Reproductive and Sexual Health Program Assessment Report, Semester 2

This report assesses the reproductive and sexual health (RSH) services provided by SHINE SA, a non-profit organization in South Australia. It examines SHINE SA's alignment with national and state policies, detailing the services offered to various priority populations, including Aboriginal and Torres Strait Islander communities, people with disabilities, and the LGBTIQ community. The report evaluates specific programs based on research evidence, highlighting strengths like the Sexual Healthline and rapid HIV testing, while also acknowledging areas for improvement, such as addressing rising STI rates. It concludes by emphasizing the importance of tailored approaches, particularly for young adults in Aboriginal communities, and offers recommendations for enhancing RSH service delivery. The report provides a detailed overview of the organization's impact on the community.

Running head: ASSESSMENT 2
Assessment 2
Subject: Reproductive and Sexual Health
Name of the Student
Name of University
Author’s note

1
ASSESSMENT 2
Introduction
Reproductive and sexual health (RSH) is regarded as the principal components of the
human life (Australian Institute of Health and Welfare [AIHW] 2018). Even before a decade, the
discussing reproductive and the sexual health was a taboo and people used to refuse to avail
healthcare access even if they are suffering from reproductive problems or complications
associated with their sexual life (AIHW 2018). The following assignment will review the
RSHrelated services provided by an organization and the selected organization of choice will be
Sexual Health Information Networking and Education (SHINE) South Australia (SA). The
assignment will highlight the facilities provided by SHINE SA with a special focus to the
services for the indigenous population residing in the remote and in the rural areas. At the end,
the paper will evaluate the quality of services offered by SHINE SA and subsequent
recommendations in order to improve the healthcare services further.
Overview of the Organisation and alignment with national and state policy
SHINE SA was established as the principal Family planning Association in SA and at
present it has expanded beyond the traditional family planning services. It is leading non-profit
organisation that provides clinical services (testing for sexually transmitted infections and
contraception), sexual health counselling and promotion of gender well-being.SHINE SA has
Sexual Healthline in order to discuss RSH related problems with nurses confidentially. SHINE
SA works in association with the Department for Education and Child Development in order to
increase awareness about the sexual health among the students studying in SA schools (SHINE
2019).SHINE SA works in alignment with the national and state level policy and is registered
under the Government of SA as sexual health service providers. The main policies include SA

2
ASSESSMENT 2
Sexually Transmissible Infection Implementation Plan (2016 to 2018) proposed by the SA
Department of Health and Ageing (2016) and Sexual Healthcare Programs as designed by the
Aboriginal Health Council of South Australia Ltd (2019). It providers for clinical services to the
clients who are below 30 years of age or have Medicare card (Government of South Australia
2019).
Services and programs for Aboriginals and Torres Strait Islanders
SHINE SA has special services for the Aboriginal communities that aim to foster a safe
and inclusive environment for the Aboriginal and Torres Strait Islander population in order to
access services related to the RSH. SHINE SAhas Aboriginal focus Schools Programs that is
aimed towards increasing the overall capacity of the teachers and Aboriginal Community
Educators in the school communities so that they can increase the reproductive health literacy
among the Aboriginal children (age group of 5 to 10 years) (SHINE 2019).
Services for people with disability
The services that are provided for the people with disability include therapeutic
counselling provided by professional sexual health counsellors in order to increase the healthcare
access and awareness about RSH. SHINE SA also seeks to promote empowerment among the
people who are living with disability so that they are participate in their own RSH developed in a
comprehensive manner and also achieve health relationships with both their own sexuality and
with other groups of people. Empowerment is given by peer support program for people who are
12 years old and above, counselling service and other gender well-being services like therapeutic
counselling (SHINE SA).

