Presented at an International Graduate Student Conference on Indonesia, October 30-31, 2013, Graduate School of Gadjah Mada University, Yogyakarta
This paper will review about adolescent reproductive health education for the students at the school. Adolescent reproductive health problems both boys and girls into a problem that must be addressed early, so teenagers can avoid things that can threaten the health of reproductive organs. Adolescents between 13-19 years of age is a time when teenagers are still at the level of junior high school (SMP) and upper (SMA). Complaints about the girls of reproductive organs were more often perceived than boys.
The cases occurred in Indonesia about sexuality among students and such, student of junior high school at Surabaya to be pimps and child prostitutes (06/2013), sex gathering of students at Situbondo (12/2012), junior high school students is impregnated by facebook friend (08/2012), student of senior high school has a baby 2 months old (06/2012), senior high school students at Seluma give birth after mid term exam (10/2012), vocational high school (SMK) at Ponorogo give birth in the toilet, and many other cases.
The pattern of adolescent reproductive health education for the students at the school most often held by various parties that will be presented in this paper. At once include material Adolescent Reproductive Health (ARH) to the Guidance and Counseling services (BK) in class, and enter the lessons on Biology, the lessons on Health and Sport, and the lessons on Religion in class. Then, through the establishment of Information and Counseling Center (PIK) at school to realize Teens Steadfast (Remaja Tegar), which encourages students to prevent getting infected diseases of reproductive organs and to refrain from sexual intercourse before marriage.
Keywords: Education, Counseling, Reproductive Health, Student
Growth of adolescents is characterized by the organs begin to mature sex, puberty and physical development can look from the body, like the chest, hips and other areas. Growth sex glands (gonads) of teens is a process that occurs in the body, and experts argue that the sex glands growth is what actually cause protrusion beyond the physical development.
In early adolescence, the development of sexual behavior is a direct result of the growth of sex glands. It becomes very important to pay attention the adolescent social interaction, it is possible that he or she met and tried to approach the opposite sex. Young boys begin to move to approach a girls, and girls adolescents has magnets to show the beauty and fragrance of her body, and actively respond to the approach taken by boys teenage. The seeds of love has grown in the hearts of the youth. (Noegroho, 2010a )
According to the definition of WHO in Sarwono (2010), the age limit 10-20 years is youth age period. The age of limit is divided into two parts, as the age limit 10-14 years is early adolescent period, and late adolescent period of 15-20 years old. In this paper, the teenagers are the students in junior high school (SMP) in the early teens, and senior high schools (SMA) in the late teens.
Stephen T. Russell Sigler and Nicole Andrews in Villarruel et.all (2003:146) argues that adolescence is a period when many people get the experience of sexual expression for the first time. The period for most teenagers, used to learn about intimacy for the first time, as dating, kissing, holding hands with a boys or girls friend, as well as identify their sexual orientation and gender differences with peer friends.
Start from that problems, the question research is how are the shape of adolescent reproductive health education in schools through preventive behaviors affect the reproductive health of adolescents? The purpose of this paper describes the various of pattern to manage the adolescent reproductive health education in junior and high schools at Banyumas residance Central Java.
Understanding the health counseling by Anwar (1983 ) in Machfoedz and Suryani (2006) is a health education activities carried out by spreading the message to the people that they are not only aware, know and understand, but also willing and able to perform a suggestion that they has to life with health. Health education can be interpreted as a form of non-formal education to change knowledge, attitudes and skills of a person or group of people so that he is able to help themselves to improve the quality of life of the less healthy to be healthy .
Health counseling in this paper is on adolescent reproductive health. According to the World Conference on Women in 2000 in New York agreed definition of reproductive health is a state of complete physical, mental, and social as a whole, not merely free from disease or disability in all matters the reproductive system and its functions and processes. (The Indonesia Department of Health Ministry, 2001). Implementation of policies on adolescent reproductive health by the Indonesian government in this regard contained in the target program BKKBN is Adolescent Reproductive Health (ARH). It is for teens and their families that have the knowledge, attitudes and awareness of reproductive health behavior and then they can prepare as a family that qualified in 2015 (BKKBN, 2002)
Adolescent reproductive health is defined as healthy condition at least socially, physically, and mentally related with the system, functions and processes of reproductive which are held by teenagers. John L. Taylor in Hughughi et.all (1997:121) describes the area for assessment of sexual knowledge and attitude:
1 ) Biological Reproduction
2 ) Puberty
3 ) Sexual Health
4 ) Masturbation
5 ) Sexuality in a comprehensive manner
6 ) Build Relationships
7 ) Sexual intimacy
8 ) Role of Sex
9 ) Sex and the Law
Adolescent reproductive health efforts that have been made such as promotion, which encourages healthy behaviors in reproductive organs, this circumstance is often used in the Health Sciences as Health Promotion (Notoatmodjo, 2007) or the terms of Information- Education and Communication (IEC). Promotive process are also followed the preventive orientation, which prevent teenagers from getting infected of reproductive organs diseased and unwilling pregnancy.
