Reproductive Health Policies Research Articles

Office of Public Affairs update: a quarterly update from the American Society for Reproductive Medicine Office of Public Affairs on key developments in reproductive health policy

Office of Public Affairs update: a quarterly update from the American Society for Reproductive Medicine Office of Public Affairs on key developments in reproductive health policy

Family planning policy and gender in Nigeria: A thematic analysis of the government's health policy perspective.

Family Planning (FP) lets people control the number and timing of child-births through using contraceptives and/or restoring fertility. Nigeria has several FP policies for managing its population, yet contraceptives usage remains suboptimal despite high FP awareness, suggesting that several factors might be inhibiting FP uptake. The literature spotlights gender as factoring into FP use due to Nigeria's patriarchal society, with men positioned as gatekeepers to women's sexual/reproductive health/expression. Therefore, we investigate if/how gender is considered in Nigeria's FP policies. We thematically analysed the 'National Reproductive Health Policy', 'National Family Planning Communication Plan' and 'Nigeria Family Planning Blueprint (Scale-Up Plan)', from a critical realist viewpoint. Our analysis generated an overarching theme-'A Gendered Human Right', with three further themes: Women's Right-Women's Issue', 'Adolescent Girls-not left out' and 'Men's Right as Supporters'. FP was portrayed as the right of women, adolescents (particularly girls≥10yrs) and men. It was highly feminised, with women, not men, majorly shouldering the FP responsibility and women's FP access was presented as hindered by men. Moreover, we advance recommendations for optimising Nigeria's policies to address gender imbalances hampering women's FP access and uphold the rights of all people, women/girls especially.

Vulnerable Youth or Vulnerabilising Contexts? A Critical Review of Youth Sexual and Reproductive Health and Rights (SRHR) Policies in Eastern and Southern Africa

Vulnerable Youth or Vulnerabilising Contexts? A Critical Review of Youth Sexual and Reproductive Health and Rights (SRHR) Policies in Eastern and Southern Africa

Opportunities for Reproductive Health Programs in the Implementation of Schools Re-Entry Policy on Teenage Pregnancy and Sexually Transmitted Infections: Case of Selected Urban Schools in Kenya

Purpose: This study was designed to determine the opportunities available for the ministry of health as the custodian of reproductive health programs on mitigating teenage pregnancy and sexually transmitted infections in Kenya. Methodology: This was an analytical cross-sectional study that triangulated various sampling techniques. Based on unmitigated increase number of school pregnancies and sexually transmitted infections, the study obtained information on opportunities available to introduce and implement reproductive health program from the specialists in the ministries of health and education using Focus Group Discussions, Key Informant interviews and questionnaires techniques. A total of 16 respondents was realized using the standard saturation point method. Multistage followed by cluster sampling techniques were used to identify selected urban towns. A sample size of 174 school-female teenage participants female were tested for pregnancy and sexually transmitted infections in the eight urban areas. Analysis of data was done by use of descriptive statistics, Analysis of Variance (ANOVA) and content analysis. Findings: The study found out that the ministry of health through the National Sexual and Reproductive Health Policy and its strategic plans had not taken up the opportunity to perform its role of supporting re-entry policy and reproductive health education in schools. Although the Ministry of health, through its established organs had a role to play in mitigating Teenage Pregnancy and Sexually Transmitted infections, it had not put structures in place for its implementation in schools. Unique contribution to Theory, practice and Policy: The ministry of health needs to support school-entry policy as part of its mandate. Successful programs and policies require the involvement of all stakeholders in designing, developing and implementing and must be inclusive and well resource supported. The findings of this study need to be appraised by the policy makers and implementers for fresh and improved interventions.

