Reproductive Rights Research Articles

Beyond the margins: antenatal health and healthcare behaviours among homeless women in Kolkata Municipal Corporation, India.

Despite high childbearing rates among homeless women in India, the antenatal health and healthcare behaviours among such population remain poorly understood. To address this research gap, a mixed-methods approach was employed in the present study, involving interviews with a sample of 400 women aged 15-49 years, utilising time and location sampling techniques. Additionally, a purposeful sample of 52 women from the same age group participated in in-depth interviews. The respondents exhibited rampant socio-economic backwardness, including chronic homelessness (36%), no formal education (54%), engagement in rag picking (31%), and low income levels. About 56% of the women reported poor self-rated health (SRH), notably higher among those aged 35 and above and those living alone (68%). Poor SRH was also prevalent among the ever married (61%), ragpickers (61%), beggars (62%), chronic homeless individuals (62%), tobacco (60%) and alcohol consumers (61%), and those with chronic diseases (61%). Common health issues included depression or anxiety (56%) and iron deficiency anaemia (35%). The level of unmet healthcare needs was 41%, with significant variation across diseases. Lack of reproductive health rights and awareness, socio-cultural beliefs, stigma, socio-economic poverty, poor quality of public healthcare services, irregularity in charity-run healthcare, and time constraints hindered antenatal care visits. The study underscores the urgent need for population-centric programmes and policies aimed at promoting reproductive health to achieve Sustainable Development Goal 3 of 'Good health and wellbeing' by 2030.

The Institutionalized Oppression of Reproductive Responsibility: A Dystopian Interpretation of the Maternal Role in The Handmaid’s Tale

This paper examines the institutionalized oppression of women through the manipulation of reproductive responsibility in Margaret Atwood’s The Handmaid’s Tale. It explores how the dystopian regime of Gilead weaponizes the maternal role by reducing women to their reproductive capacities, employing surveillance, commodification, and religious manipulation to control their bodies and identities. The analysis delves into the mechanisms by which the state sustains its patriarchal power, such as ritualized sexual violence, forced surrogacy, and the distortion of Biblical narratives, to justify its exploitation of women. The paper investigates acts of resistance and reclamation of autonomy by the female characters, revealing how small acts of defiance and solidarity challenge Gilead’s oppressive structures. Atwood’s narrative is argued to be a critique not only of the fictional society but also of contemporary real-world issues surrounding reproductive rights, gender inequality, and bodily autonomy. Ultimately, the novel serves as both a warning against the erosion of rights and a call to resist patriarchal systems that seek to control and commodify women’s bodies.

Perempuan dan Hak Asasi Manusia dalam Lensa Filsafat: Dilema Etika dan Implementasi

Human rights in the context of women through a philosophical lens brings us into deep reflection about the rights, dignity and role of women in society. In philosophy, women are considered as equal individuals to men, eliminating discrimination based on gender. The concepts of bodily autonomy, reproductive rights, and protection against violence are at the center of ethical and moral debates about women's human rights. Philosophical thinking also emphasizes that women have an active role in raising social and political awareness to achieve gender equality. This involves the moral responsibility and collective action of women in fighting for their rights. Through a philosophical lens, understanding women's human rights encourages us to see women not only as objects receiving rights, but also as subjects who are empowered to shape a more just future. Therefore, the philosophy provides a strong foundation for advocacy for gender equality and social change that is more inclusive and has equal rights to live with dignity and freedom.

Reproductive Rights Under International Regulations and Recommendations for Vietnam

Reproductive Rights Under International Regulations and Recommendations for Vietnam

A Systematic Review of Determinants Influencing Family Planning and Contraceptive Use.

Reproductive health, crucial for public health and sustainable development, encompasses family planning and contraceptive use. However, global disparities persist in the adoption of family planning, highlighting the need for a comprehensive understanding of the complex factors shaping these reproductive health choices. Following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, we conducted a systematic search of the Scopus, ScienceDirect, PubMed, Web of Science, and ProQuest databases from July to August 2023. Inclusive criteria covered various study designs and populations, ranging from individuals to communities, and encompassed sociocultural factors. The review included open access articles published between 2018 and 2023, utilizing a combination of the keywords: Family planning determinants, Contraceptive use factors, Sociocultural factors in family planning, Individual-level influences on family planning, and Factors affecting contraceptive choices. Data from 25 selected studies underscore the critical influence of determinants at both individual and community levels in shaping family planning behaviors. Key drivers at the individual level included education, age, knowledge, and attitudes. At the community level, factors such as geographical disparities and healthcare accessibility played pivotal roles. Sociocultural determinants, including media exposure, gender norms, and spousal dynamics, highlighted the need for culturally sensitive strategies. Advancing equitable family planning requires education, improved access, peer influence, and the active participation of husbands and male partners. Comprehensive programs should bridge the gap between knowledge and action, reduce disparities, and ensure equal access to contraception. Context-specific research and evaluating interventions are crucial steps toward achieving global reproductive health objectives.

