Reproductive Health Practices Research Articles

Use of Maternal and Reproductive Health Services During and After Donor Funding in Nzega District, Tanzania

One of the United Nations’ Sustainable Development Goals (SDG) is to ensure healthy lives and promote well-being for all at all ages. Therefore, maintenance of the application of maternal and reproductive health practices to Women of Reproductive Age (WRA) is crucial throughout women’s lifetime. To find out whether this was happening, the study on which this paper is based examined the socio-demographic characteristics of women who had received maternal and reproductive health services in public health facilities and the extent of application of the maternal and reproductive health practices. A clinic-based descriptive cross-sectional study was conducted on women attending reproductive and child health clinics. Data were collected in 2023 from 121 respondents, mainly using a questionnaire that included a 54-point index summated scale to determine the extent of application of various maternal and reproductive health practices during and after donor funding. The points scored on the scale were expressed as per cents and compared using a paired samples t-test. The results showed an increase in the application of maternal and reproductive health practices after donor funding (49.1% during donor funding and 52.7% after donor funding), but the extents did not differ significantly (p = 0.308; effect size, r = 0.093). Among other things, the results were influenced by the women’s socio-demographic characteristics. The increase shows that the application of the practices is likely to increase. Based on the findings and conclusion, it is recommended that the Government of Tanzania and other relevant stakeholders at all levels should take necessary measures to intervene with respect to various socio-demographic characteristics including age, gender, and marital roles, so that they cannot compromise the application of maternal and reproductive health practices in the research area

Giving Birth in the Mountains: Plants and Practices in Reproductive Health of Zapotec Women in Northern Oaxaca

Midwives/healers assist women in rural communities in Mexico and use medicinal plants to relieve different conditions related to reproductive health. This knowledge has been passed down and preserved through generations. The aims of the study were: 1) to document the floristic richness of medicinal plants used in the reproductive health of Zapotec women from the Sierra Norte of Oaxaca; 2) to document events, stages, and conditions during reproductive health; and 3) to provide evidence on the continuity of midwifery practices in the region. We interviewed 100 Zapotec women, 11 midwives/healers, the municipal authorities of four municipalities: Tabaá, Yojovi, Solaga, and Analco, and personnel from each health center. We recorded 66 plant species, with cinnamon, avocado, and rue the most mentioned. Asteraceae, Lamiaceae, Poaceae and Fabaceae were the most abundant. We identified five events with different stages/conditions during the reproductive health of women. The number of species mentioned by Analco collaborators differed by age category, indicating a breakdown in traditional knowledge. Multivariate analysis comparing the knowledge of native and introduced species between the collaborators of four municipalities revealed that they were clustered because of the mention of some introduced species (Analco) or because some species were mentioned once (Laxopa). However, the same analysis using native species shows no grouping, suggesting that women share similar knowledge. Traditional midwifery practices and medicinal plants used during the reproductive stage of Zapotec women are still based on native Mexican plants, and their persistent use will depend on the context of each locality and the global medicine system.

Using participatory art-based methods to explore experiences and practices in sexual and reproductive health

Arts-based research is an emergent yet developing methodology in application for health research over the last few decades. Visual arts in research and practice particularly among women in marginalized settings facilitate opportunities to address intricate issues around sexual and reproductive health (SRH), some of which extend to human immunodeficiency virus (HIV) risk perceptions and acceptability and uptake of new services and health options. This paper draws on visual arts-based methods using a specific technique of journey mapping adopted in two studies and aims to demonstrate how art-based methods contribute to socio-behavioural research.

Assessment of Knowledge, Attitude, and Practices on Sexuality Education among Youth in Pakistan

This study aimed to explore the sexual and reproductive health knowledge, attitudes and practices among young people in Islamabad. The objectives of research were to determine the sexual and reproductive health related knowledge score of youth, resources they commonly used for knowledge and their attitude and perceptions towards abstinence only and comprehensive sexuality education. The research used quantitative data, collected through a self-structured questionnaire which was based on closed ended questions. The study is based on responses collected from young people of Islamabad city. Both convenience and snowball sampling techniques were used for data collection. Collected data was analyzed by applying descriptive statistics along with one way ANOVA and linear regression through Statistical Package of Social Sciences (SPSS) version 26.0.The findings indicated a poor overall knowledge score among the youth, which was not affected by demographic variables. The most commonly consulted sources of information on sexuality education were found to be mass media, with formal education being the least consulted. A majority of the youth supported abstinence-only education at secondary school level, with comprehensive sexuality education being preferred at the college level. Study highlights need for effective sexuality education for Islamabad youth.

