Reproductive Health Matters Research Articles

Репродуктивное здоровье и репродуктивная культура студентов: тактика профилактических мероприятий

BACKGROUND: Statistics shows a decrease in the birth rate in Russia. This is alarming fact that obliges to take some measures, including preventive ones. Since the reproductive health of students will determine demographic indicators for many years to come, it is very important to choose methods of prevention in one direction or another, taking into account modern technical trends and hobbies of young people. AIM: To explore the knowledge of students of different specialties in matters of reproductive health, reproductive culture. To suggest the way of preventive measures based on the data obtained. MATERIALS AND METHODS: The study involved students from the Ural, Moscow and St. Petersburg universities. 537 questionnaires were processed. The questionnaire indicated the social status of the participants (gender, age, university profile). According to the latter criterion, the sample was divided into four groups: natural sciences, medical sciences, technical sciences, and humanities. An anonymous survey was conducted in the “Google form”. The respondents answered questions about the most pressing problems of reproductive health and reproductive culture. RESULTS: 64% of the respondents assess their reproductive health as good; the most popular source of information on contraception for university youth is the Internet. According to the analysis of the data obtained, in the event of an unwanted pregnancy, only 24% of the women surveyed would have the pregnancy kept, which may indicate a low reproductive culture of students. CONCLUSION: To take attention to reproductive health and prevention issues among students in accessible terms, blogging on social networks by specialists in the field of obstetrics and gynecology, urology and andrology, senior medical students or clinical residents can be proposed.

High Risk Behavior, Knowledge and Attitudes of Adolescent Health: A Study from Rajshahi City Corporation Area of Bangladesh.

Background: Adolescence is one of the most dynamic stages of human growth and development. It is an important issue in Bangladesh as well as in the world. Reproductive health of adolescents is strongly affected by sociodemographic factors. The purpose of this study was to establish the factors that influence on high-risk behavior, knowledge and attitudes of adolescent, which were regarded as determinants. Data and Methods: Socio-demographic, health related behavior was collected from 1084 adolescence girls in Rajshahi City Corporation (RCC) area, Bangladesh. Bivariate analysis has been used to show the association between the reproductive health knowledge with some socio-demographic and health related characteristics. In multivariate analysis, binary logistic regression analysis was used to determine the effects of the various factors to reproductive health knowledge among female adolescent. Findings: Education is an important determinant of adolescent health. Most the respondent is secondary level of education, which was 64.2%. The study result shows that 37.6% adolescent girl has knowledge about adolescent health care. It also shown that very few numbers of adolescent have idea about abortion, reproductive health knowledge about pregnancy avoids method and family planning method but maximum respondent heard about idea about sex, marriage and knowledge about HIV/AIDS. Logistic regression analysis findings specify that respondent in the age group 15-19 years is more expected to in turn ever having accomplished knowledge about adolescent health. Sexual violence is directly related to the duration of marriage. Married respondents have 0.221 (27.9%) times lower experienced to knowledge about adolescent health than that of the unmarried respondents. Conclusion: This study needs to strengthen public-private sector partnership and stakeholder participation, active involvement of adolescents in their reproductive health matters. Respondent educational qualification has positively significant effect on knowledge about adolescent reproductive health. Age of respondents, Idea about pregnancy, Idea about abortion, Physical problem during menstruation, knowledge about pregnancy has also significant effect on knowledge about adolescent reproductive health. The most effective interventions are probably structural changes to improve people daily life with families and peers and access to improve education.

AWARENESS, KNOWLEDGE, ATTITUDE, AND PRACTICES TOWARDS SEXUAL AND REPRODUCTIVE HEALTH AMONG SECONDARY SCHOOL STUDENTS IN MALAYSIA

Sexual and reproductive health matters are still taboo because it is sensitive to be discussed publicly as it opposed the norms of Malaysian people, especially among high school students. This study sought to investigate the awareness, knowledge, attitudes, and practices towards sexual and reproductive health among high school students between the ages of 13 to 17 years old in Petaling Perdana district in Selangor, Malaysia. A cross-sectional survey study was conducted among 382 secondary school students using a self-administered validated questionnaire. Descriptive and MANOVA analyses were used to analyse the data. The results showed that the level of awareness, knowledge, attitude, and practices towards sexual and reproductive health was high among all secondary school students. The MANOVA analysis yielded significant differences towards practices on gender F (1, 380) = 16.035, p < .001, with males (M = 1.051) scoring higher than females (M = .661), and level of education F (4, 377) = 7.202, p < .001, with Form 5 students (M = 1.172) having the highest score. The study concluded that males had better sexual practices than females and students with a higher level of education have better understanding and practices towards their sexual and reproductive health.

