“Trusted information about sexual and reproductive health is fundamental for adolescents”

"Adolescent health care is fundamental because between ages 10 and 19, decisions are made that define a person's future.  It does not seem so at first sight to most people, fathers or mothers, but adolescence is the time when self-esteem is consolidated, it is the window of opportunity to establish the bases for body care, to know how to exercise sexuality in a healthy way, and to define a life plan that leads to fulfil goals and dreams", says Dr. Butrón.

The "3 de Mayo" Health Centre of the Corea Health Network in district 3 of El Alto, is one of the few centres with specialized staff in adolescent health.  Dr. Karen María Butrón Choque, is one of them, she is a general practitioner with a specialty in differentiated adolescent care from the Catholic University of Chile. 

Until the end of April 2022, 51 adolescents between ages 10 and 20 attended the Comprehensive and Differentiated Adolescent Care (AIDA) consultation at this health centre.  According to Butrón, this number of visits surpasses all the other facilities of the Corea Network. She acknowledges that the strength of the centre is the alliance they have secured with the "3 de Mayo" Educational Unit, where they go to provide information on sexual and reproductive health and let the adolescents know that they have a reliable service where they will be treated with respect and discretion.

The trust they have built with the educational unit has allowed Butrón to stablish a WhatsApp group with adolescents interested in sharing information on sexual and reproductive health. "They often prefer to go to their friends, to talk about their concerns, so for me it is essential to have this group of empowered adolescents who help me to get their peers to come to the service and receive the guidance and advice they are looking for."

Such is the case of 20-year-old Scarlet, who is part of the group, she says that the first time she went to the centre was to ask for information requested by her 16-year-old neighbour friend.  "She needed to know how to prevent pregnancies because she is already having sex with her partner.  I shared with her all the information I received from Dr. Butrón and it has certainly helped her.  She prefers not to go to the health centre, but she knows that the service exists."

Ronald, 19, confidently says: "I prefer to come here and get the care and information I need because what is on social networks may or may not be reliable.  I tell my friends that, when in doubt, go to the clinic and they can also receive free contraceptives. I don't have a partner, but I want to be prepared when I have one and to know how to act."

"What most affects adolescents is the lack of knowledge of their sexual and reproductive rights, specifically information on contraceptive methods, on how to avoid sexually transmitted diseases and HIV, and then other pathologies such as eating disorders or dental disorders are treated in consultation," says Butrón.

The attention considers the life factors that affect the adolescent, such as: family, friends, school, the possibility of addictions, whether they have dreams or goals.  It has happened with some frequency that mothers or fathers come together with the adolescent to the consultation and realize that their son or daughter is a victim of violence either within their own home or at school. 

One resource that Butrón uses is the violentometer, which is a graph showing all forms of violence from the mildest to the most serious. "With this scale I can know what type of violence an adolescent is suffering. For example, if it is a case bullying in the school, I go to the educational unit and give talks to the whole students or class about violence, because the violent adolescent himself may be a victim of his peers or at home."

Differentiated care for adolescents suffered a setback with the pandemic; the service was beginning to receive resources for personnel and supplies, but COVID-19 care and prevention had to be prioritized. In this regard, Butrón comments: "We have provided care and training online, and even at the peak of the pandemic we have received requests for AIDA care, a situation that shows the obvious need that adolescents have."

"My greatest satisfaction in caring for adolescents is to assist them with help and guidance at such critical time of their lives.  I like when they leave happy and empowered with the information they receive.  Adolescents now can access information and services that were unthinkable when I was young, and what I didn’t receive, now I want to give to them. I tell my colleagues in the health system to use the AIDA approach in the attention of adolescents and to apply the care guidelines and protocols we have worked on the Corea Network together with the Regional Health Service and the support of UNICEF.”