Reproductive Well-being Research Articles

Factors influencing decision-making power regarding reproductive health and rights among married women in Mettu rural district, south-west, Ethiopia

BackgroundWomen’s decision-making power regarding reproductive health and rights (RHR) was the central component to achieve reproductive well-being. Literatures agree that a women having higher domestic decision-making power regarding their health care were more likely to utilize health services. More than 80% of women in Ethiopia reside in rural areas where they considered as the subordinates of their husbands. This would restrict women to fully exercise their RHR. Thus, this study aims to determine the factors influencing the women’s decision-making power regarding RHR in Mettu rural district, South West Ethiopia.MethodsA community based cross-sectional study was done among 415 by using randomly selected married women of reproductive age from March to April 2017. Data was entered by using Epi-data manger 1.4 and analyzed by SPSS version 21. Descriptive and multivariate logistic regression analysis was carried out.ResultOne hundred sixty-eight (41.5%) of the women had greater decision-making power regarding RHR. Woman’s primary education AOR 2.62[95% C. I 1.15, 5.97], secondary (9+) education AOR 3.18[95% C. I 1.16, 8.73] and husband’s primary education AOR 4.0[95% C. I 1.53, 10.42], secondary (9+) education AOR 3.95 [95% C. I 1.38, 11.26], being knowledgeable about RHR AOR 3.57 [95% C. I 1.58, 8.09], marriage duration of more than 10 years AOR 2.95 [95% C. I 1.19, 7.26], access to micro-credit enterprises AOR 4.26[95% C. I 2.06, 8.80], having gender equitable attitude AOR 6.38 [95% C. I 2.52, 12.45] and good qualities of spousal relation AOR 2.95 [95% C. I 1.30, 6.64] were positively influencing women’s decision-making power regarding RHR.ConclusionMore than four in ten rural women had greater decision-making power regarding RHR. External pressures (qualities of spousal relation, gender equitable attitude) and knowledge about RHR were found to influence women’s decision-making power. Public health interventions targeting women’s RHR should take into account strengthening rural micro-credit enterprises, qualities of spousal relations and priority should be given to women with no formal education of husband or herself and marriage duration of < 5 years.

Masturbation is associated with psychopathological and reproduction health conditions: an online survey among campus male students

In order to investigate the association between masturbation and psychopathological and reproduction relative conditions, an online survey was conducted among campus male students of Zhejiang University, which comprised of basic personal information, and questions for reproduction related health, masturbation frequency, and psychological well-being. Psychological status was evaluated with Middlesex Hospital Questionnaire (MHQ). The psychological and reproduction health related parameters were compared among the groups divided according to masturbation frequency. Finally 143 students were included in analysis. Floating anxiety, somatic, and hysteric scores were significantly associated with masturbation, with higher scores in group with highest masturbation frequency; masturbation is significantly associated with fatigue, soreness and weakness of the lumbar region, memory decline, immunity decline, insomnia dreaminess and gradual increase of frequency of masturbation, and the rates of most of the reproduction related symptoms increased accompanying the increase of the masturbation frequency. MQH scores of obsession, phobic anxiety, and depression were not associated with masturbation. It was concluded that masturbation may adversely affect psychological health as well as reproductive well-being.

Variance in Stallion Semen Quality among Equestrian Sporting Disciplines and Competition Levels.

