effect of community, university and health units collaboration on improving adolescent's health education

ABSTRACT

The large population of youths in the Islamic Republic of Iran [I.R. Iran] with their lack of access to information and services on reproductive health appropriate to their age and the cultural beliefs, forced the public health managers to develop and implement a pilot study on improving the knowledge and attitude about reproductive health and menstruation among 12-14 years old girls in a health center in Semnan province about 200 Km east of the capital. The supporting role of religious and political leaders at national and provincial levels, active involvement of university academicians and managers, direct or indirect usage of the local female volunteers as health communicators, requiring parents' consent and presence of efficient primary health care system with motivated health workers were the main factors in successful implementation of the project. The study population consisted of 12,000 registered residents of one of Semnan urban health centers. Among them, 370 girls 12-14 years old were identified. In order to prepare proper training materials and determine evaluation indicators a pre-test was performed. Then a local volunteer [mother, sister or a female volunteer] was selected to communicate the information and educate the girls with appropriate respect to parents' point of view. All volunteers were previously trained in preparatory classes. All the process was under supervision of the health workers. The study lasted 8 months from September 1998 to April 1999. To evaluate changes in knowledge, attitude and behavior of the girls on health care during puberty, menstruation, marriage and pregnancy a post-intervention test was conducted. Data analysis before intervention indicates that girls had a satisfactory knowledge and attitude towards marriage and issues related to pregnancy. However, they had poor knowledge, attitude, and behavior on issues regarding adolescent health and puberty. This was dramatically changed after intervention. This study revealed that with proper collaboration among community, university and health units, even the most complex social problems that are rooted in the culture and traditions can be resolved. Based on the positive results of this study, plans are under consideration to expand this approach to study 15-19 years old girls and boys with age-specific educational contents in appropriate format