Sexual And Reproductive Health Education Research Articles

Nimble adaptations to sexual and reproductive health service provision to adolescents and young people in the early phase of the COVID-19 pandemic

Early in the COVID-19 pandemic, emerging evidence showed that the provision and use of a range of health services, including sexual and reproductive health (SRH) services, were affected. Otherwise, there was little evidence on whether and how they were adapted to maintain the access of different population groups, including adolescents. The study aims to provide an overview of adaptations to adolescent sexual and reproductive health (ASRH) services carried out during the early phases of the pandemic in low- and middle-income countries (LMICs). The Human Reproduction Program (HRP) at the World Health Organization (WHO) called upon WHO and United Nations Populations Fund (UNFPA) regional offices to reach out to organisations that provided ASRH services to submit analytic case studies using a short-form survey. The study team charted information from 36 case studies and performed a content analysis. Results show that the adaptations covered a wide array of SRH services that were provided to a diverse group of adolescents. Most adaptations focused on SRH education and access to contraception in comparison to other SRH services. Over half of the case studies included mental health services, most of which were not provided before the pandemic. The adaptations varied between being face-to-face, remote, digital, and non-digital. Most adaptations complemented a pre-existing service and were nimble, feasible, and acceptable to the targeted adolescents. Lessons learned from this study could be extrapolated into other humanitarian settings and rapid responses for future public health emergencies, provided that rigorous evaluation takes place.

The effect of an educational peer-based intervention program on sexual and reproductive health behavior.

The fact that adolescent people experience risky sexual behavior and have insufficient knowledge of sexual and reproductive health (SRH)indicates the need for SRH education. This study investigates the impact of peer-educated SRH programs on the knowledge and behaviors of adolescents. This study was conducted as a randomized controlled trial on 275 university students. The subjects were randomly assigned to the peer educators (n = 25), intervention (n = 125) and control (n = 125) groups using systematic random sampling. Peer educators provided face-to-face SRH education to the intervention group. The researcher provided the same education to the control group via the online conference method. SRH knowledge and behavior evaluated with scales before, after, and 3 and 6 months after the SRH education. The obtained data were analyzed using SPSS version 25 through statistical tests and analysis of covariance. The female and male ratio of the participants was almost equal (49.4%, 50.6%). The mean age was found to be 20.42 ± 1.14 years. The mean scores of the students in the intervention group increased from 21.20 ± 0.14 to 35.20 ± 0.07 for sexual health knowledge questionnaire (SHKQ), and from 130.56 ± 0.55 to 147,90 ± 0,25 for reproductive health scale (RHS) after the education. Compared with the control group, these increases in the mean scores of SHKQ and RHS were found to be statistically significant. The findings show the important role of the SRH peer education method on the effect of transferring knowledge about sexual behaviors. Health and education policy-makers are advised to implicate SRH peer education.

Exploring factors influencing sexual and reproductive health knowledge among in-school adolescents in Nigeria

This study examines the factors influencing sexual and reproductive health (SRH) knowledge among in-school adolescents in Nigeria. Data were collected from a sample of 1,133 adolescents through a semi-structured survey questionnaire. Descriptive statistics, and logistic regression analysis were employed to analyze the data. Adolescents' knowledge levels on critical aspects of SRH education reveal varying levels of comprehension across domains. While 35.7% of adolescents demonstrate understanding of the anatomy and physiology of the reproductive system, only 8.0% display comprehension of contraception and birth control methods. Logistic regression coefficients unveil significant predictors of SRH knowledge, with senior secondary students demonstrating higher odds of SRH knowledge compared to junior secondary students (OR = 2.482, 95% CI [1.335, 3.693]). Urban residence is associated with higher odds of SRH knowledge (OR = 1.172, 95% CI [0.084, 1.350]). Healthcare providers significantly influence adolescents' SRH knowledge (OR = 3.519, 95% CI [2.853, 4.271]), while comfortable discussing SRH topics with teachers predicts higher odds of SRH knowledge (OR = 3.101, 95% CI [2.245, 3.355]). These findings underscore the need for tailored and comprehensive SRH education programs to address knowledge gaps and empower adolescents with accurate information and skills necessary for making informed decisions regarding their sexual health.

