Comprehensive Reproductive Health Research Articles

"They are not HIV treatments drugs; they are preventive drugs (PrEP)". Experiences of PrEP uptake among vulnerable adolescent girls and young women in Tanzania.

HIV poses a significant global health concern, affecting adolescents among other populations. This is attributed to various vulnerabilities including biological factors, gender inequalities and limited access to comprehensive sexual and reproductive health services in sub-Saharan Africa. In Tanzania, adolescent girls, and young women (AGYW) face double the risk of HIV infection compared to their male counterparts. The introduction of pre-exposure prophylaxis (PrEP) in early 2018 brought hope for changing the HIV cascade in the country. However, numerous challenges still hinder PrEP uptake. Therefore, this study explored experiences of PrEP uptake among vulnerable AGYW in Tanzania. This study employed a phenomenological qualitative approach; 52 semi-structured interviews were carried out between May to November 2022 in the selected healthcare facilities in Tanzania. The study adopted inductive-deductive thematic analysis guided by the Social Ecological Model (SEM) to elicit the views of AGYW aged 15-24. Nvivo software was utilised to organise data. This study has uplifted barriers and facilitators on PrEP uptake among AGYW in Tanzania. The barriers are categorized at individual, interpersonal, and institutional levels. The individual level barriers included pre-requisites for initiating PrEP, disbelief in the effectiveness of PrEP, interference of refill hours with working hours, financial constraints, and adherence to the pills. The interpersonal level barriers included misconceptions about PrEP pills, and labelling of PrEP users. The institutional level barriers included inadequate privacy, PrEP drug stockout, being turned away by health care facilities (HCF), long waiting times, and distance to the HCF. Facilitators included factors at individual level (experienced benefit of PrEP, adequate PrEP knowledge, having multiple partners, perceived risk due to the nature of the work, PrEP ensuring privacy), interpersonal level (support from social networks), and institutional level (Free availability of PrEP, receiving refill reminders). To overcome barriers to PrEP uptake among AGYW, it is crucial to develop multi-level interventions that consider personal, social, and structural factors hindering PrEP uptake. Implementing strategies like prioritizing off-site PrEP delivery and expanding community outreach for PrEP awareness can help dispel misconceptions and enhance uptake.

Infertility: Disparities and Access to Services: ACOG Committee Statement No. 14.

Diagnostic testing and treatment for infertility should be available to everyone in need of these services. The disparities in rates of infertility and the barriers to accessing assisted reproductive technology services should be understood through and addressed within a reproductive justice framework. Obstetrician-gynecologists and other health care professionals should identify specific populations at risk and their accompanying barriers to access to help improve infertility care across populations. Health care professionals should ask appropriate questions about social and structural drivers of health that may influence a patient's health and use of the health care system to better understand their patients' needs and lived experiences. Obstetrician-gynecologists and other health care professionals should advocate for insurance coverage for infertility services, including assisted reproductive technology; policy changes that promote comprehensive reproductive health; and evidence-based, lower cost treatment options.

Psychosocial challenges of pregnant adolescents: A narrative Inquiry of Adolescents in the Ho Municipality, Volta Region, Ghana

Adolescent health studies in Ghana’s Volta Region have often focused on topics such as family planning, teenage pregnancy, and unsafe abortions. However, limited empirical evidence exists regarding the psychosocial challenges faced by pregnant adolescents. This study explores the psychological and social difficulties impacting pregnant adolescents in the Ho Municipality, to inform policies and psychosocial interventions to support this vulnerable group. Using a narrative and phenomenological approach, this facility-based qualitative study gathered insights from pregnant adolescents aged 10-19 through in-depth interviews at the Volta Regional and Ho Municipal Hospitals. Participants were selected through purposive sampling and provided accounts of their experiences, challenges, and the factors contributing to their pregnancies. Thematic analysis revealed significant psychological challenges such as hopelessness, anxiety, sadness, isolation, and sleep disturbances. These issues were often driven by family rejection, partner denial, stigmatization, and discrimination. Poverty emerged as the primary contributor to adolescent pregnancy, alongside factors such as single parenting, lack of contraceptive access, limited sexual education, peer pressure, cultural influences, and media portrayals of sexual behaviour. The study highlights a need for multifaceted strategies at both structural and individual levels to address adolescent pregnancy and its associated psychosocial challenges in the Ho Municipality. The study recommended implementing comprehensive sexual and reproductive health education in schools, communities, and families to better support adolescents in managing and preventing pregnancy.

