Category Archives: Behaviour

Africa’s e-health start-ups rise, but not all are mobile-first based

Africa’s e-health start-ups rise, but not all are mobile-first based


ICT use in healthcare provision in Africa is not actually mobile-first despite the number of e-health start-ups accelerating, a new report released last week shows.

This is contrary to popular assumptions that a majority of them do leverage on use of mobile gadgets to reach their target audience.

Start-ups tracked in the High Tech Health: Exploring the African E-health Startup Ecosystem Report 2017, revealed that only 44 per cent of the e-health ventures sampled are mobile-based despite popular belief in the power of the gadget to reach those in far-flung areas of the continent.

Kenya, Nigeria and South Africa are early hotspots for e-health entrepreneurs, but research shows a rise in start-ups with substantial communities of e-health innovators emerging in Uganda, Ghana, Egypt and Senegal.

The report examined data on e-health start-ups across 20 countries in Africa gathered by Disrupt Africa – a firm that studies continent’s tech start-ups and investments initiatives – between January 2015 and September 2017.

The research found 115 firms active in Africa but that not all opted for the mobile phone as a first choice.

Its findings showed that a majority do not necessarily choose phones as a delivery channel, but Kenyan start-ups still do prefer the device, with 73 per cent of these using mobile them to reach their customers.

Areas where mobile delivery is particularly crucial include maternal health and emergency responses.

“This is a timely piece of research, as more and more e-health ventures enter the market and investors take note. We all know that digital health start-ups are playing a pivotal role in increasing access to quality healthcare across Africa, but for the first time this report gives an oversight of what is happening, where, and the form innovation is taking in the health space,” said Tom Jackson, co-founder of Disrupt Africa.

In the last three years, Africa’s e-health start-ups have raised investment in excess of Sh1.957 billion ($19 million).

In Kenya, four have managed to raise Sh39.098 million ($379,600). Two of these, Totohealth and SophieBot, managed two funding rounds each. The other two to raise funding are ConnectMed and Deaf Elimu.

Ventures such as Totohealth uses the mobile technology to help reduce maternal and child mortality and detect developmental abnormalities in early stages.

The platform enables mothers and fathers to receive targeted and personalised messages timed at their child’s age or stage of pregnancy.

These messages are able to highlight any warning signs in a child’s health/development, equip them with knowledge on nutrition, reproductive health, parenting and developmental stimulation.

Another venture SophieBot, is a mobile application that tackles the issue of young people not being able to access verified and curated information around sexual and reproductive health (SRH).

The solution helps relieve the awkwardness surrounding discussions and discourse SRH, particularly in the conservative African setting.

Healthcare professionals say telemedicine, e-health and m-health are examples of disruptive technologies that can effectively and affordably deliver healthcare services to the most remote areas of the continent.

Some solutions allow patients to access consultations with medical professionals via video link. Licensed practitioners are available for same-day consultations, and can provide prescriptions, sick-notes, and referrals. For doctors, the service allows them more flexibility and control over their work hours.

According to this year’s Kenya’s economic survey report, there has been an upward trend in most of the ICT indicators over the last five years.

Mobile-cellular penetration rate, internet and mobile money subscriptions stood at 85.9 per cent, 58.8 per cent and 70.5 per cent in 2016 from 85.4 per cent, 54.2 per cent and 60.6 per cent in 2015.

Senior UN Official Says Health Care is a Human Right

Senior UN Official Says Health Care is a Human Right


Health care is a human right, senior UN official says; urges protection for medical workers

24 October 2017 – Health is a human right and health care workers are human rights defenders, the United Nations Deputy High Commissioner for Human Rights has said, reminding Governments to provide healthcare for their citizens and to protect professionals who deliver these services.

“We see health not only as the absence of disease and not only a question of access to services, but in face the right to be human is a manner that you have your physical and mental integrity upheld,” Kate Gilmore said in an interview with UN News.

Similarly, health care workers are part of the “machinery of human rights defence,” yet are increasingly being targeted for doing their jobs.

“In conflict settings, there has been a marked spike in the targeting of hospitals, of doctors, of ambulances and of nurses. And this is not only quite unconscionable,” the Deputy High Commissioner said, noting these attacks are also against international humanitarian law and the basic rules of war to which each Government has signed up by virtue of being a member of the United Nations.

“But in other settings, too,” she continued. “In non-conflict settings, health workers who work with communities that are subjected to terrible bigotry, those working with those suffering leprosy, historically health workers providing services to those living with HIV and AIDS, workers whose priority is sexual and reproductive health.”

