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STUDY FACTORS AFFECTING SEXUAL AND REPRODUCTIVE
HEALTH OF ADOLESCENTS / YOUNG PEOPLE IN TWO
UNIVERSITIES IN TURKEY"
2000-2002 HACETTEPE UNIVERSITY PUBLIC HEALTH
DEPT. WORLD HEALTH ORGANIZATION AND DICLE
UNIVERSITY
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• STUDY FACTORS AFFECTING SEXUAL AND REPRODUCTIVE
  HEALTH OF ADOLESCENTS / YOUNG PEOPLE IN TWO
  UNIVERSITIES IN TURKEY"
• (Project No A05153)
• The project was supported by UNDP/UNFPA/WHO/World
  Bank Special Programme of Research, Development
  and Research Training in Human Reproduction (HRP)
• Proje Coordinators
• Prof. Dr. Ayse Akin
• Prof. Dr. Sevkat Bahar Özvaris
• Project Team
• Assoc. Prof. Meliksah Ertem
• Assoc. Prof. Nalan Sahin Hodoglugil
• Assoc. Prof. Dilek Aslan
• Yrd. Doç. Dr. Günay Saka
• Çigdem Esin, MSc.
• Kezban Çelik, MSc.

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Why are Adolescents / Young People very Important?
1/5 of the world population are adolescents The
number is even more including young people
50 of the population in Turkley are at or below
20 years of age

• In the course of physical and psychological
  growth and development, this group faces risks
  and new situations.

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Many of Such Risks are Related with Adolescent /
Youth SRH

• Every year nearly 15 million adolescents become
  mothers

• Every year 4 million adolescents have abortion
  in healthy conditions (25 of total)

• 1 out of every 20 adolescents have an STI except
  HIV/AIDS.

• Half of new HIV/AIDS cases are of
• 10-24 age group.

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Study Flowchart
STUDY FACTORS AFFECTING SEXUAL AND REPRODUCTIVE
HEALTH OF ADOLESCENTS / YOUNG PEOPLE IN TWO
UNIVERSITIES IN TURKEY"
28 APRIL 2004 RESULTS PRESENTED
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Research Group
Hacettepe University Beytepe Campus and Dicle
University
Departments not related to health
1st grade students
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Short-term objectives of the study are to
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Long-term objectives of the study are to
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Develop a Sexual and Reproductive Health Model
Provide Youth Friendly SRH Services in
universities
Create change in behavior among students in
utilization of SRH services, contraceptive use
and risky behaviors
Contribute to improvement of SRH services for
adolescents / young people in Turkey.
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Focal group discussions(FGD),
Surveys, and
Semi-structured interview techniques were used.
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During FGDs, adolescents were asked about
Information sources,
Safe sex and risk in sexual intercourse
Gender roles
Sexual and reproductive health
SRH services
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The survey was aimed for 4332 students in
2000-2001 education year

• HACETTEPE U
• Beytepe
• 2169 1789
• 82.5

• DICLE U
• 2163 1877
  
• 86.8

3666 were reached.
(85 of the targeted group)
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The survey included 76 open- and closed-ended
questions to assess
Socio-demographic characteristics
Knowledge and perception about SRH
Knowledge of sexual intercourse and risk
perception
SRH service utilization and expectations
Views about gender
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In order to assess their

• observations
• experience, and
• views and suggestions

Ankara
Diyarbakir
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interviews were made with 45 service providers.
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FINDINGS
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• In Hacettepe Uni. Age average of students is
  19.71.3, 60 girls and 40 boys in Dicle age
  average is 20.41.9, 37 girls and 63 boys.
• Socio-economic and psycho-social characteristics
  of the students in both universities are parallel
  to the regional properties and reflect regional
  differences.

• The first grade students in both universities
  have gaps of knowledge of and need services in
  SRH.

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• Students of both universities came from closer
  provinces.
• One of every two young people is a smoker.
  Starting age is early.
• One of every two young people in HU and one of
  every 3 in DU has tried alcohol.
• 3 of young people have tried substance use.
• Knowledge and views of young people on SRH vary
  considerably.
• Knowledge level of students is poor (on KS, STI
  and risks)
• Information sources are books, peers and
  school-teachers respectively.

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• Young people prefer to talk to their mothers more
  about SRH. HU students talk to their parents
  more.
• In both universities, SRH issues are discussed
  more as education level of parents increases
  (plt0.05).
• Young people want to get information from
  doctors/experts, printed materials and parents,
  respectively.
• 76 of HU students and 66 of DU students have
  boy/girlfriends. 6.5 in HU and 9 in DU had
  sexual experience (boys more in both
  universities).

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• Perception of sexuality varies regional
  traditions and gender discrimination mark the
  difference.
• Knowledge of young people is not at desired
  level, they have risky behaviors they need
  services. Service utilization is
• HU 18 and DU 9.5
• With respect to frequency, students in both
  universities prefer the private sector, public
  health facilities and then university health
  centers (7.6 in HU and 11 in DU)
• Social security is an important factor in
  receiving services in HU. It was not the case in
  DU.
• Students in both universities want to get SRH
  services from university health centers.

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Quality of Services Students Expect

• Services
• Confidential / private,
• Counseling and treatment,
• Easy to access,
• Individual and group services,
• Provider and client of the same sex.

• Providers
• Knowledfeable / professional,
• Non-judgmental, understanding,
• Young, reliable and friendly.

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• Views, Experience and Recommendations of
  Providers Working with Young People
• Providers say
• Young people need information and clinical
  services in SRH,
• Current services are not sufficient,
• University health centres are not sufficiently
  equipped they should be restructured,
• Providers do not see themselves competent enough
  to provider SRH services to young people.

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According to Providers
Service providers should

• Be well educated and knowledgeable,
• Be regularly updated,
• Be friendly,

• Be attentive to privacy,
• Not be embarrassed by sexuality,
• Be physicians,
• Be obstetricians, and
• psychologists.

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Service delivery point

• Adequate physical conditions,
• Clean,
• Easily accessible,
• Appointment system, waiting times not long,
• Ownership by university,
• Financially sustainable,
• Free services
• Continuity of care.

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RECOMMENDATIONS

• Young people should be informed in SRH as they
  have a lot of gaps in this area.
• Young people should get SRH services from expert
  service providers in university health centers.
• Quality of services should meet expectations of
  young people.

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• Privacy / confidentiality are essential in
  service delivery,
• Services should include information, counseling,
  early diagnosis and treatment,
• Peer education should be used,
• Client feedback is essential,
• A proper recording / reporting system should be
  established in university health centers service
  quality should be monitored and evaluated.

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• Research findings show that cultural and regional
  discrepancies should be taken into account in
  developing SRH service programmes for adolescents
  / young people.
• A uniform single intervention model should
  never be considered in Turkey where there are
  many demographic and regional differences.

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• Gender discrimination patterns on SRH are most
  visible especially in Dicle Uni. where patriarchy
  is more dominant.
• This issue should be handled with appropriate
  mechanisms including various sectors of the
  community.
• The gender perspective should be integrated into
  the master national plans and programmes
  considering gender equality and equity.

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THANK YOU... Prof. Dr. Sevkat Bahar-Özvaris Hacet
tepe Uni. Faculty of Medicine Dept. Public
Health Research and Implementation Centres on
Women Issues sevkato_at_hacettepe.edu.tr
www.huksam.hacettepe.edu.tr