Determinants of men’s perspectives on women contraceptive use in Ghana: an analysis of the 2022 Ghana demographic and health survey

BackgroundMale dominance in reproductive health decision-making, specifically regarding family planning and contraceptive use among women, has been argued to have a significant influence on Africa’s fertility transition. However, there is a paucity of research evidence on the extent to which men influence contraceptive adoption and the factors shaping their perspectives on contraceptive use among women in Ghana. This study aims to examine the factors influencing men’s perspectives on women’s contraceptive use in Ghana.MethodsData for this study was obtained from the 2022 Ghana Demographic and Health Survey (GDHS) conducted between October 17, 2022 and January 14, 2023. A total weighted sample of 7,044 men aged 15–59 was extracted from the men’s data file. Data was analyzed with SPSS version 27, employing both descriptive and binary logistics regression modeling. Statistical significance was set at p < 0.05.ResultsThe results indicate that 63% of men disagreed with the opinion that contraception is solely a woman’s concern, while 59% agreed with the view that contraceptive use encourages promiscuity among women. With factors that significantly influence men’s opinion on contraception being solely a woman’s concern, men with secondary (aOR = 0.69; C.I: 0.57–0.82) and higher education, residing in urban areas, belonging to other Christian faiths, Ga/Dangme, Ewe, and Mole-Dagbani men were less likely to agree with such opinions. Conversely, men dwelling in the Coastal zones were more likely to agree with that view. Men exposure to FP messages on radio and during community durbars had higher odds of agreeing with that opinion. Regarding the factors influencing men’s perspective on the perception that contraceptive use by women encourages promiscuity, men who are 20–24 (aOR = 1.51; C.I:1.12–2.03) and 35–39 years in Coastal and Middle Belt zones, cohabiting and formerly married men were more likely to agree with such opinions. Conversely, men with higher educational levels, in urban areas and unemployed had lower odds to agreeing with such perception.ConclusionsThe study underscores the importance of men’s socio-demographic characteristics and their exposure to FP messages in shaping their perspectives on women’s contraceptive use. Policy implications highlight the need to involve men in promoting safe sexual and reproductive health practices.

Fertility apps, datafication and knowledge production in reproductive health.

Despite being the target of much criticism, commercialised digital technologies have proliferated in reproductive health arenas. Fertility applications (apps) are now some of the most popular and ubiquitous digital health tracking technologies, with millions of downloads. Previous scholarship has already underlined the problematic nature of their design and surveillance features. However, less attention has been paid to the wider effects of datafied knowledge availability. This research specifically asks: How does the proliferation of fertility apps shape knowledge (and associated practices) in reproductive health? Drawing on an analysis of key document sources, I here argue that fertility apps act as mediators between stakeholders, data and datafied outputs, thus facilitating: (1) the datafication of fertility awareness knowledge and the production of new datafied knowledge, (2) legitimation discourses and practices and (3) the remaking of private/public expertise and knowledge production networks in reproductive health. To effectively analyse the effects of commercialised reproductive health apps, this work argues for an understanding of data technologies that is informed by critical data studies.

Praktik Kesehatan Reproduksi pada Remaja Pasca Penyuluhan

The aim of this study was to analyze the influence of adolescent knowledge, the role of teachers, the role of parents, the role of peers and access to information media on reproductive health practices in post-counseling adolescents. This research method used cross sectional, sample was 287 people, using stratified sampling technique. The results of the study showed the factors that influence reproductive health practices are knowledge (p = 0.000), the role of teachers (p = 0.000), the role of parents (p = 0.006), the role of peers (p = 0.022) while access to information media (p = 0.877) is not a factor affecting reproductive health practices. The conclusion was knowledge, the role of teachers, the role of parents, and the role of peers factors influence adolescents reproductive health practice, while access to information media is not a factor that influence adolescents reproductive health practice in post-counseling adolescent. Keywords: Health Reproduction, Adolescent, Counseling

Society for endocrinology guideline for understanding, diagnosing and treating female hypogonadism.

Female hypogonadism (FH) is a relatively common endocrine disorder in women of premenopausal age, but there are significant uncertainties and wide variation in its management. Most current guidelines are monospecialty and only address premature ovarian insufficiency (POI); some allude to management in very brief and general terms, and most rely upon the extrapolation of evidence from the studies relating to physiological estrogen deficiency in postmenopausal women. The Society for Endocrinology commissioned new guidance to provide all care providers with a multidisciplinary perspective on managing patients with all forms of FH. It has been compiled using expertise from Endocrinology, Primary Care, Gynaecology and Reproductive Health practices, with contributions from expert patients and a patient support group, to help clinicians best manage FH resulting from both POI and hypothalamo-pituitary disorders, whether organic or functional.