Ms. Gilmore noted “a pattern across the globe of health workers being targeted for providing compassionate, humane care rooted in medical science.”

She denounced such attacks calling them “wrong, unfair and unjust.”

Ms. Gilmore, along with Assistant Secretary-General for Human Rights Andrew Gilmour, will participate at a dialogue today at the UN Headquarters in New York on how human rights, including the right to health, are reflected in the 2030 Agenda for Sustainable Development.

How To Respond If Your Partner Has Been Sexually Assaulted Or Harassed

How To Respond If Your Partner Has Been Sexually Assaulted Or Harassed


News of widespread sexual assault and harassment allegations against film executive Harvey Weinstein has prompted more and more victims to come forward by the day.

Actress and director Asia Argento, one of more than 20 women who have spoken out about their experiences, has had a fierce defender in her camp: Boyfriend Anthony Bourdain.

“I am proud and honored to know you,” the celebrity chef tweeted on Tuesday, alongside a link to The New Yorker exposé Argento was interviewed for. “You just did the hardest thing in the world.”

Bourdain’s support of Argento highlights an important, but rarely discussed side of sexual assault and harassment: How spouses and partners of victims respond and support their significant others.

While there’s no “right” way to respond, there are things you can do that are helpful rather than hindering. Below, therapists and experts in sexual abuse share seven tips.

Many abuse survivors doubt the severity of what happened to them or feel like they’re somehow to blame because of what their abuser told them or made them feel in the aftermath of the incident.

As their partner, your job is to listen, be in their corner and remind them that you believe them, 100 percent, said Virginia Gilbert, a marriage and family therapist in Los Angeles, California.

“Survivors’ self-doubt and shame grows exponentially if their family or culture colludes with abusers ― if everyone around the survivor normalizes and enables abuse,” she said. “The first step in helping your partner heal is to validate their experience by calling out abuse.”

That means talking about what happened in matter-of-fact terms, Gilbert said: “You were raped;” “People knew what was happening to you and didn’t stop it;” “You were in a vulnerable position and were afraid of the consequences if you spoke up.”

That kind of directness can help clear up any self-doubt your partner may be experiencing in the wake of the abuse.

The revelation will very likely leave you feeling shaken up. While it’s natural to feel protective and react with anger, remind yourself to stay calm. The last thing your partner needs is to feel like they need to support you emotionally now instead, said Martha Lee, a Singapore-based clinical sexologist and relationship coach.

“It’s very important that they feel heard and that there’s space for them to articulate what happened and how they feel,” she told HuffPost. “You don’t want your reaction to make it about you because that can short-circuit their processing and healing process. Just listen. Sometimes, just telling yourself, ‘this is not about me’ can help.”

Don’t try to downplay what happened or worse, suggest your partner could have done something differently to avoid the situation, said Laura Palumbo, the communications director at the National Sexual Violence Resource Center in Harrisburg, Pennsylvania.

“You may think you’re trying to help by saying, ‘I’m sure he didn’t mean it like that,’ but instead, it just makes them question their perceptions or feel silly for sharing. It’s better to say supportive things like, ’I believe you’ or ‘You did nothing wrong and I am here for you.’

Sexual assault and harassment disempowers victims and emboldens abusers. That’s why it’s so important to remind your partner that they’re not powerless, said Sandra Henriquez, the CEO of the California Coalition Against Sexual Assault.

“If a physical assault occurred within the last 72 hours, contact a local sexual assault agency for guidance and advocacy in dealing with hospitals and law enforcement,” she said. “Remind your S.O. that there are avenues for redress that are available when they feel ready and able to explore those options.”

And regardless of when the assault happened, free and confidential counseling is always available through local rape crisis centers. For a full list of crisis centers and hotlines for sexual assault survivors, head here.

Accusing someone ― especially a higher-up at work ― of sexual abuse is not easy. Recognize the difficulty your partner may feel in bringing charges or coming forward, said Janet Brito, a psychologist and sex therapist at the Center for Sexual and Reproductive Health in Honolulu, Hawaii

“There could be apprehension since it’s not uncommon for others to deny the victim’s experiences or minimize it,” she said. “Ask your S.O. what you can do to make them feel supported and respect the choices they make along the way. The goal is to limit your opinions about what you think is best for them and not pressure them.”

Your support likely means the world to your partner. That said, don’t be afraid to say something if you feel overwhelmed by the situation, said Kurt Smith, a therapist who works with men and women at Guy Stuff Counseling & Coaching.

“Because of how traumatizing it can be to hear these details, sometimes, it’s best to limit how much you try to help and leave it to trained mental health specialists who have worked with sexual abuse survivors,” he told HuffPost.

