Sexual Health Support Interventions for Prepubescents and Young Adolescents (7–14 Years) in the United States and Sub-Saharan Africa: A Scoping Review Protocol

Research Priorities to Support Women Veterans' Reproductive Health and Health Care Within a Learning Health Care System.

What about access to birth control and emergency contraception now that abortion rights are overturned?

Introduction Younger adolescents (aged 10–14 years) in sub-Saharan Africa (SSA) have disproportionate sexual and reproductive health (SRH) outcomes due to structural, behavioural, socioeconomic and other factors. Social and gender norms have important consequences for the SRH and wellbeing of younger adolescents both now and over their life course. SRH programming often focuses on older adolescents (aged 15–19 years), overlooking younger ones. This scoping review sets out to explore how gender and social norms influence younger adolescents’ SRH in SSA, to inform tailored interventions. Methods The Arksey and O'Malley strategy will be used to review the available literature. Online databases (PubMed/MEDLINE, CINHAL, EMBASE, PsycINFO, Cochrane Library, and African Index Medicus) will be searched for original studies published between 1 January 2000 and 30 September 2024. Further, a manual search to include relevant grey literature will be performed. The steps in the review are: 1) defining the research question, 2) identifying relevant studies, 3) selecting studies, 4) charting the data, and 5) collating, summarising, and reporting the results. Results Findings will be reported in accordance with the guidance provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. Discussion The review will generate the most up-to-date evidence and identify gaps in literature in addition to informing future research on how gender and social norms influence younger adolescents’ SRH in SSA. Findings will inform and influence future interventions and evaluations in this area.

What About the Boys? The Importance of Including Boys and Young Men in Sexual and Reproductive Health Research

IntroductionApproximately 15% of people with disabilities are women of reproductive age. Women with physical disabilities are neglected in reproductive and sexual health. Complex health conditions, mobility limitations, negative disability stereotypes, and misconceptions about their needs directly and indirectly affect their sexual and reproductive health. Access to appropriate reproductive health care is crucial for empowering these women to manage their reproductive and sexual health challenges effectively. This scoping review aims to identify, explore, and map the existing evidence on reproductive health programs and interventions in women with physical disabilities.Materials and methodsThis scoping review will be based on Arksey and O’Malley’s methodological framework and the subsequent recommendations of Levac et al. We will search for studies published from January 2006–2024 in English and Persian without restriction by study design in databases such as Web of Science, PubMed, ProQuest, Springer, Google Scholar, ScienceDirect, Cochrane Library, Agency for Healthcare Research and Quality, and websites like the World Health Organization, UNICEF and government sites for policies and reports about reproductive health programs for women with physical disabilities. Two or more reviewers will independently conduct all stages of the study. Data synthesis will utilize a qualitative analysis approach, and this review will be reported using the PRISMA-ScR checklist.ConclusionThis scoping review synthesizes evidence on reproductive health interventions for women with physical disabilities, including educational and awareness programs, healthcare access initiatives, support groups, and policy interventions. We will explore these interventions across various dimensions of reproductive health. The results of this review will offer a comprehensive overview of available resources and identify critical gaps in reproductive health for this population. To our understanding, this study may be the first scoping review in this field, which could provide valuable guidance to key stakeholders.

Introduction Very young adolescents (VYAs, aged 10-14 years) in sub-Saharan Africa (SSA) have the worst sexual and reproductive health (SRH) outcomes of this age group worldwide due to structural, behavioural, socioeconomic and other factors. Social and gender norms have important consequences for the SRH and wellbeing of VYAs both now and over their life course. SRH programming often focuses on older adolescents (aged 15-19 years), overlooking younger ones. This scoping review sets out to explore how social and gender norms influence VYAs' SRH in SSA, in addition to exploring interventions that have been effective, to inform a context-specific intervention. We will employ the methodology developed by Arksey and O'Malley to review the available literature. We will search online databases (PubMed/MEDLINE, CINHAL, EMBASE, PsycINFO, Cochrane Library, and African Index Medicus) for original studies published between 1 January 2000 and 31 December 2024. Further, we will perform a manual search to include relevant grey literature. The steps in the review are: 1) defining the research question, 2) identifying relevant studies, 3) selecting studies, 4) charting the data, and 5) collating, summarising, and reporting the results. Results We will report findings in accordance with the guidance provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. We will analyse and summarise data about study characteristics using descriptive statistics. We will use thematic analysis to analyse and summarise key themes and issues. We will triangulate quantitative and qualitative findings. The review will map the breadth of studies focusing on social and gender norms, and SRH among VYAs, in addition to exploring interventions that have been effective. Findings will help us and others develop context-specific, bespoke interventions.

