Reproductive Health Needs Research Articles

SOCIODEMOGRAPHIC DETERMINANTS OF EARLY, NORMAL, AND DELAYED MENARCHE AMONG FEMALE COLLEGE-AGED STUDENTS IN BANGLADESH

Introduction: The onset of menstruation in adolescence is an important part of the maturational process. However, menstrual disorders are common in all parts of the society. The aim of this study was to identify the factors that influence the menarcheal age of adult female students in Rajshahi University, Bangladesh.
 Methods: The data was collected from 1000 female students at Rajshahi University using a purposive sampling technique with direct interview method. The cross-sectional data was used for univariate analysis, to carry out the description of the variables and their attributes on data in list; and bivariate analysis, to find the associations among the variables.
 Results: The results revealed that among the respondents more than half (54%) experienced menarche at an early age, more than one-third (37.8%) experienced menarche at normal age, and a few (8.2%) experienced menarche at a later age. The results also revealed that a few (9.2%) respondents experienced irregular menstrual cycles whereas, most of the respondents (69.2%) suffered menstrual pain. The menarcheal age is significantly associated with their living areas. The association between age at menarche and socioeconomic factors was found to be statistically significant. The students having lower mean age at menarche live in urban areas with high family income than that of rural areas and middle or low family income group.
 Conclusion and Implications for Translation: Most of the respondents were experienced early menarche and suffered from menstrual pain. The sociodemographic factors were found significantly associated with age at menarche. Information on the factors that influence the menarcheal age of adult female students and related issues on reproductive health need special attention.
 Key words: Age at Menarche • Sociodemographic Factors • Duration of Menstrual Flow • Menstrual Cycle
 
 © 2017 Khatun et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reproductive health service utilization and associated factors: the case of north Shewa zone youth, Amhara region, Ethiopia.

IntroductionMany youth are less informed, less experienced and less comfortable in utilizing reproductive health services. In the Sub-Saharan region the adolescents account for a higher proportion of new HIV infections and unmet need for reproductive health (RH) services. This study assessed reproductive health service utilization and associated factors among the youth in Amhara Region, Ethiopia.MethodsA community based cross-sectional study was conducted from June 15-July 30, 2014. Three hundred ninety one youth were selected by systematic random sampling technique and interviewed using structured questionnaire. Data were anlyzed using SPSS windows version 20. Multiple logistic regression was done to control potential confounding variables. P-values <0.05 were considered statistically significant.ResultsThree hundred and nighty one in-school and out-of-school youth were interviewed; 256 (65.5%) participants were in school and 209 (53.5%) were males. Almost all respondents (93.9%) had heard about reproductive health services and a third 129 (33%) had ever practiced sexual intercourse and 54.7% of them had utilized at least one reproductive health services. Never had sexual intercourse (AOR=3.693, 95%CI: 1.266, 10.775), families that asked their children about friends (parental monitoring) (AOR=1.892, 95%CI: 1.026, 3.491), know where service provided (AOR=3.273, 95%CI: 1.158, 9.247), youths who reads newspaper readers (AOR=3.787, 95%CI: 1.849were independent predictors of youth reproductive service utilization at 95 % CI and p-value <0.05%.ConclusionEven though the youth have information about reproductive health services, youth reproductive health services utilization is very low. Therefore, building life skill, facilitating parent to child communication, establishing and strengthening of youth centres and increasing awareness for youth about those services are important steps to improve adolescents' reproductive health (RH) service utilization.

Factors associated with parental communication with young people about sexual and reproductive health