Reproductive health rights: a bibliometric analysis of childbirth

Purpose Reproductive health rights became an issue of interest long before the 1990s. Several policies were created to guarantee reproductive health rights, including birth rights. Women have the right to give birth in a way that is respectful and free from obstetric violence. Policymaking must, of course, be based on empirical evidence, so it is necessary to map studies on human rights in the context of childbirth. This study aims to investigate the viewpoint on human rights during childbirth across time by using a bibliometric methodology. Design/methodology/approach Bibliometric analysis was conducted using the VOSviewer application. The analysis was sourced from 301 articles on human rights during delivery for the 1976–2023 period from the Scopus database. Findings The studies concerning reproductive health rights encompass various topics, including reproductive health policy, human rights during childbirth, child marriage and human rights, pandemics and health care related to human rights. Research limitations/implications Studies related to human rights in reproductive health (especially childbirth) must be increased. Remember, policymaking must be based on the evidence found. Apart from that, empirical information about harmful actions during childbirth must be revealed so that it becomes a concern. While there has been a significant increase in the establishment of human rights during childbirth, there is a lack of research on this topic specifically in the Asian context. Researchers might consider this to be a matter of concern, given the implications for human rights. Two themes that have citations but a small number relate to obstetric violence and respectful maternity care during childbirth, so this could be a concern for other researchers for further studies. Originality/value This paper provides an overview of the most cited topics of human rights during childbirth, contributions by the distribution of studies throughout time, distribution of studies by country, the highest number of publications and citations.

Effects of short inter-pregnancy/birth interval on adverse perinatal outcomes in Asia-Pacific region: A systematic review and meta-analysis.

Short inter-pregnancy or birth interval is associated with an increased risk of adverse perinatal outcomes. However, some emerging evidence questions this association and there are also inconsistencies among the existing findings. This study aimed to systematically review the evidence regarding the effect of short inter-pregnancy or birth intervals on adverse perinatal outcomes in the Asia-Pacific region. A comprehensive search of five databases was conducted targeting studies published between 2000 to 2023. Studies that reported on short inter-pregnancy or birth interval and examined adverse perinatal outcomes, such as low birthweight (LBW) preterm birth (PTB), small for gestational age (SGA), and neonatal mortality were included and appraised for methodological quality using the Joanna Briggs Institute critical appraisal tools. Three reviewers independently screened the studies and performed data extraction. Narrative synthesis and meta-analyses were conducted to summarise the key findings. A total of 41 studies that fulfilled the inclusion criteria were included. A short-interpregnancy interval was associated with an increased risk of low birthweight (odds ratio [OR] = 1.65; 95%CI:1.39, 1.95), preterm birth (OR = 1.50; 95%CI: 1.35, 1.66), and small for gestational age (OR = 1.24; 95%CI:1.09, 1.41). We also found elevated odds of early neonatal mortality (OR = 1.91; 95%CI: 1.11, 3.29) and neonatal mortality (OR = 1.78; 95%CI: 1.25, 2.55) among women with short birth intervals. This review indicates that both short inter-pregnancy and birth interval increased the risk of adverse perinatal outcomes. This underscores the importance of advocating for and implementing strategies to promote optimal pregnancy and birth spacing to reduce the occurrence of adverse perinatal outcomes. Reproductive health policies and programs need to be further strengthened and promote access to comprehensive family planning services and increase awareness about the importance of optimal pregnancy and birth spacing.

Perceptions of Women in Opioid Recovery Regarding Policies and Laws on Sexual and Reproductive Health

