Know the terms

Family planning refers to thoughtful decision making around when to have children, how many to have, how often to have them and how to prepare yourself to raise a family.

Reproductive health refers to the ability for individuals to have a responsible, satisfying and safer sex life and to reproduce when and how often they desire. Implicit is access to safe and affordable methods of birth control and access to health care.

My parents still think that I shouldn't talk about it because I am young and it is kind of obscene.

Modern methods of birth control

Condoms

What are they?

Latex or plastic sleeves that are worn on the penis. If put on properly, they are safe and effective.

Cost: $1 each (are often distributed for free)

Reliability of protection:

Pregancy: 90-98%

STD protection: Yes

Birth control pills

What are they?

Once-a-day pills that, when taken on schedule, are very effective at preventing pregnancy. Convenient to take and easy to get with a prescription.

Cost: $15 to $50 a month

Reliability of protection:

Pregancy: 95-99%

STD protection: No

IUDs

What are they?

A small t-shaped device inserted into the uterus to prevent pregancy. Costs from $500 to $1,000 but lasts for up to 12 years. Must be inserted by a doctor.

Reliability of protection:

Pregancy: 99%

STD protection: None

Condoms

What are they?

A substance that prevents pregnancy by stopping sperm from moving. Safe and convenient and easy to use.

Cost: up to $8 a package

Reliability of protection:

Pregancy: 89-91%

STD protection: No

Abstinence

What is it? Not having sex

Cost: free

Reliability of protection:

Pregancy: 100% STD protection: Yes

Condoms, birth control, abortion, abstinence; the list of terms under the umbrella of “family planning” goes on. But while these practices have been well-publicised in the West, many Cambodians don’t know what family planning is, let alone how it should be practised.

Due to a simultaneous rise in the level of sexual activity among youth, along with increased risks associated with those activities due to the rising prevalence of sexually transmitted diseases, information around family planning and reproductive health is vital to today’s youth And it is youth themselves who have driven a recent nation-wide effort to spread the word.

“We select both male and female students from high schools and communities and train them to go back to their schools and villages and teach their friends,” said Dr Or Sivarin, community health specialist in charge of family planning at Reproductive Health Association of Cambodia, which, in 1998, launched a reproductive healthcare initiative called Active Peer Educators. In July, 2010 RHAC had 1,107 peer educators working in 38 schools and 2,461 peers working in 1,461 villages in 10 provinces.

USAID, a non-profit partner in the government’s reproductive health programme, also activated youth to spread the message about how to be safe. Their peer education programme, which uses a network of 11,800 unpaid volunteers aged 18 to 24 to educate other young people about issues such as reproductive health, has taken its message to 460,000 young people in more than 1,000 villages through group discussions, dance performances and mobile videos, according to their website.

A 2008 survey conducted by USAID showed 71 percent of young people reached by peer volunteers knew the consequences of early pregnancy, a 19 percent increase over those not reached by the programme. Fifty percent of youth reached by the programme could accurately name two methods of contraception, a 13-percent increase over those not reached.

As part of their reproductive health initiative, the Ministry of Health has also partnered with donor agencies to produce public service spots broadcast through radio and TV.

Dr Paou Linar, the head of Child and Maternal Health Care in Phnom Penh’s Municipal Health Department, said that if youth go into parenthood unprepared, they might face poor living standards and other complications. “Youth should know about family planning so they can plan for the prosperity and happiness of their future family,” he said.

The impact of ignorance about reproductive health is severe, said Dr Suon Bophea, youth health manager at RHAC. “If a young woman becomes pregnant while studying, she may drop out of school and face discrimination from her family, friends, and society,” he said. “She may even commit suicide, or decide on abortion, which leads to other problems that may affect her physically, mentally and socially.”

Or Sivarin said her organisation has established 18 clinics in Phnom Penh and seven other provinces that provide family planning consultancy and services.

While the government, donor agencies and NGOs have made great strides in the last decade, it has not always been easy to involve youth in education projects, Suon Bophea said.

“Students have to study, so they don’t have much time for us, and sometimes we don’t get the cooperation from the school principal and teachers,” he said. “In the village youth have to work to support their family.

“Some parents and old people in the village do not allow their children to learn about family planning because they think that it is obscene, and that youth will do something bad after learning about it.” In response, RHAC tries to explain that an open dialogue will not encourage the behaviour but allow youth to deal with problems that might arise, said Suon Bophea.

According to an evaluation done by RHAC last year, 82 percent of Cambodia’s youth knew at least three forms of birth control, and many of them talked about it openly with friends.

Sam Chancheyseth, 22, a university student, said he knew about birth control, and often talked about it with his friends.

“Some of my friends have girlfriends or like hanging out at night, so we usually talk about how to use condoms to protect ourselves and prevent pregnancy,” he said, but added he dared not talk to his parents about it. “My parents still think that I should not talk about it because I am young and it is kind of obscene.”

But gains still need to be made, as some Cambodian teens still feel inclined to stay silent about sex-related subjects.

“Women should not openly talk about sex,” said Sin Chhorvivan, an 18 year-old female high school student. “I feel so shy while talking about it and I’m afraid guys will gossip.”

For more information about RHAC centres and services, visit www.rhac.org.kh