3
ASSESSMENT 2
Services for the LGBTIQ people
SHINE SA provides a free service named gender wellbeing service for LBGTIQ people
who are constantly questioning their gender or people who identify themselves as Trans or
gender diverse. Not only LGBTIQ community people, but also the family members and friends
of LGBTIQ people are also included in the gender wellbeing services. The gender wellbeing
service is supportive, individually focused service that provides peer group support. This service
is mainly available in the Metropolitan area of Adelaide (SHINE SA 2019). SHINE SA also has
Peer Support Program for the gender diverse and Trans people. It is driven by Peer Support
Coordinator along with a group of volunteers who have lived experience in gender diversity. The
support programs are customised for the people 12 years and above. Peer Support Program is
however, not a replacement of professional counselling (SHINE SA). SHINE SA also has a
special program known as SAMESH. This program provides support, education and training to
men who have sex with men and people living with HIV along with services for broader
LGBTQI community in SA. SAMESH was created in the year 2015 and is located in 57 Hyde
Street Adelaide.
Evaluation of specific services/ programs for priority population group in relation to
research evidence
Meeting the RSH needs of each group
Aboriginals and Torres Strait Islanders (ATSI)
The services provided for the Aboriginals and Torres Strait Islanders (ATSI) includes
indigenous healthcare workers working specifically for the promotion of RSH and hygiene.
According to the Australian Medical Association (AMA) (2017), indigenous population in

4
ASSESSMENT 2
Australia who are residing in the remote and in the rural areas suffer from poor RSH. They also
have high reported cases of HIV and Sexually Transmitted Infections (STIs). The statistics
published by AIHW (2018) STIs occurring due of Syphilis, Gonorrhoea remain unreported the
main reason behind this is lack of healthcare access in the rural and in the remote areas and lack
of trained indigenous healthcare workers. Indigenous people are more comfortable in discussing
their RSH related concerns to the people of their own communities (Azzopardi et al. 2018). Thus
SHINE SA by increasing the healthcare setup in the rural and remote areas and recruiting trained
indigenous workers is helping to reduce the RSH inequalities among the indigenous population.
School education and support provided by SHINE focused to Aboriginal Focus Schools Program
is helpful in increasing the capacity of the principals, teachers, aboriginal community workers
and Anangu Education Workers. This help in promoting heath literacy among students (5 to 10
years). The SHINE SA services for Aboriginals require booking and appointment to the SHINE
SA clinica, this can be regarded as a weakness of the designed program as Aboriginal are less
likely to reach out to out-patient clinic proactively (Morgan 2017).
People with disability
SHINE SA provides therapeutic counselling for the people with disability. People with
disability encompass people who have disability related to sexual issues, people who are victims
of child sexual abuse or sexual assaults or people having issues with ejaculations and orgasms or
people living with STIs (SHINE SA 2019). Workowski and Bolan (2015) stated that therapeutic
counselling for the people living with the STIs increase the reporting of the disease and at the
same time increases the healthcare access. This in turn helps in improving the STI related service
delivery. Moreover, therapeutic counselling helps to address the psycho-social needs of the
people living with HIV AIDS and thus helping to improve their overall health and well-being.

5
ASSESSMENT 2
SHINE SA provides contraception services, pregnancy testing, counselling and referrals for
people with disability and this helps them to indulge in safe sex and to get proper assistance in
handling unwanted pregnancies (Lee et al. 2015). SHINE SA also provide services for the people
with disability in order to discuss the sexual health issues however, such services might receive
minimal participation as majority of the people feel uncomfortable in discussing about their
sexual life (Lee et al. 2015).
LGBTIQ community
LGBTIQ community in Australia experiences marginalization and the condition are
adverse among the population who are residing in the remote or in the rural areas (Australian
Human Rights Commission 2019). Giving peer support and promotion of the gender well-being
helps to reduce the social isolation and at the same time helps to community to accept their
gender identity. This understanding and promotion of the gender wellbeing helps to reduce the
RSH taboo of people towards LGBTQI and thus helping in the promotion of gender equality
(Butler 2018).
Strengths for SHINE SA
The main strength for SHINE SA is their
experienced team of professionals who have
the desired skills to work with the diverse group of people in order to meet their RSH needs like
people with disability and people from the indigenous communities. SHINE SA also conducts
special training programs for the indigenous healthcare workers in increase the RSH
participation among the indigenous people in SA.
SHINE also provides school-based
awareness program for RSH in SA and this helps to promote RSH and hygiene since their early
age. Walsh et al. (2018) conducted a study in order to assess the evidence and the overall
effectiveness of the school-based education programs in order to reduce the chances of the child

