Reproductive health education and early sexual behavior prevention assistance for Madrasah Aliyah students in Bandung

Health reproduction knowledge is a crucial factor in preventing acts of early sexual behavior. Early sexual behavior is reflected in many ways, from attraction to different sexes to building a relationship and making physical contact. Adequate knowledge of sexuality in teenagers especially in health reproduction would prevent teenagers from acting in early sexual behavior. This activity aims to increase knowledge about the health of reproductive organs and the prevention of early sexual intercourse among Madrasah Aliyah students. The method used is education regarding the health of reproductive organs, pre-marital sexual psychology, and social jurisprudence approaches. All material is presented interestingly and interactively. This activity found that 63 percent of the participants had previous knowledge of this topic. More than 50 percent of respondents were students, and students had quite good knowledge about reproductive health. Madrasah Aliyah students already have sufficient knowledge about reproductive health, but it has not yet been seen whether it is enough to prevent students from premature sexual behavior. However, we do not have any data regarding the act of early sexual behavior among respondents or how knowledge in health reproduction would relate to the act of early sexual behavior.

Current health development aims to comprehensively improve the level of public health to determine the improvement in quality of life.Many factors influence reproductive health, in general these factors are; socio-economic, cultural, environmental, psychological, and biological factors.Introduction to the components of the reproductive organs, the function of the reproductive organs, and diseases to which the reproductive organs are susceptible are examples of complex reproductive health problems.Reproductive health education with counseling is an activity that seeks to improve the level of reproductive health and prepare family life in supporting efforts to improve the quality of future generations by increasing awareness, knowledge and good behavior regarding the nature and health of reproduction (Alavi-Arjas et al., 2018).Education provided using varied methods involving the senses of sight, and hearing, and supported by two-way interaction has proven to be effective in increasing knowledge about reproductive health (Damayanti et al., 2023).
The incidence of teenage pregnancy has experienced a downward trend over the previous ten years, a development that is heartening for healthcare specialists specializing in adolescent health.Certain risk variables, such as community disorganization, family disruption, low parental education, and poverty, provide challenges when it comes to making modifications.Protective variables, such as favorable peer norms or endorsement of contraceptive usage, as well as personal positive attitudes and motivation towards using condoms and contraception, may be more receptive to intervention.The method currently used is quite effective with the telehealth method.Telehealth is the provision of medical care or education from a distal site through the use of teleconferencing equipment (Yoost et al., 2017).
The problem currently faced by the partner community, related to reproductive health, is that there is no data that shows the effectiveness and harmony between knowledge about the health of reproductive organs, knowledge about early sexual behavior, the establishment of a peer counselor program in preventing early sexual behavior (Shakti et al., 2022).This activity was carried out at Madrasah Aliyah in Cigadung, Bandung City.Madrasah Aliyah is a school with an Islamic curriculum at the high school level.Madrasas have a curriculum that allows students to receive more knowledge about religion.The issue of reproductive organ health and its problems, including premature sexual behavior, is a problem that is currently getting quite a lot of attention considering the high number of premarital pregnancies is still quite high.Therefore, it is not enough to just be equipped with religious knowledge, but it needs to be accompanied by other scientific knowledge, especially regarding the health of reproductive organs, to prevent premature sexual behavior in teenagers.Research conducted by Yusuf et al. (2023) found that there is a mismatch between Islamic values and current teenage trends, including changes in clothing styles, an increase in premarital relationships, drug abuse, and materialistic pursuits.The need for guidance from teenagers and parents to bridge the gap between Islamic principles and contemporary trends, by emphasizing No 2, May 2024: 262-270 the importance of fiqh education in adolescence as a basis for navigating life in accordance with Islamic values (Yusuf et al., 2023).
Based on these problems, the aim of this activity is to provide reproductive health education and assistance in preventing early sexual behavior to Madrasah Aliyah Bandung students as an effort to increase knowledge about reproductive health and preventing early sexual behavior.In accordance with the results of the survey and situation analysis described above, a series of programs are needed which include counseling, training and assistance regarding the health of reproductive organs, as well as providing the necessary supporting facilities.

METHODS
The target of this activity is teenagers aged 16-18 years so the activity is carried out using interactive discussion and visualization methods using interesting media.The technical implementation of counseling is divided into 3 activities, first, program socialization based on an analysis of the partner's needs situation, second, education and assistance in understanding the health of reproductive organs with 3 resource persons who discuss reproductive health and early sexual behavior in terms of psychological, health and religious aspects.Participants were also given questionnaire questions before the socialization as an evaluation to assess the respondent's knowledge (Table 1).

