Sex Education Programmes in Kenyan Schools Are Failing Students
ANALYSISBy Estelle Monique Sidze, Guttmacher Institute and Melissa Stillman
Imagine giving Kenyan students something that has been proven to help them make healthy informed choices about their sexual and reproductive lives.
The solution already exists: comprehensive sexuality education.
To be comprehensive, sexuality education needs to be scientifically accurate, age-appropriate, nonjudgmental and gender-sensitive. The lessons should extend to prevention of HIV and other sexually transmitted infections (STIs), as well as contraception and unintended pregnancy. The students should also learn about values and interpersonal skills, gender, and sexual and reproductive rights. Programmes that cover all of these topics can have a positive impact on adolescents’ sexual and reproductive health.
Previous research shows that nationally more than a third of Kenyan teens between the ages of 15 and 19 have already had sex. About one-fifth are currently sexually active. And while only four in ten sexually active unmarried teenage girls use any modern method of contraception, the vast majority of them want to avoid pregnancy. About one-fifth of them are already mothers, and more than half of these births were unplanned.
Early childbearing may limit girls’ ability to stay enrolled in school and to develop the skills needed to successfully transition to adulthood. Knowledge about HIV infection also remains a concern: around half of adolescents in Kenya do not have comprehensive knowledge of HIV/AIDS.
At a time when a new national school curriculum is starting its pilot phase, our recently released study provides critical evidence of the gaps in the content and delivery of existing sexuality education programmes and an opportunity for strengthening them.
The study, conducted in 2015 in 78 public and private schools, found that three out of four surveyed teachers are reportedly teaching all the topics that constitute a comprehensive sexuality education programme. Yet only 2% of the 2,484 sampled students said they learned about all the topics.
Worse still, incomplete and sometimes inaccurate information is being taught. A majority of surveyed teachers reported emphasising in their classes that abstinence is the best or only method to prevent pregnancy and STIs. Yet numerous studies have shown that abstinence-only programmes do not work.
Only 20% of students in our study had learned about types of contraceptive methods. And even fewer had learned how to use and where to access methods. The majority of teachers also reported very strongly emphasising that having sex is dangerous or immoral for young people. Furthermore, almost six in 10 teachers who teach about condoms incorrectly tell their students that condoms alone are not effective for pregnancy prevention. Something is wrong with this picture
The reality is that at the time of being surveyed for our study, a quarter of the students – who were mostly aged between 15 and 17 – had already had sex. Students want and need information about how to prevent unintended pregnancies, HIV and other STIs.
Kenya already has the policy infrastructure for a comprehensive programme. Its National School Health Policy was developed by the Ministry of Education and the Ministry of Public Health and Sanitation and their partners in 2009. The policy underscores the need to ensure that students receive quality health education, including sexuality education.
Kenya has also been a signatory since 2013 of a joint health and education ministerial commitment to provide comprehensive and rights-based sex education starting in primary school. Twenty-one other countries of East and Southern Africa are also part of this initiative.
However, implementation has been slow and uneven. Nairobi City county has acknowledged this gap and is working to increase coverage of sexuality education. Recently the county launched a plan of action to strengthen school health programming to increase the number of schools that offer comprehensive sexuality education.
Sexuality education is primarily taught under the subject Life Skills, which is compulsory but not examinable. Teachers face pressure to focus on examinable subjects, such as Mathematics and English. Even in schools that teach a wider range of sexuality education topics, many teachers lack the training to teach them effectively.
We owe it to young people
That’s why the ministries of Health and Education should honour their prior commitments. An immediate priority should be fostering partnerships between schools and community health care providers. Health care providers may be better placed to provide some particularly sensitive sexuality education content, such as where to access and how to use contraceptive methods.
As a longer term priority, the ministries should invest in improved pre-service and in-service teacher training in how to teach sexuality education effectively. They should also ensure that teachers have sufficient time to cover the full range of topics in their classes.
Increased focus on pregnancy and STI prevention strategies should cover a broad range of contraceptive methods and negotiation skills within relationships. This is necessary to ensure that all Kenyan youth have the knowledge to make informed decisions about their sexual and reproductive health. We owe it to young people to do much better.
The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond the academic appointment above.
Retiring to the bedroom: Older people still enjoy healthy sex life after 50
WE MIGHT like to think that parents and grandparents stop having a sex drive at 50 but the reality is starkly different.
A new study has revealed that geriatrics not only continue their antics between the sheets, but they explore their sexuality even more.