Influence Alcohol, Sexuality, And Reproductive Health To Quality Of Life For Teenagers In Bolaang Mongondow

Adolescence is an important period in human development marked by significant physical, psychological, and social changes. In this context, alcohol consumption, sexual health, and reproductive health can affect the overall quality of life of adolescents. This study aims to analyze the effect of alcohol consumption, sexual health, and reproductive health on the quality of life of adolescents in Bolaang Mongondow Regency. This study used a quantitative approach with an observational method and cross-sectional design. The study sample consisted of 406 adolescents selected by simple random sampling. Data were collected through questionnaires and analyzed using univariate, bivariate (Chi Square test), and multivariate (logistic regression) analysis. The results showed that alcohol consumption had a significant effect on the quality of life of adolescents in the psychological domain (p = 0.001) and environment (p = 0.000). Meanwhile, sexual and reproductive health had a significant effect on the psychological domain (p = 0.006) and environment (p = 0.042). Alcohol consumption has been shown to contribute to impaired self-confidence, concentration, and discomfort in the social environment, while poor sexual and reproductive health causes difficulties in building personal relationships and social comfort. The results of this study have important implications for policy makers, particularly in strengthening regulations related to alcohol consumption among adolescents and developing more comprehensive sexual and reproductive health education programs. Community-based interventions also need to be improved to create a social environment that supports healthy and responsible adolescent development. This study provides an evidence-based basis for designing relevant and sustainable policies to improve the quality of life of adolescents.

Do school students study enough about the reproductive system? Data from Jordan

BackgroundUnderstanding reproductive anatomy and physiology is essential for safe wealthy sexual practices as well as reproductive attitudes. It has been advised that comprehensive sexual reproductive health (SRH) education should be provided in educational systems, colleges, and communities. We aimed to explore the knowledge about the reproductive system among first-year students in non-medical health schools.MethodA pre-validated questionnaire was distributed among first year non-medical health care school students in two universities.ResultsA number of 384 students were included. The average score of knowledge was 14.12 out of 42, Female students scored higher than males (15.06 versus 11.54).ConclusionFrom the results of the current study, it appears that Jordanian students do not study enough about reproductive systems. It is recommended that the school curricula in the fields about reproductive systems, need to be reassessed and reformed, teachers need to be trained for better teaching strategies about reproductive subjects as well.

Survey of Public Needs on The Design of an Integrated Information System Model for Adolescent, Mother, and Child Health

Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Indonesia are still high, with MMR reaching 305/100,000 live births and IMR at 22.23 per 1,000 live births. Although the government has launched various programs for adolescent, maternal, and child health, there has been no effort to integrate these programs into a comprehensive reproductive health cycle. This study aims to analyze the needs of the community in designing an integrated information system model for adolescent, maternal, and child health. This study used a survey design conducted in Dau, Malang Regency, Indonesia. The population consisted of all women of childbearing age (15-49 years) totaling 945 people, with a sample size of 311 respondents obtained using the Slovin formula. The sampling technique used cluster sampling from 4 RW in Petungsewu Village, and 279 respondents could be processed. The research instrument used a questionnaire, and the data were analyzed quantitatively in the form of frequency distribution. The results of the data analysis showed that the design of the integrated model of adolescent, maternal, and child health has significant potential as the basis for developing an integrated website system. This system not only facilitates comprehensive health education but also strengthens real-time health recording and reporting mechanisms. This study shows that the integration of health education is essential to meet the different information needs of adolescents, mothers, and children. The model successfully identified and categorized these needs, so that the developed website could provide relevant and specific content for each user group.