Economics of primary healthcare: cost estimation of clinical services at primary care facilities in the six countries of the Gulf Cooperation Council

ObjectiveWhile the Gulf Cooperation Council (GCC) countries have demonstrated a strong commitment to strengthening primary healthcare (PHC), the costs of delivering these services in this region remain relatively unexplored. Understanding...

Peningkatan pengetahuan, sikap, dan psikomotorik melalui pembekalan duta Usaha Kesehatan Sekolah (UKS) SMK Kesehatan Binatama Yogyakarta

Healthy behavior must be accustomed to from an early age and become a habit. At the school age, healthy living habits can be carried out by integrating health programs with school activities through School Health Business activities commonly known as School Health Units (UKS). The purpose of this community service is to provide training for class X students of SMK Kesehatan Binatama Yogyakarta as UKS Ambassador candidates and will carry out the UKS mentoring program at the junior high school level. The debriefing is carried out through an interactive method of delivering material using counseling media/tools, discussion, and simulations/direct practice. The themes given are introduction of UKS, communication, counseling methods, Three Basic Threats Adolescent Reproductive Health (TRIAD KRR), basic health and hand washing practices, drug management guidelines and self-medication. From the pre and post test the results are the percentage of participants' knowledge and attitudes increased by 90.5%. Participants also showed an increase in psychomotor abilities through simulations/practices that were directly observed. In order to become a sustainable program, the UKS Ambassador debriefing activities can be attended by students of class XI and XII, with a longer duration of time, and presenting the UKS Advisory Team as one of the presenters.

A scoping review: Forced/coerced sterilization as a socio-cultural risk factor for sexually transmitted HIV for older Black women.

Understanding socio-cultural factors that influence older (age 50 and up) Black women's risk for sexually transmitted HIV has often been absent from policies and programs. This scoping review asked: What does academic literature reveal about forced/coerced sterilization as a risk factor for older Black women who are disproportionately affected by sexually transmitted HIV? Using the Arksey and O'Malley scoping review methodology, the authors identified academic and gray literature published between 2000 and 2023. Of the 407 sources identified and screened, three articles met the criteria for inclusion. One study focused on birth control conspiracy beliefs, another focused on racial differences in Norplant use, and the third focused on the intergenerational transmission of mistrust of medical care that influences HIV prevention among Black Americans. The study findings suggest that because the link has not been made between socio-cultural factors that impact older Black women's reproductive health practices, further investigation is warranted.

Exploring Reproductive Health Knowledge and Practices of Female Students under 24 Years: A Study at the University of Dschang Main Campus

Context: Reproductive health encompasses people’s freedom and ability to procreate and have a sexual life that is not only safe but also satisfying. Identifying factors related to the under-utilization of reproductive health services among young girls could help reduce the incidence of reproductive health problems affecting them. Methods: This was a cross sectional study carried out from January to July 2022 among the female students aged 24years and below of the University of Dschang’s main campus. The sampling method was proportionate stratified sampling. Categorical and continuous variables were expressed as frequencies and means respectively. Multiple logistic regression was used to assess the relationship between dependent and independent variables. Results: A total of 395 participants were recruited, with a mean age of 20.6 years and a reported high level of knowledge about reproductive health at 88.9%. Furthermore, 56.2% of the respondents were already sexually active, with the average age at first sex being 18.8 years. However, 30.6% of the participants had made use of reproductive health services. Being aged 21-22 years and being of a religion other than Christianity were some of the predictors of the participants' knowledge and practices towards reproductive health services. Conclusion: This study highlights the low use of reproductive health services among female students and provides new grounds for implementing interventions that will not only improve their reproductive health status but will also be culturally appropriate.

A Community-Based Reproductive Health Care Model Effectively Enhances Reproductive Health Among Lahu Women in Northern Thailand.

