Books and Chapters of Books

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    An exploratory qualitative study on marriage and pregnancy of adolescent females in the Hikkaduwa Medical Officer of Health (MOH) area
    (Faculty of Medicine, University of Kelaniya & Plan International, 2008) Kasturiratne, K.T.A.A.
    INTRODUCTION: Marriage in adolescence before 18 years is prohibited in Sri Lanka. However, marriages of adolescent females are not rare in some areas in Sri Lanka. OBJECTIVE: To describe the factors associated with marriage of and pregnancy among adolescent females (14-17 years) in a village in the Hikkaduwa Medical Officer of Health (MOH) area. METHODS: This exploratory qualitative study was conducted in Angankanda in the Kalupe PHM division in the Hikkaduwa MOH area in November 2007. Data were collected through focus group discussions and key informant interviews and analysed using qualitative content analysis. RESULTS: Fourteen females who had been married during adolescence (14-17 years) and five key informants participated in the study. Marriages of adolescent females have taken place following emotional relationships. Married adolescents have a low level of education and reduced awareness about health issues. Death or separation of a parent, poverty and lack of security within the family unit are important predisposing factors to adolescent marriages. Elopement is common following which parents or relatives from both parties collaborate to register the marriage to avoid litigation on the male partner. Most male partners are above 18 years of age at the time of the marriage. The age of the adolescent provided at registration of the marriage was false. Public health field staff of the area were aware of the problem and have taken preliminary steps to focus on this group. The services provided by the Public Health Midwife for married females are sought and acknowledged but not strictly adhered to, due to negative pressures or lack of motivation from the family. Delaying of the first pregnancy is not a common practice. Exposure to other modes providing awareness on health issues is limited. CONCLUSION: Despite legislature, marriages of adolescent females are a common occurrence in this community. Targetted interventions to prevent these marriages and to upgrade the overall health of adolescent females are necessary in areas where this problem is prevalent.
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    Sri Lankan parents' attitudes towards adolescent reproductive and sexual health education needs: A qualitative study
    (Faculty of Medicine, University of Kelaniya & Plan International, 2008) Godamunne, P.K.S.
    INTRODUCTION: Adolescents have unique reproductive health needs when compared to adults, and the behaviours adopted in adolescence have serious implications for their later well being. Serious gaps have been found in providing sexual and reproductive health information to adolescents in Sri Lanka. OBJECTIVE: To explore the attitudes of Sri Lankan parents' towards adolescent reproductive and sexual health education, to identify current parental practices of imparting reproductive and sexual health information to their children and to identify perceived barriers parents face in discussing sexual and reproductive health issues with their children. METHODS: A qualitative study conducted using focus groups discussions in Kurunegala, Kandy, Gampaha and Colombo districts among 71 parents having an adolescent child. RESULTS: All'parents said that it was essential to provide reproductive and sexual health education to adolescents, mainly to deter them from engaging in any precocious sexual activity and to protect children from various threats posed by society, such as sexually transmitted diseases and child sexual abuse. Generally most parents were reluctant to directly discuss reproductive and sexual health issues with their children due to cultural taboos and resultant feelings of shyness and embarrassment. However, mothers, to some extent, discussed reproductive and sexual health matters with their children, often with their daughters and sometimes even with sons. However, some parents expressed lack of knowledge to do so. Parents also indirectly educated their children on sexual and reproductive health topics by providing them with books to read. Many parents considered school and teachers to be the best source of reproductive and sexual health information for their children. Doctors too were considered by parents to be a reliable source of reproductive and sexual health information. CONCLUSION: Parents considered adolescent reproductive and sexual health education as essential to protect and deter children from engaging in any precocious sexual activity. However, most parents were reluctant to openly discuss reproductive and sexual health topics with their children. In general, parents preferred outside sources, people other than themselves, such as teachers and doctors to provide their children with reproductive and sexual health information.
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