You can be supportive by listening to your partner and encouraging them to speak with a professional in a non-pressuring way.

“It’s ultimately their call but encourage them to find a therapist to speak with to get the help and support they need,” Smith said. “The common response is to bury the memories and pain and move on with life. But that’s a mistake because oftentimes, the trauma doesn’t go away and negatively impacts survivors in ways they don’t fully recognize until they address it with a professional.”

Recognize that moving on and recovering is a slow, painstaking process and that your romantic relationship may not be the same for a long time, Palumbo said.

“Reclaiming sexuality after sexual assault may take support, treatment and time,” she said. “Let your partner express their needs, wants and boundaries. If you aren’t sure whether they’re comfortable or ready for something, ask. Ultimately, everyone heals in their own time and their own way – and for most survivors the path isn’t a straight line.

Reproductive health: Rights in an age of inequality

Reproductive health: Rights in an age of inequality

Expanding options for the poorest women by empowering them to enjoy their right to make their own decisions about the timing and spacing of pregnancies is one important pathway towards their economic security and independence.

Our world is increasingly unequal. But this inequality is not only about money. It’s also about power, rights and opportunities. And it has many dimensions that feed on each other. One dimension of inequality that has received too little attention is in the enjoyment or denial of reproductive rights and the effects of that on half of humanity.

This is the focus of the UNFPA flagship report, The State of World Population 2017. Consider this: In most developing countries, the poorest women have the least power to decide whether, when or how often to become pregnant. The poorest women also have the least access to quality care during pregnancy and childbirth.

This inequity has lasting repercussions for women’s health, work life and earnings potential and for their contribution to their nations’ development and elimination of poverty.

As a medical doctor myself and as a former Representative of UNFPA in Tanzania, I have seen first hand the devastating and needless suffering caused by fistula, and heard the most heartbreaking stories.

More than two million women still have this condition and cannot afford or cannot reach treatment.

Contraception, too, is often out of reach for the poor, particularly those who are less educated and living in rural areas. And this puts women and adolescent girls at greater risk of unintended pregnancy.

An unintended pregnancy can set in motion a lifetime of missed opportunities and unrealized potential, trapping a woman and her children in an endless cycle of poverty. The economic slide can continue for generations.

We also know that many emergencies and humanitarian crises are fueled by inequalities. And inequalities and the vulnerabilities engendered by them are magnified in times of crisis.

A woman or adolescent girl who cannot enjoy her reproductive rights is one who cannot stay healthy, cannot complete her education, cannot find decent work outside the home and cannot chart her own economic future.

Inequality in reproductive health and rights disenfranchises untold millions of women. It also bolsters social and economic systems that enable a privileged few to rise to the top and stay there, while dragging the vast majority to the bottom, robbing individuals of their rights and denying whole nations the foundations for development.

Countries seeking to tackle economic inequality should start by addressing related and underlying inequalities, such as in reproductive health.

Reproductive health and rights are critical but under-appreciated variables in the solution to economic inequality and can propel countries towards achieving the top United Nations Sustainable Development Goal: eliminating poverty.

Expanding options and choices for the poorest women by empowering them to enjoy their right to make their own decisions about the timing and spacing of pregnancies is one important pathway towards their economic security and independence. It is also a pathway towards more balanced economies and societies. And if poor women are disadvantaged, poor adolescents, especially girls, are even more so. Investments in adolescent girls are critical.

A recent study in The Lancet showed that improving the physical, mental and sexual health of adolescents, at a cost of about $4.60 per person per year, would yield more than 10 times as much in benefits to society. Moreover, the highest returns would be in the lowest income countries that are suffering the greatest burden of adolescent death. Innovation and creative solutions are needed to reach the furthest behind first. As Helen Keller once stated: “Although the world is full of suffering, it is also full of the overcoming of it.” Stopping the present downward spiral of inequality will require a new vision for inclusive societies, where all human potential is realized.

This is the vision that informed the goals of the UNFPA Strategic Plan, 2018-2021, which is the first of three Plans to get us to the Sustainable Development Goals 2030 target. Working with other United Nations agencies, partners and governments, UNFPA is committed to a future where zero is the only acceptable number: zero maternal deaths, zero unintended pregnancies and zero gender-based violence and harmful practices, including female genital mutilation and child marriage.

We, therefore, call today for action on multiple fronts to tackle all forms of inequality of sexual reproductive health and rights from the root, laying the foundation for an alternative–equitable–future. A future where all women govern their own lives with equal access to sexual and reproductive health care, where they are free from unintended pregnancies.