WhatsApp-based sexual and reproductive health education for adolescents with perinatally acquired HIV: lessons learned from an mHealth pilot intervention in South Africa

ABSTRACT Adolescents with perinatally acquired HIV in South Africa have limited access to relevant sexual and reproductive health (SRH) education. Mobile health (mHealth) can discreetly deliver such education but has not been tested with members of this population. In this study, we describe the effects of an mHealth intervention to support transition to adult care – Interactive Transition Support for Adolescents with HIV (InTSHA) – on SRH attitudes. Between May 2021 and February 2022, we enrolled adolescents with perinatally acquired HIV aged 15–19 from a government clinic in urban KwaZulu-Natal, South Africa. Baseline and six-month SRH questionnaires were adapted from a WHO adolescent SRH survey, consisting of nine positively worded items on a 4-point Likert scale. Transcripts of the mHealth intervention modules were thematically analysed. Of 80 participants enrolled, 47 completed the SRH survey at both time points (mean age: 17.2 years); 25 (53.2%) were female and 19 (40.4%) were randomised to InTSHA. Likert scores improved from baseline to follow-up for the InTSHA group for specific SRH questions, overlapping with the frequency that topics such as ‘Defining Sexuality’, ‘Discussing Sex with Caregivers’, and ‘Comfort Saying No to Sex’ – were discussed by adolescents. mHealth is a tool for interactive SRH education that should be further developed.

Implementation and evaluation of a fertility preservation telehealth counseling intervention for males with cystic fibrosis

BackgroundMost males with cystic fibrosis (MwCF) have congenital bilateral absence of the vas deferens and require assisted reproductive technology to conceive, yet many have limited knowledge about how CF affects sexual and reproductive health (SRH). This study evaluates the feasibility, acceptability, and potential effectiveness of telehealth fertility preservation (FP) counseling for MwCF. MethodsPre-lung transplant MwCF ≥18 years, recruited from U.S. CF centers, social media, and via snowball sampling, received individualized telehealth counseling. Participants completed intervention feasibility/acceptability one week post-counseling and FP knowledge, care satisfaction, and self-efficacy assessments at baseline and two months post-counseling. We completed acceptability interviews one-week post-counseling and audio-recorded, transcribed, and thematically analyzed results. We descriptively analyzed survey results and conducted pre/post comparisons using paired t-tests. ResultsThirty MwCF (ages 22–49 years) completed counseling. Most were in a relationship (70 %) and White (86.7 %). Telehealth FP counseling was acceptable (M = 4.38/5 ± 0.60), appropriate (M = 4.37/5 ± 0.60), and feasible (M = 4.60/5 ± 0.45) to MwCF. FP knowledge (9.53 vs. 10.40/12; p = .010), care satisfaction (20.23 vs 26.67/32; p<.001), and self-efficacy (22.87 vs 25.20/30; p = .016) improved at two months post-counseling. Despite desiring provider-initiated SRH, wanting children (81 %), and perceiving the CF team as their primary care provider (97 %), 44 % report not receiving information about infertility by the CF team. ConclusionsIntegrating FP counseling into CF care is feasible and acceptable to MwCF and can improve FP knowledge, self-efficacy, and care satisfaction. MwCF desire early and regular provider-initiated SRH education.

Understanding the contents and gaps in sexual and reproductive health toolkits designed for adolescence and young adults: a scoping review.

Adolescence is a crucial stage of physical and sexual maturation and development and a period in which understanding sexual and reproductive health (SRH) is important. SRH interventions and toolkits provide a range of valuable resources and information to young people, educators, and members of the community on numerous topics, including contraception and puberty. The usefulness and reliability of these available toolkits have not been previously studied, thus limiting our understanding of their appropriateness and contents. Hence, this scoping review aimed to synthesize the available toolkits aimed at the SRH of adolescents and young adults to understand the contents, design, and information gaps. A systematic search was conducted of 6 medical databases and 12 gray literature sites. Sixteen toolkits published globally before May 2023 were included in our review. The majority of toolkits (n = 12) contained information related to general SRH knowledge and contraception, whereas only 3 contained information on teenage pregnancy. We found that aiming the toolkits toward educators and health care workers was a favorable design over targeting adolescents and young adults directly and that vulnerable youth-including LGBTQI+ (lesbian, gay, bisexual, transgender, queer or questioning, asexual or allied, intersex, and additional identities) and youth from humanitarian settings-were not well represented. We identified key gaps in the inclusion of information in a range of SRH topics, such as LGBTQI+ sexuality, teenage pregnancy, and safe abortion, in the currently available SRH toolkits and their lack of applicability in a global context. Furthermore, we provide recommendations for areas of improvement to encourage adolescents' agency in their SRH education.