Purpose Available studies on parent-child communication about sexual and reproductive health in Ghana have largely focused on assessing communication frequency, barriers, and who communicates with whom within the family. The purpose of this paper is to examine parental and family contextual factors that predict parental communication with young people about sexual and reproductive health. Design/methodology/approach A cross-sectional interviewer-administered survey was conducted among 790 parents selected through a multistage sampling technique. The Cronbach’s α statistic was used to assess various parental and family contextual constructs on parent-child communication about sexual and reproductive health. Separate hierarchical multiple regression models for mothers and fathers were constructed to assess predictors of parental communication about sexual and reproductive health. Findings Nearly the same factors predicted mothers’ and fathers’ communication with young people about sexual and reproductive health matters. The predictors for both mothers and fathers included high socioeconomic status (SES), family religiousity, parent discipline, perceived parent sexual knowledge and parent trustworthiness. Parent permissiveness predicted only for fathers. Social implications Parental communication on sexual and reproductive health is influenced by high SES, family religiousity, parent sexual knowledge, parent discipline and trustworthiness. Interventional programmes on communication about sexual and reproductive health need to take cognisance of these factors to improve parent-child communication about sexual and reproductive health. Originality/value This paper adds to the limited evidence on parent-child communication about sexual and reproductive health in Ghana, by examining parental and family contextual factors that influence parental communication with young people about sexual and reproductive health.

An Interventional Strategy for addressing The Social Development and Reproductive Health Needs of The Youth in Nigeria; Lessons Learnt

The youth constitute a critical age group especially in a populous nation like Nigeria. Therefore, a lot more needs to be done to address the needs (social development and reproductive health) of the youth. The Nigerian Academy of Science set up a project to address the needs of youth by working with the youth and various stakeholders, including two state governments, to identify and develop evidence-based policy to respond to the needs. The needs assessment involved data collection from the youth and other stakeholders and the collective review of the findings. Consequently, strategic plans were developed for each state. Diverse strategies were employed which promoted partnership among the stakeholders and led to ownership of the policy documents (strategic plans) developed.

Photovoice: A Strategy to Better Understand the Reproductive and Sexual Health Needs of Young Mothers

Study ObjectiveAdolescent women face significant sexual and reproductive health challenges and are more vulnerable than their male peers. Photovoice methodology might allow them to provide more meaningful and accurate representations of the health challenges they encounter. Our objectives were to: (1) use Photovoice to understand how young mothers frame reproductive and sexual health within the context of their lives; (2) explore how they define reproductive and sexual health; (3) identify youth perspectives on how their life situations influence their ability to affect their health; and (4) connect their perspectives to social determinants of health framework to facilitate implementation of effective programs and policies to address their needs. Design, Setting, Participants, Interventions, and Main Outcome MeasuresThis was a prospective qualitative community-based participatory research study involving young women (ages 15-25 years) recruited from a local youth outreach center. A 9-step validated qualitative participatory approach that combined documentary photography with focus groups was used. Qualitative analysis was conducted with NVivo version 10 software (QSR International Inc., Burlington, MA, USA). Data were coded and themes were developed. ResultsThirty women were recruited and nine women completed the study. Key themes included: personal sexual health practices and coping skills, influence of poverty, physical environments, community resources and sexual health services, education, and stigma of pregnancy. Participating in community-based participatory research empowered participants to advocate for their own health. ConclusionPhotovoice methodology contributes to understanding complex factors influencing sexual and reproductive health of young mothers. This participatory-based methodology highlights their individual situations, allowing us to seek connections, create analytical perspectives from which to relate their situations to root causes, and consider strategies for change.

Contraception for women with diabetes: challenges and solutions

Diabetes mellitus (DM), the most common of metabolic disorders, is a global public health concern. Numbers are rising with 383 million adults currently diagnosed with DM and another 175 million as yet undiagnosed. The rise in cases includes increasing numbers of women of a reproductive age whose reproductive health and contraception need careful consideration. Unintended pregnancy with poor glycemic control at the time of conception increases the chance of adverse pregnancy outcomes including stillbirth, congenital abnormalities, and perinatal mortality. In order to minimize complications, safe and effective contraception is paramount for all women with DM. This is a challenge as women have been found to be reticent to ask for advice, appear to lack understanding of risks, and are less likely to be using contraception than women without DM. The World Health Organization has developed Medical Eligibility Criteria to guide contraceptive choice. Women with DM without complications can choose from the full range of contraceptive methods including hormonal contraception as the advantages of use outweigh any risk. Women with diabetic complications may need specialist advice to assess the risk–benefit equation, particularly in respect of hormonal contraception. Women should be aware that there is no restriction to the use of oral and copper intrauterine emergency contraception methods. There is a need for an integrated approach to diabetes and reproductive health with improved communication between women with DM and their health care providers. Women need to be aware of advice and services and should make their own choice of contraception based on their needs and associated risk factors. Practitioners can offer nonjudgmental guidance working in partnership with women. This will enable discussion of risks and benefits of contraceptive methods and provision of advice dedicated to improving overall health and well-being.