Traditional socio-cultural practices and early pregnancies in Togo: Between social norms and violation of adolescent rights.

This article shows how certain traditional socio-cultural practices that influence the root causes of teenage pregnancy violate the rights of adolescents. The data came from the action-research entitled "Multisectoral and transformative approaches to rites and initiations for adolescent sexual and reproductive health rights", conducted by the Togolese Association for Family Welfare (ATBEF) in May 2022. The option is made for a qualitative approach. The information collected was recorded on dictaphones and then transcribed from the local languages of collection into French. Content analysis was used to write the research report. The results reveal that these practices, which are still prevalent in the localities of the study, and which exert pressure on adolescent girls, are also products of violations of many girls' rights.

New evidence on adolescent sexual and reproductive health and rights from the West and Central African region.

The African Journal of Reproductive Health is pleased to publish these compendiums of original research in this special edition that document new findings in adolescent sexual and reproductive health and rights from the West and Central African region (WCA). While sub-Saharan Africa has some of the worst indicators of sexual and reproductive health and rights (SRHR) in the world, the indicators are more daunting in the WCA region. To date, the WCA is recognized to have the highest rates of unwanted pregnancy, unsafe abortion, and human immunodeficiency virus (HIV) and other sexually transmissible infections, as well as the lowest contraceptive prevalence rates among adolescents worldwide.1 Despite the high rate of adverse adolescent reproductive health outcomes in WCA, there has been limited documentations of the socio-cultural and economic circumstances that perpetuate these adverse consequences. There have also been no purposefully designed interventions that provide strong scientific evidence for developing strategies to reverse the trend.

Gender-based violence and sexual and reproductive health and rights of adolescent girls in Senegal: an analysis of social control practices.

This article problematizes gender-based violence (GBV) as a social practice and explains its role as a social mechanism for controlling bodies. Based on a mixed methodological approach (combining questionnaires, qualitative interviews, focus groups, and participant observation) targeting both adolescent girls and community actors, this study reveals forms of GBV that are little explored among the adolescent population. Social practices, such as "nëpp nëppël" or the culture of silence, frequently conceal GBV within families, hindering reporting and thus limiting adolescents' access to sexual and reproductive health and rights (SRHR) services and influencing their limited knowledge of SRHR. Shelter centres, such as Kullimaaroo, are crucially important in this context by providing holistic support to victims of GBV, but such structures are rare in Senegal. We conclude that it is necessary to adopt a holistic approach taking into account social practices to address the complex relationship between GBV and SRHR among adolescents in Senegal.

Health aspects of the presidential election in the United States.

The prospect of a Biden-Trump rematch had raised concerns. The argument of Trump on the older age of Biden led to a boomerang effect when the latter was replaced by the much younger Kamala Harris whose mixed African and Asian ancestry should lead to her support on international issues. Swing voters might be attracted by her potential as the first female president. Assertive on the politically controversial issue of abortion, Kamala Harris already spent a substantial part of her vice-presidency on women issues. Her promotion of sexual and reproductive rights during the presidential campaign augurs well for restoring those priorities on the American political agenda.

Knowledge and practice of health workers on sexual and reproductive health and rights and gender-based violence: Evidence from three municipalities in Senegal.