Objectives
-Comprehend the explanation of information and conduct pertaining to the well-being of reproductive organs.
-Offer information and instruction on the well-being of reproductive organs, psychological aspects of pre-marital sexual activity, and the legal aspects of social norms.

Activity -Evaluation of activity programs
Objective -To find out the extent of the influence of providing education and assistance regarding reproductive organ health and problems on madrasah students.

Module
The module consists of counseling material in the form of presentation slides, then a flipchart regarding a summary of reproductive health, as well as tools in the form of a questionnaire to measure students' level of knowledge and behavior.The questionnaire consists of two types of questions.Questionnaire one questions regarding knowledge about reproductive health while questionnaire two concerns early sexual behavior.Questions on questionnaire 1 consists of 15 questions include general structure of reproductive organs and their functions, signs of puberty, psychological development of adolescents.Questions on questionnaire 2 consists of 16 questions include social changes, peer relationships, behavior during puberty, behavior to maintain the health of reproductive organs.

Evaluation
Evaluation activities are carried out with post-activity discussions, to find out how much benefit there is from implementing counseling and assistance regarding reproductive health

Results
The activity method chosen is offline education.This PKM activity was carried out for one day and was attended by 99 students of the Aliyah Insan Mandiri Bandung madrasah.The implementation time is in August 2023 at Madrasah Aliyah Insan Mandiri, Cigadung, Cibeunying Kaler District, Bandung City.Community service activities were carried out well and smoothly with a total of 99 participants.The participants were madrasah aliyah students in grades X-XII.The gender characteristics of the participants can be seen in table 2 below that the majority of respondents were women 55.5 percent.PKM activities consist of providing questionnaires and counseling to participants.The questionnaire assesses knowledge, attitudes, and behavior in efforts to prevent premature sexual behavior and reproductive health.From diagram on figure 1 it is known that as many as 67 percent of respondents had received information before, and 33 percent had never received information about reproductive health before.
After carrying out the analysis, it can be seen the distribution of knowledge, attitudes and behavior in reproductive health and efforts to prevent premature sexual behavior which can be seen in diagrams on Figure 2 and Figure 3. Baseds on Figure 2 and Figure 3 which contain the answers given by respondents to questionnaires 1 and 2, it is known that for most of the questions, more than 50 percent of respondents answered correctly.Question number 1 from questionnaire 1, which contained reproductive organ health, was answered correctly by all participants, while only 2 respondents answered the question regarding preventing premature sexual behavior incorrectly.PKM activities consist of providing questionnaires and counseling to participants.The questionnaire assesses knowledge, attitudes, and behavior in efforts to prevent premature sexual behavior and reproductive health.From diagram on figure 1 it is known that as many as 67 percent of respondents had received information before, and 33 percent had never received information about reproductive health before.After carrying out the analysis, it can be seen the distribution of knowledge, attitudes and behavior in reproductive health and efforts to prevent premature sexual behavior which can be seen in diagrams on Figure 2 and Figure 3. Baseds on Figure 2 and Figure 3 which contain the answers given by respondents to questionnaires 1 and 2, it is known that for most of the questions, more than 50 percent of respondents answered correctly.Question number 1 from questionnaire 1, which contained reproductive organ health, was answered correctly by all participants, while only 2 respondents answered the question regarding preventing premature sexual behavior incorrectly.
Based on the evaluation of the results of the questionnaire distributed, it was stated that students' knowledge about reproductive health was good and their behavior towards early sexual prevention was good.Based on the evaluation of the results of the questionnaire distributed, it was stated that students' knowledge about reproductive health was good and their behavior towards early sexual prevention was good.From the results obtained above, it can be concluded that overall Madrasah Aliyah Insan Mandiri students and students in classes X-XII have quite good knowledge about reproductive health based on the results of the questionnaire distributed.Armed with this sufficient knowledge, it is hoped that in the future it can become a guide for students in protecting themselves from premature sexual behavior.Most students (66.7 percent) admitted that they had received knowledge about reproductive health, but most could not clearly state the source.As many as 23 percent of students stated that they had received information from school/teachers regarding reproductive health, and only one student stated that this information was obtained from biology lessons.Unfortunately, there is no data yet on whether this knowledge is in line with student behavior.From the results obtained above, it can be concluded that overall Madrasah Aliyah Insan Mandiri students and students in classes X-XII have quite good knowledge about reproductive health based on the results of the questionnaire distributed.Armed with this sufficient knowledge, it is hoped that in the future it can become a guide for students in protecting themselves from premature sexual behavior.Most students (66.7 percent) admitted that they had received knowledge about reproductive health, but most could not clearly state the source.As many as 23 percent of students stated that they had received information from school/teachers regarding reproductive health, and only one student stated that this information was obtained from biology lessons.Unfortunately, there is no data yet on whether this knowledge is in line with student behavior.
The activity of filling out the questionnaire was carried out jointly accompanied by the service team, then continued with providing reproductive health education (Figures 4 and 5).