Determinants of Male Partner Involvement in Antenatal and Postnatal Care in Bumula Sub-County, Kenya

Introduction
 Men play a significant role in health-seeking behaviour of their families. While determinants of men’s involvement in reproductive health matters have been studied, the same are likely to vary on the basis of social context. The objective of this study was to determine socio-demographic, cultural and health facility factors influencing male partner involvement in Antenatal Care (ANC) and Postnatal Care (PNC). Moreover, the study intended to determine perceived benefits of male involvement in ANC and PNC services.
 Methods
 This was a cross-sectional household survey. Simple random sampling was used to select 398 men and women participants out of 1,716 households in Bumula Sub-County. The men and women interviewed were not necessarily couples. Questionnaires were administered to participants within the households by face-to-face interview. The data collected through the questionnaires were on their sociodemographic, cultural, and health-related factors, and perceived benefits of male involvement in ANC and PNC. Key informant interviews were conducted among 14 health workers.
 Results
 Participants having college education were more likely to report male involvement (adjusted Odds Ratio (AOR) = 3.25, 95% CI [1.03-10.25], p=0.044) compared to those with no education. Participants who made joint decisions with partners (p<0.0001) and who viewed PNC as necessary (p=0.021) were more likely to report male involvement. Cultural practices were a major impediment to male involvement because of the portrayal of male dominance in roles of financial support and inferiority if a male accompanies a spouse to a clinic. 
 Conclusion
 Education had a favorable influence on male involvement. Cultural practices were a major impediment to male involvement due to its portrayal of male dominance in roles of financial support and inferiority if male accompanies spouse to PNC and ANC. The study recommends intensified health education messaging to increase support for male involvement and a further study to explore specific societal norms and beliefs that undermine male partner participation in ANC and PNC.

Midwives and Dukun Beranak, the Choices for Handling Childbirth

Since the colonial era, there have been attempts to provide clinical childbirth services by establishing midwifery schools. Although these schools were closed, reorganized then re-opened several times, in an effort to graduate native midwives in the colony. The majority of the European doctors believed the existence of native midwives could reduce mortality rates for difficult deliveries. The colonial government also tried to replace dukun beranak (local midwives) with graduate midwives, as many doctors considered dukun beranak practices unsafe and unhygienic. Of note, even though midwifery school graduates provided childbirth services, most of the population preferred to use dukun beranak. This situation continued until independence. Dukun beranak remained the preferred provider of assistance among the working and lower class. The continued popularity of the dukun beranak can be seen as a colonial failure to replace them. After the proclamation of Indonesian independence, midwives who supported the Indonesian Republic, still provided childbearing assistance although with limited infrastructure and inadequate personnel during the independence war. Midwives also founded a midwifes association, rebuilt the national midwifery system, and discontinued colonial elements. This transformation can be interpreted as the decolonisation of midwifery. Midwives and dukun beranak were the available options for assisting in the labour of an Indonesian woman. The Indonesian government had a different approach to the colonial government toward society and dukun beranak and built cooperation between midwives and the dukun beranak. The cooperative work among midwives and dukun beranak changed awareness of Indonesian women’s reproductive health matters. This article traces efforts to provide safer childbirth services by looking at the problem through the lens of midwives and dukun beranak relations. The evolution of this relationship shows the decolonisation process inside midwifery and childbearing services.

The Role of Culture and Religion on Sexual and Reproductive Health Indicators and Help-Seeking Attitudes amongst 1.5 Generation Migrants in Australia: A Quantitative Pilot Study.

