Adolescent Sexual Reproductive Health Research Articles

Statistical Analysis of the Effect of Educational Opportunities and Community Involvement on Adolescents and Sexual Reproductive Health Policy on Retention of Girl Child in Public Secondary Schools in Butula Sub-County, Kenya

Girls’ retention in schools has been found to be a major challenge. Failure to retain girls in secondary schools can be considered as a waste of potential human resources and money spend on them in primary education and time lost in sending them to school in the first place. These girls may become a breed of illiterate women who are less productive economically, socially and politically. Among the critical contemporary social issues affecting many countries is teenage pregnancies. This research, therefore, analyses the effect of educational opportunities and community involvement on girl child retention in public secondary schools in Butula sub-county, Kenya using statistical method. Specifically, the research seeks to establish statistically the impact of educational opportunities and community involvement on girl child retention in public secondary schools in Butula Sub-county, Busia County. The study targeted a sample size of 300 respondents which were selected using convenient and purposive sampling techniques based Mugenda and Mugenda (2004) formula. Also, the data from both primary and secondary sources was used in the study. The instruments for gathering the data comprised questionnaires, interviews, and records from the schools. A SPSS version 25 was used to establish any link between the Adolescent Sexual Reproductive Health Policy and girl child retention in public secondary schools Butula Sub-County, Busia County. This study will increase understanding of the effect of teenage pregnancy on class attendance in public secondary schools in Butula Sub-county. The findings of the study indicated that girls missed school during their menstruation because sanitary facilities were inadequate.

Boosting Contraceptive Uptake in Urban Uganda: Older Women Benefit When Layering Adolescent and Youth Interventions Onto Existing Family Planning Programming.

Uganda has a large young population with a high unmet need for family planning (FP). Although there have been many efforts to improve access to and uptake of contraception, improvements have been slow. The Ministry of Health Uganda partnered with The Challenge Initiative (TCI) to implement a novel multipronged approach layering adolescent and youth sexual reproductive health (AYSRH) onto a functioning general FP program for women of reproductive age in 3 local governments of Buikwe, Mukono, and Iganga. We describe the approach and aim to determine whether layering AYSRH interventions onto an existing program resulted in increased contraceptive uptake among adolescents and youth aged 10-24 years and among women aged 25-49 years. We analyzed service statistics from the Uganda Health Management Information System to assess contraceptive uptake for adolescents and youth (aged 10-24 years) and older women (aged 25-49 years) before and after the implementation of the AYSRH approach in 3 areas (Buikwe, Iganga, and Mukono) compared to 11 areas where only the general FP program was implemented and the Uganda country total. This analysis showed that before the start of TCI's support, levels of contraceptive uptake were similar in all local governments. However, after implementation, there was an increase in uptake for general FP program only areas (1.7-point advantage over country total) and an even greater increase in general FP+AYSRH areas (2.4-point advantage over FP only programming). This was observed in both adolescents and youth aged 10-24 years and among women aged 25-49 years. The layering of TCI's AYSRH interventions onto a well-functioning FP platform not only increased contraceptive uptake among adolescents and youth aged 10-24 years but also boosted uptake among women older than age 25 years.

Implementing Quality Improvement Initiatives to Improve the Use of Adolescent- and Youth-Friendly Health Services in Zou, Benin.

In Benin, the unmet need for family planning services is especially high for adolescent girls and youth aged 15-24 years. The Challenge Initiative (TCI) supported the health system to assess and improve the quality of adolescent and youth sexual reproductive health services and enhance contraceptive uptake in 65 service delivery points (SDPs) of the Zou department. Between June 2019 and March 2021, TCI supported the health districts in Zou to train an assessment team to complete 3 cycles of quality assessments (QAs) using a QA checklist adapted to the local context. Based on assessment scores, the SDPs were categorized into poor, moderate, or good to excellent quality. The SDP managers developed remedial action plans after each cycle and for each SDP and followed up with supportive supervision. The first QA cycle showed that 52% of assessed SDPs achieved a good to excellent classification; by the second QA cycle, this reached 74%. However, the quality of adolescent- and youth-friendly health services regressed during the third QA cycle (during COVID-19 pandemic disruptions), when only 40% of SDPs achieved the good to excellent category. Between the first and second QA cycles, contraceptive uptake for adolescents and youth improved in the SDPs that had good or excellent quality of services, compared to the ones that were of lower quality (established significance level of 5% with a P value of .031). Further assessments could deepen our understanding of the internal and external factors that can affect service quality. The findings reinforce the importance of investing in quality improvement strategies to maximize the use of sexual and reproductive health services among adolescents and youth. They also underscore the need for a contextual and nuanced approach to ensure enduring results.