Adolescents in low- and middle-income countries face numerous developmental, sexual and reproductive health (SRHR) challenges, including exposure to multidimensional violence. Dealing with gender-based violence (GBV) is of great importance and health personnel are key players. The objective of this work was to study the knowledge and practices of health personnel on SRHR and gender-based violence in Guédiawaye, Kaolack and Kolda communities in Senegal. A descriptive and analytical cross-sectional study was conducted, which consisted of health professionals (general practitioners and specialists, nurses, and midwives) and community health workers (community relays, bajenu gox, matrons). All health facilities in the three communities were included. Data analysis consisted of univariate analysis and logistic regression modeling to investigate the factors associated with the knowledge and practice of health personnels. An alpha risk of 5% was taken. A total of 78 health professionals and 128 community actors were included in the study. More than half of the health personnel (56.3%) had good knowledge of policies, standards and protocols relating to sexual and reproductive health services for women (adolescents) and about 60% on conventions and laws. The level of knowledge was good among 51% of respondents and good practices among 54.9%. The factors associated with good knowledge were the municipality in which the profession was practiced, and the effects of training received in the social construction of gender. The factors associated with the practices were knowledge of policies, standards and protocols through training, training received in the provision of family planning services, and in medico-psychosocial management of cases of sexual violence. We conclude that the knowledge of stakeholders (health professionals and community health workers) about sexual and reproductive health and gender-based violence is important for better service provision and good management of cases of gender based violence.

Positive masculinity programmes and sexual and reproductive health behaviours among boys and men in poor urban settlements in Democratic Republic of Congo, Nigeria, and Rwanda.

As Positive Masculinity (PM) Programmes continue to develop globally, it is important to examine their role in Sexual and Reproductive Health and Rights (SRHR) outcomes. This multi-country qualitative study was conducted using in-depth interviews (IDI) and focus group discussions (FGDs) with community members, beneficiaries and implementers of PM programmes. The findings show that PM programmes are designed using a gender lens to make boys and men more aware and conscious of harmful masculinity traits and their effect on SRHR. The beneficiaries of the interventions report imbibing positive SRHR behaviours by being sexually responsible - upholding sexual rights, taking precautions against sexually transmitted Infections (STIs) and learning proper communication with their partners. They also report acting as vanguards of positive gender norms to their families and peers. Although there are challenges in implementing PM programmes, the results of the study suggest that interventions targeting boys and men hold promise for improving boys' and men's health behaviours and promoting gender equality in poor urban settings.

Ending child marriages through young people’s movement building: the case of community champions in Mutasa District, Zimbabwe

Despite efforts made to promote gender equality in all spheres of life, women, especially young girls below the age of 18 years from marginalised African communities continue to face a plethora of challenges such as harmful practises and negative gender stereotypes which hinder them from realising their full potential. Included in these harmful practises is the abhorrent act of child sexual exploitation in the name of child marriages. There are several initiatives by different actors to end child marriages and Sexual Reproductive Health and Rights (SRHR) Africa Trust (SAT), Zimbabwe is one Civil Society Organisation (CSO) that has made significant strides in contributing towards ending child sexual exploitation. The organisation works to empower adolescent girls and young women (AGYW) to define their needs and undertakes various forms of advocacy including awareness raising and direct advocacy with key decision-makers. Interventions contribute to reducing self-stigma that disempowers adolescents and young people from realising their full potential. This article discusses an intervention that SAT has spearheaded in a bid to contribute to the end of child sexual exploitation and the role social workers can play to work with Non-Governmental Organisations (NGOs) such as SAT in ending child marriages. How to reference using ASWNet style: Mushunje, M., Ismail-Mauto, H. & Mazhambe R. (2024). Ending child marriages through young people’s movement building: the case of community champions in Mutasa District, Zimbabwe. African Journal of Social Work, 14(4), 207-216. https://dx.doi.org/10.4314/ajsw.v14i4.4 Visit journal website: https://ajsw.africasocialwork.net

Positive masculinity programmes and attitudes towards nonconforming gender identities among young males in urban Democratic Republic of Congo, Nigeria, and Rwanda.

Implementing programmes on sexual and reproductive health and rights (SRHR) in sub-Saharan Africa often involves promoting inclusive sexual identity/orientation. However, whether and how the programmes are changing gender norms in the target populations have not been established. This study was designed to determine whether participation in Positive Masculinity (PM) programmes can change attitudes associated with prevailing gender norms. We explored attitudes towards nonconforming sexual identity/orientation among young males in selected informal settlements in Democratic Republic of the Congo (DRC), Nigeria and Rwanda. The key variables we tested included "country of participation" and other socio-demographics such as "education", "marital status" and "prior residential location" (rural or urban). We found no significant association between participation in PM programmes with attitudes towards nonconforming sexual identities/orientations across our target populations irrespective of educational qualification, marital status, and previous location of residence. By contrast, religious teachings showed up in the qualitative responses as a significant factor influencing young people's resistance to PM programmes' advocating for inclusive sexuality. Additionally, negative masculinity attributes had significant negative association with attitudes towards nonconforming sexual identity, while respondents with violent tendencies showed significant positive attitudes. We conclude that current PM interventions do not significantly contribute to positive attitudes towards inclusive sexuality in DRC, Nigeria, and Rwanda.