In Australia, 1.5 generation migrants (those who migrated as children) often enter a new cultural and religious environment, with its own set of constructs of sexual and reproductive health (SRH), at a crucial time in their psychosexual development—puberty/adolescence. Therefore, 1.5 generation migrants may thus have to contend with constructions of SRH from at least two cultures which may be at conflict on the matter. This study was designed to investigate the role of culture and religion on sexual and reproductive health indicators and help-seeking amongst 1.5 generation migrants. An online survey was completed by 111 participants who answered questions about their cultural connectedness, religion, sexual and reproductive health and help-seeking. Kruskall-Wallis tests were used to analyse the data. There was no significant difference between ethnocultural groups or levels of cultural connectedness in relation to sexual and reproductive health help-seeking attitudes. The results do suggest differences between religious groups in regard to seeking help specifically from participants’ parents. Notably, participants who reported having ‘no religion’ were more likely to seek help with sexual and reproductive health matters from their parent(s). Managing cross-cultural experiences is often noted in the extant literature as a barrier to sexual and reproductive health help-seeking. However, while cultural norms of migrants’ country of origin can remain strong, it is religion that seems to have more of an impact on how 1.5 generation migrants seek help for SRH issues. The findings suggest that 1.5 generation migrants may not need to adapt their religious beliefs or practices, despite entering a new ethnocultural environment. Given that religion can play a role in the participants’ sexual and reproductive health, religious organizations are well-placed to encourage young migrants to adopt help-seeking attitudes.

Does family life education influence attitudes towards sexual and reproductive health matters among unmarried young women in India?

Inadequate efforts towards meeting the sexual and reproductive health needs of adolescents and young people, who disproportionately share the burden of unwanted pregnancies, poor maternal and child health outcomes, risks of RTI/STI and HIV/AIDS, increase the risk of losing much of the progress made towards the Millennium Development Goals over the last decade, particularly in the context of low-and-middle-income countries like India. Using the nationally representative data on 160551 unmarried young women aged 15-24 years from the District Level Reproductive and Child Health Survey (DLHS: 2007-2008) in India, this research evaluated the demographic and socioeconomic differentials in the access to family life/sex education (FLE) among youth in India. Using the adjusted multiple logistic regression models, the association between access to family life/sex education and attitudes towards a range of sexual and reproductive health matters among young unmarried Indian women were investigated. Less than half of the unmarried young women had received some form of FLE (48 percent) in India. However, there were substantial demographic and socioeconomic variations in their access to FLE, as relatively less educated women from the poorest wealth quintiles, religious and social minorities (Muslims, Scheduled Castes/Scheduled Tribes) were significantly less likely to receive FLE as compared to other women. Importantly, the likelihood of holding favourable/positive attitudes towards reproductive processes, knowledge and discussion of contraceptive methods, precise awareness about the transmission pathways of RTIs/STIs and HIV/AIDS was significantly higher among those women in India who had access to FLE. The present research underscores the protective role of family life education towards improving the sexual and reproductive life experiences of young people. It further underscores the vital need to implement a comprehensive and culturally appropriate programme of family life education in order to meet the sexual and reproductive health demands of the adolescents and young people in India.

Utilization of Long-Acting Reversible Contraceptive (LARC) Methods in a tertiary hospital in southwestern Nigeria: A Mixed Methods Study.

There is an increasing trend in the utilization of long-acting reversible contraceptive (LARC) methods globally. The study assessed the utilization of LARC methods and its determinants in a tertiary hospital, southwestern Nigeria using a mixed method study. A cross-sectional study of women attending the Family Planning Clinic of the tertiary hospital was conducted between November 1, 2018 and October 31, 2019 using both quantitative and qualitative methods. Quantitative data was collected using structured questionnaire while in-depth interviewer topic guide was used to obtain qualitative data from the respondents. The quantitative and qualitative data obtained from the respondents were analyzed using SPSS version 22 and open code version 3.6.2, respectively, and the determinants of utilization of LARC methods were identified using multivariate regression model. The current utilization rate of LARC methods was 65.6% and implants accounted for 75% of LARC used. Higher education (p = 0.035), more than 3 living children (p = 0.030), previous use of LARC (p = 0.028), good knowledge (p = 0.025) and positive attitude of the women about LARC (p = 0.026) were significant determinants of utilization among the women. Limiting size of family was the commonest reason among LARC users, while partner disapproval, fear of procedure and side effects were reasons given by non-users. The utilization rate of LARC methods are high, and this should be sustained through improved information dissemination, education of women and involvement of male partners in reproductive health matters including family planning.

