Martin van Rijn, State Secretary of Health, Welfare and Sport in the Netherlands highlights how in all their programs they aim to build awareness and resilience to sexual health problems.
In the Netherlands we have found that an integral approach is the best way to promote good sexual health. Sexual health covers much more than controlling sexually transmitted infections (STIs). Sexual health is about enjoying healthy relationships based on equality and being resilient. Sexual health is about access to reliable education and contraception; about the reduction of unintentional pregnancies and about combatting sexual violence.
The gains of this integral approach can be measured by the broad access to low-threshold facilities, by good comprehensive sexual education and by a relatively low number of teenage pregnancies and abortions.
This article focuses on the sexual health of young people. From the age of 12 until the mid-twenties, people undergo almost continuous and critical changes in their sexual development. In order to gain an insight of the state of the sexual health of young people, I have commissioned a program to monitor this group at 5 year intervals.
STI-clinics and local health authorities
At the base of the Dutch approach lies the regular health care system. General practitioners work according to standardised guidelines on sexual health. They offer STI testing and care, as well as referral to regular specialised help in case of unintended pregnancies, abortion or sexual violence. Additionally and in support of public health issues relating to infectious diseases I subsidise STI-clinics and sexuality counselling by local health authorities.
These facilities test for and treat STIs, including HIV, but they also deal with regular sexual health issues. Low-threshold help is offered free of charge, anonymously if needed. It is offered to targeted, well-defined high risk groups, vulnerable populations, young people and victims of sexual violence. STIs and HIV are not mandatorily reported diseases in the Netherlands, but thanks to the monitoring and registration at these sexual health care centres, we can gain a good insight into the incidence of STIs in key populations, including young adults. Other sexual topics can likewise be monitored. Moreover, local health authorities have customised their approach to fit the needs of young people by offering e-health facilities such as chat and email consultations.
Non-governmental organisation (NGOs)
Several NGOs receive government funding to support professionals in various settings of sexual health. NGOs, in cooperation with the local health authorities, provide comprehensive sexual education in schools. They have also developed educational resources about love, relationships and sexuality, such as the docu-series ‘Long live Love’. These resources address the needs of secondary schools but are adaptable to the needs of other schools, such as vocational institutions. The series covers issues such as puberty, falling in love, relationships, sexual diversity, safe sex, contraception among others, in an integrated way.
Another example is the widely appreciated television program ‘Dokter Corrie’ aimed at primary school children. The program dares to touch taboo issues in a humorous and respectful way.
NGOs have also developed specific resources for social media; some of which have received awards internationally for their innovative approach and broad reach. I am very proud of the recently international acknowledgement of the website www.sense.info, a website with interactive information on all sexual health related topics, inclusive the online game ‘Can you fix it’ in which youngsters themselves can direct the outcome of a film scene by changing the communication or behaviour of one of the actors.
The game was awarded the prestigious Lovie in the European online awards for winning gold as the ‘people’s winner’, as well as the jury’s silver award.
In all our programs we aim to build awareness and resilience, to allow young people to make informed and sensible choices, and to access reliable information and care when needed.
I believe sexual health requires ongoing attention because young people continuously reach new milestones in their sexual development as they mature. Also internationally, sexual health needs constant awareness. In the first place because infectious diseases themselves are crossing borders, but also because sexual health is still a complex and difficult topic, not in the least because of cultural differences, association with shame and stigmatisation. This trend will only increase, because of the globalisation, with more people travelling, migrant problems etc. The subject also affects human rights, violence, human trafficking and infectious disease control.
Different countries need different solutions, but we can learn from each other. As a start, let’s all aim for meeting the goals set internationally by the WHO, UNAIDS and ECDC in the elimination of HIV. For instance, even though the Dutch are a worldwide exception to the rule of HIV being a notifiable disease, the Dutch approach of registration and monitoring of people in care is exemplary. All HIV-treatment centres enter patient data into a national registry guaranteeing a well-documented continuation of care. From this data, it is evident that the Netherlands meets the international goals.
In the same way, we are determined to achieve our aims of an emotionally and physically resilient, well-informed youth population in our own cultural setting.
Martin van Rijn
State Secretary of Health, Welfare and Sport
Ministry of Health, Welfare and Sport – Netherlands