A future where all women, men, girls and boys may understand and enjoy their rights and have the knowledge and the power to set their own course in life.

So, to close, inequality is indeed about power–about the few who have it and the many who do not. Worlds Apart–the 2017 UNFPA State of World Population report–is a clarion call for putting power in the hands of women to control their reproductive choices and their futures. With that power in women’s hands, Worlds Apart no longer holds. With that power, instead of separation and inequality, fairness prevails–and a more equitable world for women and girls is the reward.

Dr. Kanem is the Executive Director of United Nations Population Fund (UNFPA)

Barriers to sexual health among male teens and young men

Barriers to sexual health among male teens and young men


Date:January 9, 2017Source:Johns Hopkins MedicineSummary:Researchers who conducted a dozen focus groups with 70 straight and gay/bisexual Hispanic and African-American males ages 15 to 24 report that gaining a better understanding of the context in which young men grow up will allow health care providers to improve this population’s use of sexual and reproductive health care.

Johns Hopkins researchers who conducted a dozen focus groups with 70 straight and gay/bisexual Hispanic and African-American males ages 15 to 24 report that gaining a better understanding of the context in which young men grow up will allow health care providers to improve this population’s use of sexual and reproductive health care.

In a report of the research, published Jan. 6 in the Journal of Adolescent Health, the investigators say the sessions revealed the important influences of these young men’s social ecology on their use of such care, including the role of personal experiences and social interactions with family, peers and health care providers. For example, fears of sexually transmitted infections testing, having a choice in the provider they see, and a lack of clear messages about why to access the sexual and reproductive health care that young women receive were identified as common barriers to such care among these young men.

The focus groups were conducted between April 2013 and May 2014, and facilitated by trained male staff members matched by race/ethnicity.

“This study tells the story of how the health care system is not well-set up to serve young men’s sexual and reproductive health care because it’s often viewed as women’s domain,” says Arik Marcell, M.D., M.P.H., associate professor of pediatrics at the Johns Hopkins University School of Medicine and the paper’s first author.

Few men also have received sexual and reproductive care (SRH) because historically, few clinical guidelines have outlined care that providers should deliver to this population, and few public health efforts have focused on engaging this population in SRH, he adds.

In an attempt to document young males’ direct perceptions about SRH use, Marcell and his team held 60- to 90-minute focus group discussions with 70 males. Sixty-six percent (46 of 70) of participants were African-American, and the remaining 34 percent were Hispanic. In self-reported histories, 84 percent (59 of 70) were heterosexual, and the remaining 16 percent were gay or bisexual.

The research team recruited participants from eight community settings, such as recreation centers, faith-based organizations and LGBT organizations, across Baltimore. Eight focus groups were conducted in English, and four were conducted in Spanish.

The research team says results of a five-minute self-administered questionnaire participants completed before the focus groups were conducted found that just over half of participants (38 of 70) had a regular source of care and health insurance (36 of 70). In the last year, the majority of participants — 47 of 70 — reported having had a physical exam, 35 said they received HIV testing and 27 received testing for sexually transmitted infections (STIs).

In the focus group sessions, some young men shared the belief that condom use protected them from HIV and other STIs, and they did not see the benefit for STI testing, whereas other young men made decisions to get tested based on self-assessed engagement in risky behaviors. Many said that in the absence of physical symptoms, they saw no reason to seek care or they feared results of a positive test for an STI. These young men also discussed wanting people in their lives to talk about sexual and reproductive health, and cited their mothers and health care providers as being very helpful sources of sexual and reproductive health information. However, some young men, especially adolescents, didn’t always know where to go for sexual and reproductive health care and reported relying on their friends. Some participants also discussed needing greater self-confidence when asking and answering questions about their health in general, especially about their sexual health.

The focus group discussions also revealed that heterosexual male adolescent participants preferred female providers if given a choice, Hispanic participants preferred Spanish-speaking providers and gay/bisexual young adults did not want providers to judge them based solely on their sexual orientation.

Long wait times at clinics, costs and concerns about privacy also emerged as deterrents to seeking sexual and reproductive health care, in addition to the stigma of being seen at certain types of clinics (e.g., STI clinics).

“This study adds to a small body of evidence that no one particular factor is responsible for young men’s lack of engagement in SRH use. We need to think about working at multiple levels to effect change rather than focusing solely on the individual level, which may place undue blame on the individual,” says Marcell.

Future research, Marcell says, focuses in part on a new program called Project Connect Baltimore ( that trains people who work in community settings, rather than only clinics, to talk with young men about SRH care and how to get it.