ObjectiveTo explore perceptions of policies and laws on sexual and reproductive health among women in recovery from opioid use disorder (OUD). DesignQualitative descriptive. SettingTelephone interviews conducted in a midsized urban area in the midwestern region of the United States. ParticipantsTwenty-two women ages 18 to 49 years who self-identified as being in recovery from OUD. MethodsWe conducted individual, semistructured telephone interviews and analyzed the data using reflexive thematic analysis. ResultsWe identified three themes: Barriers to OUD Treatment and Recovery, Pregnancy as a Gateway to Treatment and Recovery, and The Dobbs Effect. Participants described OUD treatment barriers such as inadequate recovery resources for women and the criminalization of drug use. Many participants described pregnancy as a gateway to recovery because of improved access to treatment services and enhanced motivation for engaging in recovery. Participants described unintended pregnancy as a threat to recovery that made them seek woman-controlled contraceptive methods they could use without negotiating with a partner (e.g., intrauterine devices) after the Supreme Court overturned constitutionally protected access to abortion. ConclusionOpioid use disorder is a public and mental health crisis in the United States that affects reproductive-age women. Participants in our study closely connected recovery from OUD with sexual and reproductive health policy and laws. There is a need for regulation to support the unique needs of women in OUD treatment. The recent Supreme Court decision that overturned constitutionally protected abortion creates challenges for women in recovery from OUD. Nurses are ideally positioned to advocate for recovery and sexual and reproductive health policies and laws that improve the physical and mental health of women in recovery.

Awareness and Attitude of Wives of Laborer Outmigrants Originating from Indian Subcontinent Towards Emergency Contraceptives- A Multi-Country Study

Objective : The present study aims to analyze the attitude and awareness of wives of male migrants (WMM) towards EC (Emergency Contraceptives Pills) residing in either of three countries of the Indian subcontinent (India, Bangladesh, and Nepal). Further, the present study also aims to identify the socioeconomic determinants of the EC awareness of WMM. Methods : A cross-sectional survey of 621 WMM was conducted across multiple low-income sites in the three countries. Findings: The majority of the respondents (77.6%) reported being aware of EC methods, out of which the majority (32%) reported their friends circle to be the primary source of knowledge followed by husband (23.4%), family members (19.9%) and healthcare workers (9.8%), respectively. About 56% of the respondents reported that they consumed EC pills more than thrice in the last year. The study discovered that WMM engaged in unprotected intercourse about 5 times (SD= ±1.6) on average in the last year. While the reported consumption of EC pills by WMM was 2.6 times (SD= ±1.2) on an average during the same year. Regression analysis revealed that ‘place of husband’s migration’ is the strongest determinant of WMM’s EC awareness (OR=3.67, p<0.05), followed by ‘age of the WMM’ (OR=2.12, p<0.05), and ‘religion’ (OR=1.32, p<0.05) respectively. Furthermore, ‘having children’ was also found to be a significant determinant (p<0.05). Novelty : Firstly, the study offers an examination of comparison of WMMs’ attitudes and awareness residing in three low- and middle-income countries (LMICs), an area not thoroughly investigated in previous studies. Secondly, the study has identified the factors influencing the awareness of EC among WMM, a subject largely unexplored in prior research. Conclusion : We conclude that based on the findings the level of awareness of EC is not adequate and policymakers could use these findings to strengthen the reproductive health policies of targeted intervention groups. Keywords: Emergency contraceptives, Left behind, Wives of migrants, India, Bangladesh, Nepal, Low- and middle-income countries

Estimates of unintended pregnancy among US active-duty service women and the impact on Women Peace and Security objectives as measured by potential readiness days lost

IntroductionThe prevalence of unintended pregnancy (UIP) in the United States is high among active-duty service women (ADSW).ObjectiveTo estimate the number of UIPs and the impact these pregnancies have on the...

A content analysis of freely available menstrual education resources in Australia

Background: Sexual and reproductive health education is central to both international and national public health policy and priority action areas. However, menstruation education remains peripheral in both policy and school curricula. This article aims to investigate the extent and depth of menstruation education in Australia available outside of mainstream education channels. Methods: We conducted an inductive content analysis of publicly available Australian sexual and reproductive health educational resources targeting young menstruators and parents, which at least mentioned menstruation. Resources were accessed via a desktop search (using Google) to ensure that they were accessible to the public and were provided by not-for-profit or government organisations. Results: We identified a total of 31 resources from 10 organisations and subjected them to conventional content analysis. Our inductive coding process focused on the extent and depth of menstruation content. The main content areas included a discussion of pads and tampons, menarche, period pains, when to see a doctor and pre-menstrual syndrome. Three key themes were identified across the resources: holism, normalisation and managing menstruation. Conclusions: We develop recommendations for organisations developing or improving their menstruation resources and offer future direction for sexual and reproductive health policy and education in Australia that is inclusive of menstruation. The recommendations relate to the three themes identified during the analysis and include concepts such as recognising the biological changes that come with menstruation, variation of menstruation experiences, normality and assumptions about menstruation and menstrual hygiene management.

