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Knowledge, Attitude, and Behavior about Sexual and Reproductive Health among Adolescents Students in Denpasar, Bali, Indonesia
Abstract and Figures
Background: Adolescent sexual and reproductive health (SRH) problems remain an important public health issue in many developing countries, such as Indonesia. Therefore, assessing SRH knowledge, attitude, and behavior among adolescents are worth considering for public health intervention purpose in order to reduce their vulnerability to SRH problems.
Aims: This study aimed to assess SRH knowledge, attitude, and behavior among adolescent students in Denpasar, Bali, Indonesia.
Methods: This was a cross-sectional school-based study conducted in Denpasar, Bali, Indonesia from July to September 2016. This study applied multi-stage random sampling to recruit 1,200 students out of 24 junior, senior, and vocational high schools. Variables in this study consisted of socio-demographic characteristics, knowledge, attitude, and behavior related to SRH. Data were analyzed using descriptive analysis and cross-tabulation to identify proportion differences.
Results: Regarding knowledge on SRH, students had less knowledge on a reproductive process (10.1%) and reproductive risk (11.4%), but half of them knew about the sexually transmitted infections (STIs) and HIV&AIDS (55.6%) and almost all had sufficient knowledge on puberty (90.7%). Meanwhile, few students argued that several sexual behaviors can be performed before getting married, such as kissing and hugging (48.9%), petting and oral sex (18.7%) and sexual intercourse (vaginal sex) (13.8%). Out of 1,200 adolescent students, 880 (73.3%) reported for have ever been in dating with someone. Among adolescent dating, few students reported for an experience of petting (14.3%), oral sex (9.8%), vaginal sex (6.5%), and anal sex (2.6%).
Conclusion: Adolescent students in Denpasar, Bali, had a low level of sufficient knowledge in some SRH aspects, a few students reported for permissive attitude and performed premarital sexual behaviors. Therefore, providing comprehensive sexuality education (CSE) is worth considering to improve knowledge and appropriate skills in order to prevent risky sexual behavior among adolescents.
Keywords: Sexual and reproductive health, adolescents, students, knowledge, attitude, sexual behavior.
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... Namun di Indonesia, informasi mengenai pubertas ini masih bersifat formal dan disampaikan oleh guru di sekolah melalui mata pelajaran IPA atau biologi. Hasil penelitian di Denpasar, Bali menunjukkan 84,2% remaja menerima informasi mengenai pubertas dari orang tua dan 18,1% remaja menerima informasi dari guru (Pradnyani et al., 2017). Beberapa orang tua yang mendukung pendidikan seksual yang selaras dengan ajaran agama dan budaya. ...
Dating in adolescents has become a behavior that occurs in general and it can increase to sexual
contact as like touching, kissing and without kissing, touching sensitive parts and sexual relations.
During a pandemic, a study also reported that there was an increasing in masturbation behavior,
viewing of pornography, messaging on websites or phones, and chatting by phone or video with
partners. Therefore, researchers are interested in seeing how the dating phenomenon carried out by
adolescents during the pandemic is reviewed with Social Cognitive Theory. This study used a
qualitative design. The information was collected using snowball sampling techniques, data collection
with in-depth interviews using WhatsApp Call. Source triangulation was carried out with youth and
peer psychologist. Research ethic used the Helsinki concept declaration and data analysis used
thematic unbeatable with the framework of Social Cognitive Theory. The results of this study are 1)
adolescents know what is permitted and what is not when dating, 2) adolescents tend to agree about
dating in their teens, 3) adolescent’s communication with parents is not so open especially about
dating, it is different from communication with peers, and 4) adolescents get minimal exposure to
sexual information about sexual and reproduction health. The conclusion is adolescents during the
pandemic often use social media to communicate with her/his beloved and their time is less to meet.
Through this online, adolescent can also send kiss emoticons or even long distance kisses.