Health Services Strategy of Adolescent Sexual Reproductive Health in Developing Countries

Background: In the developing country 1 in 5 women give birth before the age of 18 years old. The problem of pregnancy is part of the main causes of death in youth between 15 to 19 years old, especially because of abortion complications and unsafe childbirth. Aims: To determine the strategy of health services for adolescent reproduction in developing countries. Method: using the design of scoping review with PRISMA-ScR checklist. Using Arksey and O'Malley in the form of (1) identified research questions, (2) identified relevant articles, (3) chosen articles, (4) data mapping and (5) presented data/result, discussion, and conclusion. Finding articles using 4 databases Ebsco, ScienceDirect, Pubmed, and Wiley Online Library. Results: The strategy of health service for adolescent reproduction in developing countries that can be done is health education/comprehensive sexuality education (CSE), youth-friendly service, and model of sexuality education enhancement (SEE). Conclusion: all of the three strategies the most applied is youth-friendly service followed by health education in the form of CSE. For the next research, it is expected to be able to analyze and evaluate a more dominant strategy also more effective in handling sexual health and adolescent reproduction both in developed countries and developing countries.

Quality Health Services for Adolescents: Assessing Awareness and Use of Adolescent Sexual Reproductive Health Services in Keta, Ghana

ABSTRACT Introduction Although adolescents have access to sexual and reproductive health services, they encounter a variety of obstacles, including limited access to safe abortion and contraceptives, early pregnancy and parenthood, and a high occurrence of sexually transmitted infections. This research assessed the awareness and use of adolescent sexual reproductive health services in the Keta Sub-district of Ghana. Methods A cross-sectional study using a quantitative method of analysis and the administration of a structured questionnaire to 350 adolescents between the ages of 14 and 19 in the Keta Sub-district was conducted. Results Of the 10 services covering adolescent sexual and reproductive health, 75% of participants were aware only of comprehensive sex education. Only 27% were aware of sexually transmitted infection prevention and care services. Awareness was 13% or lower for the remaining eight services. Only 24% had used an adolescent sexual reproductive health service. Conclusion Awareness of adolescent sexual reproductive health services and their use is low in the Keta Sub-district. To improve access to sexual and reproductive health information, sub-district health services should create school-based satellite clinics for adolescents. Adolescents’ ambassadors should be created to educate peers on adolescent issues, especially sexual and reproductive health.

Female adolescent sexual reproductive health service utilization concerns: A qualitative enquiry in the Tema metropolis of Ghana.

Evidence globally indicates that female adolescents face numerous sexual and reproductive health (SRH) risks. Utilization of sexual reproductive health services among adolescents is of global health importance and plays a crucial role in adolescent sexual reproductive health outcomes and their quality of life. The current study explored sexual reproductive health service utilization concerns among female adolescents in the Tema Metropolis in Southern Ghana using the Anderson and Newman Behavioural model of Health Service Utilization as a guiding framework. The study utilized a qualitative exploratory descriptive design. Purposive sampling was used to recruit female adolescents. In-depth face-to-face interviews were conducted using a semi-structured interview guide. In all, 12 interviews were conducted. Each interview lasted between 45 and 60 minutes. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. Thematic analysis was guided by the constructs of the Anderson and Newman Behavioural model of health service utilization. Utilization of sexual reproductive health services among female adolescents is low in the Tema metropolis. Factors such as unprotected non-consensual sexual activity or an unwanted pregnancy sometimes triggered the use of these services. Barriers to utilization identified include lack of awareness on sexual reproductive health services, unreliable sources of SRH information, underestimation of the severity of sexual reproductive health problems faced, unmet expectations and poor experiences with service providers. The current study identified poor utilization of sexual reproductive health services among female adolescents within the Tema metropolis of Ghana. There is the need to increase the number of adolescent health corners, increase awareness about SRH services among adolescents, improve parent-child SRH communication and provide adequate training for healthcare providers to improve provider attitude towards adolescent SRH service delivery in order to increase utilization of sexual reproductive health services among female adolescents in the Metropolis.