Early sexual debut and pregnancy termination: uncovering the link among sexually active young women in 23 sub-Saharan African countries

BackgroundUnplanned pregnancy could be a socio-economic burden for many young women in sub-Saharan Africa (SSA) which often leads to pregnancy termination. The role of age at sexual debut in pregnancy termination in countries with lower income remains unknown. Hence, this study examines the association between age at sexual debut and pregnancy termination among sexually active young women between the ages of 15 -24 in 23 SSA countries.MethodsCross-sectional secondary datasets from the most recent Demographic and Health Survey conducted in 23 countries in SSA conducted between 2010 and 2018 among 34,343 sexually active young women were analysed using bivariate and multivariable logistic regression to examine the association between age at sexual debut and pregnancy termination with statistical significance of p < 0.05.ResultsThe pooled prevalence of pregnancy termination among sexually active young women in SSA was 11.00%. Higher odds of pregnancy termination were found among those who had early sexual debut (below 16 years) [(aOR = 1.34, 95% CI = (1.22–1.48)] compared to those who had late sexual debut. Furthermore, those who were exposed to mass media [(aOR = 1.29, 95% CI = (1.16–1.43)] were more likely to report pregnancy termination compared to those who were not exposed. On the other hand, those residing in rural areas and those within the richest wealth index were associated with lower odds of pregnancy termination.ConclusionThe study concluded that early sexual debut of sexually active young women in SSA was significantly associated with pregnancy termination. Mass media exposure was found to be a risk factor for pregnancy termination whilst residing in rural areas, and those within the richest wealth index were protective factors. Interventions should be designed to target young women with early sexual debut to provide comprehensive sexual and reproductive health education to enable them to make informed decisions on pregnancy termination.

Factors Associated With Delay in Seeking Abortion Care Until the Second Trimester at Jimma University Medical Centre: A Prospective Cross‐Sectional Study Jimma, Southwest Ethiopia

ABSTRACTObjectiveAlthough the overall abortion‐related maternal mortality ratio has shown a downward trend in Ethiopia, the case‐fatality rate from abortion is still high. This study identified factors associated with delays in seeking an abortion until the second trimester at Jimma Medical Centre, Jimma, southwest Ethiopia.MethodsFrom February to August 2023, we conducted a cross‐sectional study on pregnant women seeking safe abortion care. Participants were selected through systematic sampling from a sample size of 260 calculated based on a previous study's prevalence of second‐trimester abortion (19.2%), with 80% power and a 5% margin of error. Participants were selected using systematic sampling and data were collected by an interviewer‐administered questionnaire. P‐value adjusted odds ratios (AORs) with their 95% confidence interval (CI) were used to determine the association between variables.ResultsThe study found a high prevalence of second‐trimester abortion at 58%. Factors significantly associated with delays in seeking abortion services until the second trimester included being from a rural area (AOR = 2.1, 95% CI: 1.2–3.8), experiencing social stigma (AOR = 4.2, 95% CI: 2.9–7.8), being unmarried (AOR = 1.6, 95% CI: 1.0–3.0), having limited knowledge of menstrual periods (AOR = 2.3, 95% CI: 1.2–4.6), delaying suspicion and testing for pregnancy (AOR = 18.2, 95% CI: 2.1–8.9–37.3), postponing the decision to have an abortion by more than 1 week (AOR = 4.9, CI: 1.0–23.7), and being a primigravidae (AOR = 2.1, CI: 1.1–4.1).ConclusionsBeing from a rural area, social stigma surrounding abortion, being unmarried, limited knowledge of menstrual periods, and being a primigravidae were found to be significantly associated with delays in seeking abortion services until the second trimester. A multifaceted approach and efforts should focus on improving access to healthcare resources in rural areas, reducing social stigma surrounding abortion through education and advocacy, and providing comprehensive reproductive health education to enhance knowledge about menstrual cycles and pregnancy testing adapting to local contexts including employing community‐based approaches, using visual and interactive tools, and ensuring cultural sensitivity.