Curriculum-based sexual and reproductive health education: revealing its relevance for risky sexual behaviors among secondary school students in Mwanza, Tanzania

BackgroundSecondary school students are vulnerable to risky sexual behaviors (RSBs) which may lead to adverse health consequences, such as teenage pregnancies and sexually transmitted diseases (STDs), including HIV/AIDS. In Tanzania, the burden of teenage pregnancy was reported to be 27% in 2016. The integration of sexual and reproductive health (SRH) education into the school curriculum is one of the proven crucial interventions. However, there is limited information on the extent to which curriculum-based SRH education is relevant for fostering good practices for coping with RSBs. This study sought to describe students’ and teachers’ perceptions of the relevance of curriculum-based SRH education.MethodsA qualitative study was conducted from May to June 2020 (involving 5 secondary schools in Ilemela district, Mwanza, Tanzania). In-depth interviews (30) were conducted among secondary school students and 10 interviews for teachers. The data were collected in Swahili and then transcribed and translated into English after which thematic content analysis was performed.ResultsThe majority (56%) of secondary school students were revealed to have a limited understanding of curriculum-based SRH education, which was limited to a few aspects of health that involved married people and pregnant women. Teachers of different subjects had different perceptions about the relevance of curriculum-based SRH education. Civics teachers had the perception that it was relevant and enough, while Biology teachers thought that it was not enough. Students reported utilizing the information taught in class to manage and navigate RSBs. Moreover, they expressed a need for additional delivery strategies to be used for a comprehensive understanding of sexual and reproductive health.ConclusionDespite the identified gaps in providing a comprehensive knowledge that builds on the appropriate attitudes and skills, the existing curriculum-based SRH education in secondary schools was utilized to help students in addressing and managing RSBs. However, there is a need for more comprehensive information and an improved delivery approach for SRH to equip students with the necessary skills when faced with RSBs.

(175) Knowledge, Attitude, and Practice on Sexual and Reproductive Health among Adolescent in Malaysia: A Systematic Review

Abstract Introduction A good sexual and reproductive health (SRH) encompasses dimensions of physical, emotional, mental and social-wellbeing in relation to sexuality; it is not merely the absence of disease, dysfunction, or infirmity. A proper curriculum is needed to ensure that all adolescents have a good grasp of knowledge of SRH to have proper attitudes and the right practices in SRH. Objective Currently, it is believed that there is no improvement in status of knowledge, attitude and practice of SRH among adolescents in Malaysia, despite the introduction of sexual and reproductive health topics in the school curriculum. No systematic or proper evaluation to evaluate the effectiveness of the said improved SRH curriculum. This review aims to investigate the status of level of knowledge among adolescents since the introduction of SRH curriculum. Methods A systematic literature review in the form of narrative review was used to investigate the status of knowledge, attitude, and practice of SRH. 109 potential articles were found through Medline, PubMed, Google Scholar and Google. Articles removed due to duplications within and between databases. 109 potential articles were found but only 29 articles met the inclusion/exclusion criteria. Selected articles were read through based on the 8 key concepts in the International Technical Guidance on Sexuality Education, 2018. Results The results reported that the knowledge of sexual health among adolescents was just above the average, while poor knowledge in reproductive health. They have a positive attitude towards introducing SRH curriculum as early as primary school. It was found that these adolescents have poor information-seeking behavior, and main resources of information are from peers, internet, and magazine. Parents and teachers were the least chosen as reference. Conclusions There is the need to re-evaluate the current SRH curriculum, and to integrate the healthcare personnel as educator to the adolescents, trainers to the teachers and parents to ensure a holistic approach to a proper SRH education following the CSE guideline. Disclosure No.