Applying ADDIE Model to Develop Multimedia Lessons for Adolescent Reproductive Health Education in Uganda

This study aimed to develop and evaluate a multimedia application intervention for adolescent sexual reproductive health education in secondary schools in Uganda. The lack of access to quality reproductive health education and services, exacerbated by the recent COVID-19 pandemic, contributes to unplanned pregnancies, health complications, and sexual and gender-based violence (SGBV) among adolescents in Uganda. Researchers and teachers collaborated to create multimedia lessons covering topics such as sexual reproductive health and rights (SRHR) and SGBV for adolescents in participating schools. The educational content and format were co-designed to better incorporate the local context and address priority issues by involving end users of the software (adolescents and their teachers) as content contributors during the development phase. The innovative multimedia application was developed using the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model. A student manual was also created as a teaching tool, providing educators with lesson introductions and guiding questions for post-lesson group discussions. The manual includes a simplified print version of the educational content, ensuring that students and teachers in schools without ICT resources can benefit from the intervention. Questionnaires were developed and administered to 14 Results indicate that all 14 trained teachers demonstrated improved knowledge about the use of multimedia applications to deliver adolescent-friendly sexual reproductive health (SRH) education. Additionally, all 14 teachers self-reported that the multimedia application is a feasible and acceptable method to deliver adolescent-friendly SRH education.

Assessment of Structural and Process Factors in Delivering Quality Adolescent Sexual and Reproductive Health Services in Ghana.

Sexual and reproductive health services are often underserved to adolescents in many societies. For many of these sexually active adolescents, reproductive health services such as the provision of contraception and treatment for sexually transmitted infections, either are not available or are provided in a way that makes adolescents feel unwelcome and embarrassed. This study assessed the structural and process factors available in delivering quality adolescent sexual and reproductive health (ASRH) services in health facilities across three regions in Ghana. A facility-based descriptive cross-sectional study assessed the structural and process factors available for delivering quality adolescent sexual reproductive health services in 158 selected health facilities across three regions (Oti, Eastern, and Volta) of Ghana. A simple random sampling by balloting was used to select the health facilities and a total of 158 adolescents who used ASRH services in the selected facilities were sampled for an existing interview. The Donabedian model of quality assessment was adopted and modified into an assessment tool and a questionnaire to assess the selected health facilities and respondents. The Statistical Package for the Social Sciences (SPSS) version 20.0 was used to analyze the data collected and the findings presented in the tables. The study found some structural and process barriers that affected the delivery of quality ASRH services in Ghana. A proportion of 85 (53.50%) of the facilities assessed did not have separate spaces for delivering services for adolescents. All 158 health facilities had the National Health Insurance Scheme (NHIS) covering contraceptive/family planning services for adolescents. Most (128, 81.01%) facilities had available educational materials on ASRH but were not made available for take home by adolescents. The findings indicated that most respondents did not require parental, spouse, or guardian consent before using ASRH services. The average waiting time for adolescents to be attended to by service providers was ≤30 minutes. The study found some structural and process barriers that affected the delivery of quality ASRH services in Ghana. ASRH services, particularly contraceptive/family planning services, were well integrated into NHIS to improve access and utilization by adolescents.