A Multicentric Cross-Sectional Study Investigating the Profile and Motivations of Women Seeking Unsafe Abortions in Yaoundé, Cameroon.

Unsafe abortions represent a significant public health issue in Cameroon, often resulting in severe health consequences. This study aimed to investigate the prevalence, motivations, and factors associated with unsafe abortions among women in Yaoundé, Cameroon. A cross-sectional study was conducted among women of childbearing age attending three urban health facilities in Yaoundé, Cameroon. Participants provided information on their reproductive history, including any previous abortions. Data on reasons for abortion, methods used, and sociodemographic factors were collected. Regression analysis was performed to identify factors associated with unsafe abortions. Among 234 women aged 17 to 43, 51 (21.8%) reported at least one unsafe abortion. The primary reasons cited were fear of parental disapproval (24%) and partner refusal (20%). Physicians were the main providers (39.5%), using suction curettage and/or intravaginal misoprostol (89%). Being single (adjusted odds ratio (aOR): 13.6 (5.39-34.4)), nulliparous (aOR: 5.81 (2.41-13.9)), and secondary school students (aOR: 3.23 (1.06-9.81)) were significantly associated with an increased risk of unsafe abortions. Our study highlights the significant public health problem posed by unsafe abortions in Yaoundé, Cameroon. Single, nulliparous women and secondary school students are at heightened risk. These findings emphasize the urgent need for comprehensive sexual and reproductive health education, increased access to contraception, and safe abortion services targeting these groups.

Beyond borders: The global impact of violating reproductive human rights.

A fundamental component of the basic right to health is the right to sexual health, encompassing an individual's right to decide freely on matters of sexual and reproductive health without discrimination. Provision of these rights is inextricably linked with a wide range of other internationally agreed upon human rights, including the right to information, participation, and equality. Evidence has shown that provision of these rights not only improves maternal and neonatal health, but also healthcare worker safety and the provision of a vast array of critical and necessary medical care. And yet, too often-and with increasing frequency-sexual and reproductive rights are being violated worldwide, with rising taboos, stigma, and discrimination, particularly within abortion, contraception, and fertility care. FIGO strongly supports comprehensive, equitable, and accessible sexual and reproductive health care for all individuals, recognizing that these rights are essential components of global health and fundamental human rights. This includes a particular emphasis on special populations, healthcare workers, and women and girls in crisis zones. FIGO encourages its member societies to deliver comprehensive sexual and reproductive health care, advocate for coverage for sexual and reproductive health care, become involved in analyzing barriers to access within health systems, and provide nonjudgemental, confidential, person-centered care.

“It became a cycle I was not able to break” towards menstrual justice: addressing human rights violation at Indian workplaces