Statistical Analysis of the Effect of Educational Opportunities and Community Involvement on Adolescents and Sexual Reproductive Health Policy on Retention of Girl Child in Public Secondary Schools in Butula Sub-County, Kenya

Girls’ retention in schools has been found to be a major challenge. Failure to retain girls in secondary schools can be considered as a waste of potential human resources and money spend on them in primary education and time lost in sending them to school in the first place. These girls may become a breed of illiterate women who are less productive economically, socially and politically. Among the critical contemporary social issues affecting many countries is teenage pregnancies. This research, therefore, analyses the effect of educational opportunities and community involvement on girl child retention in public secondary schools in Butula sub-county, Kenya using statistical method. Specifically, the research seeks to establish statistically the impact of educational opportunities and community involvement on girl child retention in public secondary schools in Butula Sub-county, Busia County. The study targeted a sample size of 300 respondents which were selected using convenient and purposive sampling techniques based Mugenda and Mugenda (2004) formula. Also, the data from both primary and secondary sources was used in the study. The instruments for gathering the data comprised questionnaires, interviews, and records from the schools. A SPSS version 25 was used to establish any link between the Adolescent Sexual Reproductive Health Policy and girl child retention in public secondary schools Butula Sub-County, Busia County. This study will increase understanding of the effect of teenage pregnancy on class attendance in public secondary schools in Butula Sub-county. The findings of the study indicated that girls missed school during their menstruation because sanitary facilities were inadequate.

Perspectives from the pandemic epicenter: Sexual and reproductive health of immigrant women in New York City.

The United States' response to COVID-19 created a policy, economic, and healthcare provision environment that had implications for the sexual and reproductive health (SRH) of racialized and minoritized communities. Perspectives from heterogenous immigrant communities in New York City, the pandemic epicenter in the United States (US), provides a glimpse into how restrictive social policy environments shape contraception, abortion, pregnancy preferences, and other aspects of SRH for marginalized immigrant communities. We conducted in-depth interviews in 2020 and 2021 with 44 cisgender immigrant women from different national origins and 19 direct service providers for immigrant communities in New York City to explore how immigrants were forced to adapt their SRH preferences and behaviors to the structural barriers of the COVID-19 pandemic. We coded and analyzed the interviews using a constant comparative approach. Pandemic-related fears and structural barriers to healthcare access shaped shifts in contraceptive use and preferences among our participants. Immigrant women weighed their concerns for health and safety and the potential of facing discrimination as part of their contraceptive preferences. Immigrants also described shifts in their pregnancy preferences as rooted in concerns for their health and safety and economic constraints unique to immigrant communities. Understanding how immigrant women's SRH shifted in response to the structural and policy constraints of the COVID-19 pandemic can reveal how historically marginalized communities will be impacted by an increasingly restrictive reproductive health and immigration policy landscape.

Socio-economic disparities and predictors of fertility among adolescents aged 15 to 19 in Zambia: Evidence from the Zambia Demographic and Health Survey (2018).