Individual, socio-cultural, and health facility factors affecting men's involvement in facility-based childbirth in Southwest, Ethiopia: A mixed method study.

Introduction:Traditionally, men are not supposed to take part in maternal health issues in many cultures. Nevertheless, pregnancy care and childbirth are the most crucial matters of reproductive health influenced by men. Hence, the aim of this study was to identify individual, sociocultural, and health facility factors affecting men’s involvement in facility-based childbirth in Southwest, Ethiopia.Objectives:The aim of this study was to identify individual, sociocultural, and health facility factors affecting men’s involvement in facility-based childbirth in Southwest, Ethiopia.Methods:A community-based cross-sectional study accompanied with a qualitative method was carried out from 1 July to 30 August 2019. A multistage cluster sampling technique was employed to recruit study participants. Descriptive statistics, frequencies, proportions, and mean were calculated, and the results of the analysis were presented in text, tables, and graphs. A multivariate logistic regression model was fitted to investigate the independent effect of each explanatory variable on the likelihood of men’s involvement in facility-based childbirth. Qualitative data were analyzed thematically using OpenCode 4.0 software.Results:Out of 800 men, only 36.5% (95% confidence interval: 33.3%–39.6%) were found to have involved in facility-based childbirth. Several factors were associated with men’s involvement in facility-based childbirth of this, being in the age group of 40–49 (adjusted odds ratio 5.04, 95% confidence interval: 2.49–10.20), attaining secondary education and above (adjusted odds ratio 2.14, 95% confidence interval: 1.53–5.60), and having sufficient knowledge of danger signs during pregnancy (adjusted odds ratio 5.65, 95% confidence interval: 3.25–7.46) associated with men’s involvement in facility-based childbirth.Conclusion:Relevant entities had better design-specific educational programs targeting younger age groups, those with lower schooling, and had previous bad obstetrics outcomes. Involving elders and religious leaders in the reproductive health program could also help in overcoming the existing cultural barriers. Moreover, creating a men-friendly facility environment and extensively engaging medias are suggested to improve men’s involvement in the study area.

Views of learners on prevention and management of pregnancies in schools of Madibeng municipality, North West province of South Africa.

Learner pregnancies have increased in recent years, despite improved access to reproductive health services, contraceptives and sexual and reproductive education. In this article, a pregnant learner refers to any person who gets pregnant while being admitted as a learner in primary or secondary schools of the South African basic education system. Currently in South Africa there is no formal collaboration between the Departments of Health and Education concerning learner pregnancy prevention and management in schools. This study, conducted in Madibeng Municipality schools, aimed to develop implementation guidelines of the policy on prevention and management of learner pregnancy in schools. This qualitative, exploratory and descriptive study used a purposive sampling method. Data collection yielded 17 individual interviews and data was analysed using content analysis by Tesch's approach. Learners reflected that they lacked support from schools regarding learner pregnancy prevention and management, with the majority agreeing that nurses should visit schools to assist with reproductive health matters such as learner pregnancy. The education system of South Africa has invested in sexual and reproductive education, but learner pregnancies have doubled despite more than a decade of extensive sexual and reproductive education in schools. Stakeholders outside the classroom should be engaged to improve learner pregnancy prevention and management as part of support to teachers and schools. Such stakeholders include parents, peer educators, youth and community organisations, non-governmental organisations, community healthcare nurses and other relevant stakeholders.

