People Reproductive Health Research Articles

(340) Sexual Dysfunction in Women with Sickle Cell Disease

Abstract Introduction Sickle cell disease (SCD) is a genetic hemoglobinopathy with clinical and epidemiological relevance. Its clinical manifestations directly affect the quality of life of affected individuals. There is a gap in the literature regarding the approach to aspects related to the sexual and reproductive health of people with sickle cell disease, especially in the female population, given that most of the available studies evaluated men. The aim of this study was to assess the sexual health of adult women with SCD. Objective The aim of this study was to assess the sexual health of adult women with SCD. Methods We prospectively evaluated 29 women with SCD with a median age 34 (26.5 - 40). Nineteen women had HbSS and 10 HbSC hemoglobinopathies. Quantitative data on sociodemographic, biological, and clinical characteristics were collected. Sexual dysfunction was assessed using the Female Sexual Function Index (FSFI). Results The median age at diagnosis was 9(1-22) years old, the median age at menarche was 14(13-15) years, and the onset of sexual life occurred on average at 19(16-20) years. Sexual activity was reported by 75.8%. Of the sexually active patients, 40.9% had impaired sexual function (the FSFI total score < 26.55). The Median, FSFI score was 23.5 (1-32.5). The median scores of each domain are detailed in fig 1.The most prevalent sexual dysfunction was hypoactive desire, reported by 72.7% of women. Conclusions Sexual function is tremendously affected by SCD in most women. They present a significant decrease in overall satisfaction with sexual life and markedly reduced sexual desire and orgasmic function. Disclosure No

Accessibility and Utilization of Adolescent Sexual and Reproductive Health Services Among Undergraduate Students

Background: Young people's reproductive health services have been largely neglected in the past, leaving them vulnerable to reproductive health problems like Sexually Transmitted Infections (STIs), unintended pregnancy, unsafe abortion and other harmful practices. Although studies have been done on Adolescent Sexual and Reproductive Health, a persistence of reproductive health problems among undergraduates in Nigeria, especially in the Universities necessitated this study. Methods: The study utilized a descriptive cross-sectional design involving 357 students of randomly selected faculties in the university of Ibadan. A self-administered semi-structured questionnaire was used to assess the accessibility and utilization of Sexual and Reproductive Health Services (SRHSs) among the students. Statistical analysis of data was done using IBM-SPSS version 21.0 software, associations and differences were then tested using Pearson’s correlation test (with significance set at P≤ 0.05), while descriptive data were presented in frequency & percentages. Results: The study found that 70.8% of the respondents have high access to SRHSs, while more than 67.3% underutilized those services. Attitudes of staff in the clinic, religion, cultural practices, longer waiting periods, and lack of privacy were all identified as factors that negatively affect the accessibility and utilization of SRHS. Gender (p=.012), and Accessibility (p=.000) were found to be significantly associated with Utilization of SRHSs. Conclusion: Despite high accessibility, most students still do not utilize available SRHSs. To ensure that young people have access to sexual and reproductive health care in all nursing practice sites, nurses need to gain the knowledge and hone the skills required to deliver evidence based counseling and services to adolescents.

"It Was a Mistake, but We Knew That Something Might Happen": Narratives of Teenage Girls' Experiences With Unintended Teenage Pregnancy.