Story Source:

Materials provided by Johns Hopkins Medicine. Note: Content may be edited for style and length.

Fearful of parents, many teens still avoid sex-related health care

Fearful of parents, many teens still avoid sex-related health care


Nearly one in five U.S. teens between the ages of 15 and 17 are not seeking out sexual or reproductive health care because they’re afraid their parents will find out, according to a data analysis by the National Center for Health Statistics.


“This research really falls in line with a lot of other research that a lot of other reproductive health organizations have done,” said Casey Copen, one of the study’s authors. “So it’s not surprising, but it does make the statistics more current.”

Under California law, teenagers can get reproductive care and treatment for sexual issues confidentially, without parental consent or notification.

The Center for Health Statistics studied 2013-2015 data compiled by the National Survey of Family Growth. It found that nearly 18 percent of youths between 15 and 17 won’t go to a provider at all because of confidentiality concerns.

Celinda Vasquez of Planned Parenthood L.A. said this is why her organization has changed its sex education curriculum into one that has what she calls a “rights-based framework.”

“It goes above and beyond the birds and the bees,” Vasquez said. “It’s really about advocating for their own healthcare needs … and fostering a dialogue about gender roles, healthy relationships and media stereotypes.”

Additionally, Planned Parenthood L.A. now has sexual education programs for adolescents and parents.

The survey also found that teenagers who spend time alone with a health care provider are significantly more likely to receive contraceptive care and treatment for sexual diseases than those who don’t.

Men, Depression and Sex

Men, Depression and Sex


It is an incredibly complex condition which brings with it a whole slew of emotional, mental and physical symptoms with it. For men and women both, part of the problem can revolve around their sexuality – and this in turn can cause problems in a relationship at the time when the depressed person most needs the support.  Fortunately, there are ways to help treat this particular problem and restore intimacy and pleasure to a relationship.

Depression and Male Sexuality

It is common for both men and women to experience sexual problems as part of their depression – but the ways in which this presents itself can be different.  Healthline notes that in men, depression will often express itself as feelings of low-esteem, anxiety and guilt and this, in turn, can cause problems with erectile dysfunction, delayed orgasm, premature ejaculation or just a loss of interest in sex itself.

There is still a lot we just don’t know about exactly how depression affects the brain. But according to Net Doctor, researchers have learned that the chemical changes which take place when someone has this condition can lead to an increase in emotional withdrawal and low energy levels so that activities like sex, which require a connection to your partner as well as physical energy to perform, can become a challenge.  This can be hurtful for the person’s partner and make them feel unwanted or unloved, putting a strain on the relationship that can, in itself, be difficult to deal with.

To make matters worse, many antidepressants are notorious for their side effect of causing sexual dysfunction or loss of interest.  Included in this group are MAOI inhibitors, SSRI’s and SSNRI’s and both tetracyclic and tricyclic antidepressants. 

What to Do

So the long and short of it is, both depression itself and some of the treatments for depression can both put a damper on a guy’s sex life. So what are some solutions to the problem?

Get the Treatment You Need

Depression is not a choice that people make – and it is usually not a problem that goes away by itself. If you have not yet been diagnosed, talk to your doctor about the symptoms you are having and get started on a plan of care that involves the combination of medications, therapy and lifestyle changes that are right for you.

If you are already being treated for depression and suspect that your anti-depressants might be putting the kybosh on your sex life, find out if you can switch medications. While it might take a little time to take effect, there are some drugs which do not seem to effect one’s libido, including Wellbutrin and Remeron.


Both Healthline and Everyday Health recommend regular exercise – preferably with your partner – as part of a program to help reconnect sexually. First, it gives you and your partner time together doing something enjoyable and this alone can be good for a relationship. It also helps to release feel-good chemicals like endorphins that help fight depression naturally and keeps you in good shape so that you feel good about yourself and the way you look. All this can go a long way to enhancing your sex life.

Take Your Time

According to Everyday Health, sex therapist Dr. Sandra Caron also has a few tips for couples who are struggling to overcome the barrier that depression has placed on their sex lives.  She recommends, first of all, that couples engage in more foreplay and other physical expressions of intimacy – hand holding, caressing, massage – before engaging in intercourse itself.  Depression tends to slow down all responses, so taking this extra time to achieve arousal can help enhance the pleasure for both partners.  She also recommends the use, if needed, of estrogen creams or lubricants and even erotica (like lingerie or sexy movies) to help spark the mood.