Parent-adolescent communication on sexual and reproductive health issues and its associated factors in Ethiopia: a systematic review and meta-analysis

BackgroundEvery year, 1.3 million young people reported to die from preventable causes of death. Parent-adolescent communication on sexuality is critical in informing youth about risk and protective behaviors which in turn decrease the likelihood of involvement in risky sexual behaviors. This systematic review and meta-analysis was intended to assess the prevalence of parent-adolescent communication on sexual and reproductive health (SRH) issues and its associated factors in Ethiopia.MethodsPubMed, EMBASE, HINARI, Google Scholar, and University repositories were used to search studies. Article search was conducted from May 20 to June 9, 2020. Critical appraisal of studies was conducted using Newcastle-Ottawa Quality Assessment Scale (NOS). Data analysis was conducted using Stata 11 software following the abstraction of data using a format prepared on Microsoft excel. The heterogeneity of studies was tested using Cochran (Q test) and I2 test statistics. Similarly, funnel plot and Egger’s regression asymmetry were used to assess publication bias. Subgroup analysis was conducted based on study Regions and sample size.ResultFourteen studies with sample of 8018 adolescents were included in this systematic review and meta-analysis. The pooled prevalence of parent-adolescent communication on SRH issues in Ethiopia was found to be 45.18% (95%, CI, 32.23, 58.13%). Adolescents’ knowledge of reproductive health matters (OR = 2.91, 95% CI:1.21, 7.01), believe on importance of discussion on SRH issues (OR = 4.18, 95% CI: 2.63, 6.65), had history of sexual exposure (OR = 1.95, 95% CI: 1.53, 2.50), parents openness to discuss SRH issues (OR = 3.39, 95% CI: (2.48, 4.62), and being female (OR = 1.60, 95% CI:1.07, 2.38) were the positive predictors of parent-adolescent communications on SRH issues.ConclusionThe prevalence of parent-adolescent communication on SRH issues was found to be low. Knowledge of adolescents about reproductive health matters, believe on the importance of discussion on reproductive health issues, history of sexual exposure, parents’ openness to discuss SRH issues, and being female were found to be the positive predictors of parent-adolescent communication on SRH issues in Ethiopia. The finding our study indicated that evidence based education about reproductive health matters could significant to improve adolescent parent communication on SRH issues.

Emergency contraceptive knowledge, utilization and associated factors among secondary school students in Wolkite town, southern Ethiopia, cross sectional study

BackgroundEthiopia is one of the sub-Saharan African countries with high maternal mortality and morbidity, unsafe abortion and adolescent births. Despite different policy measures taken by the government to improve sexual and reproductive health among adolescents their success is not well studied in Ethiopia. The objective of this study is to explore emergency contraceptive related knowledge, practice and its determinants among secondary school students in southern Ethiopia.MethodsAn institution-based cross-sectional study was conducted in selected high schools of Wolkite town, Southern Ethiopia from December to November 2019. Single population proportion formula was used to calculate sample size. A total of 327 female students participated in the study with a total response rate of 97%. Data were collected using a self-administered, structured questionnaire and cleaned, entered and analyzed using Statistical package for social science software version 21.Result153 (54.8%) of the study participants had good knowledge about emergency contraceptives and only (40.5%) of sexually active participates used emergency contraceptives after unprotected sex. Type of admission and grade level of participants and discussion of reproductive health related issues with parents were significantly associated with good knowledge of Emergency contraceptive. Having partner and grade level of students were among the significant determinants of emergency contraceptive utilization.ConclusionThe study showed an acceptable level of emergency contraceptive knowledge but only less than half of sexually active respondents used emergency contraceptives. To prevent unintended pregnancy among secondary school students sexual and reproductive health education should be given to students starting from their enrollment. Furthermore, parents should be encouraged to freely discuss sexual and reproductive health matters with their children.