Purpose This paper aims to advance the concept of “menstrual justice” by building on the comprehensive framework developed by Margaret E. Johnson (2019), which integrates legal rights, social justice and intersectional analysis. By applying Johnson’s insights and human rights frameworks to menstrual health management, the study advocates for state interventions to safeguard women labourers from exploitative practices that endanger their reproductive health and to uphold their menstrual rights. Design/methodology/approach A case study methodology is used to scrutinize menstrual injustices experienced by women labourers in precarious employment conditions. Specifically, it examines two cases, the mass hysterectomies in Beed, Maharashtra and the administration of unidentified pharmaceuticals to women in Tamil Nadu factories to mitigate menstrual pain and maximize productivity. Findings The findings reveal severe violations pertaining to menstrual justice, with practices deeply rooted in socioeconomic deprivation and systemic neglect. These issues subject female workers to various forms of gender-based violence that goes beyond physical abuse, raising critical concerns about menstrual justice and human rights violations. Research limitations/implications The study’s findings have limited generalizability due to the specific contexts of the case study. Furthermore, the absence of insights from managers/supervisors, and factory owners limits a comprehensive understanding of the policies and factors leading to neglect of menstrual management practices. Practical implications The findings of the study will prompt the medical industry to initiate research into medications that can effectively alleviate period pain while minimizing harmful side effects. Current treatments often come with significant drawbacks, highlighting the need for safer and more effective alternatives. Addressing this research gap is vital for achieving menstrual equity, as it ensures that individuals suffering from menstrual pain have access to relief that does not jeopardize their overall health. Advancing research in this area will not only enhance the quality of life for menstruators but also contribute to a more equitable and inclusive approach to menstrual health care. Social implications The findings support reframing menstrual friendly labour policies including comprehensive sexual and reproductive health information to everyone, regardless of gender, to reduce misinformation and stigma associated with menstruation at workplaces. Additionally, the study proposes the introduction of reusable menstrual products like menstrual cups to overcome period poverty. Thus, ensuring access to these resources is crucial for enabling informed decision-making, promoting gender equality, addressing health disparities and fostering the development of menstrual-friendly workplace policies. Originality/value This study, by using a case study-based approach, has thoroughly examined the issues and challenges faced by female labourers in fields and factories. It uniquely identifies the inadequacies in menstrual management provisions for female workers in India and advocates for a human rights-based approach to ensure that menstruators can manage their menstrual health safely. Unlike most existing studies, which primarily focus on product usage and the stigma or myths surrounding menstruation, this study advances menstrual justice by calling for labour policy reforms and medical research to lessen menstrual pain without compromising menstruators’ health. These reforms aim to provide working women with adequate rest and necessary provisions during menstruation. Addressing these gaps is essential and has been largely overlooked in global health policies.

An innovative mobile app for educating teens and young adults about reproductive health and wellness including sexually transmitted infections, pregnancy and contraception

Objective: The authors studied the use of a new mobile app technology platform to offer easy access to accurate, evidence-based comprehensive reproductive health information with links to resources for teens and young adults to enhance wellness and reduce the risks of HIV, other STIs, pregnancy, and complications such as infertility and pelvic inflammatory disease.Methods: The Healthy Teens Mobile App was designed, developed, tested, and implemented to deliver up-to-date sexual and reproductive health education based on science and written by experts. Initial testing was done for useability, readability and ease of navigation of the app.Results: Beta testing among teens, young adults, parents, health educators, and nurse clinicians (n = 32) revealed the app was valuable, engaging, and could be revised to improve flow and functionality. 60% strongly agreed and 40% agreed the app was valuable, with important information and resources on sexual health and wellbeing. 55% strongly agreed and 45% agreed the images improved the experience of using the app and the text size was adequate for readability. Other comments were utilized to enhance the app, add more images, and decrease the amount of white space on certain sections of the app. The app was released in June 2024 in both the Apple &amp; Google App Stores.Conclusions: Utilizing a mobile app to delivery evidence-based sexual and reproductive health information for teens and young adults is practical and well accepted by teens, young adults, parents, health educators, and nurse clinicians. Plans are underway to disseminate the app widely. Future plans include translating the app into Spanish, French and other languages to promote global sexual and reproductive health and wellness and reduce the risks of HIV, other STIs, pregnancy, and complications such as infertility and pelvic inflammatory disease.

Access to reproductive health services by female survivors of sexual gender-based violence: a descriptive cross-sectional study of Nairobi City County, Kenya

Background: Sixty percent of women globally are exposed to reproductive health problems related to sexual gender-based violence. In Kenya, sexual violence is one of the top 10 risk factors for disease burden. The study aimed to determine access to reproductive health services by female survivors of sexual gender-based violence in Nairobi city county, Kenya. Methods: The study adopted descriptive cross-sectional design using pretested questionnaires. Study population was 269 female survivors of sexual gender-based violence. Data was analysed thematically and presented by use of percentages and frequencies distribution tables. Binary logistic regression model was used to determine relationships between dependent and independent variables. Odds ratios were evaluated for significance by considering the 95% confidence interval at p value ≤0.05. Results: Access to reproductive health services by female survivors of sexual gender-based violence was 26%. Service availability for survivors in the facilities had a 3 times likelihood of access sexual, knowledge on failure to seek immediate medical attention had 4 times likelihood to increase access while awareness of the period to have prophylaxis had 4.66 times likelihood to increase access. Services provided to survivor had 39% likelihood to increase access, survivors screened for sexually transmitted disease before admission had 10% more likelihood to access and survivors who received post exposure prophylaxis had 0.62 times likelihood of access to sexual reproductive health services. Conclusions: Availability of comprehensive sexual reproductive health services at the facility and good knowledge would increase access to reproductive health services.

