Evaluation of a sexuality education program for young adolescents in Jamaica / Evaluación de un programa de educación sexual para adolescentes jóvenes en Jamaica

Despite their increasing numbers, few of the sexuality education and pregnancy prevention programs in developing countries have been evaluated. This study, conducted in 1995-1997, assesses the impact of a school-based sexuality education program, the Grade 7 Project, on 945 Jamaican seventh graders (aged 11-14) and their initiation of sexual activity and use of contraception at first intercourse, as well as the knowledge and attitudes that ingluence their behaviors. Using a quasi-experimental design, the study measured the effects of the Grade 7 Project when the nine-month intervention was completed (short term) and one year after that (long term). Multivariate logistic regression analysis indicated that the project had no effect on initiation of sexual activity, but it had a positive short-term impact on use of contraception at first intercourse (P=.08); adolescents in the intervention group were more than twice as likely to use contraception. The project also had a positive short-term influence on several aspects of the adolescents' knowledge of and attitudes about sexuality and pregnancy. The modest impact of the Grade 7 Project is encouraging, as school-based sexuality education programs of limited duration rarely have a long-term impact. Moreover, competing socioeconomic and cultural forces in Jamaica encourage early sexuality and parenthood among adolescents. The use of more participatory teaching methods and smaller class sizes might strengthen the Grade 7 Project and enhance its impact

Pese a su número creciente, son pocos los programas de educación sexual y prevención del embarazo que han sido evaluados en los países en desarrollo. Este estudio, realizado entre 1995 y 1997, evalúa en 945 escolares jamaiquinos de 7o grado (11 a 14 años de edad) el impacto de un programa escolar de educación sexual, el denominado "Proyecto de 7o grado", sobre la iniciación de su actividad sexual, el empleo de anticonceptivos durante el primer coito y los conocimientos y actitudes que influyen en sus comportamientos. Utilizando un diseño casi experimental, el estudio midió los efectos del proyecto al final de los nueve meses de intervención (corto plazo) y un año más tarde (largo plazo). El análisis de regresión logística multivariado reveló que el proyecto no tuvo efectos sobre la edad de inicio de la actividad sexual, aunque sí tuvo un impacto positivo a corto plazo sobre el empleo de anticonceptivos en el primer coito (P = 0,08); la probabilidad de utilizar anticonceptivos fue dos veces mayor en los adolescentes del grupo sometido a la intervención educativa. El proyecto también tuvo una influencia positiva a corto plazo sobre varios aspectos de los conocimientos y actitudes de los adolescentes hacia la sexualidad y el embarazo. El moderado impacto del proyecto es alentador, dado que los programas escolares de educación sexual de duración limitada raramente tienen impacto a largo plazo y que, además, en Jamaica existen fuerzas socioeconómicas y culturales antagónicas que alientan la sexualidad temprana y la paternidad entre los adolescentes. El empleo de métodos educativos más participatorios y la reducción del número de alumnos por clase podría fortalecer el "Proyecto de 7o grado" y aumentar su impacto

Mapping study and private physicians' survey opportunities for expanded family planning services in Jamaica: final report

Reports on a project aimed at importing the effectiveness and sustainability of Jamaica's National Family Planning Programme in light of the planned phasedown of international donor support particularly the reduction of USAID-donated contraceptive supplies. A "Mapping Study and Private Physicians Survey" was designed to collect background information on the existing infrastructure of service delivery points (SDPs)and a better undrestanding of physicians' skill and interest levels pertaining to long-term and permanent methods. This information would enable interventions to be designed that would target less-well-served areas offer appropriate incentives for private-practice physicians to become more involved in family planning, and meet specific needs among the private physician community as they try to become more involved. Among the noteworthy findings of this study are, given that a key goal of the project is to increase use of longer-acting methods, these methods are not readily available at affordable prices to rural consumers/patients ie. half the Jamaican population. long-term and permanent methods are concentrated in urban areas and offered primarily by private physicians. Short-term or supply methods were widely available to both urban and rural users and were quite affordable. Another significant finding is that private physicians have an interest in increasing their understanding of and involvement in family planning, widespread interest was expressed in the Private Physicians' Pilot Project. The private sector it was found offers the most SDPs, the widest range of methods and the greatest number of hours of operation, however, it is the public sector that provides the most services ie. about 60 percent of family planning services. These was a tendency for private sector providers to be concentrated in urban areas due to available supporting medical services; a further intra-urban clustering of private sector sites was also found; ther was a tendency among newer doctors to establish practices in urban areas outside of Kingston; a more evenly distributed pattern for public sector SDP was found, along with a clear emphasis on serving rural communities; an expansionary trend in terms of number of SDPs in urban areas is noticeable whereas a slight reduction in overall number of SDPs serving rural areas was noted. The recommendations are, to use the findings from this mapping study to plan future activities; to improve availability on long-term and permanent methods for rural groups; to encourage the private sector to increase its participation in family planning; to engage pharmacies and private physicians in expanded social marketingprogrammes; and that the social marketing programme be encouraged to expand its marketing support to include longer-acting methods.