A qualitative assessment of the impact of a community-embedded intervention on beneficiaries' attitudes and beliefs about adolescent sexual reproductive health in Ebonyi State, Southeast, Nigeria

BackgroundAdolescents and their communities in Ebonyi State, Nigeria have poor attitudes and beliefs towards adolescent sexual and reproductive health (SRH). This paper reports on the effects of a community-embedded intervention that focused on creating positive changes in the attitudes and beliefs of adolescents and community members to enhance adolescents’ access to SRH information and services. MethodsThis study adopted the Qualitative Impact Assessment approach to evaluate the changes in attitudes and beliefs about the SRH of adolescents from the perspectives of the beneficiaries of a community-embedded intervention namely, adolescents, parents, school teachers, and community leaders. The intervention was implemented in six local government areas in Ebonyi State, southeast Nigeria and the evaluation was undertaken four months after the implementation of the interventions commenced. Eighteen (18) interviews were conducted with 82 intervention beneficiaries including: (i) six in-depth interviews with school teachers; (ii) two sex-disaggregated FGDs with parents; (iii) two sex-disaggregated FGDs with community leaders; and (iv) eight sex-disaggregated FGDs with in school and out of school adolescents. A thematic analysis of data was performed with the aid of NVivo software, version 12.ResultsThe community-embedded intervention led to changes in individual attitudes and beliefs, as well as changes in community norms and values concerning adolescent SRH. Adolescents reported that following the community-embedded SRH intervention, they have become more comfortable discussing openly SRH issues with their peers, and they could more easily approach their parents and initiate SRH discussions. The parents of adolescents reported that following the intervention, they have become more willing to discuss sensitive SRH issues with adolescents, and frequently make out time to do so. It was also reported that parents no longer use euphemisms to describe sexual body parts, and community leaders now believe that it is all right to discuss SRH with adolescents. Hence, initiating or having SRH discussions with adolescents is no longer misconceived as encouraging sex, and menstruation in unmarried adolescents is no longer viewed as a sign of promiscuity. Respondents also highlighted changes in community norms of, (i) gendered parental communication of SRH matters, as both mothers and fathers have started discussing SRH issues with their adolescent boys and girls; and (ii) public shaming and discipline of pregnant teenage girls are on the decline.ConclusionThe community-based intervention had a positive impact on individual attitudes and beliefs, as well as community and societal values and norms about adolescent SRH. Interventions that take into account community norms and values regarding adolescent SRH should be prioritized to enable the achievement of the SRH-related target of SDG 3.

Effect of Adolescents and Sexual Reproductive Health Policy on Girl Child Retention in Public Secondary Schools in Butula Sub-County, Kenya

The challenge of girls' retention in educational institutions has been identified as a significant obstacle. The inability to maintain the enrollment of female students in secondary schools can be regarded as a squandering of valuable human capital and financial investments made in their primary education, as well as a loss of time invested in their initial enrollment. These young females have the potential to develop into a demographic of women lacking in literacy skills, resulting in diminished economic, social, and political contributions. Among the critical contemporary social issues affecting many countries is teenage pregnancies. The matter of ASRH is a global issue affecting both developed and underdeveloped countries. The problem has drawn attention of governments from both developed and underdeveloped nations. Researchers have also given it consideration and studied it to some extent in their efforts to solve the recurring puzzle of solving the sex related matters that affect adolescents. This research was guided by a general objective, the effect of adolescents and sexual reproductive health policy on girl child retention in public secondary schools in Butula sub-county, Kenya. The study also adopted specific objective as; i)To assess the effect of educational opportunities on girl child retention in public secondary schools in Butula Sub-county Kenya.The study was guided by Human Capital theory of adolescence. Research adopted the descriptive survey design. The study also targeted a sample size of 488 respondents, out of the targeted population of 1335 respondents. The criteria for selecting sample size using convenient and purposive sampling techniques was fixed upon Mugenda and Mugenda (2004) formula. Also, the data from both primary and secondary sources was utilized in the study. The instruments for gathering the data comprised questionnaires, interviews, and records from the schools. Before utilizing the instruments in this research, they were tested using test-retest methods to ascertain validity and reliability. To establish links between variables, the study used correlational analysis. Precisely, a SPSS version 25 was used when seeking to establish any link between the Adolescent Sexual Reproductive Health Policy and girl child retention in public secondary schools Butula Sub-County, Busia County. There is an expectation that this study increased towards knowledge or understanding of the effect of teenage pregnancy on class attendance in public secondary schools in Butula Sub-county. Due to the sensitivity of the research all information that was obtained it was regarded as confidential and the participants including the schools kept it anonymous. Also, no one was coerced to become part of the sample space, but consent was the criteria upon selection of respondents in the study. Therefore, this study involved the highest level of confidentiality, acknowledgment and consent when dealing with respondents and sources of data. The finding of the study was that ASRH services were significant to girl retention in schools. Moreover, it was found that information on ASRH on girls’ retention was from media and school. This study recommends that school administrators assume the role of fostering a collaborative relationship between schools and the community. This partnership would facilitate the identification of opportunities for teachers, parents, and community members to collaborate in order to enhance the educational outcomes of students.