... Pradnyani, et al., was suggested that maternal education, peer norm, PIK-KRR program, attitudes, and subjective norms were effected to pre-marital sexual behavior in adolescents [12]. Adolescents can be exposed to sexy content in the media during the development period compilation of gender roles, sexy attitudes, and sexy behavior are being formed, so that it's may very risky because cognitive skills that allow them to critically analyze the media and make decisions about future results are not supported [13]. ...
A lack of communication, support, and information from parents on sexual issues are involved an inability to prevent or intervene in the sexual activity of adolescents. This study aimed to determine the effect of adolescent reproductive health education on premarital sexual behavior in Palembang, Indonesia. This study was an experimental design with pre and post-intervention. The 192 students were obtained based on the criteria of samples required. The result of bivariate analysis between the Chi-Square confounding variable and premarital sexual behavior after the intervention shows that there is a significant relationship between knowledge about sex, reproductive health, and attitudes with premarital sexual behavior. There is a significant relationship between control behavior and sexual behavior after performing the intervention (p= 0.00). The result of multivariate shows that there is a dominant variable that is the variable of knowledge about reproductive health (p= 0.00). This study suggested that information about adolescent reproductive health should be included in the curriculum, especially in Biology class.
... This factor might indirectly affect suicidal behavior. As the practice of engaging in protected sex among Indonesian adolescents was considerably low [64], [65], unprotected sex by adolescents can contribute to adverse reproductive health outcomes such as unintended pregnancy, HIV transmission, early childbearing or abortion [13], [58]. Those stressful life events can be a trigger for impulsive suicidal behaviors [66]. ...
Suicide among young people is growing as a public health threat worldwide. With a paucity of studies on this issue in Indonesia, this study aimed to identify factors associated with suicidal behaviors (suicidal ideation and suicide attempt) among Indonesian adolescents. This was a cross-sectional study using secondary data analysis from the Global School-based Student Health Survey (GSHS) of Indonesia in 2015. The samples were 8634 school-going adolescents aged 13–18 years old. The data analysis consisted of univariate, bivariate and multivariate analysis. The chi-square (χ ² ) test was employed to identify proportion differences of suicidal behaviors by independent variables whereas multiple logistic regression was used to develop models for factors associated with suicidal ideation and suicide attempt. This study found that 4.75% and 2.46% reported for having suicidal ideation and suicide attempt in the last 12 months, respectively. The effects of intrapersonal factors (sex, age, loneliness, anxiety, current use of tobacco and alcohol) and interpersonal factors (physically attacked, bullying victimization, having no close friends, parental understanding and having sexual intercourse) varied by suicidal behavior and sex. Therefore, developing comprehensive approaches for prevention of mental health problems, including suicidal behaviors in the school setting is essential by asking for a collaboration of schools, parents, public health centers (PHCs), related stakeholders and non-governmental organizations (NGOs).
Adolescent sexual and reproductive health problems remain a public health concern in Indonesia. An increase of premarital sex as well as early sexual debut among adolescents without any protection leads to a high risk of adverse sexual and reproductive health consequences. This study aimed to assess condom use prevalence and identify its determinants among male adolescents who are sexually active in Indonesia. This was a cross-sectional study using secondary data from the Adolescent Reproductive Health component of the Indonesia Demographic and Health Survey (IDHS) 2012. The sample for this study was 1341 sexually active male adolescents aged 15–24 years old. Data were analyzed descriptively and using binary logistic regression for bivariate and multivariate analysis. This study found that condom use prevalence among male adolescents at first and last sex accounted for 25.0% and 27.4%, respectively. Determinants of condom use varied by time of sexual intercourse. Knowledge of sexual and reproductive health and obtaining information about condoms were consistently related to condom use at first and last sexual encounter. Meanwhile, residential type, age at first sex, and sexual partner were significant determinants of condom use at sexual debut whilst educational level was only associated with condom use at last sex. As the level of protected sex among male adolescents was very low, providing comprehensive sexuality education (CSE) is suggested in order to develop the capacity among adolescents in making informed decisions and preventing unsafe sex.