The end point of it is abstinence: a qualitative analysis of underlying factors influencing Christian leaders’ adoption and implementation of sex and sexuality education in Bolgatanga, Ghana

Adolescents’ sexual and reproductive health challenges are of global public health concern and good quality sexual and reproductive health (SRH) education has an important role to play in addressing these negative sexual health outcomes. Yet in most Sub-Saharan African countries including Ghana, there is limited implementation of SRH education. Several environmental factors hinder the implementation of SRH education with the attitudes expressed by religious leaders having a major impact. We conducted semi-structured interviews with 15 Christian leaders in Bolgatanga, Ghana, to explore the factors influencing their decision to adopt and implement SRH education. Findings show that although Christian leaders were aware of (unsafe) sexual practices among adolescents, they held a conservative position on SRH education. While leaders were open to educating adolescents about sexual health, most held the opinion that SRH education for adolescents should be limited to abstinence-only and not acknowledge sexual activity or promote contraceptive use. Beliefs related to sexual morality, the perceived cause(s) of teenage pregnancy, and perceived responsibility for SRH education influenced Christian leaders’ thinking about SRH education. Implementing SRH education programmes to address young people’s sexual behaviour will require intervention programmes to change Christian leaders’ beliefs and attitudes towards SRH education.

“I still don’t know how someone gets pregnant”: determinants of poor reproductive health among young female refugees in South Africa

BackgroundStudies exploring the sexual and reproductive health (SRH) of refugee women have focused primarily on first generation refugees in humanitarian and crisis settings. There is a paucity of research exploring the reproductive health of girls and young women who are born to refugee parents in a host country or who have migrated with their parents at a very young age and who have since reached sexual maturity. We conducted a qualitative study which aimed to explore the reproductive health and rights’ needs and challenges amongst young refugee women in South Africa.MethodsThe study was carried out in the city of eThekwini (Durban) in South Africa in 2021 and 2022. A total of 35 semi-structured, in person interviews were conducted amongst young refugee women between the ages of 18 and 24 years living in the city centre.ResultsTwenty-five participants were 17 years or younger on arriving in South Africa, one of whom was born in South Africa. Eleven of these women had experienced one or more pregnancies while living in South Africa and all of these women had experienced at least one unintended pregnancy. Participants had poor reproductive health knowledge of the role of menstruation and how conception occurs. Economic, social, and legal insecurities intersected in complex ways as determinants of poor reproductive health outcomes. Despite availability, contraceptive use was poor and linked to lack of knowledge, myths and unwanted side effects. There were negative economic and social impacts for young refugee women experiencing early pregnancies irrespective of whether they were intended or not. Being unable to conceive or experiencing an unintended pregnancy negatively impacted sexual relationships which were entered primarily for material support. Desire for confidentiality shaped lack of access to legal termination of pregnancy in the public health sector.ConclusionParticipants experienced specific vulnerabilities resulting from their position as refugees despite length of stay in South Africa. It is important to better understand these specificities in the design of programmes and policies aimed at ensuring positive health outcomes for these young women. Peer education amongst refugee communities may be an important tool in the provision of culturally acceptable SRH education.

Uncovering the Knowledge Gap: Sexual and Reproductive Health Education and Knowledge Among Unmarried Sri Lankan Youth

Introduction: Sexual and reproductive health (SRH) education is crucial to prevent unwanted pregnancies and sexually transmitted infections (STIs) among young people. However, in Sri Lanka, little is known about the level of access to SRH education and knowledge among unmarried youth. This study aimed to assess perceptions of SRH education at school and the level of knowledge on selected aspects of SRH among unmarried youth aged 15–24 years in Sri Lanka. Methods: A cross-sectional study was conducted among 1057 unmarried male and female youth aged 15–24 years in three selected districts of Sri Lanka. A semi-structured, self-administered questionnaire was operationalized after receiving informed consent. Twelve focus group discussions were also conducted with the youth. Results: A sizable proportion of youth demonstrated low access to SRH education and a low level of knowledge on pregnancy, contraception, and STIs. Although it is limited, respondents felt that the SRH education received in school is useful for their life. Friends and the Internet were identified as the primary sources of information among boys, whereas the mother was the primary source for the majority of girls. Boys demonstrated better SRH knowledge compared to girls for most of the aspects. SRH knowledge was increased among both boys and girls significantly with maturity. Conclusion: Results conclude that there is a significant knowledge gap on SRH among unmarried youth. Introduction of age-specific and gender-sensitive SRH education is important to address the current gap in SRH knowledge.