Parent-Adolescent/Youth Sexual and Reproductive Health Communication: The Case of Secondary and Preparatory School Students in Fiche Town, Oromia Regional State, Ethiopia

Background: Adolescence/youth is a continuum of physical, cognitive, behavioral, and psychosocial development. Due to a lack of comprehensive knowledge regarding sexual and reproductive health, adolescents face a number of problems. Clear family communication of reproductive health issues often leads to increased awareness of reproductive health matters and reduces risky behaviors and its consequences in adolescent populations. Objective: To assess parent-adolescent/youth communication and associated factors among students attending secondary and preparatory schools in Fiche town, Oromia Regional State, Ethiopia. Methods: An institution-based cross-sectional study was conducted from March 27 to 30,2017, using a structured self-administered questionnaire. Two schools in the town were included in the study. Data were entered using epidata manager version 4.0.2.101 and exported to SPSS version 21 for analysis. Multivariable logistic regression analysis was performed, and variables with a p-value of less than 0.05 were considered statistically significant. Results: The number of students who had ever discussed sexual and reproductive health issues with their parents was 118 (31.2%). Mothers’ educational status of diploma [adjusted odds ratio (AOR)=3.52, 95%CI=1.13-10.95], fathers’ educational status of diploma [AOR=3.84, 95%CI=1.29-11.41], students’ perceived importance of sexual and reproductive health issues discussion [AOR=6.69, 95%CI=2.04-22.00], students’ knowledge about sexual and reproductive health issues [AOR=4.80, 95%CI=2.56-9.01], and students’ attitude towards sexual and reproductive health issues [AOR=3.13, 95%CI=1.76-5.57] were identified as independent predictors of parent-student sexual and reproductive health communication. Conclusion: The level of parent-student sexual and reproductive health communication is low among secondary and preparatory schools in Fiche town. Therefore, school administration, in collaboration with stakeholders, should facilitate adolescent-friendly services to enhance sexual and reproductive health-related awareness.

Exploring factors constraining utilization of contraceptive services among adolescents in Southeast Nigeria: an application of the socio-ecological model

BackgroundHigh rate of teenage pregnancy in Nigeria is potentially an indication of poor access to and utilization of contraceptives among this age group. This paper presents findings from in-depth exploration of perceived barriers to utilization of contraceptive services by adolescents.MethodsA qualitative study was conducted in six communities in Ebonyi state, southeast Nigeria. Eighty-one in-depth interviews and six focus group discussions were conducted. Respondents comprised policy makers, community leaders, health service providers and parents of adolescents. Pre-tested interview guides were used to collect information on perceived barriers to utilization of contraceptive services by adolescents. All interviews were audio recorded and transcribed in English. Data was analysed using thematic framework approach, and the socio-ecological model was adapted for data synthesis.ResultsIndividual level factors that limit access to contraceptives for adolescents include lack of awareness and poor knowledge, fear of side effects, low self-esteem, and inability to afford cost of services. Interpersonal (family-related) barriers to access include poor parent-child communication of sexual and reproductive health matters and negative attitude of parents towards to sexuality education for adolescents. Health systems barriers to accessing contraceptives for adolescents include lack of privacy and confidentiality, stock-out of contraceptive commodities, judgmental attitude of health workers, insufficient staff that are skilled in adolescent sexual and reproductive health. Gendered cultural norms, societal shaming and religious intolerance also preclude adolescents from accessing and using contraceptive services. Wider societal factors such as negative peer and media influence, absence of sexuality education in schools, lack of social networks in communities; and macro level factors such as poor economic conditions were also perceived to limit access to contraceptives for adolescents.ConclusionUtilization of contraception is constrained by an interplay of factors acting at various levels. Addressing these barriers could contribute to improved access to contraceptive services for adolescents, as well as reduction in unwanted teenage pregnancy.

Study of Knowledge of Adolescent Female Students regarding their Reproductive Health

Background: Reproductive health (RH) is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health care includes having access to a range of good-quality information and services. Purpose: Study Knowledge of Adolescent Female regarding their Reproductive Health in Hafr Al Batin University. Design and Methods: a descriptive study design was carried out at three faculties. Through purposive sample: 500 female students who were available at the time of data collection. A questionnaire sheet was developed to collect the necessary data. Data were collected through a self- administered structured questionnaire sheet: It composed of two main parts: Socio-demographic characteristics and knowledge about RH matters. Results, and Practice Implications: The present study revealed that (70.8%) have a fair knowledge and (38.2%) of them have a good knowledge regarding reproductive health matters. Also, a statistically significant difference between age and their knowledge, while a highly statistically significant difference between residence, marital status, family size of them, and their RH knowledge. The study concluded that (70.8%) have a fair knowledge and (38.2%) of them have a good knowledge regarding reproductive health matters. The study recommended, develop reproductive health education programs for female adolescents directed to reproductive health programs to confirm its validity in satisfying their needs and to motivate them. Further researches are needed to explore adolescents' obstacles for the utilization of reproductive health services.