It has been over a quarter of a century since the sexual reproductive health of young people came under the spotlight. The upsurge in human immunodeficiency virus (HIV) infections spurred on an era of intense development of services and strategies to ensure people's reproductive health rights were attainable, including the right to choose when to fall pregnant and have a baby. The statistics on teenage pregnancy are more than just numbers, but a represent stark reality for some girls in South African schools. Given that pregnancy in the teenage years is largely unintentional, prevention strategies need to extend beyond addressing risky sexual behavior; gaining deeper insights into teenagers' experiences and the events leading up to pregnancy would serve to better inform pregnancy prevention programs. This study explored the experiences of teenage mothers and pregnant teenagers, with the objective of acquiring a broader understanding of alternative approaches to preventing unintended pregnancy. A qualitative study was conducted in Ekurhuleni's township in the east of Johannesburg, South Africa. Fifteen narrative interviews with girls aged 13–19 years were conducted between July 2015 and July 2016, and were analyzed chronologically through narrative analysis. The findings revealed that participants who had engaged in socio-sexual and romantic relationships had no intention of falling pregnant and were familiar with existing strategies to prevent pregnancy. Social-sexual relationships were presented as an important aspect of their lives and demonstrated their ability to create spaces and opportunities to spend time with their social sexual partners and engage in sexual activity. Focusing on how teenage girls evaluate their sexual activity against the consequences of their actions is critical. However, sexual and reproductive health programs should refrain from representing young people's sexual behavior as a pathological condition, framing it instead as an integral component of creative sexual development. Programs should include relevant practical advice in relation to sexual engagement and be considered an extension of the State's existing Road to Health program.

“The Disabled Community Is Still Waiting for Equality”: What do Users Have to say About Sexual Reproductive Health of Persons With Disabilities in Online News Comments

Drawing from the literature of the internet as a public sphere, the present study investigates online news comments related to sexual reproductive health of people with disabilities (PWDs) published in The New York Times and The Guardian. We analyzed 3,633 online comments published between January 1, 2016, and December 31, 2019, using thematic analysis. The findings revealed eight major themes: economic consequences; gender; stereotypes; awareness and education; independence and autonomy; medical standpoint; media portrayal; and social justice and accommodation. Further, our study found that 47% of online commenters from The NYT and 49.3% from The Guardian had a positive perception that PWDs should have equal access to sexual reproductive health, compared with non-disabled people. Our study also revealed that comments in The NYT were more focused on the legal issues in the United States, while comments in The Guardian emphasized positive media representation and human aspects of the issue.

Clinic Staff Perspectives on Barriers and Facilitators to Integrating Transgender Healthcare into Family Planning Clinics.

Although some research exists about transgender and nonbinary people's reproductive health needs, little research has explored the expansion of transgender health care in a family planning clinic context. This study investigates the expansion of transition-related care in family planning clinics in the United States from the perspective of clinic staff members. Between 2018 and 2019, 25 in-depth interviews with family planning clinic staff across the United States explored themes in incorporation and continuation of transgender care. Qualitative data were also collected at several national reproductive health professional conferences in sessions focused on transgender health care. Content analysis on the type of care available at clinics from public websites was analyzed using descriptive statistics. Family planning clinics became invested in offering transition related care through existing patient requests and community requests, including from staff members themselves. Clinics faced administrative and scheduling challenges in adding care. They reported that medical protocol components were easiest to learn. Analysis of clinic websites indicates that ∼10% of nationally networked clinics offer transgender care compared to 21% of independent member clinics of the Abortion Care Network. Family planning clinics should consider adding transgender care based on patient or community demand as an extension of existing expertise in providing patient-centered care. Clinics should be aware that tool kits and protocols already exist to support integrating transition related care in family planning clinics.

Gestational age limits for abortion and cross‐border reproductive care in Europe: a mixed‐methods study

ObjectivesLittle is known about the experiences of women who travel within Europe for abortion care from countries with relatively liberal laws. This paper aims to assess the primary reasons for travel among a sample of women who travelled from European countries with relatively liberal abortion laws to obtain abortion care mainly in the UK and the Netherlands.DesignMulti‐country, 5‐year mixed methods study on barriers to legal abortion and travel for abortion.SettingUK, the Netherlands and Spain.Population or SampleWe present quantitative data from 204 surveys, and qualitative data from 30 in‐depth interviews with pregnant people who travelled to the UK, the Netherlands and Spain from countries where abortion is legal on broad grounds within specific gestational age (GA) limits.MethodsMixed‐methods.Main outcome measuresGA when presenting at abortion clinic, primary reason for abortion‐related travel.ResultsStudy participants overwhelmingly reported travelling for abortion because they had exceeded GA limits in their country of residence. Participants also reported numerous delays and barriers to receiving care.ConclusionsOur findings highlight the need for policies that support access to abortion throughout pregnancy and illustrate that early access to it is necessary but not sufficient to meet people’s reproductive health needs.FundingThis study is funded by the European Research Council (ERC).Tweetable abstractThis study shows that GA limits drive women from EU countries where abortion is legal to seek abortions abroad.