Exploring sexual and reproductive health education for individuals labeled as intellectually disabled – A constructivist grounded theory

Discourses regarding intellectual disability (ID) have traditionally excluded people with this label from sexual and reproductive health education (SRHE). While politically, much has changed, deficit-oriented narratives about labeled people remain and threaten their access to sexual and reproductive health services. Although SRHE providers in Germany are described as crucial for labeled people's sexual literacy, critical and in-depth analyses of SRHE providers' accounts are lacking thus far. To address this gap, people that offer SRHE to labeled individuals in Bavaria, Germany, were interviewed virtually. Data were collected until the categories were saturated, leading to 14 interviews. One core category was constructed using a constructivist grounded theory: ‘promoting integration through SRHE.’ Overall, participants described SRHE as an important part of labeled people's education that aims to facilitate sexual autonomy. Nevertheless, the analysis illustrates how participants recreated traditional narratives about ID and sexuality, despite their attempt to advocate for their target group. This highlights the pervasiveness of deficit-oriented discourses and stresses the need for questioning cognitive ableism to address the root causes of stigmatization that limit the sexual health of labeled people.

Web-based program for sexual and reproductive health education of immigrant women: A scoping review protocol.

Developing web-based education sexual and reproductive health (SRH) programs for immigrant women is crucial. This scoping review aims to provide basic data for developing more advanced programs by examining web-based educational program literature. This review considers web-based SRH education programs for adult immigrant women and focuses on their characteristics, instructional strategies, and outcome evaluations. Data will be extracted following the Minimum Initial Service Package (MISP) and Kirkpatrick level and summarized to show future-oriented results while documenting web-based approach evidence for educating immigrant women on SRH. It is expected to provide information for web-based education programs to meet the MISP and develop various evaluation methods. As such, the findings can be used to determine the direction and level of SRH education.

Adolescents Knowledge and Attitude towards Sexual and Reproductive Health in Bhopal (Madhya Pradesh)

With a staggering adolescent population of 253 million, India stands as the world's epicenter of youth. Adolescence, a distinctive phase marked by active physical and psychological growth, often initiates the exploration of romantic and sexual realms. Adolescents are particularly susceptible to various reproductive and sexual health vulnerabilities such as unintended pregnancies, sexually transmitted infections, reproductive tract infections, and the heightened risk of maternal and infant mortality. This susceptibility is accentuated in regions where healthcare services are constrained and knowledge regarding health matters is limited. A descriptive cross-sectional survey was conducted in the year 2022, with due ethical considerations, among students in the 9th to 12th grades (n=322) in Bhopal District, Madhya Pradesh, a region where utilisation of Adolescent Reproductive and Sexual Health (ARSH) services remains notably modest. The objectives were to assess the knowledge and attitudes of adolescents regarding SRH and to find the relationship between the knowledge and attitude. Data was collected in schools from adolescents aged 14 to 18 years, using researcher-developed structured questionnaires. The findings revealed that the majority (50.9%) of participants had poor knowledge, 34.5 percent showed moderate knowledge and 14.6 percent exhibited good knowledge. About 60 percent of the participants expressed a favorable attitude towards sexual and reproductive health (SRH). The relationship between knowledge and attitude was positive but weak. These outcomes collectively underscore the need for improving adolescents' SRH knowledge and attitudes in the region. Focusing efforts towards comprehensive SRH education and promoting well-informed attitudes may help reduce the adolescents’ susceptibility to SRH vulnerabilities.

Impact of the COVID-19 pandemic on the sexual and reproductive health of adolescents in Alberta, Canada

PurposeThe COVID-19 pandemic led to major service disruptions in the healthcare sector, especially regarding sexual and reproductive health services. However, the impact of the pandemic on Canadian adolescents is relatively unknown. This study aimed to investigate the impacts of the COVID-19 pandemic and associated public health measures on the sexual and reproductive health (SRH) of adolescents in Alberta, Canada.MethodsA qualitative study using an interpretive description (ID) approach and community-based participatory research principles was conducted to capture the subjective experience and perceptions of adolescents and service providers. With the collaboration of the Adolescent Advisory Group and community partners, 18 adolescents and 15 service providers were recruited for the study through purposive sampling. Findings from the qualitative interviews were analyzed using thematic analysis.ResultsThree major themes emerged from the analysis: (1) COVID-19 SRH experience, (2) barriers to SRH, and (3) adolescent SRH strategies. Our findings highlight numerous barriers and challenges that prevented adolescents from accessing SRH education, products, and services.ConclusionThe COVID-19 pandemic had a profound impact on the SRH and the well-being of adolescents. Our study reflects the need for diverse SRH strategies to maintain continued access to SRH resources during disruptive events, such as the pandemic.