Access to and provision of sexual and reproductive health services in Ekurhuleni, South Africa: Experiences and coping strategies of migrant women and healthcare workers.

The importance of universal access to health services including sexual and reproductive health and rights (SRHR) services by migrant populations and the fundamental role of healthcare workers in providing SRHR services, requires a balanced understanding of the experiences of both migrants and healthcare workers. This study explored the experiences of migrant women in accessing and utilising SRHR services and the experiences of healthcare workers in providing SRHR and HIV services in Ekurhuleni, South Africa. In-depth interviews were conducted with five internal migrants, eight international migrant women aged 18-49 years, and four healthcare workers. Migrant women were selected using snowball sampling while healthcare workers were purposively sampled. Migrant women face multifaceted challenges including but not limited to language barriers, discrimination based on migration status, cultural and religious hurdles when accessing and utilising SRHR and HIV services. Similarly, healthcare workers encounter challenges in providing SRHR and HIV services to migrant women which include language barriers and having migrants who seek services without referral documentation and legal migration documents. Training healthcare workers on cultural sensitivity and integration of migrant friendly services in the health policy may improve migrant women's experiences in accessing and utilising as well as healthcare workers' experiences in providing SRHR services.

Gender differences in adolescents' perceptions of condom use in Ebonyi State, Southeast Nigeria.

This paper assessed gender differences and perceptions towards condom use among in-school adolescents in Ebonyi State, Nigeria. This was a cross-sectional study undertaken in six local government areas in Ebonyi State, Nigeria. Data were collected using a structured questionnaire and summarised using frequencies and proportions. Chi-square test and binary logistic regression were used in the analysis. The level of statistical significance was a p-value of <0.05. Findings showed that a significantly higher proportion of male respondents (58.8%) had a good perception of condom use when compared to female respondents (45.8%). Gender, level of schooling, and working for pay had significant associations with good perceptions of condom use, while the significant predictors in the logistic regression model were gender, level of schooling, and working for pay. Interventions that promote the sexual and reproductive health and rights of adolescents and those that empower women with relevant skills by addressing unequal gender power relations in relationships should be prioritized.

Adolescents' accessibility and use of sexual and reproductive health services in Kaolack and Gossas, Senegal.

In Senegal, the needs for care related to sexual and reproductive health and rights (SRHR) among adolescents are significant. This study evaluates the accessibility and use of gender-related SRHR services by adolescents in the municipalities of Kaolack and Gossas. It is based on quantitative and qualitative data from 2,263 adolescents in the 2 sites, 84 in-depth individual interviews, 12 focus groups with adolescents and sexual reproductive Health actors, and 4 interviews with key informants. Quantitative analysis consisted of the interpretation of univariate statistics and bivariate analyses, while qualitative analysis relied on the coding and thematic analysis of verbatim statements. The results show low use of health structures (3% and 0.4% in Gossas and Kaolack respectively). This was attributed to the perceptions that services are not suitable to the needs of adolescents, and also because of socio-cultural constraints in the two sites. Additionally, the distribution of access to reproductive health services by sex shows gaps between boys and girls. We conclude that efforts should be made to tailor the sexual and reproductive health services offered to adolescents to their needs and social circumstances.

Gender and adolescent sexual and reproductive health and rights in West and Central Africa: New evidence and emerging gaps.

The West and Central Africa (WCA) region is a natural resource-rich, 24-country, contiguous area with a population of nearly 500 million people. The median age for the region is currently 18 years and approximately one-third of its population is aged between 10 and 24 years. If current demographic trends in the region persist, its population will reach 1.5 billion by 2050. At that time, WCA will not only have the largest number of young people globally, but it will also be the only part of the world whose population of young people will continue to increase1. Many countries in the region are also or have recently been involved in armed conflicts, which have devastated infrastructure, displaced people, stifled development, and more importantly, resulted in myriad deaths and morbidities.

Beyond the decision: Reproductive justice and cervical cancer care in a post-Dobbs era

Cervical cancer is among the most commonly diagnosed cancers in pregnancy and for some patients, abortion may be desired or recommended. The Dobbs v Jackson decision has the potential to limit choice while exacerbating disparities in cervical cancer care. We highlight the necessity of employing a reproductive justice framework to both clinical care and research for cervical cancer care in pregnancy to increase access to reproductive choice and to address inequities.