Internalization Of Understanding Of Poor People Reproductive Health (Case Study In Mangasa Village Tamalate Subdistrict In The City Of Makassar)

Lack of public awareness of the importance of education makes many families caught in the vicious cycle of poverty which will ultimately affect the health sector, especially health reproduction. This research aimed to find out the depth information on the Internalisation of Understanding of Poor People Reproduction Health. This study uses a qualitative design with the research type of case study. The informants of this study are key informants (Health Officers), ordinary (the poor people), and the supporters (head of RW, Health Cadre). The data collection was conducted through observation, interview, and documentation. The data were then analyzed by triangulation analysis. The results showed that there is still a lack of knowledge on reproductive health in most of the poor people due to ineffective socialization activities conducted by parties related to the poor is still less so that the acceptance of society's poor reproductive health is still very limited. It is suggested that the increase of knowledge on the poor by regularly counseling on the poor by involving the role of parents, family, a community of peers. All poor people should find information on the health workers and people around them. The health workers further improve program promotion and education through reproductive health education.

Promotion of awareness and utilization of youth friendly service through multi-sectoral cooperation mechanism in China

BackgroundYouth friendly services (YFS) was established in pilot areas in China. This study aimed to explore the promoting level on the awareness and utilization of YFS after the implementing of a multi-sectoral cooperation mechanism (MSCM) supported by social network theory (SNT) among multiple sectors related to young people reproductive health (YRH) closely.MethodsA cross-sectional study with two separate self-administered questionnaire surveys was conducted before and after the implementing of a MSCM supported by SNT in both in-school and out-school unmarried young people aged 12–24 year-old in pilot areas in China. Both pre- and post- implementation surveys were conducted between December, 2008 and January, 2009, and between October, 2010 and January, 2011 respectively. The collected categorical data about the awareness on YFS in young people was described in percentage (%). χ 2 test was used to compare the differences between interventional and control areas, pre and after intervention, and changes in investigated areas after the intervention respectively. Binary logistic regression was used to analyze interventional effects after adjusting gender, in-school or out-school, and other factors. Significance level α was 0.05.ResultsThe percentages of young people in interventional areas who could receive YRH education including that about YFS in schools, working sites and communities increased (OR = 15.485, 6.166, 3.723; 95% CI: 2.939~4.715, 4.014~9.473, 11.421~20.994 respectively) statistically significantly (P < 0.05). The percentages of young people in interventional areas who “have heard of YFS clinic” and “know that YFS clinic has been established in local area” (OR = 9.325, 11.244; 95% CI: 7.433~11.699, 8.780~14.399 respectively), and knowledge rates on YFS manner and contents also increased (OR = 14.830, 8.676; 95% CI: 9.728~22.607, 5.175~14.548 respectively) statistically significantly (P < 0.05). The increments of knowledge rates on YFS price, time, hotline number, contents on contraception, pregnancy and sexual harass/violence were statistically significant (P < 0.05). The satisfaction degree on this service has also increased (OR = 6.394, 95% CI: 2.789~14.655) statistically significantly (P < 0.05).ConclusionsSNT is a helpful tool to facilitate the construction of an effective multi-sectoral cooperation mechanism to promote the awareness and satisfactory degree of YRH services.