Unlocking policy synergies, challenges and contradictions influencing implementation of the Comprehensive Sexuality Education Framework in Zambia: a policy analysis

BackgroundComprehensive sexuality education (CSE) has recently become salient, but adolescent sexual reproductive health and rights (ASRHR) challenges are still a global health problem. Studying policies which have implications for CSE implementation is a crucial but neglected issue, especially in low and middle-income countries (LMICs) like Zambia. We analyzed policy synergies, challenges and contradictions influencing implementation of CSE framework in Zambia.MethodsWe conducted a document review and qualitative interviews with key stakeholders from Non-Governmental Organizations, as well as health and education ministries at the National and all (10) provincial headquarters. Our methods allowed us to capture valuable insights into the synergies, challenges and contradictions that exist in promoting CSE framework in Zambia.ResultsThe study highlighted the synergies between policies that create opportunities for implementation of CSE through the policy window for adoption of sexual reproductive health and rights (SRHR) that opened around the 1990s in Zambia, promotion of inclusive development via education, adoption of an integrated approach in dealing with SRHR problems, and criminalization of gender-based violence (GBV). This analysis also identified the policy challenges and contradictions including restricted delivery of education on contraception in schools; defining childhood: dual legal controversies and implications for children, grey zones on the minimum age to access SRHR services; inadequate disability inclusiveness in SRHR legal frameworks; policy silences/contentious topics: LGBTQI + rights, abortion, and grey zones on the minimum age to access SRHR services.ConclusionWhile many policies support the implementation of CSE in schools, the existence of policy silences and challenges are among the barriers affecting CSE implementation. Thus, policy reformulation is required to address policy silences and challenges to enhance effective promotion and integration of the CSE framework.

The Effectiveness of Reloud Model in Increasing Knowledge and Literacy of Health Reproduction’s Adolescents Based on Health Education in Samarinda City

Reloud aims to foster students' love for reading. Indonesian adolescent sexual reproductive health research states that 10% of those aged 15-24 have had premarital sex, used condoms (49% of women & 27% of men), had unwanted pregnancies 24%, knowing that their friends had abortions ( 23% of girls and 19% of boys) and 15% of them consume alcohol, this is influenced by various factors, one of which is the lack of information about adolescent reproductive health. Literacy in Indonesia is included in the low category (37.32%), so efforts to increase literacy are very urgent to be carried out as an effort to improve the quality of the Indonesian nation's resources. The target population in this study was health-based senior high school students in Samarinda City. The design of this study used a Quasi Experiment with a pre-posttest approach with a control group design. Samples were taken from as many as 3 (three) health-based schools in Samarinda city with a purposive sampling of 60 respondents. Characteristics of the dominant respondent are 16 years old (31.6%), female (65%), and in class X (38.3%). The results of data analysis on differences in the level of adolescent reproductive health knowledge obtained a p-value of 0.826 if no intervention was given, a p-value of 0.153 if given 1 (one) intervention, and a p-value of 0.001 if given 2 (two) Reloud interventions. Of the three groups that described the effectiveness of the Reloud intervention method, it occurred significantly in increasing adolescent knowledge related to reproductive health by a p-value of 0.031 so this method is one that can be applied to adolescents.