Approximately 15% of people with disabilities are women of reproductive age. Women with physical disabilities are neglected in reproductive and sexual health. Complex health conditions, mobility limitations, negative disability stereotypes, and misconceptions about their needs directly and indirectly affect their sexual and reproductive health. Access to appropriate reproductive health care is crucial for empowering these women to manage their reproductive and sexual health challenges effectively. This scoping review aims to identify, explore, and map the existing evidence on reproductive health programs and interventions in women with physical disabilities. This scoping review will be based on Arksey and O'Malley's methodological framework and the subsequent recommendations of Levac et al. We will search for studies published from January 2006-2024 in English and Persian without restriction by study design in databases such as Web of Science, PubMed, ProQuest, Springer, Google Scholar, ScienceDirect, Cochrane Library, Agency for Healthcare Research and Quality, and websites like the World Health Organization, UNICEF and government sites for policies and reports about reproductive health programs for women with physical disabilities. Two or more reviewers will independently conduct all stages of the study. Data synthesis will utilize a qualitative analysis approach, and this review will be reported using the PRISMA-ScR checklist. This scoping review synthesizes evidence on reproductive health interventions for women with physical disabilities, including educational and awareness programs, healthcare access initiatives, support groups, and policy interventions. We will explore these interventions across various dimensions of reproductive health. The results of this review will offer a comprehensive overview of available resources and identify critical gaps in reproductive health for this population. To our understanding, this study may be the first scoping review in this field, which could provide valuable guidance to key stakeholders.

IntroductionTargeting very young adolescents (VYAs) with sexual health (SH) interventions is increasingly being recognised as one of the strategies for addressing SH challenges in late adolescence. However, there is a...

In Sub-Saharan Africa (SSA), very young adolescents (aged 10-14 years) have the worst sexual and reproductive health (SRH) outcomes of this age group worldwide due to a range of factors, including social and gender norms. However, in this setting, SRH programming often focuses on older adolescents (aged 15-19 years), overlooking very young adolescents. This scoping review sought to explore how social and gender norms influence very young adolescents' SRH-related attitudes and behaviours in SSA and draw inferences for culturally sensitive, gender-responsive interventions. The review followed the five-step framework developed by Arksey and O'Malley: (1) defining the research question, (2) identifying relevant studies, (3) selecting studies, (4) charting the data, and (5) collating, summarising, and reporting the results. We searched four databases (MEDLINE, CINAHL, Global Health, and Web of Science) for peer-reviewed articles published between January 1, 2000 and December 31, 2024. We identified 24 studies: n = 11 (46%) were entirely qualitative, n = 8 (33%) exclusively quantitative, and three other quantitative studies incorporated qualitative components. Two studies used participatory techniques. Studies were from nine countries in SSA. Identified norms included those relating to menstruation, puberty, circumcision, romantic relationships and gender stereotypes. Social norms led to very young adolescents' limited SRH knowledge and access, and behaviours and practices that heightened very young adolescents' vulnerabilities and poor SRH outcomes. Evaluations of interventions to shift these norms reported mixed results, and highlighted the importance of adapting gender-responsive/gender-transformative interventions to the local context. Scoping review findings affirm the importance of intervening in very young adolescence to positively influence social and gender norms. The review underscores the importance of tailored, multifaceted, culturally sensitive, gender-responsive/gender-transformative interventions to improve young adolescents' SRH-related attitudes and behaviours in Sub-Saharan Africa.

A blueprint for a new model of sexual and reproductive health care in subspecialty medicine.