Open Up

Probably the most important advice for men who are trying to reconnect with their partner sexually is to open up and communicate with your partner. This can be more difficult for men to do in general, but is even more of a challenge when it comes to talking about intimate issues like sexuality, desire and arousal. But being honest about how you are feeling and letting your partner know that it is the depression that is a problem and not a loss of interest or a loss of love can be an incredibly powerful way to overcome this challenges and get support from your loved one at a time when you need it the most.  Also, partners can be more understanding and supportive if they understand more about what is going on – otherwise, it is easy to interpret a low mood or lack of responsiveness as being hostile or unloving.

In short, depression is a difficult condition with a whole slew of symptoms that go far beyond just feelings of sadness or being blue.  And when depression begins to affect a person’s sexuality, this in turn can lead to a strain on intimate partner relationships.  However, while there are no quick solutions to this problem, getting on a treatment program that is tailored to someone’s individual needs as well as exercising regularly, spending time with a partner to engage in more foreplay and simply opening up and talking about the problem can all help to reignite the sexual spark in a relationship – and hopefully make the battle against depression that much easier.

About Dr. Brian W. Wu

Brian W. Wu graduated from the University of Maryland with a Bachelor’s of Science in Physiology and Neurobiology. He earned his Ph.D. in integrative biology and disease for his research in exercise physiology and rehabilitation. He is currently an M.D. candidate at the Keck School of Medicine (University of Southern California). He is the founder, a media company changing medicine one story at a time through narrative medicine. Read more at his personal website:

Do boys know more about sex than girls?

Do boys know more about sex than girls?


WHAT do Malaysian youths know about sex? Not a whole lot, according to the findings of a survey on Malaysian Youth Sexual and Reproductive Health (SRH). The little that they know about SRH is gleaned from a hodgepodge of sources, including school, the Internet and friends.

Forty-two per cent believe that withdrawal before ejaculation is effective protection against unplanned pregnancy. Thirty-five per cent believe a woman cannot become pregnant when she has sex for the first time. The survey also reveals that boys know more about SRH than girls.

For instance, when asked whether standing up during sex will prevent pregnancies, 51 per cent of the female respondents said they do not know, compared with 20 per cent of the male respondents. Fifty-one per cent do not know that a woman can get pregnant during menstruation.

Many respondents do not know how to protect themselves from sexually transmitted infections and 25 per cent believe that protection is not required when there is mutual trust between partners.

SRH knowledge-driven programmes are focused on helping youths to understand their bodies, protect themselves and inculcate respect for everyone, but 25 per cent of those surveyed have the impression that SRH education is about teaching them how to have sex.

However, the Women’s Aid Organisation (WAO) says the findings of the survey may not be representative of young people in Malaysia as “we must keep in mind that the survey results are based on a limited pool of respondents”.

A WAO spokesman says it is likely that boys are better informed about sex because it is a greater taboo for girls. “In Malaysian society, girls are expected to keep their virginity, abstinence is the only option that is encouraged and sex before marriage, let alone early sexual activity, is not openly acknowledged.

These factors may result in girls being less educated about sex than boys.” All Women’s Action Society (AWAM) programme officer Choong Yong Yi says it is not enough to only promote abstinence to prevent unwanted pregnancies and sexually transmitted infections.

“It is much better to implement comprehensive and age appropriate sex education for teens where they are taught about consent, peer refusal skills, safe sex and how to value their bodies. Contraceptives must also be made available.”

Her colleague, information communications officer Evelynne Gomez says the taboo over sex education must be broken. “It is a big taboo in Malaysia and it is going to be a difficult issue to approach, but looking at how unsure young people are in the survey, there should be more comprehensive sex education for youths on their sexual and reproductive health.

“There’s scarcely any information on sexually transmitted diseases and many sexually active youths would rather not deal with the issue.” The survey found that 11 per cent of sexually active respondents have had a sexually transmitted infection and 24 per cent did not seek treatment.

Federation of Reproductive Health Associations Malaysia (FRHAM) executive director Mary Pang says the organisation has been advocating sex education for a long time. “In fact, the topic of consent is a chapter on its own in our Life’s Journey module, which is a manual on sexual and reproductive health for adolescents.

“We use the module in all our training sessions at FRHAM centres, as well as in outreach sessions.”

In the chapter on consent, titled Are you ready for a sexual relationship?, Pang says the key messages are:

• Every right comes with responsibility.

• Make an informed choice. Think, before you act. Don’t just do it.

• Sexual relationships should be pleasurable and not under pressure.

• Pregnancy should be intended and desired.

