Improving the accessibility of health services that meet the sexual and reproductive health needs of adolescents in schools : Bulgaria

Abstract

This report was part of an inter-regional project funded by UNAIDS and coordinated by the Programme of Child and Adolescent Health and Development in WHO Headquarters, Geneva. The district of Varna, Bulgaria was chosen as a pilot in the European Region. The other participating countries were Costa Rica (‎American Regional Office)‎, Malawi (‎African Regional Office)‎, Malaysia (‎Western Pacific Regional Office)‎, Sri Lanka (‎South East Asia Regional Office)‎ and Tunisia (‎Eastern Mediterranean Regional Office)‎. The key findings were as follows. School-based health services (‎whether provided by a doctor or nurse housed on the school premises or by teams which visit the school periodically)‎ make a valuable contribution to the health and development of children and adolescents in many parts of the world through such activities as: periodic monitoring of growth and development ; routine checks for the identification of problems (‎such as visual and auditory disorders)‎; administration of vaccinations; and the diagnosis and treatment of common illnesses. In many other parts of the world, school health service programmes are weak or non-existent, and this represents an enormous missed opportunity for preventing health problems, detecting them early (‎if and when they do arise)‎ and managing them. Even in countries where school-based health centres exist, they often do not provide preventive and curative health services relating to sexual and reproductive health. This appears to be the case in many western countries, and to be universally true in countries of Asia, Africa, Latin America, and eastern and central Europe. In this situation, it is vitally important to strengthen functional links between schools (‎and other institutions of learning)‎ and organizations which provide the health and social services that children and adolescents need. It is also important for initiatives in this area to be planned and implemented with the utmost attention paid to local sensitivities. However, it must be stressed that if there is resistance to the idea of expanding the availability and improving the accessibility of health services for adolescents, there is sound public health rationale (‎even an imperative)‎ for engaging influential people in the community and other community members in a discussion on the subject