Scientific Research in Midwifery and Health Adolescent Reproduction

The research method applied is qualitative with a phenomenological approach. Thematic analysis technique was used to analyze the data obtained. The results showed that adolescents' knowledge about reproductive health is still limited and diverse. The majority of adolescents get information from peers and social media, while sources of information from family and school are still lacking. Factors that contribute to risky behavior include lack of comprehensive sexual education, peer pressure, and limited access to reproductive health services. The conclusion of this study highlights the importance of improving comprehensive reproductive health education at school and within the family. In addition, easier and more youth-friendly access to reproductive health services is needed. These effects are expected to reduce risky behaviors and improve overall adolescent reproductive health.

Socio-ecological influences on access to abortion care in Costa Rica: a qualitative analysis of key perspectives from clinical and policy stakeholders

Costa Rica prohibits abortion except under narrow circumstances to save the pregnant person’s life. The country boasts historically strong support for social policy and human rights, while also presenting a complex and restrictive abortion access landscape. From September 2021 to March 2022, we conducted 23 interviews with obstetrician-gynecologist (OB/GYN) physicians, OB/GYN medical residents, and policy stakeholders to explore the socio-ecological influences on abortion access in Costa Rica. We sampled clinicians and policy stakeholders from the Universidad de Ciencias Médicas listserv through snowball sampling and conducted semi-structured in-depth interviews in Spanish. We identified limited access to comprehensive sexual health education, lack of support from interpersonal networks, inadequate provider knowledge and training, financial and migratory status, and both provider and community stigma as substantial barriers to abortion access. This study addresses a gap in published research around the social determinants of abortion in Costa Rica and sheds light on the attitudes and opinions of the medical and policy stakeholder communities about abortion access. The results highlight the need for expanded access to comprehensive sexual health education, abortion-related training for healthcare providers, and increased programming efforts, such as funding, outreach, and implementation, to ensure comprehensive reproductive health services are available and accessible, especially for vulnerable populations in Costa Rica.

Perceived needs and recommendations on adolescent pregnancy-related services in the Philippines.

Adolescent pregnancy remains to be a significant social and public health problem in the Philippines, despite the widespread implementation of a comprehensive sexual and reproductive health (SRH) law. The current study explored the perceptions on teenage pregnancy and adolescent-oriented services across different views of stakeholders. Twelve focus group discussions involving sets of teenage boys and girls, teenage mothers, and parents of the teenage mothers were conducted. Data analysis using a descriptive qualitative approach adopting both inductive and deductive thematic analysis was implemented on the gathered data. Four main themes emerged from the focus groups. First, discussants expressed community perceptions, emphasizing factors perceived to contribute to the occurrence of teenage pregnancy cases. Second, the adolescents expressed the coping responses they used or have observed in others to cope with teenage pregnancy, while the teenage mothers and their parents highlighted their immediate feelings toward the event. Last, the participants verbalized their perceptions of community services including criticisms and suggestions to improve the delivery of these services. The findings underscore the importance of stratifying and customizing the delivery of adolescent services as well as the possibility of expanding the content and coverage of community actions. This study also suggests that there is a need to create local ordinances that are culturally specific based on the Republic Act 10354 or the Responsible Parenthood and Reproductive Health Act of 2012. These ordinances must be coupled with other programs on reproductive health including training of personnel, ensuring the availability of resources, and reframing service delivery to the needs of adolescents. Further research is needed to explore variability of perceptions across contexts and cultures and the need for more appropriate service delivery models, thus contributing to a better understanding of teenage pregnancy and more tangible impact toward its reduction.