Globally, 12 million girls aged 15-19 give birth each year, and Africa hosts 19% of youth aged 15-24. In Zambia, 29% of adolescents experience childbirth, with variations by age. Projections suggest a continued rise in these trends by 2030. Zambia came up with Adolescent Health Strategic Plan 2011-2015 among the specific policies being advocated for was Adolescent-Friendly Health Services (ADFHS) in order to mitigate among others adolescent fertility. The study aims to investigate socio-economic disparities and predictors of fertility in Zambian adolescents aged 15 to 19. The study used a cross-sectional study design utilized the 2018 Zambia Demographic Health Survey (ZDHS). The variable of interest in this study is "total number of children ever born" among adolescents aged 15 to 19 years. The explanatory variables that were used in the study were demographic, socio-economic, behavioral and community level factors. The Rao-Scott Chi-square test was used to test for association between categorical variables. Determinants of adolescent fertility were identified through a multilevel ordinal logistic regression conducted at a significance level of 5%. Analysis in the study was carried out using Stata version 14.2. A total of 3,000 adolescents were involved in the study, revealing that 75.88% had not given birth, 21.14% had one child, and 2.98% had at least two children. The findings revealed that education played a protective role, with adjusted odds ratios (AOR) of 0.47 (95% CI, 0.23-0.97), 0.21 (95% CI, 0.10-0.47), and 0.03 (95% CI, 0.00-0.54) for primary, secondary, and tertiary education, respectively. On the other hand, certain factors were associated with an elevated risk of fertility. These included the age of adolescents, educational attainment, marital status, wealth index, contraceptive use, exposure to family planning (FP) messages, being educated about FP at health facilities, and age at first sexual encounter. Among contextual factors, only community age at first birth was identified as a predictor of fertility, AOR, 1.59 (95% CI, 1.01-2.52). The study highlights sociodemographic disparities in adolescent fertility, emphasizing the need for targeted sexual reproductive health policies. Education protects against having more than one child, while marital status significantly influences fertility, particularly for married adolescents. The research provides valuable insights into the complex factors shaping adolescent fertility in Zambia, offering guidance for interventions and policies to support this vulnerable demographic.

Potential consequences of the Dobbs v. Jackson Women's Health Organization decision.

In June 2022, the U.S. Supreme Court released a landmark decision in which they held that the right to abortion is not protected by the U.S. Constitution, ending almost 50 years of federally legal abortion in the United States. Because prior research demonstrates linkages between reproductive health and substance use at multiple socioecological levels, in this special section, we present studies that take a broad scope to understanding how addictive behaviors and reproduction-related behaviors, options, and access to care interrelate across a variety of contexts. In this introduction, the guest editors detail the impetus for this special section, provide a brief overview of the present studies, discuss policy and intervention implications, and suggest future research directions. The five studies presented in this special section span a wide range of populations, methods, and substance use and reproduction-related issues, including reasons for past abortions among women with opioid use disorder, alcohol effects on men's condom use resistance, considerations regarding alcohol-involved rape on implementation of "rape exceptions" to abortion bans, the role of early exposure to substance use and sexual abuse on reproductive health outcomes, and the effects of exposure to abortion-related media coverage on alcohol use intentions following the Supreme Court decision. The studies in this special section highlight the ways in which substance use and reproductive health are inextricably intertwined. Recent and future changes in reproductive health legislation and policy underscore the critical need for continued empirical inquiry into these intersecting public health concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Decriminalization of Abortion in the era of COVID-19

Reproductive health policies, focused on the decriminalization of abortion, have effects on the beliefs, attitudes, intentions and behaviors of termination of pregnancy. As women get older, more educated and more income, they rationally choose an abortion, but they move away from the ideal age for procreation of 22 years. The objective of the present work is to establish the exploratory factor structure of scales that measure four factors and 28 indicators (seven for each factor) related to the termination of pregnancy. Consequently, a non-experimental, cross-sectional and exploratory study was carried out with a non-probabilistic selection of 100 students. From a structural model the intentions determined the behaviors, but the factor solution was explained by beliefs. However, the context, sample selection, and type of analysis precludes generalizing the data to other settings. It is recommended to carry out a confirmatory factor analysis with a probabilistic selection of the sample in the local population.

Women decision making on use of modern family planning methods and associated factors, evidence from PMA Ethiopia.