Live-streaming comprehensive sexuality education in Western China: an analysis of the views of implementers and junior secondary students

ABSTRACT Following China’s rapid socioeconomic transition, the sexual attitudes and behaviours of Chinese youth have changed considerably, raising serious concerns about their sexual and reproductive health (SRH). While comprehensive and high-quality formal sexuality education has been shown to lead to safer sexual behaviour, the delivery of formal SRH education in China remains insufficient, especially in Western regions. This study usedd qualitative approaches to evaluate the implementation of a live-streaming comprehensive sexuality education (CSE) programme in Western China between 2019 and 2021, Nineteen participants were recruited to participate in this study. Ten face-to-face, semi-structured interviews were conducted privately with specialists, school principals, and live-streaming tutors. Two focus groups were conducted with classroom teachers and junior secondary students, respectively. Findings reveal that both programme implementers and students demonstrated high satisfaction with CSE implementation. They indicated that CSE provision helped enhance adolescents’ SRH knowledge and attitudes so as to better prepare them for a healthy and secure future. Findings demonstrate the effectiveness, efficiency, relevance, sustainability, and scale-up possibilities of the both the CSE curriculum and the live-streaming delivery approach. Findings may help guide future implementation of CSE at all levels, and thus improve access to CSE for vulnerable populations and diminish SRH disparities more effectively.

Effects of COVID-19 on sexual and reproductive health services access in the Asia-Pacific region: a qualitative study of expert and policymaker perspectives

The COVID-19 pandemic has strained health systems globally, with governments imposing strict distancing and movement restrictions. Little is known about the effects of the COVID-19 pandemic on sexual and reproductive health (SRH). This study examined perceived effects of COVID-19 on SRH service provision and use in the Asia-Pacific region. We conducted a qualitative study using semi-structured interviews with 28 purposively sampled SRH experts in 12 Asia-Pacific countries (e.g. United Nations, international and national non-governmental organisations, ministries of health, academia) between November 2020 and January 2021. We analysed data using the six-stage thematic analysis approach proposed by Braun and Clarke (2019). Interviewees reported that COVID-19 mitigation measures, such as transport restrictions and those that decreased the availability of personal protective equipment (PPE), reduced SRH service provision and use in most countries. SRH needs related to service barriers and gender-based violence increased. Systemic challenges included fragmented COVID-19 response plans and insufficient communication and collaboration, particularly between public and private sectors. SRH service-delivery challenges included COVID-19 response prioritisation, e.g. SRH staff task-shifting to COVID-19 screening and contact tracing, and lack of necessary supplies and equipment. Innovative SRH delivery responses included door-to-door antenatal care and family planning provision in the Philippines, online platforms for SRH education and outreach in Viet Nam, and increasing SRH service engagement through social media in Myanmar and Indonesia. To ensure continuation of SRH services during health emergencies, governments should earmark human and financial resources and prioritise frontline health-worker safety; work with communities and the private sector; and develop effective risk communications.

From Exploits to Remedy: Sexual Behaviour and Utilisation of Reproductive Health Services among In-School Adolescents in a South-Western Nigerian Town

Background: Adolescents are often involved in risky sexual behaviour. It has been reported that most male adolescents have multiple sexual partners, and most female adolescents use condoms inconsistently. This study assessed sexual behaviour, information sources on Sexual and Reproductive Health (SRH), knowledge of SRH, and utilization of RH services among senior secondary school students in Ile- Ife, Nigeria.&#x0D; Methods: A cross-sectional study was conducted on 424 students randomly selected from six public secondary schools in Ile-Ife. The instrument was a pretested, self-administered questionnaire. The median score was used to categorise SRH knowledge into good and poor. Respondents who did not use condoms consistently, or had multiple sexual partners, or engaged in transactional sex were categorized as having engaged in risky sexual behaviour. Respondents who sought any RH service in a health facility were categorized as having utilized SRH services. ChiSquare was used for associations between categorical variables, while binary logistic regression was used to test for the predictors of utilization of SRH services.&#x0D; Results: Over a quarter (26.9%) of the respondents had experienced a sexual debut, with 52.6% doing so before 14 years. Teachers were the most reported information source on pubertal changes (65.1%) and sexually transmitted infections (STIs) (71.7%). About 60.8% of respondents had good knowledge of SRH; 55.3% of respondents had multiple sexual partners and 55.9% of respondents had utilized RH services.&#x0D; Conclusion: A good proportion of the respondents had good SRH knowledge; however, the prevalence of risky sexual behaviour was high. Adolescents need adequate SRH education and promotion.