BackgroundThe number of young people utilising sexual and reproductive health services in Pacific Island Countries and Territories remains poor despite the availability and the existence of the fundamental rights to access these services. Adolescents and youth need accurate information and timely access to contraceptives to prevent adverse consequences associated with unintended pregnancies, abortion, childbirth and untreated sexually transmitted infections. This scoping review identifies and analyses factors contributing to young people’s low access to sexual and reproductive health information and services in this region.MethodsGuided by the PRISMA Scoping review guidelines, we searched three databases (Medline Ovid, Scopus and CINAHL Complete) for peer-reviewed articles published between 1st January 2000 and 31st August 2020 that reported on factors, including barriers and enablers, affecting access to sexual and reproductive health information and services by young people living in Pacific Island Countries and Territories. We assessed the quality of each study according to the study designs, methods of data collection, data analysis and ethical considerations. All information was sorted and organised using an Excel Spreadsheet. Text data from published articles were charted inductively using thematic analysis with no predetermined codes and themes.FindingsFive hundred eighty-nine articles were screened, and only eight met the inclusion criteria outlined in this scoping review protocol. These eight articles reported studies conducted in four Pacific Island Countries and Territories: Cook Islands, Fiji, Papua New Guinea, and Vanuatu. Factors such as lack of accurate sexual and reproductive health knowledge and social stigma were the leading causes of young people’s limited access to sexual and reproductive health services. Cultural and religious beliefs also invoked stigmatising behaviours in some family and community members.ConclusionThis scoping review revealed that social stigma and judgemental attitudes imposed by family and community members, including healthcare providers, hinder young unmarried individuals in Pacific Island Countries and Territories from accessing sexual and reproductive health information and contraceptives. Alternatively, a non-judgmental healthcare provider is perceived as an enabler in accessing sexual and reproductive health information and services. Moreover, given that only a few studies have actually focused on young people’s sexual and reproductive health needs in the region, more research is required to fully understand the health-seeking behaviours of young people in their specific contexts.

The number of young people utilising sexual and reproductive health services in Pacific Island Countries and Territories remains poor despite the availability and the existence of the fundamental rights to access these services. Adolescents and youth need accurate information and timely access to contraceptives to prevent adverse consequences associated with unintended pregnancies, abortion, childbirth and untreated sexually transmitted infections. This scoping review identifies and analyses factors contributing to young people's low access to sexual and reproductive health information and services in this region. Guided by the PRISMA Scoping review guidelines, we searched three databases (Medline Ovid, Scopus and CINAHL Complete) for peer-reviewed articles published between 1st January 2000 and 31st August 2020 that reported on factors, including barriers and enablers, affecting access to sexual and reproductive health information and services by young people living in Pacific Island Countries and Territories. We assessed the quality of each study according to the study designs, methods of data collection, data analysis and ethical considerations. All information was sorted and organised using an Excel Spreadsheet. Text data from published articles were charted inductively using thematic analysis with no predetermined codes and themes. Five hundred eighty-nine articles were screened, and only eight met the inclusion criteria outlined in this scoping review protocol. These eight articles reported studies conducted in four Pacific Island Countries and Territories: Cook Islands, Fiji, Papua New Guinea, and Vanuatu. Factors such as lack of accurate sexual and reproductive health knowledge and social stigma were the leading causes of young people's limited access to sexual and reproductive health services. Cultural and religious beliefs also invoked stigmatising behaviours in some family and community members. This scoping review revealed that social stigma and judgemental attitudes imposed by family and community members, including healthcare providers, hinder young unmarried individuals in Pacific Island Countries and Territories from accessing sexual and reproductive health information and contraceptives. Alternatively, a non-judgmental healthcare provider is perceived as an enabler in accessing sexual and reproductive health information and services. Moreover, given that only a few studies have actually focused on young people's sexual and reproductive health needs in the region, more research is required to fully understand the health-seeking behaviours of young people in their specific contexts.