Reproductive health education
The aim of adolescent reproductive health education is to understand responsible sexual behavior, reduce the impact of ignorance about reproductive organ processes (for example: unwanted pregnancy),

Reproductive health education and early sexual behavior prevention assistance for Madrasah Aliyah students in Bandung
Ermina Widiyastuti, Meta Maulida Damayanti, Ismet Muchtar Nur, Tita Barriah Siddiq, Indri Budiarti, Ayu Prasetia and prevent the spread of sexually transmitted diseases.This activity is carried out for teenagers during which there are major changes in the maturation of the reproductive organs, namely puberty and heterogeneous relationships in addressing sexuality issues in teenagers.
Puberty occurs when the reproductive organs develop to become more mature and perfect, both in men and women.Natural and natural processes as part of the adaptation of living creatures to survive in nature.All living creatures must reproduce so that their kind (species) does not become extinct (Magnusson & Stattin, 2018).Humans are given privileges by Allah SWT in the form of reason and thoughts which are used to control their desires (the basic instincts of living creatures).Guidance has been given by Allah in the Qur'an that humans must guard their morals.Female reproductive organs begin to function at puberty (9-15 years).Its main function is to produce the hormone estrogen and produce egg cells.In animals and plants, it is identical to the female species group.The purpose of estrogen production is to provide a typical female body shape (breasts, pubic hair, ovulation, menstruation) in preparation for pregnancy.The purpose of ovulation (hatching of the egg) is to complete the process of fertilization by sperm which occurs through sexual intercourse (naturally) (Rassool et al., 2020).From the results obtained above, it can be concluded that overall Madrasah Aliyah Insan Mandiri students and students in classes X-XII have quite good knowledge about reproductive health based on the results of the questionnaire distributed.Armed with this sufficient knowledge, it is hoped that in the future it can become a guide for students in protecting themselves from premature sexual behavior.Most students (66.7 percent) admitted that they had received knowledge about reproductive health, but most could not clearly state the source.As many as 23 percent of students stated that they had received information from school/teachers regarding reproductive health, and only one student stated that this information was obtained from biology lessons.Unfortunately, there is no data yet on whether this knowledge is in line with student behavior.The activity of filling out the questionnaire was carried out jointly accompanied by the service team, then continued with providing reproductive health education (Figures 4 and 5).

Discussions Reproductive health education
The aim of adolescent reproductive health education is to understand responsible sexual behavior, reduce the impact of ignorance about reproductive organ processes (for example: unwanted pregnancy), and prevent the spread of sexually transmitted diseases.This activity is carried out for teenagers during which there are major changes in the maturation of the reproductive organs, namely puberty and heterogeneous relationships in addressing sexuality issues in teenagers.Simplex Virus, HIV), parasites (syphilis, Trichomonas) (Siracusano et al., 2014).Problems that will arise in the future, due to damage to the structure of the Fallopian tubes, making it difficult to get pregnant, pregnancy outside the womb.Due to viral infections, namely HIV-AIDS, cervical cancer.In men, infertility can occur due to sticky sperm ducts due to infection.Adolescence is a transition period from the world of children to the world of adults.Hormonal and bodily changes will cause emotional and physical waves that must be controlled.It is important to find out and ask the right sources.Sexual relations before marriage: risk of unplanned pregnancy, multiple sexual partners & spreading sexually transmitted diseases (Shu et al., 2016).