6
ASSESSMENT 2
sexual abuse (CSA). The analysis of the 24 studies containing 5,802 participants highlighted that
school-based counselling and promotion of the awareness about child sexual abuse helps to
increase the child self-protective skills. The school-based counselling also helps to reduce the
anxiety, fear and post-traumatic disorder among the victims of the sexual abuse and thus helping
them to resume normal life.
SHINE SA has Sexual Healthline where one can communicate
their RSH related concerns under complete privacy and confidentiality. The tool-free number is
open from Monday to Friday (9 am to 12:30 pm). The main help is provided in the domain of
STIs, pregnancy testing, emergency contraception, puberty issues, safe sex information and
counseling about the unplanned pregnancy. McNair and Bush (2016) same sex attracted women
(SSAW) are disproportionately affected due to depression and anxiety and due to experiences of
the gender-based discrimination. The assessment of the over the phone healthcare services in the
form of access helps to improve the mental health status of the hetero-sexual women and at the
same time helps to improve their level of mental satisfaction. McNair and Bush (2016)further
stated that peer support given either over phone or through face-to-face interaction is regarded as
an important adjunct of professional support that helps to increase the RSH literacy. SHINE SA
has special Adelaide’s first rapid HIV testing
services. It offers free and less confronting
testing experience for the gay men and the men who have sex with men (MSM) along with the
trans and the gender diverse people. Their model of services is regarded as the “peer” model that
deals with rapid testing for the HIV within just 20 minutes. Rosenberg et al. (2015) detection of
the early HIV infection including the acute HIV infection (AHI) is important for the health of the
individuals and also for the effective prevention of the HIV transmission and proper
measurement of the incidence of the HIV. RSH services offering rapid detection of the HIV
helps to reduce the severity of the disease outcome and at the same time helps to decrease the

7
ASSESSMENT 2
poor healthcare outcomes. Thus rapid HIV testing can be regarded another strength of the
services of SHINE SA.
Is organization doing well?
According to the surveillance report of the STIs in the SA (2017) published by the
Communicable Disease Control Branch SA Health, the reported cases of the hepatitis B and C
has reduced significantly during the tenure of 2012 or 2015. However, the rate of spread of the
STIs occurring due to chlamydia, gonorrhoea, and syphilis has increased considerably in SA
during the tenure of 2012 to 2016 (Communicable Disease Control Branch SA Health 2012).
Thus from the statistics of the STIs in the SA, it can be seen that over success of SHINE SA is
not overwhelming. It is thus recommended that SHINE SA must draft from customised approach
directed towards the STIs occurring due to Syphilis and Chlamydia.
Working with that priority population group
The main priority population in the RSH is the
adolescents and the young adults from
the ATSI communities. AIHW (2018) statistics report that adolescents and the young adults
from ATSI communities are the main victims of the STIs, human papilloma virus and teenage
pregnancy. Working for the young adults of ATSI communities in SA will help in the reduction
of the health inequalities in the domain for RSH (Aboriginal Health Council of South Australia
Ltd. 2019). Good practice for working with that priority population group is maintenance of
privacy and confidentiality of the client while dealing with the RSH. Copen, Dittus and
Leichliter (2016) argued that confidentiality is the main concern about the RSH care among the
young adults and adolescents who are aged between 15 to 25 years. SHINE SA has their
confidentiality policy along with the confidential records given by the Court of Law. Ensuring

8
ASSESSMENT 2
confidentiality and privacy of RSH, helps to increase the RSH care and thus helps in proper
reporting of the teenage pregnancy and STIs among ATSI communities.
Gaps in Service
SAMESH is located in 57 Hyde Street Adelaide whereas; the gender wellbeing service is
available in the Metropolitan area of Adelaide. Thus the main services LBGTIQ communities are
present in the urban or in the metropolitan areas. Government of South Australia Department of
Human Services (2018) states that LBGTIQ communities are not only concentrated in the rural
areas, but are also available in the remote areas of the South Australia. The concentration of the
RSH services in the metropolitan areas fails to incorporate the LBGTIQ people residing in the
remote areas of SA and thus prolonging the health inequalities and gender discrimination. For
the people with disabilities, services RSH services are free for all the clients who are 30 years or
under and people over 30-year need to pay $20 (people who hold Health Care Card) or $50 per
session (SHINE SA 2019). People with disability in sexual health mainly reside under poor-
socio-economic set-up, and thus creating a barrier in comprehensive RSH access (people who are
over 30) (Choudhury & Goswami 2018).
Recommendations
The main recommendations for improving the organisation RSH services are:
As per the findings
As per the findings the under the aboriginal community based information, SHINE SA
aims to work in partnership with the ATSI staffs and community members in order to promote
health inequalities in the RSH in the SA. The community based services for the ATIS is directed
towards school-based education and community based education. However, the young adults and