Exploring issues in caregivers and parent communication of sexual and reproductive health matters with adolescents in Ebonyi state, Nigeria

BackgroundParent-child communication is an effective tool for fostering healthy sexual and reproductive behaviours among adolescents. However, the topic is underexplored in Nigeria. This study examines how parents and caregivers communicate sexual and reproductive health-related matters with adolescents aged 13–18 years in Nigeria.MethodThe study was undertaken in six communities in Ebonyi state, Nigeria using quantitative and qualitative research methods. Data were collected through, i) cluster randomized survey of 1057 adolescents aged 13–18 years, ii) twelve sex-disaggregated focus group discussions with adolescents aged 13 to 18 years, and iii) eight in-depth interviews with parents and caregivers. Univariate and bivariate analysis were performed for quantitative data, while qualitative data were analysed using thematic framework approach.ResultsLess than half (47.9%) of adolescents in the survey reported ever discussing sex-related matters with anyone. Three-quarters of those who had this discussion did so with a friend/peer and this had significant correlation with sex/gender (p = 0.04). Out of 1057 adolescents who participated in the survey only 4.5% had ever discussed sex-related matters with a parent and this correlated significantly with wealth index (p = 0.003). Findings from qualitative interviews show that sex-related discussions between parents and adolescents are sporadic, mostly triggered by unpleasant occurrences, and consist of, i) information on pubertal changes, ii) warnings against intersex relationships and premarital sex, iii) promotion of abstinence, and iv) warnings against teenage pregnancy and unsafe abortion. Some parents were of the opinion that sex-related matters should not be discussed with adolescents because it could be interpreted as tolerance for sexual promiscuity. Overall, parents expressed that their capacity to discuss sex-related matters with adolescents is limited by lack of knowledge, and restrictive religious and cultural norms about adolescent sexuality.ConclusionCommunication between parents and adolescents on sexual health and reproductive-related matters rarely occurs. However, when it does, it mostly consists of strict warnings that may not protect adolescents from making unhealthy sexual and reproductive health choices. Interventions to improve parent-adolescent communication of sexual and reproductive health (SRH) should aim at improving parents’ capacity to communicate sexual and reproductive health matters, and deconstructing sociocultural norms around adolescent sexuality.

The Natal Journey and Perinatal Palliative Care.

Doctors often focus on the science of medicine involved in matters of reproductive health and childbirth, at times to the exclusion of the psychosocial and spiritual dimensions of health. Pregnancy and childbirth are clothed in mystery when it comes to the question of why a pregnancy goes well or is fraught with complications. And while explanations may abound in this age of increasing genetic understanding, the meaning attached to these matters is beyond the scope of medicine alone-especially when the newborn's very survival is in question. Perinatal palliative care can bring solace to such troubling realities.

Self-Esteem Assessment among Adolescents Living with HIV and Seeking Healthcare at Komfo Anokye Teaching Hospital-Kumasi, Ghana.

Background:This study assessed the predictors of self-esteem among Adolescents Living with HIV (ALHIV) in Ghana seeking healthcare at Komfo Anokye Teaching Hospital.Methods:A cross-sectional study was employed in sampling 139 adolescents using a purposive sampling technique. Rosenberg’s rating scale was used in assessing the self-esteem of the participants.Results:A total of 139 adolescents made up of 78 (56.12%) females and 61 (43.88%) males were recruited. Low self-esteem was reported among 66 (47.00%) of the adolescents. Adolescents aged 17-19 years (aOR = 2.97, 95%CI = 1.34-6.56, p = 0.007) were significantly associated with low self-esteem.Conclusion:The occurrence of low self-esteem among ALHIV was high and more pronounced among those in age cohorts of 17 to 19 years. Social support interventions designed which includes psychosocial support, life skills training, and avenue for discussing sexual and reproductive health matters could improve self-esteem.