Reproductive Health Needs of Adolescents With Sickle Cell Disease

Reproductive Health Needs of Adolescents With Sickle Cell Disease

Differences in the Sexual and Reproductive Health Needs of Adolescents in the US With Perinatally-acquired HIV and Behaviorally-acquired HIV: Provider Perspectives

Differences in the Sexual and Reproductive Health Needs of Adolescents in the US With Perinatally-acquired HIV and Behaviorally-acquired HIV: Provider Perspectives

Reproductive Health Needs Among Substance Use Disorder Treatment Clients.

Individuals with substance use disorders (SUDs) have unique reproductive health needs. The aim of this study was to evaluate these needs and assess the acceptability of family planning service delivery of SUD treatment clients. Reproductive health needs of drug treatment clients were assessed using a cross-sectional anonymous survey in 4 treatment sites in Baltimore City, MD. Surveys were distributed by staff. Contraceptives assessed included sterilization, intrauterine devices, implants, injections, pills, patches, rings, condoms, spermicide, withdrawal, and the rhythm method. Results are stratified by sex and between those using and not using highly effective contraceptive methods. A total of 115 women and 95 men completed the survey (80% younger than 50 years), with 39% of women and 54% of men reporting using condoms, but only 24% of women and 26% of men reporting consistent use. All other methods were used by less than 12% of the sample. Only 20% of sexually active women reported using a highly reliable form of contraception and only 53% were using any form of contraception at all. Contraceptive use correlated inversely with age, but did not correlate with having had sexually transmitted infection testing or other preventive health services. Although more than 90% of participants had access to health care services in the past 3 years, 25% of women and 33% of men reported difficulty accessing health care providers. The majority of respondents said they would likely use family planning services if available at their SUD treatment (83% of women and 58% of men). Men and women in SUD treatment have unmet reproductive health needs. As SUD treatment moves toward greater integration, the programmatic inclusion of family planning services should be considered.

Understanding the Broader Sexual and Reproductive Health Needs of Female Sex Workers in Dhaka, Bangladesh.

Little is known about the sexual and reproductive health care needs of female sex workers in Dhaka, Bangladesh. Survey data were collected from 354 hotel-based and 323 street-based female sex workers using a venue-based stratified cluster sampling approach. In addition, in-depth interviews were conducted with 20 female sex workers recruited from drop-in centers. We calculated unmet need for family planning and examined fertility desires, use of condoms and other contraceptive methods, experiences with gender-based violence, sexual and reproductive health service needs, and preferences on where to receive services. The prevalence of unmet need was 25% among hotel-based female sex workers and 36% among street-based female sex workers. Almost all participants reported having used condoms in the past 30 days, and 44% of hotel-based sex workers and 30% of street-based sex workers reported dual method use during that period. Condom use was inconsistent, however, and condom breakage and nonuse for extra money were common. Many women reported experiencing gender-based violence. Sexual and reproductive health services had been obtained by 64% of hotel-based and 89% of street-based sex workers in the past six months; drop-in centers were their preferred site for receiving health services. Female sex workers in Dhaka need family planning and other sexual and reproductive health services and prefer receiving them from drop-in centers.

Determining the Sexual and Reproductive Health Needs of Deaf People in Ghana

This article examines how deaf people in Ghana prioritize their sexual and reproductive health (SRH) needs. The aim is to determine the most pressing SRH needs of the deaf community in Ghana and then propose appropriate measures to make SRH information and services accessible to them. The study was a SRH needs assessment with deaf people in Ghana, which utilized a participatory needs assessment method. A total sample of 179 participants took part in the study: 26 were focus group participants, 152 were survey respondents, and one person acted as a key informant. The study findings indicated that deaf people in Ghana have many SRH challenges, but the most pressing needs were related to barriers associated with communication and attitude of health professionals. To design SRH programmes that are deaf-friendly, there is the need to take into account the linguistic and cultural values of the deaf community.