Simple SummaryDespite the increased demand for breeding stallions to be performing at elite levels of competition, little research has been conducted into how equestrian disciplines and competition level affect seminal quality. Using statistical analysis, we found that competing stallions have lower quality semen than non-competing stallions and competitive activity may have a greater negative impact on spermatogenesis than age. In addition, dressage stallions recorded improved semen characteristics when compared to show jumping and eventing stallions. Stallions at elite levels of competition recorded higher total sperm count and progressive motility compared to those competing at lower levels of competition. We suggest that appropriate management of the competition stallion may reduce the negative impacts which exercise can induce on semen quality.Most stallions within breeding programmes are expected to breed and compete concurrently. The exercising of stallions with regards to training regimes during the breeding season is a controversial subject. Daily exercise at low intensities is important for the mental and reproductive well-being of the stallion, however higher intensities of exercise, as seen in competing stallions, may have detrimental effects on seminal quality. To calculate if competition does affect semen quality, this study investigated the effect that equestrian discipline and timing of competition had on a range of stallion semen characteristics. This was a retrospective study that evaluated the seminal data of 1130 stallion semen collections from two UK based stud farms between 2009 and 2016. Competing stallion semen quality was significantly lower with regards to concentration (p < 0.05) and progressive motility (p < 0.05) than non-competing stallions. Semen volume was higher in competing stallions (p < 0.05) than non-competing stallions. There was a significant difference in seminal attributes among disciplines and competition levels (p < 0.05). The difference in semen quality among competing and non-competing stallions, as well as the difference among disciplines suggests endocrinological and physiological changes occur in relation to training intensity and competition.

Child Marriages, Child Protection and Sustainable Development in Kenya: Is Legislation Sufficient?

Globally, 15 million girls are married before the age of 18, with Kenya having one of the highest child marriages prevalence in the world, estimated at 25-30%. Child marriages in Kenya are rampant in rural areas. Child marriages are part of customary practices in communities where they are prevalent. Child marriages have also been used as a survival strategy by families. Child marriages compromise a child's development and threaten the achievement of Sustainable Development Goals. This paper highlights international conventions and analyses Kenyan legislative framework that have been put in place to protect children from child marriages. A review of literature was undertaken and the analysis showed that Kenya has a strong legal framework to fight child marriages and to prosecute perpetrators. However, the practice still remains rampant and is on the increase in certain areas. Indeed, child marriage policies and reproductive health measures targeting children should reflect a child-rights approach and also focus on socioeconomic vulnerabilities to address the root causes. In addition, it should be acknowledged that child protection and reproductive well-being are collective processes requiring collective responsibility and not only legislative and policy reforms.

Contraception Use: Does Socio Economic Factors Matter in Maharashtra, India? An Investigation through NFHS-4 Data

Introduction: Reproductive health care is the collection of preventive methods, techniques and indicators that contribute towards healthy and reproductive well-being. Under reproductive health and rights, it is the right of every women and men to be informed about the contraceptive choices and to have access to quality family planning techniques. Objective: The research paper examines the use of modern limiting, spacing and traditional methods of contraceptives among tribal and non-tribal women of Maharashtra. It also attempts to study the factors associated with the current use of modern methods of contraceptives in Maharashtra. The reason behind lack of contraceptive usage is analyzed. Method: The NFHS IV (2015-16) data published by Ministry of Health and Family Welfare (MoHFW) is used for the study. The data on family planning is accessed from woman questionnaire of the survey with a sample size of 29,460 women of Maharashtra. The data is analyzed using SPSS by applying binary logistic regression method. Results: The use of modern contraceptives in association with place of residence, age, education, wealth index among the young couples of both tribal and non-tribal married women is found. Unmet need for High Priority Districts (HPS’s) and a district wise trend for modern use of contraceptives among tribal and non tribal women is analyzed. Conclusion:The findings of research study will contribute to identify the varioussocio cultural, demographic and community-based interventions which can significantly improve the modern contraceptive usage among married couples of Maharashtra

Quality of life of older women living with HIV: comparative assessment of physical and mental health-related markers using a large Canadian Sexual and Reproductive Health Cohort Study

