1. Values clarification: making meaningful reproductive choices
Dr Delene Botha
School of Nursing
University of the Free State

2. Objectives of reproductive health
HEALTH PROFESSIONAL
Provide factual correct information
Provide services
Enable and support responsible voluntarily decisions about childbearing and family planning
Meet changing reproductive health needs over the life span… sensitively
Still today, with Google and all, teenagers do not have the correct information about reproductive health issues..
We are looking at teenagers, but what are adults meaningful reproductive health care choices?

3. Strategies to end maternal and child mortalities: facing teenage pregnancy

4. Meaningful reproductive health choices…
“What is meaningful reproductive health choices?”
It is a choice that is:
significant, deep, far reaching….
Having an important effect…

5. Expecting this from our teenagers?

6. … to make serious choices about reproductive health?!

7. “The teenagers’ brain”

8. Values: some facts… did you know..?
We are not born with values….
Morris Massey (sociologist) describes three stages:
Imprint period: (birth-7 years): “sponges” absorb as much as they can accepting all as true, especially if comes from the parent (“blind acceptance”).
“follow what they see…”
Modeling: (8-13 years): “copy people’s behavior” rather than blind acceptance
Impressed by teachers, religion
Socialization (14-21 years): Influenced by peers; turns to people who “seem to be more like myself…!”
MEDIA

9. MEDIA!!! Emphasize “sexual double standards…”
Two different sets of standards – male and female

10. Responsible reproductive health education programme
Three phases
1 – Caring for a “baby”
2 – Values clarification
3. “Bringing it together”

11. Values clarification –Grade 8 learners
Grade 8 learners: average age: yrs
According to Massey’s model: modeling, socialization
“copy people’s behavior” rather than blind acceptance,
impressed by teachers, religion
Influenced by peers; turns to people who “seem to be more
like myself…!”
MEDIA

12. Purpose Grade 8 learners to identify their main values (n=185)
Link this to meaningful reproductive health…

13. The instrument (adapted from the Iceberg Model of Human behavior)
Three main headings:
Personal values
Socio-economic values
Sexual and reproductive health values
Under each heading 9-11 items
Learner chooses: A= most, most important, B, less….G= least important

14. Findings: (“how important is it for you to have…”-responded with A,B -G) Personal values
Achievement (get results, completes tasks)
Advancement ( Moving ahead, striving to grow)
Assertiveness (being able to say “no”)
Independence ( self-reliant, freedom from others’ control)
Inner harmony (being at peace with oneself /do not hold grudges)
Integrity (honest, sincerity, living by your values)
Health/ well-being (Free from disease)
Pleasure ( always having fun, enjoyment)
Kindness (do good to others)
Humility (being humble)
Respect (for yourself and others)
Achievement was mostly chosen – one would think independence or assertiveness would be more popular

15. Personal values - achievement
Blue was A choices; 48%; Brown B choices 6.5%; A+B grey =55% so more than half of the group chose achievement as most/second most important

16. Socio-economic
Acceptance by peers
Education ( commitment to learning)
Freedom from financial worries
Fame (being well known)
Family happiness ( getting along, respecting family members)
Friendship (close companionship with others)
Prestige (showing success, rank, status)
Spirituality (strong belief in God, devotion)
Wealth (material prosperity, abundance)
Expect acceptance by peers to be a popular choice or friendship; Education and family happiness was mostly chosen

17. Socio-economic –education
Blue = A choices 12.4%; Brown 9.7% and together =24.1% about a quarter of the group chose education as a socio-economic value

18. Socio-economic: family happiness
With regard to family happiness – one A choice! 5.9% Orange; E and G both 9.7% = 18 choices

19. Sexual and reproductive health choices:
Abstinence (not to have sex)
Becoming a parent
Body image (your feelings about your body)
Caring for a baby (feeding, nappy changing etc.)
Dating
Self-concept (do you like yourself?)
Sexual engagement (being sexually active)
Talking to your parents- (about sex)
Talking to your peers (getting information; sharing about sex)
Talking to any other adult (teachers, nurses, neighbor)
Teenage pregnancy (Avoiding pregnancy, prevention)

20. Sexual and reproductive health choices:
Standing out: F choices for self-concept. A choices? Abstinence…only 6%? Avoiding pregnancy??? Dating!?

21. Discussion: Personal values:
Achievement – real value, or modeling period?
Socio-economic value:
Education -real value, or modeling period?
Family happiness –E + G (5th and 6th choices)

22. (discussion –continued)
Sexual and reproductive health values
6% A; in total 24% chose the value - ?out of 185?
Body image – for most the 6th choice
Dating: - less than 2%!!! As a first choice -? Validity
Self-concept: 6th choice the most…
Talking to: parents and peers – few; other adults: 4th and 5th choice
Avoid pregnancy….seemingly not everyone’s choice?!

23. Conclusion:
Limitations: the learners could maybe misunderstood the instrument…
“Halo-effect” provide the “correct” answers
What we have learnt: “what we want, is not necessary what learners want…”
Take note of “talking to other adults…” (professionals, we have a role to play!!)
Getting to meaningful reproductive health is a complexed task…

24. Thank you!