Data on adolescents’ sexuality and
reproductive health is needed for
the development of appropriate
and effective programs to address
the health needs of adolescents
in the Cook Islands. Health policy
makers, program managers and
service providers need relevant data
to enable them to make informed
decisions and direct their efforts
towards meeting adolescents’ needs
and the corresponding demand for
need based interventions. Despite
the availability of Adolescent
Reproductive Health (ARH) services
in the Cook Islands, teenage
pregnancy rates continue to be
relatively high suggesting a lack
of utilization or access to quality
contraceptive services. To date,
there is little available information
related to utilization of services
by adolescents in Rarotonga,
particularly for the prevention of
unintended teenage pregnancies.
The goal of this study was to
determine the factors contributing
to the low utilization by adolescents
of Government and NGO family
planning clinics or community based
services that have been available in
Rarotonga, Cook Islands.
An exploratory qualitative study with
focus group discussions, in-depth
interviews and observations was
undertaken. This was accompanied
by a quantitative element involving
a school-based survey of students
to determine their knowledge
and attitudes towards teenage
pregnancy as well as utilization of
health services. The respondents
comprised both males and females,
15-19 years of age, and health care
providers.
Major results found that a higher
percentage of students were
knowledgeable about family
planning, where to go for services
and the factors associated with
teenage pregnancy. However, very
few used contraception. Participants
in the study stated that to increase
utilization of Sexual Reproductive
Health (SRH) services by young
people there was need for a separate
youth friendly clinic in communities
close to them which had hours
convenient for youth.
Recommendations relate to
improved awareness activities at
the national and community levels,
particularly Information, Education
and Communication (IEC) /
Behavioral Change Communication
(BCC) interventions. It is hoped
that, through the utilization
of the outcomes of this study,
the community: church, village
community and family as well as
Ministries of Education and Health,
will be able to work together
to support adolescents’ needs
in reproductive health. Specific
recommendations include the
establishment of ASRH counseling
centres/clinics, strengthening of
peer education activities, improved
behavioural change communication
interventions for young people
and the training of health care
providers in youth friendly services
establishment.