Objective: This study assessed and compared physical and mental health components of quality of life (QoL) for older and younger women living with HIV (WLWH).Method: Using survey data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study, demographic, well-being, and physical and mental health-related QoL (HR-QoL) variables were compared between older (≥50 years) and younger (<50 years) WLWH. As the only significantly different QoL component, bivariate analyses and linear regression were used to assess factors associated with physical HR-QoL of older women.Results: The sample frame comprised 1,422 women (28.0% older women). Younger WLWH’s mean age was 37.8 years (SD = 7.4) compared to older WLWH (55.8 years, SD = 5.3). Compared to younger WLWH, older WLWH had poorer physical HR-QoL (40.0 vs. 50.7; p < 0.001) but similar mental HR-QoL (42.7 vs. 42.1; p > 0.001). Older WLWH had lower social support (p < 0.001) with no significant differences in depressive symptoms or resilience. Resilience was associated with improved physical HR-QOL. Food insecurity, poorer mental HR-QoL and depressive symptoms were associated with poorer physical health.Discussion: Compared to younger WLWH, older WLWH had poorer physical HR-QoL, which was associated with resilience, food insecurity and mental health factors, highlighting the complex interactions of health-related social-ecological factors impacting aging WLWH.

Contraception Care for Transmasculine Individuals on Testosterone Therapy.

Contraception and fertility-associated advisement is needed for any individual with a uterus who is engaging in sexual activity with reproductive potential. As greater awareness spreads regarding the health care needs of transgender, nonbinary, and gender-nonconforming individuals, the research on evidence-based care for these populations lags behind. Many clinicians may not be well versed in the best practices to support the sexual and reproductive well-being of individuals who are taking gender-affirming hormone therapy. This article reviews the use of contraception for individuals who are on testosterone gender-affirming hormone therapy. Each contraceptive method is individually considered for the risks and benefits that are unique to this population.

A cross-sectional survey of relationships between sexual knowledge, sexual attitudes, and reproductive health behaviour among female university students

Background: Reproductive health includes responsible, satisfying, and safe sex as well as reproductive well-being. This study aimed to examine relationships between sexual knowledge, sexual attitudes, and reproductive health behaviour among female college students.Design: Cross-sectional survey.Methods: Female undergraduate students (N = 407) from 4 universities completed a series of self-report questionnaires consisted of sexual knowledge, sexual attitudes, and reproductive health behaviour.Results: Reproductive health behaviour was significantly influenced by sexual knowledge (β = .67) and sexual attitudes (β = .20). Structural equation modelling indicated that sexual knowledge directly and indirectly affected reproductive health behaviour with sexual attitudes acting as a mediator.Conclusions: The findings indicate that it is necessary to consider sexual attitudes as well as sexual knowledge in promoting young women’s reproductive health behaviour. The results may guide the development of sexual education programmes for young women.Impact Statement: Sexual attitude is an important factor influencing relationship between sexual knowledge and reproductive health behaviour among young female.

Metrics of Survival: Post-Abortion Care and Reproductive Rights in Senegal

ABSTRACT Drawing on ethnographic fieldwork conducted in Senegal between 2010 and 2011, I demonstrate how health professionals have deployed indicators such as number of women and abortion type treated in government hospitals to demonstrate commitment to global mandates on reproductive rights. These indicators obscure discrimination against women suspected of illegal abortion as health workers negotiate obstetric treatment with the abortion law. By measuring hospitals’ capacity to keep women with abortion complications alive, post-abortion care (PAC) indicators have normalized survival as a state of reproductive well-being.

Factors related to fertility desire among female sex workers living with HIV in the Dominican Republic

BackgroundFemale sex workers living with HIV are at increased risk for negative health outcomes and multiple levels of stigma. However, there is limited research on female sex workers living with HIV and even less focused on reproductive health.MethodsWe analyzed data using logistic regression from a cohort of 247 female sex workers of reproductive age living with HIV in Santo Domingo, Dominican Republic to assess factors associated with fertility desire.ResultsMost participants had children (93.1%; mean: 2.8; range: 1,8) and 28.3% reported fertility desire. Bivariate regression analysis uncovered that participants who desired children were less likely to report being on antiretroviral treatment and more likely to have a detectable viral load. Multivariate regression results showed participants who desired more children were: less likely to be older, have higher levels of HIV-related internalized stigma, have a history of pregnancy loss, have fewer children and have a perception that their partner has negative feelings about pregnancy.ConclusionsIndividual and interpersonal characteristics were found to be associated with fertility desire in this study. Additional in-depth research is needed to understand how the role of stigma, partner dynamics and reproductive history as it relates to fertility desire, in order to ensure the reproductive health and wellbeing of this population.