This scoping review aims to examine and synthesize existing literature on the use of digital health technologies, with a focus on the extent and types of technologies used to access contraceptive services among young people in Sub-Saharan Africa (SSA). Globally, digital health technologies have emerged as pivotal tools in addressing contraceptive needs among young people. In SSA, where traditional healthcare systems often face numerous challenges, these technologies offer innovative solutions to improve access to contraceptive services. Despite growing interest in digital health technologies, comprehensive reviews on contraceptive access among young people in SSA are still lacking. Most existing studies focus broadly on sexual and reproductive health (SRH) or adult populations, leaving a gap in understanding the unique needs and experiences of young people using digital technologies for contraception services. It is unclear how much research has been conducted to examine how these technologies can facilitate contraceptive use, which technologies are used and why, where this evidence is concentrated within SSA, and the prevailing gaps. Therefore, we propose to undertake a scoping review. This scoping review will include studies focusing on young people aged 10-24 years in SSA, addressing access challenges to contraceptive services within this age group. The review will consider client-facing digital health technologies. All methodological approaches and designs will be included. Reviews, protocols, conference papers, policy briefs and studies conducted outside SSA will be excluded. The review will apply the comprehensive search strategy recommended by Joanna Briggs Institute (JBI). The initial limited search of MEDLINE (Ovid) and CINAHL Complete (EBSCOhost) was conducted with guidance from the University Librarian. This informed the selection of keywords, along with index terms, to develop a full search strategy for MEDLINE (Ovid), CINAHL Complete (EBSCOhost), Scopus, Compendix Engineering Village, and IEEE Xplore. The scoping review shall also use supplementary resources such as google scholar, and African Journal online (AJOL). We will also review the reference lists of articles that meet the inclusion criteria to ascertain articles that were not returned by the search criteria. Data will be presented using tables and charts, accompanied by a narrative summary. This scoping review was registered in Open Science Framework: https://doi.org/10.17605/OSF.IO/5QJ6P.

In South Asia, young people face myriad challenges and opportunities regarding their sexual lives relating to varied experiences of norms and restrictions; gender norms and socio-sexual taboos limit communication around sexual health which in turn can affect sexual health outcomes. In this article we focus on norms affecting young people's sexual health experiences in urban settings in Bangladesh, India, Nepal, and Pakistan. We conducted a scoping review of peer reviewed empirical studies based on qualitative data pertaining to young people's experiences of sexuality and sexual health in Bangladesh, India, Nepal, and Pakistan. We searched four electronic databases for articles published (2010-2022), using terms relating to sexual health, young people, and South Asia. Sixteen articles met the inclusion criteria with sample size ranging from 9 to 180. The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines for the design and analysis of this study. We synthesised the included articles using thematic analysis. The studies covered topics such as sexual health services and contraceptive use; sexuality education and communication; and gender and sexual violence. Recurring findings included: parental and societal expectations around premarital 'sexual purity' through abstinence; limited communication around sexuality between young people and parents/adults; gender norms limiting young women's sexual and reproductive decision making; and an absence of research on experiences of sexual and gender minorities. We identified common themes as well as prominent gaps which must be addressed if we are to capture diverse experiences and build a better evidence base to improve sexual health services for young people in the region. The body of research fails to include experiences of young people with diverse gender, sexual orientation, and sex characteristics.

The COVID-19 pandemic and its associated containment strategies have significantly impacted the logistics of supplying sexual and reproductive health (SRH) services to adolescents and young adults (AYA) in sub-Saharan Africa (SSA). Studies conducted in the region indicate an increase in sexual activity, particularly among young people, during the pandemic. However, the impact of these changes on their utilization of SRH services remains unclear. This scoping review aims to synthesize the available evidence on the impact of COVID-19 on the SRH behavior and service utilization of AYA. This review focuses on examining the demand and supply of SRH for AYA during the COVID-19 lockdown period (January 2020 – December 2021). Following the Arksey & O’Malley (2005) procedure and the Joanna Briggs Institute (JBI) Reviewer’s Manual (2020), the review encompasses comprehensive search strategies, analysis, and reporting of results. The search for relevant articles was conducted across various databases, including Medline Complete, Africa-Wide, SocINDEX, Academic Search Complete (all through EBSCOhost), Public Health, Social Science & Sociology databases, the Middle East & Africa Database (all through ProQuest), and Web of Science. Articles published between January 2020 and December 2021 were included in this review. The studies discussed in this review shed light on the discrepancies in the demand for and supply of SRH services during the COVID-19 pandemic, exposing a substantial gap in addressing the specific SRH needs of AYA. This review also examines the strategies adopted by countries in SSA to mitigate these effects. Several countries in SSA demonstrated resilience as health providers fulfilled their role, while AYA sought alternatives to mitigate the shortage in the supply chain for SRH services and commodities, often resorting to alternative medicine. The findings underscore the urgency of further research to address the risks imposed by COVID-19 on the utilization of SRH services by AYA in SSA. The evidence presented in this review can inform strategic efforts to ensure the availability and accessibility of SRH services for AYA during any unforeseen emergency or future pandemic.