Objectives
To describe the comprehensive sex education (CSE) coverage and to evaluate a set of indicators related to knowledge, attitudes, and practices associated with the seven components of the CSE framework among Mexican high-school students.
Methods
We conducted a cross-sectional survey of a nationally representative sample of students in public and private high schools in Mexico. Questions about CSE coverage and about knowledge, attitudes, and practices related to sexual health were included. We present descriptive statistics for demographic characteristics, exposure to CSE, and sexual health outcomes. We fitted a series of multivariate logistic regression models to examine the association between each CSE component exposure and sexual health outcomes, adjusting for age and sex.
Results
There were significant associations between being exposed to each CSE components and the related sexual health outcomes. The strongest one was for identifying effective contraceptives among those exposed to the Sexual and Reproductive Health component (SRH) (OR 4.10; 95%CI[2.93,5.75]). Also, students exposed to the relationships component had 20% higher odds of affirming they could convince their partner to use condoms (OR 1.20; 95%CI[1.05,1.36]).
Conclusions
This paper provides evidence of the potential beneficial effects of CSE on attitudes, knowledge, and behaviors regarding sexual and reproductive health among adolescents. In addition, it identifies areas that should be strengthened to increase the positive impact of CSE.
Adolescents’ reproductive health in Indonesia is of growing concern. Over the past decade, unintended pregnancy resulted from pre-marital sexual intercourse and unsafe sex behaviors tend to be increasing. Lack of reproductive health knowledge was a major cause of such risky behavior. With regards to Indonesian culture, men are more likely to initiate sexual intercourse. Therefore, this study aimed to examine the reproductive health knowledge of Indonesian young men and its determinants. Findings are expected to support the provision of reproductive health education for young people in Indonesia. The present study employed secondary data from Adolescents Reproductive Health component of the Indonesian Demographic and Health Survey 2012. A total of 1,840 census blocks in 874 urban and 966 rural areas were selected from the list of census blocks in the selected primary sampling units formed during the 2010 population census. A total of 10,980 never-married men aged 15 to 24 years old was selected for analysis. Only 28.5% of Indonesian young men aged 15-24 had a complete reproductive health knowledge related to pregnancy. Half of respondents had incorrect knowledge regarding fertile period and more than half (51.3%) believed incorrectly that pregnancy cannot occur with only one sexual intercourse. School-related variables were the strongest predictors of knowledge. Those who completed their education at secondary level or more, and those who obtained reproductive health lessons at school were more likely to have a complete reproductive health knowledge. Having a reference person to talk about reproductive health matters was also a strong predictor for knowledge, followed by access to reproductive health media and place of residence. In conclusion, the study indicates that most of Indonesian young men lacked health knowledge related to pregnancy. The findings also suggest that schools were able to provide a good quality of reproductive health information for young people. Therefore, providing an adequate reproductive health education at school is strongly recommended.
OBJECTIVES
Complex and diverse factors are related to reproductive health (RH) behavior among adolescents according to the social and cultural context of each countries. This study examined the prevalence of active RH and factors related to active RH behavior among Indonesian adolescents.
METHODS
A cross-sectional study was conducted among 1,040 of students who were selected through a multi-stage random sampling technique. A self-administered questionnaire was developed, including the World Health Organization Illustrative Questionnaire for Interview-Surveys with Young People, pubertal development scale, and sexual activity scale, modified in accordance to the Indonesian context. The data were analyzed using descriptive and comparative statistics, as well as logistic regression analyses.