Understanding the meaning of youth sexual and reproductive well-being in Fiji

Well-being is a term commonly used in discussions of sexuality, reproduction and sexual health, yet the meaning of the term is elusive and often disregarded. As an example, the ‘well-being’ component of sexual and reproductive health and well-being is often not explicitly addressed in research, policy and programme development. The goal of this paper is to explore the meanings of sexual and reproductive well-being among young people in Fiji and their implications. Fourteen focus group discussions with young people aged 15 to 19 years and 40 key informant interviews were held in four Fijian settings. We found both different and shared meanings of sexual and reproductive well-being and suggest areas in which it can be strengthened in Fiji.

Seven Prevention Priorities of USPHS Scientist Officers.

The article talks about seven prevention priorities of scientist officers for the Commissioned Corps of the U.S. Public Health Service (USPHS). It comments on the National Prevention Strategy (NPS) federal agenda promoting tobacco-free living, preventing excessive alcohol use and drug abuse, and healthy food habits. It talks about the NPS priority on encouraging active living and living injury- and violence-free. It talks about sexual and reproductive health, and emotional and mental well-being.

A Preliminary Comparison of Semen Quality between Competing and Non-Competing Equine Stallions

Rationale: Artificial insemination allows sport horse stallions within breeding programmes to breed and compete concurrently. The level of exercise of stallions complete during the breeding season is a controversial subject. Daily exercise at low intensities is important for the mental and reproductive well-being of the stallion, however higher intensities of exercise, as seen in competing stallions, may have detrimental effects on seminal quality. The purpose of this study was to gain a greater understanding into the effects of competition and discipline on equid stallion semen through analysis of seminal parameters. The identification of optimal competition management for breeding stallions may lead to increased stallion fertility and economic gain. Methods: This retrospective study evaluated the seminal data of 1130 stallion collections from two UK based stud farms between 2009 and 2015. Seminal volume, concentration and progressive motility were analysed for differences between competing and non-competing stallions, then for differences between stallion disciplines. Results: Competing stallion semen concentration and progressive motility was significantly lower than noncompeting stallions (p<0.05). Semen volume was significantly higher in competing stallions (p<0.05) than noncompeting stallions. Non-competing stallion semen count was significantly higher than that of competing stallions (p<0.05). Conclusion: The difference in semen quality between competing and non-competing stallions, as well as the difference between disciplines suggests endocrinological and physiological changes occur in relation to training intensity and competition. Further research into semen quality considering exercise and competition will allow for contextualisation as to why these differences occurred.

A survey of knowledge, attitudes and behaviours regarding sexual wellbeing among Chinese women living in New Zealand – a pilot study

The aims of the study were to assess sexual wellbeing knowledge and attitudes among Chinese women living in New Zealand and to investigate the factors that prevented them from seeking support from sexual wellbeing services. Seventy-nine Chinese women from Hong Kong, China and Taiwan were recruited through community and personal networks to complete a self-report survey, which included questions on socio-demographics, self-rated adjustment, knowledge of sexual wellbeing, importance of understanding sexual wellbeing, cultural influences, structural influences, and willingness to seek information and assistance. The findings in this study suggested that younger Chinese women lacked sexual wellbeing knowledge and were less likely to seek support when compared to their older age group counterparts. Three out of the eight variables assessed were found to make a significant contribution in the willingness of Chinese women seeking support from sexual wellbeing services. These were knowledge of sexual wellbeing, self-perceived importance of gaining an understanding of sexual wellbeing issues and cultural influences. Our results suggest that despite the length of residency and self-rated adjustment in New Zealand, traditional Chinese values and beliefs continue to influence the perceptions of Chinese women regarding their sexual wellbeing. Interventions to improve sexual and reproductive wellbeing in this population, particularly younger Chinese women, should be tailored to the specific enabling and reinforcing factors that include cultural views, communications between Chinese women and health and social services providers, and access to healthcare information.