9
ASSESSMENT 2
the indigenous population who resides under the poor socio-economic determinant of health also
suffer from poor RSH due to having sex with multiple partners and indulging in unprotected sex.
Thus SHINE SA must come forward with community-based health awareness program for the
ATSI adolescents and young adults by recruiting trained workers. This will help to reduce the
health inequalities among the ATSI further (SA Department of Health and Ageing 2016; Morgan
2017).
As per the policies
As per the Save Children Australia (2018), Human rights, including SRH and rights
(SRHR), must be central to the vision of prompting gender equality. However, the ATSI women
who are residing in the rural and the remote areas of the Australia die while giving birth.
The Australian Government (2019) gives importance towards national coordination and
leadership for maternity services in order to improve health-related outcomes for ATSI mothers,
their child and families. In Australia, proper planning and delivery of maternity services is states
and territories responsibilities. Thus SHINE SA must work in association with the SA
government in order to design proper material health and reproduction awareness program.
Involvement of stakeholders (both government and SHINE SA representatives) will help to make
this solution feasible (Aboriginal Health Council of South Australia Ltd. 2019).
As per the research evidences
As per the research evidences, menopause is critical phase in the life of women who are
in their 50s. Proper awareness about menopause and education about importance of lifestyle
changes like yoga and diet helps to improve the overall health and well-being of women who are
older adults. ATSI women or lesbian women have limited knowledge regarding sexual health
after menopause (Rullo & Faubion 2017). Further evidences suggest that women who are going

10
ASSESSMENT 2
through their menopause must be indulge in social or group based activities as this helps to
improve their mental health and well-being (Yazdkhasti, Simbar & Abdi, 2015). SHINE SA
apart from providing website based information must come up with group-based activities for the
post-menopausal ATSI women and lesbian or transgender women in order to improve their
mental health status. In order to implement such intervention, SHINE SA must recruit trained
midwives and community-based healthcare nurses who will work in unison for improving the
well-being of post-menopausal women (Rullo & Faubion 2017).
Conclusion
Thus from the above discussion, it can be concluded that the main services provided by
SHINE SA for the promotion of the RSH include clinical services like (testing for sexually
transmitted infections and contraception), sexual health counselling (therapeutic counselling) and
promotion of gender well-being. The main focus group of these services include ATIS
community, people living with disability, adolescents and young adults and LGBTIQ. However,
in order to refine their services further, SHINE SA must also come forward with HIV rapid
testing and SAMESH program in the rural parts of SA. SHINE SA must also provide special
ATSI community based interventions for ATSI adolescents and young adults.

11
ASSESSMENT 2
References
Aboriginal Health Council of South Australia Ltd. 2019. Sexual Healthcare Programs. Access
date: 15th October 2019. Retrieved from: https://ahcsa.org.au/health-programmes/sexual-
health/
Australian Government Department of Health. 2019. Stillbirth and Maternity services. Access
date: 2nd October 2019. Retrieved from:
https://www1.health.gov.au/internet/main/publishing.nsf/Content/pacd-pdb-maternity
Australian Human Rights Commission. 2019. Face the facts: Lesbian, Gay, Bisexual, Trans and
Intersex People. Access date: 15th October 2019. Retrieved from:
https://www.humanrights.gov.au/our-work/education/face-facts-lesbian-gay-bisexual-
trans-and-intersex-people
Australian Institute of Health and Welfare. 2018. Australia's health 2018. Access date: 30th
September 2019. Retrieved from:
https://www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/
indicators-of-australias-health/sexually-transmissible-infections-bloodborne-virus
Australian Medical Association. 2017. ByAMAPresident Dr Michael Gannon. Access date: 2nd
October 2019. Retrieved from:https://ama.com.au/ausmed/indigenous-sexual-health
Azzopardi, P.S., Sawyer, S.M., Carlin, J.B., Degenhardt, L., Brown, N., Brown, A.D. & Patton,
G.C., 2018, ‘Health and wellbeing of Indigenous adolescents in Australia: a systematic
synthesis of population data’, The Lancet, vol. 391, no. 10122, pp.766-782.