RESULTS
The prevalence of active RH behavior were more higher in boys (56.6%; 95% confidence interval [CI], 50.6% to 62.6%) than in girls (43.7%; 95% CI, 37.6% to 49.8%). Negative attitudes towards RH were a factor related to active RH behavior in both boys and girls. Smoking and kind relationship envisioned before marriage (pacaran [courtship] and nikah siri [non-registered marriage]) were factors related to active RH behavior in boys; whereas the absence of access to information on substance abuse was an additional factor in girls. Moreover, an interaction was found between access to information on development and smoking (boys) and attitudes on RH (girls) as independent variables associated with active RH behavior.
CONCLUSIONS
Sex education for adolescents in Indonesia, particularly in the context of a health promotion program, should be developed based on prevalent social, cultural, and religious values to prevent active RH behavior. Such programs should focus on the kind of relationship envisioned before marriage and smoking for boys and access to information on subtance abuse for girls.
Lack of knowledge about reproductive health in adolescent, making teens easily influenced by misinformation and harmful to their reproductive health. Health education plays an important role in increasing their knowledge and behaviour of young people in order to maintain good reproductive health. The purpose of the research was to see the impact of health education on the knowledge and behaviour of adolescents in reproductive health. Paired t test analysis results indicate that counselling on reproductive health effect on both knowledge about reproductive health (mean difference: 10.216, 95% CI: 6.622 to 13.809) and attitude about reproductive health in adolescents (mean difference: 65.417, 95% CI: 11,176 to 61.690). Knowledge of adolescents about reproductive health would be beneficial in preparing the young people in good reproductive health issues so expect teenagers do not conflict with the norms prevailing in the community. Keyword: Adolescent Knowledge and behaviour Reproductive health
Objective:
The study aimed to determine the level of knowledge and the sources of information about normal puberty and menstrual patterns in Turkish schoolgirls from İstanbul.
Methods:
The study sample was comprised of 922 randomly chosen schoolgirls. A questionnaire survey of knowledge of normal pubertal development and menstrual patterns was conducted.
Results:
The age of the girls ranged between 10 and 17 years and 82.3% had had menarche. The leading source of pubertal information was the mothers (84.2%). There was no statistically significant relationship between the mothers’ education level and the level of knowledge of the students about pubertal development (p>0.05). The main source for 18% of students was their teacher, but only 6% had a preference for their teacher providing education on this topic. Students who attained menarche preferred education about puberty to be given by health professionals and to both genders at the same setting (p<0.01). A total of 31.5% of students thought that the first symptom of puberty was acne. Half (50.7%) of the students did not know the time period between the beginning of puberty and menarche. The girls who had attained menarche were more knowledgeable about puberty, largely through their own experience.
Conclusion:
This study shows that schoolgirls have an insufficient level of knowledge about normal puberty. Education programs must be conducted for students and their parents.
Background
Evidence suggests that in spite of some adolescents being sexually active, many parents do not discuss sex-related issues with them due to lack of age-appropriate respectful vocabulary and skills. The likelihood of parent-adolescent communication improving sexual and reproductive health outcomes appears plausible. The desire to understand parent-adolescent communication and how to improve it for promotion of healthy sexual behaviours inspired this research. The paper is meant to describe perceptions of adolescents, parents and school administrators about parent-adolescent communication on sexual issues; describe the content of such communication and identify factors that influence this communication.
Methods
The study was done among two urban and two rural secondary school students in their second year of education. Data were collected from 11 focus group discussions and 10 key Informants Interviews. Data management, analysis and interpretation followed thematic analysis principles. Illuminating verbatim quotations are used to illustrate findings.
Results
Parental warmth and acceptability of children was perceived by parents to be foundational for a healthy adolescent- parent communication. Perceptions of adolescents tended to point to more open and frequent communication with mothers than fathers and to cordial relationships with mothers. Fathers were perceived by adolescents to be strict, intimidating, unapproachable and unavailable. While adolescents tended to generally discuss sexual issues with mothers, male adolescents communicated less with anyone on sex, relationships and condoms. Much of the parent-adolescent communication was perceived to focus on sexually transmitted infections and body changes. Discussions of sex and dating with adolescents were perceived to be rare. Common triggers of sexuality discussions with female adolescents were; onset of menstruation and perceived abortion in the neighbourhood. Discussion with male adolescents, if it occurred was perceived to be triggered by parental suspicion of having female ‘friends’ or coming home late. Peers at school and mass media were perceived to the main source of sexuality information.