Parent-adolescent Communication on Sexual and Reproductive Health Matters and Associated Factors among Secondary and Preparatory School Students in Robe Town, Bale zone, Southeast Ethiopia, 2017

Background Adolescents is the transition from childhood to adulthood .Which is a time of opportunity, but also one of risk. In Ethiopia, sexual and reproductive health problems of adolescents are increasing from time to time related to many parents not feeling happy to discuss sexual matters in addition to early sexual commencement among adolescents. Objective This study was intended to assess parent-adolescent communication on sexual and reproductive health matters and associated factors among secondary and preparatory school students in Robe Town, Bale Zone, South East Ethiopia, 2017. Methods Institution based cross sectional study was conducted among 394 secondary and preparatory school students in Robe town from April 10-25, 2017. Simple random sampling technique was used. Data was obtained through the use of a self administered questionnaire and supplemented by focus group discussion with parents. Data was entered using Epi Data 3.1 and analyzed by SPSS 20. Descriptive statistics and logistic regression analyses were done. Data quality was assured through careful questionnaire design, pretest and training. Results One hundred eighty six (47%) of the study participants had discussed at least two SRH issues with their parents. Grade eleven students were about nearly five times more likely discussed on sexual and reproductive matters with their parent compared with grade nine students (AOR: 4.88, 95% CI: 1.76, 13.54). Those living with relatives were 3.13 times less likely discussed as compared to those students are living with both parents (AOR: 0.32, 95%CI: (0.12, 0.80) and the odds of discussion on SRH matters is 2 times higher among females compared with their counterpart (AOR=2.02, 95% CI: 1.25, 3.26). Conclusions Communication on sexual and reproductive health matters between adolescent and parent was low. Majority of student preferred to discuss with their peers than parent. Being ashamed, parents lack of communication skill and parent knowledge on SRH issues were the major reasons mentioned by the students for not discussing about SRH matters with their parents. Therefore; comprehensive family life education needs to be initiated for the students and parents. Sexual information exchange between peers needs to be strengthened.

Sexual and reproductive health communication intervention for caretakers of adolescents: a quasi-experimental study in Unguja- Zanzibar

BackgroundCaretakers/parents or parents figure need to be trained to promote effective communication about sexual and reproductive health to their adolescents. This study assessed the effect of an intervention aiming to improve caretaker-adolescent communication on sexual and reproductive health matters through improving information, motivation, and behavioral skills related to sexual health communication. The study also evaluated the relationship of information, motivation, and behavioral skills model-constructs with communication practice. Information-Motivation-Behavioural skills model was used as a framework to guide the intervention implementation and evaluation process.MethodThis is a quasi-experimental non-randomized controlled pre- and post-test study which involved one thousand caretakers of adolescents in all the six districts of Unguja-Zanzibar. All participants completed interviewer-administered structured pre-test questionnaire. The experimental group then received sexual health communication intervention addressing the information, motivation, and behavioral skills related to sexual health communication, while the control group received the sexual health information only. All participants were then reassessed for their information, motivation, behavioral skills and their sexual health communication after 1 month, 6 months and at 1 year following the intervention. To evaluate the effect of intervention at the post-test measures, Univariate Analyses of Covariance was performed whereby the pre-test score and variables on which the groups differed were considered as covariates. Standardized mean difference statistics of Cohen’s d was used to calculate the effect size, and the cut-off point for the level of significance was set at two-sided, p-value < 0.05.ResultsResults shows that the immediate post-test sexual health communication, motivation and behavioral skills scores were statistically significantly higher in the experimental group compared to control group (p < 0.05). Moreover, sexual health communication score after 6 months and at 1 year were statistically significantly higher in the experimental group compared to control group (p < 0.05). Information construct however did not differ between groups in post-test measures. Furthermore, results revealed that communication practice is statistically significantly associated with information, motivation and behavioural skills in post-test measures.ConclusionThe findings provided preliminary evidence for the effectiveness of SRH communication intervention and supported the significance of IMB model-constructs to inform the SRH-communication intervention and to guide the intervention evaluation.