Sexual and reproductive well-being of teenage mothers in a South African township school

Research addressing the sexual health and reproductive rights of pregnant teenagers and teenage mothers is growing, although attention to the sexual well-being of young mothers who are already in school remains limited. This omission places teenage mothers at risk, who may be susceptible to repeated pregnancies that may compromise their well-being and educational outcomes. By drawing on a qualitative study, we focus on young mothers’ sexual relationships and their knowledge and choice of contraceptive methods, as well as their accessibility to them. In this paper, we ask how sexual and reproductive well-being is constructed in relation to knowledge, choice and accessibility to contraceptive methods. While the study found that schooling was constructed as vital to economic empowerment, teenage mothers’ aspirations were compromised by limited contraceptive knowledge and choices, and enduring patterns of gender inequalities within relationship dynamics. Effective interventions require attention to a comprehensive understanding of sexual health, which includes a focus on gender and relationship dynamics, as well as knowledge of and access to contraceptive methods. Accessibility to all methods of contraceptive use remains vital in all health centres. Community health workers need to engage better with young mothers so as to support their reproductive well-being. Keywords: accessibility; contraceptives; intervention; reproductive well-being; schooling; sexual health; South Africa; teenage mothers

Conceptions of and Attitude toward Multiple Sexual Partners among Youths in Bolgatanga Municipality, Northern Ghana

Objective: This study analyses the conceptions of and attitude toward multiple sexual partners among youths in Bolgatanga municipality, northern Ghana. Methods: Semi-structured and focus group interviews were held with 71 youths and 12 adults. Results: Youths’ multiple sexual partnerships were found to be related to various factors, including infidelity and distrust in relationships, cultural traditions such as the practice of polygyny and the importance of fertility, and modern developments such as increased school attendance and the use of new media. For boys, important motives for having multiple sexual partnerships are sexual prowess, prestige, desire, and pleasure, while for girls financial independence is important. Conclusion: The various influencing factors and the youths’ personal motives, combined with limited knowledge of SRH and risky sexual behavior prevents the youths from making well-advised and healthy choices concerning their sexual and reproductive wellbeing.

Minilaparoskopy (Mini Site) in surgical treatment of childbearing age patients

Nowadays gynecologists try to find less traumatic and more effective variants of surgical treatment. Minilaparoscopic surgery is a resultant achievement of developments in gynecology since the beginning of the 20th century. It is a novel real-time surgical method. During the last decade the authors have accomplished 270 minilaparoscopic operations. The present paper sums up our experience in minilaparoscopic operations involving the uterus, Fallopian tubes, ovaries (salpingolysis, decortication, endometriosis sites excision, gonadectomy, etc.). The advantages of this kind of surgical operation especially promising in infantile gynecology are disclosed. Among the advantages of minilaparoscopic approach in infantile gynecology the authors emphasize the decrease of preoperational period, optimization of diagnostics during the operation, sparing techniques, reduction of post-operational complications. The aforementioned features of laparoscopic surgery suggest breakthroughs in normalizing nature of treatment in gynecology improving reproductive well-being of females and reproductive potential of girls. As a result we expect better demographic and reproductive prospects in future.

Awareness and practice of emergency contraception at a private university in Nigeria.