Family planning decision making is defined as women´s ability to determine the family planning methods that she wanted to use through the process of informed decision making. Despite the availability and accessibility of family planning methods, the utilization rate is not more than 41% in Ethiopia. Evidence and experts have consistently show that women decisions making ability on family planning method they desired to use is one of the possible reasons for this slow rate of family planning use increment. In consideration of this and further motives family planning use decision making has become one of the top sexual and reproductive health related sustainable development agendas. Hence, this study aimed at determining the level, trend and spatial distribution of family planning use decision making among married women and identify factors affecting it. This study was based on Performance Monitoring for Action (PMA) 2020 cross sectional national survey data. Married women who are currently using or recently used family planning method were included in this study. Frequency was computed to describe the study participants while chi-square statistics was computed to examine the overall association of independent variable with family planning use decision making. To identify predictors of family planning use decision making multinomial logistics regression was employed. Results were presented in the form of percentage and relative risk ratio with 95% CI. Candidate variables were selected using p value of 0.25. Significance was declared at p value 0.05. This study revealed that one in two women (51.2%; 95% CI: 48.8%-53.6%) decide their family planning use by themselves while 37% (36.8%; 95% CI: 34.5%-39.2%) decide jointly with their husband and/or partner. Women alone family planning use decision making increased significantly 32.8% (95% CI: 29.4%, 36.4%) in 2014 to 51.2% (95% CI: 48.8%, 53.6%) in 2020. It also shows variation across regions from scanty in Afar and Somali to 63.6% in Amhara region and 61.5 Addis Ababa. Obtaining desired family planning method was found significantly to improve women alone and joint family planning use decision making. Women who have perceive control and feeling if they get pregnant now were found to be positively associated with women alone family planning use decision making. Discussion with husband, his feeling towards family planning were found positively to influence family planning use joint decision making. Moreover, women religion, was found reducing the likelihood of both women alone and joint family planning use decision making while experiencing side effect reduces the likelihood of joint family planning use decision making. Half of the women independently decide their family planning use which calls up on further improvement. Family planning use decision making ability is expected to be improved by efforts targeted on husbands' approval on wife's family planning use, discussion on family planning use with husband/partner, improving women psychosociological readiness and trust on her own to decide her desired family planning method; informing the possible side effects and what to do when they encountered during their family planning use visit. In addition, influencing women on the use of family planning via religious leader will help much in this regard. Monitoring and evaluating reproductive health policy 2021 to2025 and addressing bottlenecks which hinder women decision making health service use is hoped to improve women family planning use decision making. Further qualitative study to identify and address factors that contribute for the variation across regions also help much.

Exploring Barriers to Accessing Sexual and Reproductive Health Services among Adolescents and Young People with Physical Disabilities in South Africa.

Despite South Africa having a progressive and liberal sexual and reproductive health (SRH) policy framework, adolescents and young people with disabilities (AYPWDs) are less likely to receive sexual and reproductive healthcare, being consequently predisposed to a long-term detrimental impact on their health. Our study explored the barriers to accessing sexual and reproductive health services (SRHSs) in clinics among AYPWDs in Mpumalanga, South Africa. We conducted a descriptive qualitative study with twenty-seven AYPWDs in four focus group discussions using semi-structured interviews, audiotaped and transcribed verbatim, and then applied a thematic analysis of the data. Employing a socio-ecological model, the findings show a poor socioeconomic status, lack of information on SRH, and the attitudes of AYPWDs as barriers at the individual level, hindering AYPWDs from accessing SRHSs in clinics. AYPWDs also faced difficulties to talk about SRH with parents, a lack of support to seek SRHSs, improper care from family/parents, and negative attitudes of friends, at the interpersonal level. They further expressed barriers at the community/societal level as negative attitudes of non-disabled community members and poor infrastructure for wheelchair use. At the organization level, their access to SRHSs was negatively affected by HCWs' maltreatment, described in the forms of negative attitudes, being judgmental using verbal abuse, discrimination, and bullying. Furthermore, AYPWDs described difficulties in communication with HCWs, as well as violating their confidentiality and misconceived ideas on their sexuality. Intensified efforts to strengthen public health strategies are needed to improve access to SRHSs by AYPWDs in South Africa, as well as enhancing the proficiency and communication skills of HCWs and educating AYPWDs, parents, and non-disabled community members on SRH.