Adolescent/Youth Reproductive Mobile Access and Delivery Initiative for Love and Life Outcomes (ARMADILLO) Study: formative protocol for mHealth platform development and piloting.

BackgroundThere is a high unmet need for sexual and reproductive health (SRH) information and services among youth (ages 15-24) worldwide (MacQuarrie KLD. Unmet Need for Family Planning among Young Women: Levels and Trends 2014). With the proliferation of mobile technology, and its popularity with this age group, mobile phones offer a novel and accessible platform for a discreet, on-demand service providing SRH information. The Adolescent/Youth Reproductive Mobile Access and Delivery Initiative for Love and Life Outcomes (ARMADILLO) formative study will inform the development of an intervention, which will use the popular channel of SMS (text messages) to deliver SRH information on-demand to youth.Methods/DesignFollowing the development of potential SMS message content in partnership with SRH technical experts and youth, formative research activities will take place over two phases. Phase 1 will use focus group discussions (FGDs) with youth and parents/caregivers to develop and test the appropriateness and acceptability of the SMS messages. Phase 2 will consist of ‘peer piloting’, where youth participants will complete an SRH outcome-focused pretest, be introduced to the system and then have three weeks to interact with the system and share it with friends. Participants will then return to complete the SRH post-test and participate in an in-depth interview about their own and their peers’ opinions and experiences using ARMADILLO.DiscussionThe ARMADILLO formative stage will culminate in the finalization of country-specific ARMADILLO messaging. Reach and impact of ARMADILLO will be measured at later stages. We anticipate that the complete ARMADILLO platform will be scalable, with the potential for national-level adoption.

Perceived Sexual and Reproductive Health Needs and Service Utilization among Higher Secondary School Students in Urban Nepal

Introduction: Adolescent sexual and reproductive health (ASRH) is best addressed through the promotion of responsible, healthy behavior and the provision of age-appropriate services. This study aimed to assess Nepali adolescents’ perceived ASRH service needs and factors influencing their utilization of ASRH services. Methodology: This descriptive cross-sectional quantitative study was based on a structured, self-administered questionnaire of adolescents aged 15-19 (n = 338) in three government-run higher secondary schools in Bhaktapur, Nepal. Descriptive data was used to summarize socio demographics, sexual activity, and awareness and usage of SRH services. Chi-square and Fisher’s exact tests and binary logistical regression modeling were used to identify factors influencing ASRH service utilization. Results: ASRH service utilization was 9.2% among all respondents. Service utilization was lower among female (4.3%) than males (12.5%). Fifteen percent of students had ever felt a need to access ASRH services, a larger percentage than those who had accessed ASRH services (9.2%). Almost 37% intend to utilize ASRH services in the future. Students attending secondary schools that included ASRH in the school’s health services were 15 times more likely to utilize ASRH services(Adjusted OR: 14.85). The distance from health facility (Adjusted OR: 12.80) and being sexually active within 12 months (Adjusted OR: 10.31) were found to be associated with ASRH service utilization. Those who perceived barriers to services were more likely to utilize the services (Adjusted OR: 7.05).Lack of confidential services was the biggest barrier (71.4%),while friend and peer group influence (86.7%) was a major motivator to access ASRH services. Conclusion: ASRH service utilization among the adolescents is very low, with a gap between perceived needs and service utilization. Students who have accessed ASRH services are more likely to report that they perceived barriers, demonstrating that logistical difficulties may be considerable. Accessibility should be expanded.