Factors Hindering Adolescents from Utilizing Reproductive Health Services in Kampala International University Teaching Hospital

In Uganda, only 19% of adolescents utilize adolescents’ reproductive health services yet complications of pregnancy, abortions, and childbirth are the leading cause of disability and death among the same age group. The purpose of this study was to assess factors that were contributing to the low utilization of adolescents’ reproductive health services. A quantitative cross-sectional study employed simple random sampling among 85 adolescents that were attending Kampala international university outpatient clinic. Results found out that majority 46(53.4) of adolescents were aged from 15-16 years, 46(53.4%) were male, 28(32.5%) were Catholics most 81(94.1%) were single. 18(36%) had got the information from their friends, 28(56%) of adolescents said that the information about adolescents' reproductive health services was not freely shared in their communities and 33(66%) said that their communities did not accept adolescents sexual reproductive health services where 7(50%) gave a reason they expected to be young to have sexual intercourse. 43(86%) of adolescents were from within 1-5km, 28(73.8%) mentioned lack of privacy at the facility, and 30(79%) said that health workers segregated adolescents that needed similar reproductive health services. In conclusion, factors that were contributing to the low hindering utilization of adolescents’ reproductive health services were both demographic, socio-economic, and facility related. Keywords: Adolescents, Reproductive, Health Services, Uganda.

Trends and determinants of adolescent pregnancy: Results from Kenya demographic health surveys 2003–2014

BackgroundAdolescent pregnancy increases the risk of disability and death due to unsafe abortion, prolonged labour and delivery, and complications after birth. Availability of accurate data is important to guide decision-making related to adolescent sexual reproductive health (ASRH). This study analyses the trends in prevalence and factors associated with adolescent pregnancy in Kenya using data from three national Demographic Health Surveys (2003, 2008/2009, 2014).MethodsOur analysis focused on a subsample of data collected from women aged 20 to 24 years. A trend analysis was performed to establish a change in the rate of adolescent pregnancy in 2003, 2008/2009, and 2014 survey data points. Binary Logistic regression and pooled regression analysis were used to explore factors associated with adolescent pregnancy.ResultsThe percentage of women aged 20 to 24 years who reported their first pregnancy between ages 15 and 19 years was 42% in 2003 and 42.2% in 2009 but declined to 38.9% in 2014. Using regression analyses, we established that education status, marital status, religion and wealth quintile were associated with adolescent pregnancy. Trend analysis shows that there was an overall decreasing trend in adolescent pregnancy between 2003 and 2014.ConclusionAlthough Kenya has made strides in reducing the prevalence of adolescent pregnancy in the last decade, much more needs to be done to further reduce the burden, which remains high.DefinitionAdolescents: Although WHO defines the adolescence period as being 10–19 years, this paper focuses on the late adolescent period, 15–19 years, here in referred to as adolescents.

Influence of Sex Education on the Sexual Behaviour of Adolescents

The purpose of this study was to assess the influence of sex education on the sexual behaviour of adolescents in Senior and Junior High Schools in the New Juaben Municipality. A cross-sectional research design was adopted for the study. The population of the study are adolescents in Junior and Senior High Schools in New Juaben Municipality. A random sampling technique was used to select two-hundred and fifty (250) respondents from two Junior High Schools and two Senior High Schools in New Juaben Municipality. The main instrument used for data collection was a questionnaire. Both inferential and descriptive statistics were used to analyse the data. The study indicated that sex education (in terms of HIV/AIDS education) has had a significant influence (impact) on sexual behaviours. The positive sexual behaviours of adolescent in Junior and Senior High Schools is evident in their attitude toward premarital sex. The study also revealed that adolescents exhibited a positive attitude toward premarital sex and abstaining from sex that will make them sick or look odd in society, neither would it give them problems during intercourse when they finally marry. It is recommended that Parents should ensure that their children receive more sex education to offset the negative influences of the media. It is also recommended that Government may also consider replicating the popular nationwide Science and Mathematics quiz in the area of adolescent sexual behaviour and reproductive health in SHS and JHS to increase the awareness of students about appropriate adolescents’ sexual behaviours and reproductive health issues.