Professor Liza Berdychevsky at the university of Illinois and Galit Nimrod, from Ben-Gurion University of the Negev in Israel looked at how older generations view sex in their later lives.
And the results were surprising.
They analysed 14 leading online communities for the over-50s across the English-speaking world, including the UK and the US.
Looking at their chats on sex, researchers discovered that many “remained sexually able, interested and active.”
While some were happy to give up their sex lives – blaming health conditions and a lack of drive – others used their twilight years to make up for lost time.
Prof Berdychevsky told Medicalxpress.com: “Although some older adults reported abstaining from sexual activity due to health conditions or loss of interest, others refused to renounce sexual activity.
“Their health problems or society’s ageist stereotypes that portray seniors as asexual were not going to become excuses to give up on life – or sex.”
She revealed how many older people surveyed were inspired to explore their sexuality more and try new ways to spice up their love lives.
Last year, research by The University of Manchester told how more than half of men and a third of women over 70 in England are still sexually active.
In online chats, many revealed the ‘ageist stereotypes’ they faced, with some telling how their concerns about sexual health were dismissed by doctors.
Similarly they were met with disapproval from their children if they were candid about their sex lives.
Popular discussions online included dating advice, continuing a sex life after a bereavement and new sexual relationships.
Despite being happy to swap anecdotes online, some were embarrassed to try sex tips or aids in their own lives – for fear of judgement.
The report concluded that older people who accepted their physical imitation and adopted accordingly continued to enjoy a healthy sex life.
While many admitted they were happy to abstain, advertising for sex enhancements featuring younger models was a focal reason for problems in the bedroom.
Prof Berdychevsky said: “These stereotypes caused performance anxiety in some older men and some older women believed that both partners should have a say in whether sex enhancement drugs are prescribed.”
Screen violence — real and fictional — harmful for kids, experts say
By Jacqueline Howard, CNN
Dead bodies. Bloodied faces. Tears. Terror.
Parent Acts: When my son’s armpits smell like rotten cauliflower
By Kelly Wallace, CNN
(CNN)“Oh, puberty,” laments Amanda Rodriguez, a mom of three boys, ages 8, 11 and 14.
Tell the kids it’s ‘bacteria poop’
The Best Medications for an Overactive Bladder
An overactive bladder (OAB) is a frequent or sudden urge to urinate. Some even experience leakage, multiple episodes of nighttime urination or urinary incontinence. For many patients, OAB interferes with their daily routine and quality of life. Luckily there are lots of treatment options, including medication. First, the physician has to find out what is causing the issue. For older men, an enlarged prostate or benign prostate hyperplasia (BPH) is often the cause. Here, ED medications are sometimes prescribed. Those who have M.S. or Parkinson’s may find OAB a symptom of their condition. Bladder stones or even cancer may also be at fault, so it’s important to see a doctor. A full examination and diagnosis must be completed before the appropriate therapy can be arrived upon. Depending on the cause, some physicians suggest trying lifestyle changes and behavioral therapy before taking medication as some people can experience side effects. Creating a bathroom schedule, keeping tabs on what you drink, watching what you drink, relaxation techniques and more can help. For some patients, a specific cause cannot be found.
If these lifestyle changes fail to curb the problem, medication is usually the next step. What are the best medications for OAB? There are generally two kinds. The first relaxes the muscles in order to allow urine to pass more easily out of the body. The second is the type that strengthens the muscles of the bladder which may have weakened over time. Anticholinergics are the most commonly prescribed class of drugs for OAB. These relax the muscles and stop the spasms which lead to urination. They do so by blocking the chemical messenger acetylcholine. Dry mouth is the most common side effect. Tricyclic antidepressants are also pretty commonly prescribed. They strengthen the muscles at the neck of the bladder helping to curb incontinence while relaxing other muscles, lowering the urge to go. Sleepiness is the most common side effect. Lastly, Botox has been used to neutralize some of the muscles in the bladder that cause OAB. Though effective, this is a new procedure and may not be covered by insurance. If you haven’t already, see your doctor and find out what is causing OAB and which treatment is right for you.
