Sexual and reproductive health education and learning among Indigenous youth of the Comarca Ngäbe-Buglé, Panama

Indigenous adolescents and young people in Panama are at high-risk for sexually transmitted infections, due in part to limited access to condoms and comprehensive sexual and reproductive health (SRH) education. There is a paucity of evidence on how to develop sexual and reproductive health education programmes that incorporate different sources of learning. We used Bronfenbrenner’s Ecological Theory to understand two key sources of learning: noncaregivers (school or healthcare personnel) and caregivers (parents/grandparents/stepparents). Better understanding about sexual and reproductive health learning sources could provide a foundation for the development of targeted, culturally congruent interventions. This study included ethnographic observation in two Indigenous communities in Panama, followed by semi-structured interviews with young people and caregivers. Findings suggest non-caregiver sexual and reproductive health education was commonly provided by teachers, and increasingly through the Internet. Caregivers focused on topics of abstinence/delaying sexual debut, pregnancy, and STIs/HIV; condoms pregnancy, and STIs/HIV. Condoms and condom use were not mentioned.  Traditional sexual and reproductive health teaching by same-gender caregivers took place through the rituals of mokän (girls at menarche) and grön (boys 13–14 years). To develop culturally congruent interventions, wesuggest programmes to improve sexual and reproductive health knowledge and access to condoms, which respect and build on  social and traditional learning spaces.