Syeda Asfia Hussain  ( Dr. Ruth Katherina Martha Pfau, Civil Hospital Karachi, Pakistan )
Ayesha Mubashir  ( Dr. Ruth Katherina Martha Pfau, Civil Hospital Karachi, Pakistan )

https://doi.org/10.5455/JPMA.66591

Dear Madam, adolescents represent 23% of the Pakistani population and their Sexual and Reproductive Health (SRH) is a growing concern.¹ A majority of adolescents undergo puberty during their primary school years, a challenging time for most children. As noted in a study by Iqbal et al,¹ information regarding puberty is often event based; for example at the time of menarche in girls or adrenarche in boys. SRH is not discussed in our society as it is considered a taboo and a gateway to premarital sexual activity. Girls are at a particular disadvantage as mothers being their primary source of information are themselves often unaware.¹ The lack of information regarding the physiological, social and emotional changes occurring during puberty leaves adolescents stressed and vulnerable. Therefore, adolescents rely on informal and often inaccurate resources such as the internet. This facilitates an inappropriate exposure to explicit content at a tender age, leading to the birth of myths and misconceptions that may negatively impact the psyche of young adolescents and their outlook towards sexual relationships.² In order to stop sexual exploitation of adolescents in unexpected places and to help them navigate this transition period there is a need to promote SRH in schools and to integrate it into our education system. This would enable adolescents to protect themselves by recognizing predator y behaviors, understanding the meaning of consent and promoting gender equality and emotional maturity.³ For the reasons stated above and many others, Sexual and Reproductive Health Education (SHRE) has been controversial in Pakistan. Pakistan has been a signatory of the International Conference on Population and Development (ICPD) since 1994, which has resulted in the introduction of many SRH legislative reforms. However adults, Healthcare providers and a lot of young people deny having attended any formal session in their school regarding SRHE as shown by a study conducted by The AWAZ Foundation Pakistan.⁴ One of the biggest challenges remains resistance from conservative groups in our society.⁴ Following the publicized rape case of a minor in Kasur, the general attitude of our masses has become seemingly positive towards SRH. Thus it has become increasingly important to introduce SRHE in Pakistani schools. In order for SRHE to be successfully implemented, it is critical to design a curriculum with a clear protocol outlining content, approach, rules and regulations that are in accordance with our socio-religious values.⁴ A possible solution being conduction of separate sessions for males and females by trained professionals. This may aid in dissolving much of the stigma around SRHE.³

Disclaimer: None.

Conflict of Interest: None.

Source of Funding: None.

References

1. Iqbal S, Zakar R, Zakar M, Fischer F. Perceptions of adolescents' sexual and reproductive health and rights: A cross-sectional study in Lahore District, Pakistan. BMC Int Health Hum Rights. 2017; 17:5.

2. Ali TS, Azam Ali P, Waheed H, Memon AA. Understanding of puberty and related health problems among female adolescents in Karachi, Pakistan. J Pak Med Assoc. 2006; 56:68-72.

3. Kumar R, Goyal A, Singh P, Bhardwaj A, Mittal A, Yadav SS. Knowledge attitude and perception of sex education among school going adolescents in Ambala District, Haryana, India: A cross-sectional study. Journal of clinical and diagnostic research: J Clin Diagn Res. 2017; 11:LC01-4.

4. Awaz Foundation Pakistan. Status of Sexual and Reproductive Health Rights in Pakistan. [Online] 2018 [Cited 2019 September 16]. Available from: URL: file:///C:/Users/CC/Downloads/AwazCDSUjala- Research-on-Status-of-SRHR-in-Pakistan-Nov-2018.pdf