Pains You Should Never Ignore
A “thunderclap” headache
Could be: An aneurysm, which is a balloon-like area in an artery
Fix it: If you experience head pain that comes on suddenly and is severe, call 911. (You may also get dizzy and notice blurred vision.) Bleeding in the brain due to a ruptured aneurysm isn’t all that common, but when it does happen, swift action is key. Surgeons can save your life by sealing off the weakened spot. Photo By Getty Images
Tooth pain that wakes you up
Could be: Teeth grinding
Fix it: Frequent clenching can cause the nerve within the tooth to become inflamed and the protective enamel to wear away. You might even end up cracking teeth down to the root, which leads to extraction. Call your dentist so he or she can figure out the problem. The complications from grinding, which is often brought on by stress, can be prevented by wearing a night guard.
Dull stomach pain that gets sharper as it moves lower to the right of your abdomen
Could be: Appendicitis
Fix It: If you feel this sensation, go straight to the ER. (Usually it gets more intense over a 24-hour period as it shifts location.) You’re likely going to need surgery-soon. If the appendix bursts, bacteria from the colon can leak into the abdomen, which is dangerous.
Mid-back pain coupled with fever
Could be: A kidney infection
Fix it: Don’t assume that your temperature, nausea and back pain are just a stomach bug. This condition develops when bacteria that infiltrate the urinary tract spread to the kidneys, making the infection much more severe. (You might start with UTI symptoms, like pain during urination, but some people don’t notice anything until later.) You’ll likely need antibiotics ASAP, so call your doctor.
A tender spot on your calf
Could be: Deep vein thrombosis (DVT)
Fix it: If one small area of your leg is painful, you could have DVT, a blood clot in the deep veins. (The spot may also be red and warm to the touch.) DVT is more likely if you use birth control pills or recently took a long car or plane ride. Unless your leg is very swollen or the pain is getting worse rapidly, you can probably wait a day to see your doctor instead of going to the ER, but don’t delay any longer. The clot could increase in size-or break off, move toward the lungs and stop blood flow.
Menstrual cramps that don’t get better with medication
Could be: Endometriosis
Fix it: If meds like Advil aren’t helping, this condition-in which tissue grows outside the uterus-might be to blame. Endometriosis impedes fertility, and it’s common (40% to 60% of women whose periods are very painful may have it). Unless you’re trying to conceive, your doc can start you on oral contraceptives. If pain persists, you may need to have the tissue surgically removed.
An unexplained ache between your shoulder blades
Could be: A heart attack
Fix it: About 30% of people who have heart attacks don’t get the classic chest pressure. Pain between shoulder blades is common in women, as is jaw pain, shortness of breath and nausea. If you have these symptoms (you’ll likely have more than one), you need care ASAP. If you think you’re having a heart attack, don’t ask someone to drive you to the hospital-call 911. Emergency responders provide care the moment they reach you.
SOURCES: Alice G. Boghosian, DDS, consumer advisor spokesperson, American Dental Association. Rebekah Gross, MD, clinical assistant professor, NYU Langone Medical Center, New York. Sharonne N. Hayes, MD, professor of medicine and cardiovascular diseases and founder of the Women’s Heart Clinic, Mayo Clinic. Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology and reproductive sciences, Yale School of Medicine.
Birth Control Works in Long-Term Acne Treatment, Study Says
More effective than previously thought
Birth control pills are as effective as antibiotics for treating women’s acne in the long term, according to a new review of clinical studies.
The dermatological study shows that antibiotics are more effective than the Pill for the first three months of treatment, but are equally successful after six months.
“This confirms that birth control pills are a good solid treatment for acne, and they’re probably underutilized,” Dr. Steven R. Feldman, a dermatologist at Wake Forest University School of Medicine, toldReuters. “Given the desire to minimize antibiotic resistance and exposure, hormonal birth control could be a good alternative.”
Birth control pills may soon be the more benign alternative to some of the antibiotics and harsh topical gels used in acne treatment. Dermatologists are already recommending low doses of birth control for female acne patients, Feldman said.
Is Paying for Sex Okay?
It’s considered the oldest profession, and headlines show that it hasn’t gone away. Lots of celebrities from Eddie Murphy to Hugh Grant have been caught with ladies of the evening (askmen.com). The Secret Service too was caught in a high profile media blitz last summer when they found that many agents were enjoying a Columbian high-class call girl service. Prostitution is legal in Columbia. Though American attitudes about sex are changing and in fact have changed, by and large most men in the U.S. are loath to discuss the issue. It’s still considered taboo. A study out of the University of Portland found that around 10% of males in North America have paid for sex. These men are 44.2% less likely to be hitched. If they are married, the results of this study show that they aren’t in a happy marriage. These guys are also kinkier than average and are more open-minded when it comes to bedroom antics. One of the reasons men seek out a lady of the evening is to fulfill certain fantasies they have. Some women prefer not to do certain things. But a call girl will do what is necessary to earn her salary, and to hopefully acquire repeat business. So is paying for sex okay? That depends on a lot of factors. First, where are you emotionally? Some guys take sex very seriously, others not so much. Any guy who has spent even a trivial amount of time at a strip club for instance knows that there is always one guy who thinks the stripper is in love with him. This happens with call girls, too. If you are the type to get emotionally attached then you are setting yourself up for a fall.