12
ASSESSMENT 2
Butler, S.S., 2018, ‘Social Networks and Social Isolation Among LGBT Older Adults’, Social
Isolation of Older Adults: Strategies to Bolster Health and Well-Being, vol. 15, no. 2,
p.156.
Choudhury, S. & Goswami, S., 2018, ‘Sexual Abuse Among Individuals With Disabilities’,
In Social, Psychological, and Forensic Perspectives on Sexual Abuse (pp. 179-196). IGI
Global.
Communicable Disease Control Branch SA Health. 2017. Surveillance report of the STIs and
Blood Borne disease. Access date: 2nd October 2019. Retrieved
from:https://www.sahealth.sa.gov.au/wps/wcm/connect/1daa68f0-b9aa-40ed-983d-
1409a45ef18d/2017+Surveillance+of+STIs+and+BBVs+in+SA+-+Epi+Report+31.pdf?
MOD=AJPERES&CACHEID=ROOTWORKSPACE-1daa68f0-b9aa-40ed-983d-
1409a45ef18d-mMHPrDQ
Copen, C.E., Dittus, P.J. &Leichliter, J.S., 2016, ‘Confidentiality concerns and sexual and
reproductive health care among adolescents and young adults aged 15–25’, Age, vol. 15,
no. 17, pp.18-19.
Government of South Australia Department of Human Services. 2018. LGBTIQ Inclusion.
Access date: 2nd October 2019. Retrieved from:https://dhs.sa.gov.au/services/community-
services/lgbtiq
Government of South Australia. 2019. Sexual health services. Access date: 2nd October 2019.
Retrieved from:https://www.sahealth.sa.gov.au/wps/wcm/connect/Public+Content/
SA+Health+Internet/Health+services/Sexual+health+services/

13
ASSESSMENT 2
Lee, J., Papic, M., Baldauf, E., Updike, G. & Schwarz, E.B., 2015, ‘A checklist approach to
caring for women seeking pregnancy testing: Effects on contraceptive knowledge and
use’, Contraception, vol. 91, no. 2, pp.143-149.
McNair, R.P. & Bush, R., 2016, ‘Mental health help seeking patterns and associations among
Australian same sex attracted women, trans and gender diverse people: a survey-based
study’, BMC psychiatry, vol. 16, no. 1, pp.209.
Morgan, D., 2017. Sexual and reproductive health education project for aboriginal and Torres
Strait Islander young people in the Australian Capital Territory (ACT). Australian
Nursing and Midwifery Journal, 25(3), pp.45-45.
Rosenberg, N.E., Pilcher, C.D., Busch, M.P. & Cohen, M.S., 2015, ‘How can we better identify
early HIV infections?’,Current Opinion in HIV and AIDS, vol. 10, no.1, p.61.
Rullo, J.E. & Faubion, S.S., 2017, ‘Caring for the lesbian patient at midlife and beyond’,
Menopause, vol. 24, no. 12, pp.1402-1403.
SA Department of Health and Ageing. 2016. Sexually Transmissible Infection Implementation
Plan (2016 to 2018). Access date: 15th October 2019. Retrieved from:
https://www.sahealth.sa.gov.au/wps/wcm/connect/535381004c974616b366b3a496684d9f
/STI_ImpPlan20162018-CDCB-20161103.pdf?
MOD=AJPERES&CACHEID=ROOTWORKSPACE-
535381004c974616b366b3a496684d9f-mN5-vMw
Save Children Australia. 2018. Advancing Sexual and Reproductive Health and Rights for All.
Access date: 2nd October 2019. Retrieved

14
ASSESSMENT 2
from:https://www.care.org.au/wp-content/uploads/2018/05/2018-SRHR-
Consortium_Aus-Foreign-Policy-Briefing.pdf
SHINE SA. 2019. About SHINE SA. Access date: 30th September 2019. Retrieved from:
https://www.shinesa.org.au/about/shine-sa/
Walsh, K., Zwi, K., Woolfenden, S. &Shlonsky, A., 2018, ‘School-based education programs for
the prevention of child sexual abuse: A Cochrane systematic review and meta-analysis’,
Research on social work practice, vol. 28, no.1, pp.33-55.
Workowski, K.A. & Bolan, G.A., 2015, ‘Sexually transmitted diseases treatment guidelines,
2015’, MMWR. Recommendations and reports: Morbidity and mortality weekly report.
Recommendations and reports, vol. 64, no. RR-03, p.1.
Yazdkhasti, M., Simbar, M.&Abdi, F., 2015, ‘Empowerment and coping strategies in menopause
women: a review’, Iranian Red Crescent Medical Journal, vol. 17, no.3.