The impact of national strategies for preserving reproductive health on the improvement of the demographic situation in Ukraine

Strategic documents on reproductive health (RH) determine the priority of this component of the general state of the population health in any country, as well as through separate targeted measures – the impact on demographic trends. In particular, measures to respect woman’s rights to protect her health, to exercise reproductive rights, to give birth to a healthy child in decent conditions, and to provide access to preventive and medical-diagnostic technologies.The health status of the population, especially its positive trends, in turn affects the provision of favorable demographic prospects of the country and is an important component of the formation of its demographic potential.The objective: to study the dependence of the state of the population RH in Ukraine on the influence of program strategic measures on its main indicators.Materials and methods. Bibliosemantic, analytical, statistical and conceptual methods were used during the research. The research period is 2002–2023.Results. According to the results of the conducted research on the trends in the state of RH in women in Ukraine, it was established that it has an unsatisfactory character in terms of its main indicators: against the background of positive changes sexually transmitted infections are quite common; regulation of the birth rate in the country takes place by terminating unwanted pregnancies; the unsatisfactory state of health of pregnant women affects the health and life of newborns; the negative dynamics of complicated births and their adverse consequences lead to maternal and infant losses.The social and economic situation of women in Ukraine, the unsatisfactory state of health care and the level of women’s well-being and their integration into social and political and economic life (Ukraine currently ranks 117th place among 177 countries in the world) lead to an annual decrease in the birth rate and negative demographic trends.The results of the study on the presence and impact of domestic strategies on improving the RH state showed that they have not been developed in Ukraine today, despite the recommendations of ratified international strategic documents. Moreover, the analyzed domestic strategies for influencing the RH state with sufficient state funding and political support of power structures in 1995–2015 proved their effectiveness in achieving positive trends both in terms of RH indicators and demographic processes.Conclusions. The conducted research indicates the need to develop a domestic cross-sectoral strategic document at the national level with comprehensive reproductive health protection measures and conditions for its implementation in order to improve the demographic prospects of Ukraine.

Costs and cost drivers of comprehensive sexual reproductive health services to female sex workers in Kenya

BackgroundComprehensive sexual reproductive health (SRH) programs for female sex workers (FSW) offering clinical, behavioural, and structural interventions have contributed to declining rates of HIV in this population. However, data on costs and cost drivers is needed to support programs and their donors to better allocate resources, make an investment case for continued funding, and to identify areas of improvement in program design and implementation. We aimed to estimate the annual per-FSW costs of comprehensive services for a standalone FSW program in Kenya.MethodsWe implemented a top–bottom and activity-based costing study of comprehensive FSW services at two drop-in centres (DICs), Mtwapa and Kilifi town, in Kilifi County, Kenya. Service costs were obtained from routinely collected patient data during FSW scheduled and unscheduled visits using Kenyan Ministry of Health records. Costing data were from the program and organization’s expenditure reports, cross checked against bank documents and supported by information from in-depth interviews. Data were collected retrospectively for the fiscal year 2019. We obtained approval from the AMREF Research Ethics Committee (AMREF-ESRC P862/2020).ResultsIn 2019, the unit cost of comprehensive services was 105.93 USD per FSW per year, roughly equivalent to 10,593 Kenya shillings. Costs were higher at Mtwapa DICs compared to Kilifi town DIC; 121.90 USD and 89.90 USD respectively. HIV counselling and testing cost 63.90 USD per person, PrEP was 34.20 USD and family planning was 9.93 USD. Of the total costs, staff salaries accounted for about 60%. Adjusted for inflation, costs in 2024 would be approximately 146.60.ConclusionPrograms should strive to maximize the number of FSW served to benefit from economies of scale. Given that personnel costs contribute most to the unit costs, programs should consider alternative designs which reduce personnel and other costs.