Read More :

Sex mis-education: What young people ask their sexual health nurse

Sex mis-education: What young people ask their sexual health nurse



A nurse at a university health centre, Susan* has learnt not to judge the students who appear in her office.

Occasionally, however, she will lean forward, raise her eyebrows, and ask: “Really?”

While she’s often surprised by young people’s lack of knowledge, she’s understanding.

“Our youth have underdeveloped brains yet we are asking them to decide careers, manage money, live away from home for the first time, deal with drugs, sex, alcohol, stress, loneliness, university work load … no wonder they let their hair down.

“Plus they don’t understand consequences. They don’t. That’s why we need to teach good old fashioned communication skills, like talking.”

er day-to-day job involves “a lot of sexual health appointments and smear tests”. It also involves answering a lot of questions. And asking them.

I’m here for the Emergency Contraceptive Pill

Student: “I’m here for the ECP.”

Susan: “Why?”

Student: “I got drunk last night and I think I had sex.”

Susan: “Do you know who you had sex with?”

Student: “Not really”, or, “I woke up beside a guy in bed”, or, “I feel like I’ve had sex but I can’t remember it”.

At this point Susan is wondering if the young woman was drugged, if she passed out, if she gave consent. Susan keeps asking questions. Of course she will give the student the ECP.

Sometimes, Susan will use a diagram to explain basic female anatomy to her patients.

“You tell more than one woman they’ve got three holes. I show them pictures. I explain what a cervix is. There are a lot of things they just don’t get.”

Student: “I think I have chlamydia.”

Susan: “Why do you think that? Are you sexually active?”

Student: “Yes. I’m in a relationship.”

Susan: “How long have you been in a relationship for? And are they your first partner?”

Student: “About 18 months, and yes, she’s my first partner, and I’m her first partner.”

Susan: “Are you using contraception?”

Student: “She’s on the pill.”

Susan: “What makes you think you have chlamydia? Is it because you don’t trust her?”

Student: “Oh no, we’ve just never used condoms. At school we were told if you don’t use condoms you get chlamydia.”

Susan feels for the guy – obviously he had a hard-line health teacher.

I want an STI check

One of the main reasons young men visit a sexual health nurse is for STI checks.

“They might be starting a new relationships and want the all-clear, or their ex-partner has said they’ve got chlamydia, or they’ve had unprotected sex, or they’ve been in a relationship for a while and they want to stop using condoms …”

Student: “I want an STI check.”

Susan: “Why’s that?”

Student: “Because I had sex the other night and we didn’t use condoms.”

Susan: “Why didn’t you use condoms?”

Student: “Because she’s on the pill.”

Susan: “What’s that got to do with anything?”

Student: “Oh.”

Susan: “Why aren’t you using condoms?”

Student: “I don’t need them.”

Susan: “Obviously you do if you think you’ve got an STI.”

If it becomes clear he’s been mistreating a woman, Susan doesn’t hesitate to ask: “How would you like if that was being done to your sister?”

That really gets them, she says. “They can get quite aggressive but most just sit back and go, ‘woah’.”

Peer pressure is often to blame, she says. “That’s the biggest thing kids have got to rise above.”

Many parents ring the clinic to try to get the goss on their kids – details which the centre is prohibited from releasing. A better strategy, Susan says, is to stay in touch with your kids and discuss “the ups and downs”.

“It’s got a lot to do with your parents … being taught about respect and morals and staying safe and that sort of thing.

“Maybe as parents we do have a lot to answer for, in that our kids are being sent out into the world unprepared.”

*To protect the nurse’s identity and that of her patients we have used a pseudonym.

 – Stuff


We don’t want no sex education

We don’t want no sex education


In the age of the Internet, gender, sexuality, puberty and sexual health remain taboo topics in schools and homes.-Vangmayi Parakala

vangmayi-kqAB--621x414@LiveMintAdolescents using tools made by the Thoughtshop Foundation. Photo: Thoughtshop Foundation

During a workshop on puberty awareness targeted at 10- to 12-year-old boys, sex educator Anju Kishinchandani was faced with a curious situation. When they were talking about the growth of pubic hair, one of her students thought he would have to stop going to school. Perplexed, she asked him why, and he said that since he wore shorts to school, hair might grow out from under them.

“We take for granted that the child would know things. But (puberty) is completely new for them. It can cause so much worry,” says Kishinchandani, who conducts workshops in Mumbai schools and neighbourhoods through her company, Out of the Box. These include a “My Body is Mine”, a child-friendly workshop for five- to eight-year-olds, and “Let’s Talk”, a complete sex education session for 13- to 15-year-olds, designed to encourage informed decision making.