To respond to the adolescent problems, promotive and preventive government in this case the National Family Planning Coordinating Board (BKKBN) since 2008 has been implementing and developing programs Adolescent Reproductive Health (ARH) through the establishment of Information and Counseling Center (pusat informasi dan konseling or PIK) which are directed to achieve the teens in order to prepare the Small Family Happy Prosperous. The indicators of teen are teens that delaying the age of marriag , teenage healthy behaviors, avoid the risk of TRIAD (Sexuality, HIV/AIDS, and drugs), being model, idol and source of information for peers.
PIK – KRR or Information Center Counseling – Adolescent Reproductive Health program is a contain activity that from, by and for youth to provide information and services on reproductive health counseling and other support activities . In addition, as a package to provide solutions, advice and solutions to peers who have social problems, reproductive, and drugs. This is consistent with the tendency of teenagers who prefer talk about their problem with peers. Youth Health Club through the “karang taruna” and schools/universities devide through three stages: “Tumbuh” Growing , “Tegak” Upright, and ‘Tegar” Tough. This stage will be reached when the PIK Youth/ student meets the established with several indicators. One of the indicators that must be met is the amount of activity, Peers Educator (PE), and Peers Counselor (PC) have trainned to provide the correct information to their peers. In order to, it also needs of managers, supervisors and staff that have trained as a workshops in level province . In the training course required of trainers who have competencies as service provider in order to supply the needs of trainers in each group of youth.
Institution of Family Planning Field Workers ( PLKB ) has coordinated with group of PIK – KRR /Information Center Counseling Adolescent Reproductive Health in “youth activity in karang taruna” and the school to held the PIK Youth. The activity of PIK is carried out the youth among others with lectures and discussions, outreach through school forums, meeting community agencies, counseling through a movie, leaflet, banners appeal, sympathetic action / movement through the distribution of stickers and moral action with adolescents .
According to the Health Belief Model that preventive health behaviors are influenced by perceived health, while health perception is influenced by a variety of information from outside; case of education, the mass media, advice from peers, teachers, parents. The significant internal factors such as attitude seriously, feeling vulnerable, sociopsycological and demographics. The reproductive health education does not directly influence the behavior of adolescent preventive reproductive health . But at least the adolescent reproductive health education through youth PIK both at school and at home can shape health perceptions and influence sexual behavior before marriage for the better and the prevention of sexually transmitted diseases in young adults.
Adolescent reproductive health education that conducted by the school is an effort to guide the teens cope with sexual problems. Various model such the schools and teachers implement the reproductive health matter by entering into Biology lessons, Health and Sport lessons, and Religion lessons. This strategies in Yogyakarta has implemented and receive enough attention from the BKKBN is SMA Muhammadiyah 2 Yogyakarta.
Other forms of health promotion activities held in school is inviting stakeholders to health, such as BKKBN, the medical or midwife at the health center (Puskesmas) come to the school to provide adolescent reproductive health education to students grade 7,8,9 (SMP) and grade 10,11,12 (SMA).
The role of the teacher BP (guidance and counseling) is provide guidance to many students especially related to adolescent relationship between boys and girls student. Then provide information on the class, the teacher BK also perform the task of face-to-face counseling with troubled students to help get the right solution, so that students succeed in studies and career.
A study conducted by Rinawati (2011) found the conclusions : (1) promotion of adolescent reproductive health can affect sexual behavior before marriage to be better in adolescents in the Village District Jabon Mojoanyar Mojokerto regency. (2) Promotion of reproductive health of adolescents may affect the prevention of sexually transmitted diseases became better on teens in the Village District Jabon Mojoanyar Mojokerto regency. (3) promotion of adolescent reproductive health can affect sexual behavior before marriage and the prevention of sexually transmitted diseases became better on teens in the Village District Jabon Mojoanyar Mojokerto regency .The suggestion resulting from her research is the promotion of adolescent reproductive health should be given at home, in schools, youth and community in order to have sufficient knowledge to be able to behave healthy sex .
The first pattern of adolescent reproductive health education for the students at the school is integrate the material Adolescent Reproductive Health (ARH) to the Guidance and Counseling services (BK) in class to help find the solution of the problem with student health and success study. The second pattern is the material Adolescent Reproductive Health (ARH) include the lessons on Biology, the lessons on Health and Sport, and the lessons of Religion in class. Then, through the establishment of Information and Counseling Center (PIK) at school to Realize Steadfast Teens (Remaja Tegar), encourages students to prevent infected diseases of reproductive organs and sexual intercourse before marriage .
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