Studying Mothers' Knowledge and Perceptions of Adolescent Reproductive Health

Correction of: https://wmmjournal.org/index.php/wmm/article/view/142 DOI: https://doi.org/10.36749/wmm.4.1.8-16.2024 Background: Reproductive health education is obtaining information and forming attitudes and beliefs about sex, sexual identity, relationships, and intimacy. Mothers are the primary caregivers and have an essential role in providing reproductive health and sexual education to adolescents. Parents' lack of reproductive health education triggers deviation; therefore, parents, especially mothers, can provide comprehensive reproductive health education to prevent free sexual behaviour and sexual crimes in adolescents. Purpose: To measure the knowledge and perception of mothers about adolescent reproductive health Methods: This is a cross-sectional study with a descriptive design. The study involved 135 respondents who were selected using a purposive sampling technique. Analysis using descriptive, T-test and Pearson correlation. Results: More than 50% of respondents answered that adolescents' reproductive health education should be parents' responsibility and education should begin during elementary school. There was a correlation between mothers' knowledge and perception of adolescent reproductive health (r=0.44, p&lt;0.001). Most mothers were afraid of providing sex education due to their ignorance of teaching methods and their lack of knowledge, and mothers wanted to learn about adolescent reproductive health from experts. Conclusion: Mothers want to learn more about sex education from experts or health workers. They were interested in male/female sexual structure and sexual physiology. Open communication between mother and child on sex-related issues is essential. Providing accurate and up-to-date sex education information to parents is vital to effectively educating their children at home.

O-068 Educating young people about reproductive health

Abstract Comprehensive sex and reproductive health education is crucial for promoting overall health and wellbeing, as it plays a vital role in dispelling misinformation, fostering positive attitudes toward reproductive health, and empowering informed decision-making among young people. Despite its recognised importance by global entities such as the World Health Organisation (WHO) and the United Nations Educational, Scientific and Cultural Organisation (UNESCO), comprehensive sex and reproductive health education remains insufficient worldwide. This inadequacy is a multifaceted issue, stemming from various factors, including governmental policies, social norms, cultural beliefs, inadequate curriculum, and insufficient teacher training. Schools, as primary providers of reproductive health education, often prioritise pregnancy prevention over other important reproductive health topics, leading to significant gaps in students' knowledge, further prompting young individuals to seek supplementary knowledge from external sources, like the internet or social media. To address this disparity and to promote reproductive health awareness, the International Reproductive Health Education Collaboration (IRHEC) was established in 2019 and aims to provide educational resources for the public, teachers and health professionals. The IRHEC have created a teaching guide specifically for teachers to cover all aspects of reproductive health, to be used in schools globally. To develop this resource, it has been essential to determine what is taught in schools and the attitudes of teenagers to reproductive health education and family building. In the UK, we examined the curriculum in the four nations and huge gaps were identified in reproductive health education. Subsequently, a survey was conducted with 931, 16–18-year-olds in England and pupils were asked their views on their education, if they had been taught about a list of reproductive health topics in school and their attitudes to these topics. They reported that topics around pregnancy prevention were taught, such as contraception (90%), and sexually transmitted infections (90%) but key subjects such as fertility (30%) endometriosis (3%) and PCOS (2%) were not taught. This survey has been repeated in Belgium, Greece and Japan and similar patterns observed. Teenagers in the UK (21%) and Belgium (18%) rated their school sex and reproductive health education to be either poor or very poor compared to teenagers in Japan (3%). In the UK, Belgium, and Japan, young people have similar future parenthood intentions. Most young people in the UK (64%), Japan (60%), and Belgium (60%) want to have children in the future. A higher percentage of young people in Japan (70%) expressed a desire for two children compared to those in Belgium (60%), Greece (53%) and the UK (49%). To ensure comprehensive sex and reproductive health education, efforts must be tailored to the needs of each community and demographic. Collaboration among policymakers, educators, healthcare professionals, and communities is essential to enhance school curricula to include a broader spectrum of reproductive health topics and promote culturally sensitive educational approaches. By doing this, we can empower young people with the knowledge and skills necessary to navigate their reproductive health journey with confidence. There is an urgent need for a concerted action to bridge knowledge gaps and ensure that young people receive comprehensive sex and reproductive health education.