Abortion, Full Faith and Credit, and the "Judicial Power" Under Article III

Interstate judgments enforcement is governed by the Full Faith and Credit Clause of Article IV of the Constitution, together with its implementing statute, 28 U.S.C. 1738. Although a highly technical area of the law, interstate judgments enforcement has important social repercussions for some very modern problems of great cultural significance. One of the currently significant applications is the interstate enforcement of judgments rendered in civil suits based on state anti-abortion laws. For example, Texas statute S.B. 8 gives anyone who wishes to sue a civil cause of action against persons who facilitate abortions. Even complete strangers to the abortion can decide to become a plaintiff in such an action and can sue for money “damages” despite having suffered no injury. Non-experts seem to have the impression that the Full Faith and Credit Clause presents an ironclad requirement that judgments of sister states must always be enforced. If thatwere the case, states that recognize reproductive freedom would be obliged to enforce judgments entered into in states like Texas, despite their strong public policy against such actions. This Article shows why this impression is mistaken. First, the full faith and credit principle has for centuries been subject to exceptions,several of which are potentially relevant in the reproductive freedom context. Theseinclude lack of subject matter jurisdiction, the public policy exception, and the penallaw exception. In addition, a uniform law adopted in forty-eight states (the UniformEnforcement of Foreign Judgments Act) permits the state enforcing the judgment to applyits own judgments law to an interstate enforcement proceeding. The enforcing state will therefore apply to foreign state judgments any exceptions to judgments enforcement lawthat it has as a general matter for its own domestic judgments. Second, and more importantly, the Clause and statute both contain an important qualification: they apply only to “judicial” actions. This exception prevents a state from requiring sister-state enforcement of decisions that do not meet the usual tests for a judicial “case or controversy” (as defined in Article III of the Constitution). Article III and Article IV both use the word “judicial” to specify the standard necessary for the exercise of federal power. These two neighboring constitutional provisions are supported by a common historical origin (they were drafted at the same time and by some of the same people at the constitutional drafting convention) and fulfill comparable functions. If the two constitutional provisions are treated the same, judgments under statutes like Texas S.B. 8 would not be given mandatory force in other states because such cases would not meet the standing requirement imposed by Article III.

Knowledge gaps related to HIV and condom use for preventing pregnancy: a cross-sectional study among migrants in Sweden

BackgroundInformation and knowledge of sexual and reproductive health and rights (SRHR) plays a crucial role in promoting safe sexual practices among young migrants. We aimed to assess the sociodemographic factors of migrants associated with knowledge of condoms and the prevention, treatment, and transmission of HIV to highlight the need for SRHR information, including comprehensive sexual health education.MethodsA cross-sectional survey was conducted (2018–2019) among migrants at Swedish language schools and high schools across Sweden. The survey included questions about knowledge of condom use for preventing pregnancy and HIV treatment and transmission. Descriptive statistics were calculated, and multivariable logistic regression analyses were performed to assess the responses to the knowledge questions and sociodemographic characteristics.ResultsOut of 3430 respondents (median age: 35, interquartile range: 20), approximately 39% were unaware that condoms can prevent unplanned pregnancies. Only 58% of the respondents knew that condoms reduce the risk of contracting HIV. About 77% were unaware of HIV treatment, and 52% reported not knowing that a woman with HIV could transmit the virus to her baby during pregnancy or breastfeeding. Incorrect knowledge about condom use to prevent unwanted pregnancy was associated with several factors: younger age (15–19 years) adjusted odds ratio (aOR) 1.35; 95% confidence interval (CI), 1.02–1.79); female respondents (aOR: 1.68; 95% CI 1.36–2.07); lack of previous sexual health education (aOR: 2.57; 95% CI 2.11–3.13); low level of education (aOR: 1.30; 95% CI 1.04–1.61). Originating from the Americas, European, or sub-Saharan African regions was associated with a 34–42% decreased likelihood of incorrect knowledge that condoms can reduce the risk of HIV infection compared to respondents from the Middle East and North Africa (MENA). More than half (64%) of respondents reported needing more SRHR information.ConclusionsWe found significant knowledge gaps on HIV and condom use for preventing pregnancy among migrants in Sweden. Comprehensive sexual health education in language schools, along with information to newly arrived migrants from diverse regional backgrounds and targeted sexual health services to younger individuals, women, and those who lack sexual health education, are needed to address these information gaps and provide crucial SRHR education and information.