Make sure the girl is of a decent quality. Perhaps an escort service that comes recommended. Or spend some time on reputable websites and do some research. Guys have been robbed, blackmailed, and more by hookers. So it pays to invest some time and read reviews should she have some. It goes without saying that protection should always be used. The chances of catching an STD is far higher with a prostitute. In doing your due diligence make sure that she always uses protection. If she offers without, pay her so she doesn’t make a fuss but do not let her service you. You don’t want this one time to make you end up at the doctor’s office, or in the case of HIV/AIDS and herpes, alter your life forever. Keep it quiet. This kind of information, if it gets out, can hurt your career, your relationships with family, friends and perhaps with a significant other. If you are going to a call girl to have a fantasy fulfilled but you are with someone, approach your partner with it first. Don’t do it just because you are embarrassed to approach your romantic partner with one of your fantasies. In fact, it may be a bonding experience, bringing you closer together. But if you are single, have no moral objections and do your homework, it can be a scintillating experience, and a memory you can call up whenever the mood strikes you.
Stress less: Keys to a calmer existence
It’s one of the greatest ironies of life: We’re too frantically busy to deal with the stuff that makes us feel frantically busy — the to-do’s that overwhelm us, the clutter that eats up our homes, the niggling personal and professional issues that preoccupy our minds.
Tackling them might feel like a someday project, the kind you’ll get around to when you have the time. Right.
The key to a calmer existence, experts say, is finding bite-size, everyday solutions for stressors and releasing what we can, be it physical or psychological clutter.
“When you start to let go, your life lightens up because you have less to think about and less to maintain,” says Geralin Thomas, a professional organizer in Cary, North Carolina. “You finally feel in control.”
The payoffs don’t end there — you can sharpen your focus and even lose weight, too. These are the strategies that will ease your load and let you enjoy life a lot more.
Clear your schedule
As we juggle it all, we’re often fueled by an I-can-do-it! sense of pride. But we might be deluding ourselves, suggests a study in the Journal of Communication that found that people misperceive the emotional high they get from multitasking as productivity.
And we’re not even as good at it as we may think. Another study, published in Psychological Science, revealed that women’s ability to keep track of several tasks at once dipped significantly during ovulation, when estrogen levels are high (and can mess with brain function).
Technology sometimes hampers us more than it helps, adds Laura Vanderkam, author of the book “168 Hours: You Have More Time Than You Think.”
“Time speeds by when you’re on your smartphone e-mailing,” she says, “even if you’re really not doing anything important.”
How to lighten up:
Suss out time sucks. For one day, every couple of hours, note down exactly what you just did, including things like “Read Facebook updates for a half-hour” or “Scanned catalogs for 15 minutes after opening mail,” says Vanderkam. “You start to see the time periods that you’re not using as well as you’d like.”
Stop the auto-yes. “Everyone lives in an optimistic world and thinks that if we say yes we will find the time, but the truth is we are in denial,” says Julie Morgenstern, one of the top organization and productivity experts in the country. Instead, experiment with saying, “Let me think about how I can do that,” says Morgenstern. “This way you can step back and evaluate if you really can do what is being asked.”
Have a plan. “Most people’s to-do lists actually create fatigue, because they don’t clarify how, exactly, they are going to handle Mom’s birthday, so tasks feel bigger than they are,” says David Allen, a productivity expert and author of the best-selling book “Getting Things Done.” Take a second to jot down how you’ll tackle something. Feel better already?
Just do it. Allen regularly tells clients to follow his Two-Minute Rule: If something can be done in two minutes, go ahead and get it done. Explains Allen, “It will take you longer to look at it again than it would take to finish it the first time you think of it.”
Reconsider rewards. Carefully examine your commitments, says Morgenstern, and decide which ones energize you — and which deplete you. For the tasks that send your misery Geiger counter off the charts, pinpoint whatever reward you get from them and find a better way of scoring it.