Kishinchandani and other gender and sexual health educators have a tough job—in rural and urban India, social and cultural stigmas make it difficult to discuss sex, gender and sexual health issues with children and young adults.

A report on sexuality education in India by the Youth Coalition for Sexual and Reproductive Rights, an international organization, noted that “most schools—private and public-affiliated state boards of secondary education—don’t have any form of sexuality education in their curricula”. The Adolescence Education Programme (AEP) launched by the government in 2005 ran into trouble with state governments and didn’t quite take off. Three years ago, in a vision document for education in Delhi schools that the Bharatiya Janata Party’s Harsh Vardhan prepared in the run-up to assembly elections, he stated that “So-called ‘sex education’ (is) to be banned”. A year later, Harsh Vardhan, who became Union health minister for a while, added that he “wholeheartedly supported pedagogy that is scientific and culturally acceptable”.

The magnitude of the problem is all too visible. According to Unicef’s “The State Of World’s Children, 2016” report, India’s adolescent population (10- to 19-years-old) is over 250 million. That’s a lot of children who have to rely on misinformation, misdirected peers, pornographic material that is sexist and demeaning, and risqué Bollywood and regional cinema, to find out about the birds and the bees. Of them, the report reveals, around 71.5% of adolescent girls and 88.2% of adolescent boys use mass media.

There are, however, a handful of non- governmental organizations, parents and educators keen to hold constructive and informative conversations with children. Delhi-based not-for-profit Talking About Reproductive and Sexual Health Issues (Tarshi), for instance, has been running a helpline for sexual and reproductive health since 1996. It conducts workshops, issues publications, holds e-learning courses on sexuality, and engages with organizations to highlight the importance of such learning for young people.

“There has been a general denial of access to information on sexuality and bodies and this is especially acute with regard to younger women and girls,” says Vinita Sahasranaman, director of programmes and advocacy at the YP Foundation, a youth organization set up in 2002 to influence policy on issues of gender and sexuality, art, health and education.

The Thoughtshop Foundation, set up in 1993, creates communication tools for those working on issues like gender equity and adolescent health. It is run by Himalini Varma, a designer from the National Institute of Design, Ahmedabad, along with fellow designer Santayan Sengupta.

Over the years, Varma has found that well-meaning health workers, even those with decades of on-ground experience, are uncomfortable discussing topics of reproductive health with adolescent girls. The problem is a complex one, tinged with social taboos, assumptions that children will figure things out eventually and, paradoxically, that they aren’t old enough for this information.

Their kits are picture-intensive, with a storyline and easily relatable characters designed to address children from differing educational backgrounds. Their two adolescent health kits—“Champa” for girls, and “Shankar” for boys—which initially came out in Bengali, are also available in Telugu and Hindi now. “We design our kits keeping in mind not just the end recipient (the children), but also the grass-roots users (trainers),” says Varma. She recounts a session when a card with the picture of a teenage girl holding a little baby fostered a discussion on issues of child marriage and teenage pregnancy, as the adolescent girls related it to events in their own lives.

The YP Foundation follows a “peer educator model” for its target audience—marginalized young people, in institutional homes and government schools. “We induct and train older young adults, say 15- or 16-year-olds, to (conduct) sessions with us. This is premised on the comfort level that a peer group shares. We (have) observed that children clarified misconceptions around menstruation with less hesitation with peers than with much older adults,” Sahasranaman says.

“The backlash begins only with contentious issues like shame around menstruation, education on gender relations, sexually transmitted infections (STI), or contraceptives,” she says.

Despite this, sexual health educators like to keep things real. Gaurav Kumar, 22, currently a postgraduate student at Delhi University, facilitated sex-education sessions at a private New Delhi school for children of classes IX-XII in the last academic year. His sessions brought up several topics—sexual and reproductive health, awareness of the rights of sexual minorities, the relation between law and sexuality, the issue of Section 377 of the Indian Penal Code and notions of “natural” versus “unnatural” sex. Kumar’s programme at the school also included organizing sessions with activists and film-makers such as Pramada Menon.

“The focus was to make the students more aware and to sensitize them to these issues, even as they are growing up. To do this, I would also bring in pop-culture references, especially stories of celebrities that the kids would read about often. Because the challenge was to make the topics interesting and relatable in a non-awkward way,” says Kumar.

To keep pace with India’s children—literally, the country’s future—sexual health experts are constantly and rapidly modifying their ways of reaching out and providing healthy, much needed information. Regardless of whether they work in rural or urban areas, trainers say the children are brimming with curiosity and ready for information. The question is, are we willing to provide it to them?