Inadequate and delayed access to sexual and reproductive health services among the Hill Tribe population can be attributed to the intersection of socioeconomic challenges and distinct cultural practices. To address this limitation and create a tailored model capable of addressing it, this study assesses the effectiveness of the Community-Based Reproductive Health Care Model (CRHC) in enhancing reproductive health knowledge, attitudes, and practices among Lahu women, a prominent hill tribe population in Northern Thailand. Implementing the CRHC model includes training programs for community influencers and subsequent education for Lahu women using culturally adapted courses. The effectiveness of the model is assessed through pre-test and post-test comparisons of knowledge, attitudes, and practices related to reproductive health care and analyzed using paired t-tests and repeated ANOVA. The scores for knowledge, attitudes, and practices among Lahu women changed from 8.92 ± 2.02, 52.99 ± 5.54, and 27.76 ± 6.67 to 10.47 ± 2.32 (p < 0.001), 56.61 ± 5.54 (p < 0.001), and 29.47 ± 6.76 (p = 0.030), respectively. Significant improvements are observed in these areas, particularly in maternal health practices among pregnant Lahu women (n = 11). This study additionally evaluates the model's impact on the healthcare system by analyzing changes in government performance indexes, showing increased access to high-quality antenatal care and contraceptive usage. This study highlights the challenges faced by hill tribe populations in accessing healthcare, emphasizing the need for tailored reproductive health education and the importance of addressing health insurance barriers. The CRHC model's success illustrates the potential of community-based, culturally sensitive interventions in improving reproductive health outcomes, providing valuable insights for similar interventions in other indigenous or marginalized communities.

Indigenous sexual and reproductive health practices by girls in Makhado Municipality: A qualitative study.

Cultural practices are passed from one generation to the other. There has been limited evidence of willingness to use indigenous practices to enhance sexual and reproductive health among the youth in resource-constrained settings. This study aimed to explore the possibilities of reintroducing indigenous practices to enhance sexual and reproductive health education among girls. The study adopted a qualitative approach through participatory action research. Non-probability, purposive sampling was used to recruit girls aged 9-18. Data were generated through focus group discussions and key informant interviews. The study findings revealed that indigenous practices were beneficial in delaying sexual debut and nurturing self and peer respect. Additionally, girls appreciated indigenous knowledge and preferred introducing innovative approaches to promoting it. Youth involvement in indigenous knowledge and practices on sexual and reproductive health practices is paramount. The need to introduce critical dialogue to introduce innovative approaches to promoting indigenous practices to enhance sexual and reproductive health is imperative.

Harnessing global networks to drive country evidence-based reproductive health practices toward universal health coverage

Jhpiego provides contextual evidence-based real-life solutions that contribute to saving lives, improving health, and transforming futures for women, children, and their families living in more than 42 countries. Over its 50 years of existence and a geographic footprint of more than 150 countries, this JHU-affiliated NGO has contributed to the introduction and scale-up of multiple life-saving innovations, has been a dot connector, a trusted partner to many governments and professional and local organizations, and an innovator. In Kenya, Jhpiego has worked for more than 45 years, partnering with KOGS in multiple initiatives, and has contributed to the development and review of multiple evidence-based policies and recommendations at the global, regional, and national levels. Evidence-based practice plays a critical role in improving the quality of reproductive health care. While global recommendations are important, they require adaptation to local contexts for full implementation to be practical. Introduction of heat-stable carbetocin and the scale-up of the E-MOTIVE bundle to manage PPH, respectful care, and mental health in RH, introduction and scale-up of post-pregnancy FP, introduction and scale-up of primary and secondary cervical prevention interventions, the use of blended learning that uses multiple delivery channels, including the use of AI-powered training tools that respond to the needs of health providers, and supporting the quality of services through approved pharmacies, including e-pharmacy.

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.

Education and reproductive health: evidence from schooling expansion in Turkey.

We investigate the role of additional years of schooling mandated by a compulsory schooling expansion law in affecting reproductive preferences and safe reproductive health behaviors in Turkey-a middle-to-high-income country with gender inequity in education but overall high levels of safe reproductive health practices at the time of passing the law. Using a fuzzy regression discontinuity design, we find that the additional schooling improved several health behaviors. However, the effects on some outcomes commonly analyzed in the existing literature, such as contraceptive use or fertility, were either weak or insignificant. Overall, our findings complement the current literature on the marginal health benefits of schooling expansion and suggest that policymakers consider the institutional and cultural factors while evaluating the scope and potential non-educational benefits of such expansions.

Sexuality and Sexual and Reproductive Health Depiction in Social Media: Content Analysis of Kinyarwanda YouTube Channels.