Ethiopia has a long way to go meeting adolescent and youth sexual reproductive health needs

Ethiopia has the second-largest youth population in Africa with about 37.4 million people aged 10–24 years. To meet the needs of this population group, adolescent, and youth health (AYH) programs, including those focused on sexual and reproductive health (SRH) and youth development, have gained traction in Ethiopia in the last two decades, especially following the 2005 election in Ethiopia. However, adolescents and youths in Ethiopia continue to face a high burden of morbidity and mortality from multiple factors including, teenage pregnancy, unplanned pregnancy, compromised nutrition, HIV and STIs, unsafe abortion, early and child marriage, and unmet needs for family planning. To date, adolescents and youth-related interventions in Ethiopia are fragmented under various ministries, uncoordinated, underfunded, project-oriented, lack effective policy implementation, and lack meaningful participation of young people. Addressing adolescents and youth health and development issues require evidence-based, well-tailored, at scale, intensified, coordinated, and holistic national responses. Therefore, there is a need to advocate for a realization of robust government commitment to ensure a multi-sectoral, coordinated, at scale, and well-funded national response to address the multifaceted needs of young people in Ethiopia including their sexual and reproductive health. An example to emulate is the HIV/AIDS response in Ethiopia, which was led by a national council chaired by the President of the Federal Democratic Republic of Ethiopia and spearheaded by a secretariat leveraging resources and implementing a multisectoral national plan down to the kebele level.

An Unstructured Supplementary Service Data-Based mHealth App Providing On-Demand Sexual Reproductive Health Information for Adolescents in Kibra, Kenya: Randomized Controlled Trial.

BackgroundAdolescents transitioning from childhood to adulthood need to be equipped with sexual reproductive health (SRH) knowledge, skills, attitudes, and values that empower them. Accessible, reliable, appropriate, and friendly information can be provided through mobile phone–based health interventions.ObjectiveThis study aims to investigate the effectiveness and impact of an Unstructured Supplementary Service Data (USSD)–based app in increasing adolescents’ knowledge about contraceptives, gender-based stereotypes, sexually transmitted infections (STIs), abstinence, and perceived vulnerability, and helping adolescents make informed decisions about their SRH.MethodsA randomized controlled trial (RCT) methodology was applied to investigate the potential of a USSD-based app for providing on-demand SRH information. To be eligible, adolescents aged 15 to 19 years residing in Kibra, Kenya, had to have access to a phone and be available for the 3-month follow-up visit. Participants were randomly assigned to the intervention (n=146) and control (n=154) groups using sequentially numbered, opaque, sealed envelopes. The primary outcome was improved SRH knowledge. The secondary outcome was improved decision-making on SRH. The outcomes were measured using validated tools on adolescent SRH and user perceptions during the follow-up visit. A paired sample t test was used to compare the changes in knowledge scores in both groups. The control group did not receive any SRH information.ResultsDuring the RCT, 54.9% (62/109) of adolescents used the USSD-based app at least once. The mean age by randomization group was 17.3 (SD 1.23) years for the control group and 17.3 (SD 1.12) years for the intervention group. There was a statistically significant difference in the total knowledge scores in the intervention group (mean 10.770, SD 2.012) compared with the control group (mean 10.170, SD 2.412) conditions (t179=2.197; P=.03). There was a significant difference in abstinence (P=.01) and contraceptive use (P=.06). Of the individuals who used the app, all participants felt the information received could improve decision-making regarding SRH. Information on STIs was of particular interest, with 27% (20/62) of the adolescents seeking information in this area, of whom 55% (11/20) were female. In relation to improved decision-making, 21.6% (29/134) of responses showed the adolescents were able to identify STIs and were likely to seek treatment; 51.7% (15/29) of these were female. Ease of use was the most important feature of the app for 28.3% (54/191) of the responses.ConclusionsAdolescents require accurate and up-to-date SRH information to guide their decision-making and improve health outcomes. As adolescents already use mobile phones in their day-to-day lives, apps provide an ideal platform for this information. A USSD-based app could be an appropriate tool for increasing SRH knowledge among adolescents in low-resource settings. Adolescents in the study valued the information provided because it helped them identify SRH topics on which they needed more information.Trial RegistrationPan African Clinical Trial Registry PACTR202204774993198; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=22623

Implementing adaptive youth-centered adolescent sexual reproductive health programming: learning from the Adolescents 360 project in Tanzania, Ethiopia, and Nigeria (2016-2020).