One client of Morgenstern’s wasn’t really enjoying volunteering for the PTA because it took time away from her kids, but she kept at it because she thought it showed her children she considered school important.
Ultimately, she switched over to running the occasional fun class activity and giving her kids more hands-on help with homework. “These things took less time,” Morgenstern notes, “and she and her family got more out of them.”
Clear your clutter
Dusting, mopping, vacuuming: That’s easy. Getting rid of all the junk you have to dust, mop and vacuum around? Not so much.
“Giving things up is tough because it’s not so clear-cut when they’re no longer useful,” says Morgenstern, author of the book “Shed Your Stuff, Change Your Life.” You don’t stop wearing jeggings on a Tuesday at 4 p.m.; you just gradually stop doing so, even as they languish on a hanger.
The thing is, those pile-ups of possessions can create anxiety; a study at UCLA found that just looking at clutter elevated women’s stress hormones (although, no surprise, the men’s cortisol levels remained unchanged).
Motivation to get going on cleaning house: You may look better, too. As Thomas points out, “One big change I see in clients who have de-cluttered is weight loss. Once they have shaped their environment, they’re ready to shape up themselves.”
How to lighten up:
Think small. “We know from research that little acts of neatness cascade into larger acts of organization,” says Christine Carter, a sociologist at UC Berkeley’s Greater Good Science Center. Forget about organizing the entire kitchen; focus on, say, the plastic containers taking over your cabinets.
“With random de-cluttering, there’s always more that you can do,” notes Thomas. “When one category is tackled, there’s definitely an end point.”
Be a regular. Perhaps you dedicate, say, 10 minutes a weekday to an organizing project. Or you commit to doing a couple of hours for a few weekends in a row. The point is, be consistent and attentive; turn off your cell phone and schedule child care.
Thomas does a weekly “Trash Eve” de-clutter: “The garbage in my neighborhood is picked up on Wednesdays, which makes Tuesdays the night I make an easy supper and clear the decks!”
Decide what’s treasure and what’s toss-able. Ask yourself just one question before you start purging any collection of stuff, recommends Morgenstern: “If everything was stolen, what pieces would I go out and buy the very next day?” There you go — the costume jewelry, canned goods and linens you truly want and need.
Pre-arrange pickups. About 40% of people who purge never manage to get the stuff out of their homes, per a poll of 23,000 people on Morgenstern’s website. Avoid becoming a hoarder statistic by scheduling a pickup before you start to clean your house. Try salvationarmyusa.org, goodwill.org or excessaccess.org, a not-for-profit that connects people with local schools and charities in need of specific goods.
Clear your mind
It’s not just that we have a lot to keep track of — it’s our DIY mentality, says Dr. Orit Avni-Barron, director of Women’s Mental Health at Brigham and Women’s Hospital in Boston. “I hear women say, ‘My husband is so great, he helps me,'” as if our partners are our sous chefs instead of co-cooks.
Another issue: Women worry twice as much as men, research shows. “Worrying impairs concentration and memory,” says Robert Leahy, director of the American Institute for Cognitive Therapy in New York City. “You can’t tend to the present and worry about the future at the same time. It’s overwhelming.”
How to lighten up:
Pop annoying thought bubbles. Psychologists talk of the Zeigarnik effect, named after a Russian shrink who realized that a waiter could more easily recall incomplete orders than served ones. The follow-up study showed that people are 90% more likely to remember undone tasks than those they completed. “Tell your brain when you’ll get a task done,” says Carter. “It kills the worry loop.”
Control what’s possible. “When we don’t know how something will work out, we worry to get certainty,” says Leahy. Yet one study at Penn State University found that 85% of things people fretted about had neutral or positive outcomes. To quell anxiety, throw yourself into what you can accomplish — say, writing the introduction to the PowerPoint document instead of ruminating on the presentation. “You’ll feel good about the present and put other thoughts on pause,” says Leahy.
Be hands-on. Weed, knead dough, do a craft, says Dr. Gayatri Devi, associate professor of neurology at New York University. “When you think about something tangible, you stop thinking about the theoretical.”
Grade perfection on a curve. “We have reached a tipping point in perfection. People are realizing we can’t do it all at the level that we used to,” says Morgenstern.
That means you, sister! Start with the obvious: Divvy up more responsibilities with your partner, even if he does them differently. And try Morgenstern’s Minimum, Moderate, Maximum strategy: Decide what level of effort you can give tasks (and get away with). As she says, “You may be surprised to find that everything works out OK.”