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Enhancing Sexual Wellbeing in Scotland: A Sexual Health and Relationships Strategy: Proposal to the Scottish Executive
Footnotes
a NHS Health Scotland was established on 1st April 2003 from the merger of the Health Education Board for Scotland (HEBS) and Public Health Institute of Scotland (PHIS).
b Sexually Transmitted Infections (STIs) include HIV.
c This was developed with by a small Project Team with support and advice from a highly expert and widely experienced Reference Group, and was informed by an engagement process that invited input from NHS Board Sexual Health Strategy groups, their planning partners and other key stakeholders across Scotland.
d
http://www.who.int/reproductive-health/gender/sexual_health.html. This was discussed at an international WHO Technical Consultation on Sexual Health (28-31 Jan 2002), then refined and amended by a small working group thereafter.
e This strategy deals with the whole lifespan but seeks to emphasise the crucial role that is played by parents and carers of young people
f This could be the director with the functional duty to promote health and wellbeing, for example, or the director responsible for children's services plans, however in this case additional arrangements would be required to cover adults.
g In Scotland the target, set in
Towards a Healthier Scotland, is a reduction of 20% in the pregnancy rate in 13-15 year olds by 2010.
h The recently established Sexual Health and Wellbeing Learning Network, co-ordinated by NHS Health Scotland, will disseminate these lessons throughout Scotland.
i Comparisons of the attitudes and behaviours of young people have been summarised in terms of 'sexual competence'. NATSAL defines sexual competence by assessing variables relating to first intercourse: regret, willingness, autonomy of decision and contraception use.
j The term 'media' refers to the range of magazines, newspapers, advertising, radio and television productions and the internet.
k The term 'mass communications' means interacting with the general public via a variety of media.
l During the engagement exercise, the range of target groups suggested included young women and men, young people looked after or leaving care, LGBT people, teenage mothers, teenage fathers, disabled people, people with learning disabilities, women experiencing domestic abuse, homeless people, gypsies and travellers, BME communities, drug users, men who have sex with men, young offenders, the prison population, prostitutes/commercial sex workers, refugees and asylum seekers, individuals with HIV or AIDS, older people, parents. Some submissions stated that focussing on specific groups was not appropriate.
m The term prostitute is used here in preference to 'sex workers' or 'people working in the sex industry' which some feel suggest prostitution is something that people choose to do and that it can be legitimised as an acceptable form of work.
n The Sexual Health & Wellbeing Learning Network, based within NHS Health Scotland, has been set up to disseminate evidence-based practice and facilitate learning among policymakers, practitioners and academics.
o Local Sexual Health Co-ordinators are those who are responsible at NHS Board level for overseeing the activities of the managed sexual health network in their Board area (see paragraph 5.5).
p Throughout the report, reference will be made to NHS Board sexual health strategies. It should be noted that whilst the lead is accorded to NHS Boards, these strategies should be developed and implemented on a multi-agency basis drawing together all those with an interest in sexual health (e.g. in Community Health Partnerships, the NHS, local government and the voluntary sector and users).
q SHARE = Sexual Health and Relationships: Safe, Happy and Responsible
r NATSAL defines sexual competence by assessing variables relating to first intercourse: regret, willingness, autonomy of decision and contraception use.
s Adults are defined as everyone over 16 years of age.
t For the smaller or Island Boards, Tiers 4 and 5 may have to be provided by a neighbouring service provider as part of a service level agreement.
u For up to date statistics see
http://www.show.scot.nhs.uk/isd/sexual_health/sexual_health.htm and
www.show.scot.nhs.uk/scieh).
v The most up to date information is available directly from ISD and SCIEH at
http://www.show.scot.nhs.uk/isd/sexual_health/sexual_health.htm and
www.show.scot.nhs.uk/scieh.
w For more information see the Scottish RapeCrisis website at
www.rapecrisisscotland.org.uk.
x The range of members should reflect the wider determinants of sexual health and the range of sexual health service providers, but could include representatives from or specialists in public health and epidemiology, GUM and family planning medicine and nursing, primary care, Local Authorities, school based education, social inclusion, health promotion, voluntary sector, HIV community, user and self help groups and research/academia.
y For some areas this may require an additional post whilst in others, service redesign might free up space within an existing postholder's responsibility.
z This could be the director with the functional duty to promote health and wellbeing, for example, or the director responsible for children's services plans, however in this case additional arrangement would be required to cover adults.
aa If a patient visits health care services after contact with a sexual health advisor, this will constitute a successful outcome. This will have to be agreed locally as current data collection deficiencies do not allow for the tracking of patient attendances across different settings. Improvements in data collection should address this (see paragraph 5.16)
bb for those attending family planning and GUM clinics, infertility clinics, termination services and those attending for their first cervical smears and for all under 25 attending their GP
cc Personal communication: National Resource Centre for Ethnic Minority Health
dd Definition laid out in the national strategy to eliminate domestic abuse in Scotland, written by the Scottish Partnerships on Domestic Abuse and published by the Scottish Executive in November 2000.
ee Female Genital Mutilation: a joint WHO/UNICEF/UNIFPA statement', WHO:1997, p.3
ff Scottish Office.1998. New Community Schools Prospectus. Edinburgh: Scottish Office.
www.scotland.gov.uk
gg Aggleton p, Oliver C, Rivers K. Reducing the rate of teenage conceptions - The implications of research into young people, sex, sexuality and relationships. 1998. London: Health Education Authority.
hh
http://www.who.int.org
ii Adapted from Scottish Development Centre for Mental Health, Scottish Council Foundation and Office of Public Management.
Building community well-being: an exploration of themes and issues. 2003. Edinburgh: Scottish Executive.
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