HEALTH AND EDUCATION SECTOR COLLABORATION IN ADOLESCENT SEXUAL AND REPRODUCTIVE HEALTH IN SRI LANKA: A situational analysis and case study of the Kalutara District
Adolescent sexual and reproductive health (ASRH) issues are multi-factorial and are underpinned by biological as well as social determinants. These issues include sexual abuse, family dysfunction, poor parenting, poverty, low education and socio-cultural issues. In addition, service delivery gaps affect adolescent use of facilities and access to information. This complex environment demands intersectoral interventions and the collaboration of human resources (HR) beyond health.
A minimum package of adolescent sexual and reproductive health services and a service delivery model should be developed between health and education sectors. This can address provider, knowledge and skills gaps, attitudinal issues, provide support and encourage team work thereby enhancing health outcomes for adolescents.
Such a package requires workforce collaboration between primary health care workers, teachers and counsellors which should be fostered through cross cadre teambased approaches to education and training, clear referral pathways between sectors and performance management.
This collaboration must be supported by appropriate ASRH policy, adequate funding, planning and legislation across both the health and education sectors.
Adequate monitoring and evaluation of ASRH programs in the health and education sectors is needed and must take into consideration HR issues and broader contextual factors in order to contribute to on-going quality improvement of ASRH programs.