Adolescents 360 (A360) was a 4.5-year project working directly with young people to increase demand for, and voluntary uptake of, modern contraception among adolescent girls aged 15 to 19 years. A360 utilized human centered design (HCD) to create four adolescent sexual and reproductive health (ASRH) interventions across three countries - Smart Start in Ethiopia, Kuwa Mjanja in Tanzania, Matasa Matan Arewa (MMA) in northern Nigeria, and 9ja Girls in southern Nigeria. A360's interventions tap into girls' aspirations and position contraception as a tool that can support them in pursuing their life goals. As A360 transitioned from its first program phase into its follow-on in 2020, the project examined what it had accomplished, where it had failed, and what it had learned in the process, with the goal of contributing to the global evidence base and building on these lessons in its follow-on program. A360 draws out five key lessons in this publication. These lessons speak to 1) the value of A360's aspirational program components and the need to meaningfully support girls to pursue their life goals holistically; 2) the necessity of taking a consistent and rigorous approach to improving the enabling environment for contraceptive use to promote transformative change; 3) the need to find program and measurement approaches that respond to girls' unique patterns of sexual activity, and support contraceptive continuation; 4) the usefulness of continuous program improvement during implementation to maintain a user-centered focus and create a culture of curiosity and innovation; and 5) the tension between designing for users and beginning with program sustainability in mind from the outset. A360 continues to grow in its understanding of what it takes to support sustained, transformative, holistic change for adolescent girls and commits to openness and transparency regarding successes and failures during its next project phase.

Sexual and Reproductive Health Service Provision to Adolescents in Edmonton: A Qualitative Descriptive Study of Adolescents’ and Service Providers’ Experiences

The goal of adolescent sexual reproductive health (SRH) services is to provide information, education and healthcare to promote safe health practices and protect adolescents from negative health outcomes; however, access to timely, effective, and affordable SRH services by adolescents in Edmonton, Canada remains relatively unknown. Our study sought to understand the perspectives and experiences of adolescent girls and service providers in relation to availability, accessibility, and quality of SRH services available in Edmonton. The study objectives were to explore SRH services adolescents seek, uncover barriers in accessing SRH services and identify areas to improve accessibility. Qualitative description design was employed to conduct this study. Five service providers specializing in SRH, and eight females (ages 17–20 years) that access SRH services were recruited from the Alberta Health Services Birth Control Centre (BCC). Semi-structured interviews took place via Zoom. Thematic analysis was conducted using NVIVO software. Findings consisted of four primary themes: (1) views and current SRH practices; (2) barriers to accessibility; (3) the effects of COVID-19 on accessibility; (4) identified gaps in SRH care. The findings from our study support the development of knowledge translation strategies and make recommendations to improve the present quality of SRH services in Edmonton.

Barriers facing Bangladeshi Adolescents in Learning about Sexual and Reproductive Health

This paper looks into the barriers faced by Bangladeshi adolescents in learning about sexual and reproductive health. A mixed method approach was used to generate data gathered from the two study sites named Dhormasor Mohisa Trimukhi Uchho Bidalay and the Jaforgonj High School located in the Rangpur district, the northern part of Bangladesh. Thematic analysis was employed to develop themes, priori and other memos. Our findings demonstrate several key issues, all of which negatively impact adolescent Sexual Reproductive Health (SRHR) education. First, there is the lack of teacher training and experience in SRHR class lectures, as well as parental ignorance. Second, there are social stigmas, social taboos and cultural rigidity. Third, there are significant institutional barriers like the lack of textbook information, combined classes and age discrepancies between teachers and students. Fourth, male teachers often give SRHR lectures to female students, and female teachers give SRHR lectures to males. Fifth, misuse of appropriate technology and sometimes its lack of access can also prevent adolescents obtaining correct information about SRHR. This study contributes to the field of gender and public health.