Conclusions
Communication on sexuality issues between parents and their adolescent children was infrequent and critical elements like sex and specifics of protection against undesirable sexual behaviour consequences were avoided. Peers, schools and mass media should be creatively harnessed to improve parent-adolescent communication about sexuality issues.
Background: Unwanted pregnancy is one of the major fertility as well as social issues of all times. Ever since mankind has prevailed, man has turned towards nature to solve a number of problems he came across, and nature has served him well. Unwanted and unexpected pregnancies are often gotten rid of by painful, costly and embarrassing surgical operations. What if, there was another way to do this without being going through all that pain and embarrassment? What if, nature has a cure for this problem as well? Yes, indeed it has! Certain natural herbs possess abortifacient properties that may help one to get rid of their undesired pregnancy without any sort of surgery. Objective: The aim of our study is to make people familiar with the natural abortifacients and their potent benefits over surgical abortion to give people an alternate way to end their undesired or unexpected pregnancy instead of going towards the infamous surgical abortion. Methodology: A survey was conducted that was based on 200 (n=200) people including common public, medical student , healthcare practitioners and different professionals just to know their general opinion about herbal abortion and to aware people regarding the beneficial aspects of natural herbs used in abortion in term of safety, cost and privacy issues. Result: The study showed that 97.5% of people know about abortion. Among those people, 46% were aware with the fact that the natural herbs can be used for abortion, while 54% of the people had absolutely no idea at all. Whereas, 41.5% think that these herbs can be harmful for our health, 45.5% considered these herbs as a better option, and 13% of the people had absolutely no idea about it. Conclusion: Natural herbs possess miraculous powers to compete with surgical abortion. Herbal abortion may prove to be a better option as compared to surgical abortion. The results we got from our study reveal people's lack of knowledge regarding herbal drugs for abortion, which makes people hesitant to use them. It's the job of our medicinal researchers and healthcare professionals to come forward and promote herbal method of abortion, which can prove to bring revolution in the life of people.
Background: In Nepal, as in other Asian countries, the issue on sexuality still remains a taboo. Despite this, there are increasing numbers of sexual activities reported among Nepalese adolescents. Objective : To know the attitude towards premarital sex and unwanted pregnancy of adolescent students. Methods : Three higher secondary schools were randomly selected and students of those schools were taken purposively with structured self administered questionnaires. Cross-sectional study design was adopted and significance levels were observed with 95% confidence level (pd.0.05 for significant). Descriptive and inferential analyses were done with the sample size 324. Results: Among the total respondents, 32.4% mentioned premarital sex is appropriate and 25% had premarital sex. One third (33.3%) of the total respondents. peers were taking alcohol, 37.7% had smoking habit and 8.3% had drug dependency. Among the respondents having experience of premarital sex, 61.7% had the first sex at the age of mean ± SD 17.72 ± 0.849 years. Among the boys 32.6% and among the girls 13.7% had the premarital sexual intercourse. Majority of boys and girls had first sex with girl friend and boy friend respectively. Among the total respondents who had premarital sex, 16% faced the problem of unwanted pregnancy. Among them, 53.8% managed the unwanted pregnancy by surgical abortion procedure and remaining 46.2% managed by taking medicine (medical abortion). Conclusion: Sexual and reproductive health of the adolescents is now growing concern for many developing countries due to increasing trend in sexual activities and unwanted pregnancies among the adolescents. Health Renaissance, January-April 2013; Vol. 11 No.1; 145-149 DOI: http://dx.doi.org/10.3126/hren.v11i2.8222