Washington DC : PAHO, WHO, 2013. 19 p.
Pan American Health Organization, PAHO
This Caribbean adolescent sexual and reproductive health (ASRH) situational analysis is informed and structured by two conceptual frameworks: the Mapping Adolescent Programming and Measurement (MAPM) framework and the Ecological Framework for Health. The MAPM framework complements the logical framework and other tools for designing, monitoring and evaluating programs. It begins by defining the outcomes that are subject to change. For the purposes of this analysis the ASRH outcomes analyzed are HIV, sexually transmitted infections (STIs), adolescent pregnancies and abortions. The framework then identifies the behaviors that are directly related to these outcomes. For HIV, STI and adolescent pregnancies we examine age at sexual initiation, age differences with partners, condom use and multiple partnerships. Once the behaviors have been identified, risk and protective factors associated with ASRH are determined. There are numerous ASRH risk and protective factors including alcohol and drug use and sexual violence, among others. The framework then determines program interventions in order to increase protective factors and decrease risk factors. For the purposes of this document, not only will programmatic interventions focusing on particular determinants be reviewed but policies, laws and social environmental factors as well, that are related to outcomes. The Ecological Framework supplements the MAPM framework by examining the contextual issues affecting interventions, determinants, behaviors and outcomes. According to this framework, individual characteristics and behavior are framed and influenced by relationship experiences, community contexts, and social contextual factors. Use of this framework enables an understanding of the vulnerabilities arising from experiences and contexts that limit and shape action.
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