Iranian University Students' Perceived Reproductive Health Needs

Aim One proposed strategy to improve youth health is needs assessment, a process for determining and addressing needs of individual groups. The aim of this study is to explore the attitudes and perceptions of Iranian university students toward reproductive health need to promote the provision of reproductive health services. Methods A cross-sectional survey was conducted among 548 students randomly selected from eight universities in Sari city, Iran, using an anonymous self-administered questionnaire. Topics covered the participants' attitudes towards reproductive health needs as well as their opinion about proper source of information in this area in 5 Likert- scale type. Results Mean age of participants was 21.57 years and 57.82% were female. The maximum score of reproductive health needs in point of view of participants was related to “be informed about appropriate behavior with my spouse” and the majority of students (82.82%) supported family-based reproductive health education with emphasis on mothers' role. Although 65.14% of participants agreed that “when a young has been raped, it's better that she/he counsel with her/ his family, 11.67% of them stated that she/he must hide the problem. Finally, we found that 60.40% of students preferred someone in a health care center explain how to use any contraception which may be provide for them. Conclusion Taken as a whole, these findings support the critical importance of programming for university students as part of a comprehensive strategy to improve the health and development of young adult.

Psychometric properties of the Persian version of the Sexual and Reproductive Health Needs Assessment Questionnaire.

No tools to assess women's general sexual and reproductive health needs have been validated in the Iranian context. This study in Sari in Mazandaran province of the Islamic Republic of Iran was conducted to evaluate the psychometric properties of a Persian version of the Sexual and Reproductive Health Needs Assessment Questionnaire (first developed for the International Organization for Migration and United Nations Population Fund). The Persian version of the questionnaire was found to have adequate face and content validity (quantitative and qualitative) for assessing sexual and reproductive health needs among women (content validity index = 0.88). The test-retest reliability showed that, except for the domain of sexually transmitted infections, all domains of the questionnaire had an acceptable reliability (intra-class correlation coefficients > 0.5). This questionnaire is a valid tool for assessing the sexual and reproductive health needs of Iranian women and planning/designing strategies to meet them.

Understanding the Broader Sexual and Reproductive Health Needs of Female Sex Workers In Dhaka, Bangladesh

Understanding the Broader Sexual and Reproductive Health Needs of Female Sex Workers In Dhaka, Bangladesh

Meeting the sexual and reproductive health needs of high-school students in South Africa: experiences from rural KwaZulu-Natal.

Adolescents in South Africa (SA) have a huge unmet need for sexual and reproductive health (SRH) services. Integrating such services into schools may overcome many of the current barriers to access. We describe an SRH service model developed for high-school students and its implementation in 14 high schools in rural SA. Following consultation with community and other key stakeholders about the demand for and acceptability of adolescent-targeted SRH services, a three-tier school-based model was developed that included: (i) in-school group SRH information and awareness sessions; (ii) in-school individual SRH counselling and customised HIV counselling and testing (CCT); and (iii) referrals to in-school fixed, in-school mobile or public sector primary SRH clinics. From October 2011 to June 2012, 70 consultative meetings were held. There was overwhelming support for the pilot founded on concerns about the high HIV prevalence and teenage pregnancy rates among adolescents in the community. SRH information was provided to 8 867 high-school students, 4 171 (47.0%) of whom accessed on-site CCT services for HIV. The gender-specific prevalence of HIV in these students was 3.3% (64/1 962) and 1.1% (24/2 209) for females and males, respectively. Two hundred and thirty-nine students (5.7%) were referred for clinical services at in-school fixed, in-school mobile or public sector primary SRH clinics. The SRH service provision pilot was acceptable in the community and seems feasible for scale-up. Further work is required to understand inter-school variability in uptake, identify additional service needs of students, and characterise SRH demand dynamics.