Knowledge of Sexuality and Reproductive Health of People with Physical Disabilities in Vietnam

This paper discusses the knowledge of sexual and reproductive health among people with physical disabilities in Vietnam. A qualitative research design was adopted. In-depth interviewing and photo elicitation methods were used to collect stories from 20 participants. The findings suggest that without formal education about sexual and reproductive health people with physical disabilities in Vietnam gain knowledge through their experiences and from informal sources of information. Participants perceived safe sex to include contraceptive methods, prevention of sexually transmitted diseases, having orgasm together and finding balance between health and sexual needs. Participants related reproductive health to fertility, restriction of family size, sexually transmitted diseases, and self-care in pregnancy. Reasons for insufficient knowledge included limited education due to: disability and poor family background; limited education on sexual and reproductive health issues; absence of family and community discourse about sexual and reproductive health; and lack of information resources. Participants acknowledged that their knowledge was inadequate. They wanted to know more about sexual and reproductive health but lacked access to the relevant information. Health care providers, researchers, and policy-makers in Vietnam should address the gaps in sexual and reproductive health care knowledge among people with disabilities in Vietnam and those that provide care to them.

Social determinants of health: Social forces that shape women and men's knowledge of reproductive health in a resource-limited setting

abstractSocial forces shape people's reproductive health in many ways. We examined people's knowledge about reproductive health using focus group data collected from 93 participants in rural districts of Malawi. Participants' perspectives were contextualized by explaining the socioeconomic, cultural, and gender factors that determine reproductive health for rural Malawians. Strategies to improve reproductive health care in environments lacking in health infrastructure, staff, and economic resources are then provided. We call for a reproductive health agenda to target preventive care by providing information about anatomy and biology, communicating information in culturally competent ways, and educating men and women over the life course.

Beyond the discourse of reproductive choice: narratives of pregnancy resolution among Latina/o teenage parents

Despite the fact that the US teenage birth rate has declined dramatically in recent years, teen births among Latinas are higher than any other racial/ethnic group. Most studies focus on the causes and consequences of early motherhood among Latina teenagers, neglecting other important dimensions of the issue. This study examines how Latina/o teenage parents living in California narrate their experiences with unintended pregnancy resolution. Qualitative analysis reveals three central themes. First, participants expressed shock upon learning they or their partner was pregnant, followed by acceptance about their impending parenthood. Second, participants' views of abortion and adoption largely foreclosed these options as pathways by which to resolve their unintended pregnancies. Third, participants recounted numerous stories of the messages they received from parents, other family members and male partners that were frequently directive regarding how to resolve their pregnancies. These findings have implications for young people's reproductive health and rights, and for reproductive justice more broadly.

Rapid tests in the diagnostics of sexually transmitted infections

High prevalence of sexually transmitted infections (STIs) and their substantial adverse effect on reproductive health of people necessitate the development of accurate and rapid tests for their diagnostics, in particular those that can be used at point-of-care (POC). The majority of current immunological POC-tests have high specificity; however, their sensitivity is mainly suboptimal. The future of POC-diagnostics of STIs - highly sensitive and specific, robust and affordable - is seen in the development and implementation of molecular diagnostic technologies (amplification, microfluidic, biosensor).

Joining-up thinking: Loss in childbearing from inter-disciplinary perspectives

This editorial provides epidemiological data on the prevalence of loss in childbearing. It underscores the need for an inter-disciplinary contextualized approach by highlighting the multi-dimensional nature of loss and identifies some of the main insights that a collection of articles offers to those seeking to improve peoples reproductive health. In addition the authors draw attention to loss in childbearing as a physical psychological social economic and public health problem intertwined with social political and economic inequities that are affronts to social justice and human rights.