Psychological impact of premarital sex on adolescents
Adolescence is a transition period between childhood and adulthood, so it is natural that in adolescents, the emotional level has not yet grown completely.Marwoko (2019) mentions the characteristics of adolescence, one of which is an emotional condition that is still unstable.The presence of emotional ups and downs or "unsteadiness" is closely related to hormonal conditions.Apart from that, adolescent development is also marked by attraction to the opposite sex (Marwoko, 2019).Factors that influence premarital sexual behavior are: inappropriate social control from peers, overly romantic relationships, accessing pornographic content, lack of education provided by parents resulting in poor education, victims of sexual violence and harassment, strong urge for love, economic factors, feeling worthy of having sexual relations, permissive parents resulting in lack of control and supervision (Shrestha, 2019).
The psychological impact that will occur is feeling guilty.The higher the level of sexual behavior carried out by an individual; the higher the individual's sense of guilt will be.Research shows that teenagers who have had pre-marital sex often feel guilty towards their parents and feel guilty for violating religious and cultural norms.This feeling of guilt can create an increasingly heavy psychological burden if it continues and result in depression.Another psychological impact is anxiety.the emergence of feelings of anxiety in various aspects: pregnancy will occur, fear of being abandoned by the partner, not finding someone else who is willing to accept the condition of not being a virgin, parents are disappointed with themselves, being treated badly by future marriage partners, being ostracized by the social environment and society (Dosch et al., 2016).
The impact that occurs can also cause feelings of feeling dirty and that one's sins are not forgiven, trauma arises and no longer trusts the opposite sex, decreased self-confidence and loss of self-respect, no longer finding pleasure from ordinary sexual activities how to prevent and handle it.improve the quality of relationships between parents and teenagers, improve skills in resisting negative pressure from friends, improve the quality of spirituality, control the use of social media, look for a positive friendship environment, realize that every action taken always has accompanying consequences.Adolescents who have engaged in pre-marital sexual behavior and have difficulty controlling or stopping their risky behavior and have persistent negative feelings that interfere with their daily activities are advised to seek help from school counsellors, psychologists, or psychiatrists.One of the developments in adolescence is characterized by attraction to the opposite sex.Because brain development is not yet perfect, teenagers tend to use their emotions rather than rational understanding when deciding something.Sexual behavior is not just an expression of love, but also a statement that the perpetrator is ready to bear the consequences that arise from it (Nurmala et al., 2019).
Promoting and supporting healthy sexual development and laying the groundwork for lifetime sexual health and wellbeing can be achieved through developmentally appropriate and sexuality and

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Reproductive health education and early sexual behavior prevention assistance for Madrasah Aliyah students in Bandung Ermina Widiyastuti, Meta Maulida Damayanti, Ismet Muchtar Nur, Tita Barriah Siddiq, Indri Budiarti, Ayu Prasetia healthy relationships education (Nafisah et al., 2023).Adolescence is a crucial era of development where young individuals start forming their romantic and sexual identities.It is a significant time to acquire knowledge about engaging in healthy romantic and sexual conduct, which in turn lays the foundation for good adult relationships (Lantos et al., 2019).
Teens and young adults get a lot of their sexuality education from television, so it's crucial to study the shows that air during prime time to see how they portray sexuality and reproductive health.The television series we examined lacked narratives that offered instructional insights into the dangers and repercussions associated with sexual behavior.Additionally, we found that storylines encouraging safe sexual behavior were infrequent.Instances of sexual violence and abuse, casual sexual encounters among adults, failure to utilize contraception, and absence of depiction of the repercussions of risky behaviors were prevalent (Kinsler et al., 2019).
Through this PKM, by holding counseling, followed by education regarding early sexual behavior, in the future it is hoped that it can strengthen students' knowledge which is applied in behavior that is free from early sexual behavior.

CONCLUSION AND RECOMMENDATIONS
Madrasah Aliyah students already have sufficient knowledge about reproductive health, but it has not yet been seen whether it is enough to prevent students from premature sexual behavior.Therefore, educational activities and reproductive health assistance in preventing premature sexual behavior are very effective and provides new insights whose function is to improve knowledge, attitudes and behavior.This community service activity can be continued with a wider scope and explore initial information about early sexual behavior among students, so that it can be seen whether students' knowledge correlates with their behavior.Furthermore, another counseling method by forming a team of peer counselors among students is expected to be able to become a means of self-reflection and effective prevention of early sexual behavior among students.

Figure 1 .
Figure 1.Characteristics of respondents' prior knowledge

Figure 1 .
Figure 1.Characteristics of respondents' prior knowledge

Figure 4 .
Figure 4. Questionnaire filling activities Figure 5. Reproductive health education activities

Figure 4 .
Figure 4. Questionnaire filling activities Figure 5. Reproductive health education activities

Table 1 .
Schedule of training and mentoring activities

Table 2 .
Participant gender characteristics