Reproductive Health Needs Among Drug Treatment Clients

INTRODUCTION: Substance users are at increased risk of unintended pregnancy and sexually transmitted infections and human immunodeficiency virus (HIV). The objective of this study is to explore the prevalence of contraceptive use and reproductive health care uptake among drug treatment clients. METHODS: Between August 2012 and October 2013, clients of four Baltimore city drug treatment centers completed a one-time survey adapted from the National Survey of Family Growth. χ2 tests and logistic regression assessed associations between demographic variables and contraception use. RESULTS: A total of 95 men and 54 women participated. Most were younger than 50 years (74% women; 72% men), sexually active (68% women; 85% men), and did not desire pregnancy (74% women; 63% men). However, many did not use contraception most of the time (54% women; 39% men) with few women reporting use of a nonbarrier method (7%). Although condoms were the most common method (35% women; 45% men), only one fourth (28% women; 26% men) reported consistent use. Most women (70%) completed an obstetrics–gynecology appointment in the past year, but fewer had received an annual examination (37%), Pap test (53%), mammogram (20%), or HIV (59%) or sexually transmitted infection testing (45%). Contraception use among women was not associated with age (P=.7), parity (P=.7), self-rated health quality (P=.4), HIV (P=1.0), or hepatitis C virus status (P=1.0). Most (74% women; 57% men) stated they would definitely or maybe use family planning services at their treatment site if available. CONCLUSIONS: Drug treatment clients have high unmet reproductive health needs. Tailored family planning interventions are needed and should be incorporated into substance use programs.

Reproductive Health Needs of Adolescent Girls in the Age Group of 15–19 Years in an Urban Slum of Mumbai

Background : Behaviours adopted during adolescence affect the reproductive health in the long run. Objectives: 1.To study the socio-demographic characteristics of adolescent girls.2.To study knowledge, attitude and behaviour of adolescent girls with reference to reproductive health issues .3.To explore the reproductive health needs of adolescent girls. Materials and Method : A list of all adolescent girls was obtained from ICDS project catering to the study area. Total 200 adolescent girls in the age group of 15-19 years were interviewed by systematic random sampling, maintaining full privacy, with prior consent using a pretested questionnaire containing structured, pre-coded and few open ended questions. The data was analyzed by using percentages and chi-square test. Results : Only 28.14% females had a prior knowledge of menstruation. About 11.5% mentioned that females determine the sex of the child. Less than half, 49.5% were aware about any family planning method. More than 3/4th adolescent girls interviewed knew about the principle modes of transmission of AIDS. Only 38.5% females were aware of the potential benefit of condom use in preventing HIV transmission.92% expressed the need to have detail information on conception and family planning. Interpretation and conclusions : A significant number of girls were unaware about the various reproductive health issues, ranging from menstruation, conception, contraception to STI'S and HIV-AIDS. Significant association was seen between their level of education and knowledge on HIV-AIDS and Myths about HIV.

Reproductive Health Needs of Women Living with HIV/AIDS in Yaounde, Cameroon

The population plagued with the HIV/AIDS pandemic in Cameroon is young, a generation that may desire or control fertility. For those who may become pregnant, the desire to have children may not be there. We carried out this study to look at the picture of the reproductive health needs of women living with HIV/AIDS in our setting. In this cross-sectional non-analytic design that lasted for three years, we employed both qualitative and quantitative methods to collect data from them after receiving ethical clearance (N221/CM/2009) from the National Ethics Committee. Consenting HIV infected women who were attending the “HIV Day Care” clinics and those who delivered and were in the post partum wards in four of our major hospitals in Yaounde were enrolled. Interviews were individualized. We used both CSPro version 4.1 and Statistical Package for Social Sciences (SPSS) version 19.0 softwares for data analysis. Four hundred and fifteen (415) women were enrolled; the mean age was 29 ± 7.8 years; the most represented age group was 24 -29 years. They were single (36.14%), well educated (5 out of 10 had attained university level of education), 61.20% revealed that their partners knew their HIV status, 82.4% believed that screening for cancer of the cervix was necessary for their status and 47.70% would want to be screened for some or all STIs. About 36.86% had the desire to have children, 57.1% of those who delivered did not plan to have the pregnancies out of which 82% would have wanted a modern method of contraception but did not have (82% unmet needs). Modern contraceptive use was associated with age and individual characteristics such as level of education. It was 64.34% among women who had secondary level of education and below as against 35.66% among those who had high school level of education and above. Contraceptive use was also high among women who were unmarried as against those who were married (89.64% vs 10.36%). The desire to have children decreased as age increased (43.85% vs 18.79%) and was lower among married women compared to those who were single (13.01% versus 49.64%). These women were found to have high unmet needs for modern contraception and showed interest in STIs and cervical cancer screening.