people are embedded in and navigate within their local contexts
Thirdly, we need evaluation approaches that capture the full complexity of gender transformative initiatives, such as on what works (or what does not) in implementation, and the careful balance between fidelity to original models with that of local adaptation needs
Fourthly, we need to broaden the focus of programmes to include all children and young people irrespective of their age, sex, gender or sexual identity
Finally, we must address structural factors to create the space for large-scale and sustained change in gender equality. Read More