Effectiveness of school-based sexual and reproductive health education among adolescent girls in Urban areas of Odisha, India: a cluster randomized trial

BackgroundVarious studies revealed that adolescent girls have limited knowledge pertaining to sexual and reproductive health (SRH). The current study assessed the effectiveness of SRH education among adolescent girls in urban areas of Odisha, India.MethodsThe study design was a cluster randomized trial, where the clusters composed of eight Odia (regional language) medium government girls’ high schools in Bhubaneswar, the capital city of the state of Odisha, India. For the selection of study participants, adolescent girls who were studying in the ninth and tenth standards were recruited from each school. Eight schools were randomized through restrictive randomization at a 1:1 ratio, with four schools each in the intervention and control arm. Baseline and end-line assessments were done using a pre-tested, semi-structured questionnaire. Following baseline assessment, an intervention was given with the help of handbooks developed by the study authors to the schools in the intervention arm. Outcomes included change in knowledge, attitude and practices pertaining to SRH.ResultsIn our study at baseline, there were a total of 790 students, where 469 (59.4%) students were in the intervention arm, and 321 (40.6%) students were in the control arm. At baseline, only 282 (60.1%) in the intervention arm and 171 (53.3%) in the control arm were aware that physical bodily changes due to puberty were normal. After the intervention, there was a statistically significant increase in knowledge in intervention group 367 (94.8%) (p-value < 0.001). Most students used sanitary pads as absorbent, 97.2% in the intervention group and 98.4% in the control group. However, after the intervention, the use of other absorbents reduced to zero in the intervention group with a statistically significant difference (p < 0.05). The number of students having awareness on different methods of contraception increased from 51 (10.9%) to 337 (87.1%) in the intervention arm (p < 0.001), and of those having awareness on STIs/RTIs increased from 177 (38.2%) to 371 (96.1%) in the intervention group (p < 0.001).ConclusionFrom our study, there is a significant proportional change in knowledge, attitude, and practices pertaining to SRH. Our study recommends policymakers and program managers for the implementation of comprehensive SRH in the regular school curriculum.Trial registration CTRI/2021/01/030490, registered on January 15, 2021. Prospectively registered at https://ctri.nic.in/Clinicaltrials/login.php

Through Their Eyes: Youth Perspectives on Sexual and Reproductive Health Barriers and Facilitators in Baltimore, Maryland

PurposeYouth face barriers to sexual and reproductive health (SRH). Few states require the delivery of comprehensive sex education in schools, and youth report challenges with accessing clinical care. We sought to identify youth's perceived barriers and facilitators to SRH in their communities. MethodsWe utilized photovoice, a community-based participatory research methodology. Youth were recruited from high schools in Baltimore, Maryland. Participants were given a tutorial on Photovoice methodology and photography. In groups of 5–7 participants, youth brainstormed questions relevant to their perspective of SRH. Three months were allocated to taking photographs. Participants wrote brief narratives to accompany their photographs, and group level assessment was used for participants to comment on others' photographs. Participants discussed the narratives and comments, created themes, and generated action steps to address barriers to SRH. Further thematic analysis was conducted using NVivo. ResultsThere were 30 participants aged 14–19 years with 26 self-identifying as female and four nonbinary. Self-identified race/ethnicity included 50% Black/African American, 30% Asian American, and 20% White or Hispanic/Latino. Four domains emerged: desire for societal-level change, community-level change, peer-level change, and positive examples of SRH within their communities (e.g., gender-inclusive spaces and free menstrual products). DiscussionYouth photographs shed light on a strong desire for an improved school environment, in terms of safety, cleanliness, gender-inclusivity, menstrual product access, and SRH education.