Adolescent Reproductive Health in Indonesia: Contested Values and Policy Inaction

This study examines the changing social and political context of adolescent sexual and reproductive health policy in Indonesia. We describe how, in 2001, Indonesia was on the brink of implementing an adolescent reproductive health policy that was consistent with international agreements to which the Indonesian government was a party. Although the health of young Indonesians was known to be at risk, the opportunity for reform passed quickly with the emergence of a new competing force, Middle Eastern fundamentalist Islam. Faced with the risk of regional separatism and competing politico-religious influences, the Indonesian government retreated to the safety of inaction in this area of policy. In the absence of a supportive and committed political environment that reinforces policy specifically targeted to young people's reproductive health, extremist approaches that involve considerable health risk prevailed. The sexual and reproductive values and behaviors that are emerging among single young people in contemporary Indonesia are conditioned by a political context that allows the conflicting forces of traditional Indonesian values, Westernization, and the strong emerging force of fundamentalist Islam to compete for the allegiance of young people.

(Re)Defining Reproductive Health with and for the Community: An Example of Participatory Research from Mali

Qualitative research was carried out in central Mali to inform the development of curricula for an intervention to improve young people's reproductive health. Both the young people and 'societal gatekeepers' (including religious leaders and traditional healers) perceived reproductive health to comprise the social dynamics in which reproductive health decision-making is embedded and not just the biological aspects of sexual relations and fertility. Their definitions of reproductive health reflected social taboos about pre-marital sex, infidelity and illegitimate children, and comprised holistic notions of bodily and spiritual cleanliness. It is argued that the 'Cairo' definition sees many of the social factors identified by respondents as comprising the context or background of reproductive health. The findings presented here indicate that local populations may see them as integral to the concept itself. It is discussed how the 'Cairo' definition of reproductive health needs to be made culturally specific in order to facilitate programme design and implementation.

Promoting Sexual Responsibility among Young People in Zimbabwe

A 1997-98 multimedia campaign promoted sexual responsibility among young people in Zimbabwe while strengthening their access to reproductive health services by training providers. Baseline and follow-up surveys each involving approximately 1400 women and men aged 10-24 were conducted in 5 campaign and 2 comparison sites. Logistic regression analyses were conducted to assess exposure to the campaign and its impact on young peoples reproductive health knowledge and discussion safer sexual behaviors and use of services. The campaign reached 97% of the youth audience. Awareness of contraceptive methods increased in campaign areas but general reproductive health knowledge changed little. As a result of the campaign 80% of the respondents had discussions about reproductive health--with friends (72%) siblings (49%) parents (44%) teachers (34%) or partners (28%). In response to the campaign young people in campaign areas were 2.5 times as likely as those in comparison sites to report saying no to sex 4.7 times as likely to visit a health center and 14.0 times as likely to visit a youth center. Contraceptive use at last sex rose significantly in campaign areas (from 56% to 67%). Launch events leaflets and dramas were the most influential campaign components. The more components respondents were exposed to the more likely were to take action in response. A multimedia approach increases the reach and impact of reproductive health interventions directed to young people. Building community support for behavior change also is essential to ensure that young people find approval for their actions and have access to services. (authors)

Religious leaders′ perceptions and support of reproductive health of young people in Anambra State, Nigeria

This article assesses religious leaders' perceptions of young people's reproductive health in Anambra State. Through self-administered semi-structured questionnaires, and in depth interviews, religious leaders perceptions of young peoples reproductive health in Anambra State Nigeria was elicited from two hundred and fifty religious leaders selected by multistage random sampling. Over 85% of the religious leaders thought that young people are sexually active, and are involved in high risk behaviour for unintended pregnancy, unsafe abortion, and STD and HIV/AIDS. Eighty five per cent felt that there is need for sexuality education in schools, and that sexuality education will reduce unintended pregnancy, abortion, STDS and HIV/AIDS among young people. However 52.2% felt that sexuality education in school would increase promiscuity. Some religious leaders did not support teaching of contraception and safe abortion in schools. Religious leaders in Anambra State have a high awareness of young people's reproductive health problem, and are in support of sexuality education in schools. They differ however in what should be the content of the curriculum. There is need to harmonise and agree on programme contents to minimise sending conflicting and confusing messages to young people.