The prevalence of and factors associated with prior induced abortion among women who gave birth in Victoria, 2010-2019.

To assess the prevalence of a history of induced abortion among women who gave birth in Victoria during 2010-2019; to assess the association of socio-demographic factors with a history of induced abortion. Retrospective cohort study; analysis of cross-sectional perinatal data in the Victorian Perinatal Data Collection (VPDC). All women who gave birth (live or stillborn) in Victoria, 1 January 2010 - 31 December 2019. Self-reported induced abortions prior to the index birth; outcome of the most recent pregnancy preceding the index pregnancy. Of the 766 488 women who gave birth during 2010-2019, 93 251 reported induced abortions (12.2%), including 36 938 of 338 547 nulliparous women (10.9%). Women living in inner regional (adjusted odds ratio [aOR], 0.94; 95% confidence interval [CI], 0.93-0.96) or outer regional/remote/very remote areas (aOR, 0.86; 95% CI, 0.83-0.89) were less likely than women in major cities to report induced abortions. The likelihood increased steadily with age at the index birth and with parity, and was also higher for women without partners at the index birth (aOR, 2.20; 95% CI, 2.16-2.25) and Aboriginal and Torres Strait Islander women (aOR, 1.32; 95% CI, 1.25-1.40). The likelihood was lower for women born in most areas outside Australia than for those born in Australia. The likelihood of a history of induced abortion declined across the study period overall (2019 v 2010: 0.93; 95% CI, 0.90-0.96) and for women in major cities (0.88; 95% CI, 0.84-0.91); rises in inner regional and outer regional/remote/very remote areas were not statistically significant. Access to abortion care in Victoria improved during 2010-2019, but the complex interplay between contraceptive use, unintended pregnancy, and induced abortion requires further exploration by remoteness of residence. Robust information about numbers of unintended pregnancies and access to reproductive health services are needed to guide national sexual and reproductive health policy and practice.

Evaluation of Reproductive Health Policy Performance Safe Signs Program for Prospective Brides (Marriage Sign) in Gorontalo City

Evaluation of Reproductive Health Policy Performance Safe Signs Program for Prospective Brides (Marriage Sign) in Gorontalo City

Trends in vasectomy and sexually transmitted diseases in Chile: findings from robust national databases.

A controversy about the increase or decline of vasectomy is emerging; however, the evidence is still scarce in Latin America. This ecological study analyzed the vasectomy and sexual transmitted diseases (STD) trends over a period of 10 years in Chile and determined if there is any relationship between them. We conducted a mixed ecological study using secondary and representative data on the number of vasectomies and STD cases from 2008 to 2017. Vasectomy rates were calculated for age-specific groups of men aged 20-59 years, and specific STD (HIV, chlamydia, gonorrhea, trichomoniasis, and syphilis) for the same period. Multivariate negative binomial regression models were fitted to evaluate rate trends and relationships. The mean vasectomy age was 40.3 years, with no significant differences between the years of the study (p = 0.058). The overall vasectomy rate significantly increased from 2008 to 2017 (p < 0.001), with differences between age groups (p < 0.001). The most significant increase was observed in men aged 30-49 (p < 0.001). The STD rates significantly increased (p < 0.05) during the study period. A significant positive correlation was found between vasectomy and gonorrhea incidence rates (p = 0.008) and an inverse correlation was found with hepatitis B incidence rates (p = 0.002). Vasectomy trends and STD rates significantly increased from 2018 to 2017 in Chile. especially among men aged 30-49 years. The relationship between vasectomy and STD increments suggests a new risk factor for reproductive and sexual health policies to aid controlling the HIV and STD epidemic.