BackgroundThe pursuit of formal education now causes many people in developing countries to marry later in life, thereby leading to increased premarital sex and unintended pregnancies. Efforts have been made to characterize awareness and use of emergency contraception (EC) among undergraduate students in public universities in Nigeria; however, it is not known if students in private tertiary institutions adopt different practices or if having an affluent family background plays a role. This pilot study therefore aimed to assess the awareness and use of EC among students at a private Nigerian university toward assisting education planners in developing strategies in improving students’ reproductive well-being.ResultsOut of 94 female students, 42 (44.7%) had sexual experience, but only 32 (34.0%) were currently sexually active. Six students (6.4%) had had unwanted pregnancies, of which all but one were terminated. Fifty-seven respondents (60.6%) were aware of EC, though only 10 (10.6%) ever practiced it. The greatest source of EC information was from health workers and peers; the lowest source was family or relatives. Most respondents desired orientation and availability of EC on campus. EC awareness among the students was predicted by upper social class background (adjusted odds ratio [OR], 2.73; 95% confidence interval [CI], 1.06–7.45) and upbringing in the Federal Capital Territory (adjusted OR, 4.45; 95% CI, 1.56–14.22).ConclusionsThough awareness of EC was higher among the private university students in this study than at most public universities, there was no difference in EC usage. A high pregnancy termination rate was observed; dilatation and curettage were mainly adopted. In Nigeria, youth-friendly reproductive health information and access should not be limited to government-owned tertiary institutions but also extended to private ones.

Idiopathic Ovarian Follicular Atresia in the Very Young: Implications and Review of the Literature

Abstract Background: Follicular atresia accounts for a >99% reduction in the number of ovarian follicles from intrauterine life to reproductive senescence. Although the mechanism is unclear, the process of accelerated follicular atresia has immense implications for physical, reproductive, and psychologic well-being of the individual. The case of a 17-year-old girl with primary amenorrhea, who was diagnosed with ovarian follicular atresia via an ovarian biopsy is presented, and the available literature on this rare disorder is reviewed. Case: A 17-year-old girl presented to an outpatient department with a history of primary amenorrhea. She also had a history of taking a progestational agent for 5 days 4 months prior to presentation, but this approach failed to work. After various hematologic, endocrine, and radiologic tests, she underwent a diagnostic laparoscopy and histology testing. She was then prescribed a combination of oral contraceptive pills (50 μg ethinyl estradiol in each tablet), vitamin D, and...

A cross-sectional study on attitudes toward gender equality, sexual behavior, positive sexual experiences, and communication about sex among sexually active and non-sexually active adolescents in Bolivia and Ecuador

BackgroundIt is widely agreed upon that gender is a key aspect of sexuality however, questions remain on how gender exactly influences adolescents’ sexual health.ObjectiveThe aim of this research was to study correlations between gender equality attitudes and sexual behavior, sexual experiences and communication about sex among sexually active and non-sexually active adolescents in 2 Latin American countries.DesignIn 2011, a cross-sectional study was carried out among 5,913 adolescents aged 14–18 in 20 secondary schools in Cochabamba (Bolivia) and 6 secondary schools in Cuenca (Ecuador). Models were built using logistic regressions to assess the predictive value of attitudes toward gender equality on adolescents’ sexual behavior, on experiences and on communication.ResultsThe analysis shows that sexually active adolescents who consider gender equality as important report higher current use of contraceptives within the couple. They are more likely to describe their last sexual intercourse as a positive experience and consider it easier to talk with their partner about sexuality than sexually experienced adolescents who are less positively inclined toward gender equality. These correlations remained consistent whether the respondent was a boy or a girl. Non-sexually active adolescents, who consider gender equality to be important, are more likely to think that sexual intercourse is a positive experience. They consider it less necessary to have sexual intercourse to maintain a relationship and find it easier to communicate with their girlfriend or boyfriend than sexually non-active adolescents who consider gender equality to be less important. Comparable results were found for boys and girls.ConclusionsOur results suggest that gender equality attitudes have a positive impact on adolescents’ sexual and reproductive health (SRH) and wellbeing. Further research is necessary to better understand the relationship between gender attitudes and specific SRH outcomes such as unwanted teenage pregnancies and sexual pleasure among adolescents worldwide.