Social media platforms such as YouTube can be used to educate people of reproductive age about healthy and nonrisky sexual and reproductive health (SRH) practices and behaviors. However, there is a paucity of evidence to ascertain the authenticity of sexuality and SRH content on Kinyarwanda YouTube, making it difficult to determine the extent to which these topics are covered, the characteristics of available videos, and the themes covered by these videos. The aims of this study were (1) to determine the extent to which YouTube channels in Kinyarwanda-language videos address sexuality and SRH issues, identify the general characteristics of the available videos (type of video, when published, intention for the audience, and content focus), and the aspects of sexuality and SRH covered; and (2) to identify the themes covered by retrieved Kinyarwanda videos, and the extent to which the channels have been used to communicate issues of sexuality and SRH during the COVID-19 pandemic. Using a content analysis approach, we searched Kinyarwanda YouTube channels to analyze videos about sexuality and SRH. The adopted framework for data collection from social media platforms builds on three key steps: (1) development, (2) application, and (3) assessment of search filters. To be included, an audio and/or visual video had to be in Kinyarwanda and the video had to be directed to the general public. Descriptive statistics (frequency and percentages) were computed to characterize the basic characteristics of retrieved channels, portrayal of the videos, and presentation of sexuality and SRH themes that emerged from retrieved videos. Further analysis involved cross-tabulations to explore associations between the focus of the channel and the date when the channel was opened and the focus of the channel and who was involved in the video. The YouTube search retrieved 21,506 videos that tackled sexuality and SRH topics. During the COVID-19 pandemic, there was a 4-fold increase (from 7.2% to 30.6%) in channels that solely focused on sexually explicit content. The majority of the 1369 retrieved channels (n=1150, 84.0%) tackled the topic of sexuality, with sexually explicit content predominantly found in the majority of these videos (n=1082, 79%), and only 16% (n=287) of the videos covered SRH topics. This is the first study to analyze the use of YouTube in communicating about sexuality and SRH in the Kinyarwanda language. This study relied on videos that appeared online. Further research should gather information about who accesses the videos, and how channel owners and individuals involved in the videos perceive the impact of their videos on the Rwandan community's sexuality and SRH.

“I Need to Get My Culture Back”: Youth and Provider Perspectives on Integrating Culturally Based Approaches into Sexual and Reproductive Health Programs for Native Hawaiian and Pacific Islander Youth Experiencing Homelessness

There is growing interest in decolonizing sexual and reproductive health (SRH) and embedding cultural practices into social and medical services in Hawai‘i. Wahine (“woman”) Talk is a multilevel, comprehensive SRH program for female youth experiencing homelessness (YEH) led by community health, social work, and medical providers. This study examines youth and program provider perspectives of culturally based approaches that may strengthen SRH programs. The study team conducted three focus groups and ten in-depth interviews with participating youth and program providers after the program’s conclusion. Youth participants were aged 14 to 22 years (M = 18.1) and of Native Hawaiian or Pacific Islander ancestry. Interview transcripts were analyzed using structured thematic analysis. The youth described feeling estranged from their ancestral cultures and suggested incorporating multiple cultural practices to enhance their connection to community, body, and land into SRH programming for YEH. They identified several ʻāina (“land”)–based approaches, hands-on learning, hula, and language as possible practices to weave into the program. While youth felt estranged from their ancestral cultures, they discussed Native Hawaiian and Pacific Islander health perspectives where ʻāina and relationships are considered life-sustaining. Youth and program staff stressed incorporating culture respectfully, caring for the whole person, and providing trauma-informed care. Future policy, practice, and research should consider protecting and integrating Native Hawaiian conceptions of health into SRH policy and practice and include youths’ cultural identities in SRH intervention development.

PENGEMBANGAN PROGRAM EDUKASI KEBIDANAN UNTUK REMAJA TENTANG KESEHATAN REPRODUKSI

Comprehensive sexual education for adolescents is important in efforts to improve their reproductive health. This article presents community service conducted at MA Plus Walisongo, North Lampung, with the aim of developing a midwifery education program that focuses on adolescent reproductive health. Through outreach, counseling, and training, this program aims to increase youth's knowledge and awareness about reproductive anatomy, menstruation, contraception, sexually transmitted infections, pregnancy, and wise decisions in sexual life. The method used involved a comprehensive sex education module, group discussions, and question and answer sessions. The results of this dedication show an increase in youth's knowledge and understanding of reproductive health, as well as increased awareness of safe and responsible reproductive health practices. This program has also succeeded in reducing the risk of teenage pregnancy, unsafe abortion, and transmission of sexually transmitted diseases. In conclusion, this community service makes a positive contribution in improving adolescent reproductive health at MA Plus Walisongo, North Lampung, and emphasizes the importance of accurate, scientific and dignified sexual education as a solution to addressing adolescent reproductive health problems.