Sexual And Reproductive Health Issues Research Articles

Application of community dialogue approach to prevent adolescent pregnancy, early marriage and school dropout in Zambia: a case study

BackgroundAdolescent pregnancy carries both health and economic risks for the pregnant girl and resulting baby, and it is common in Zambia. Providing alternative methods of preventing early pregnancy than abstinence is regarded as culturally and religiously unacceptable in most parts of the country. The community dialogue approach is being tested to address norms and beliefs around early pregnancy, marriage and school dropout, and is based on Paulo Freire’s transformative communication approach. The objective of this paper was to understand parents’ perspectives on the application of the community dialogue approach in addressing adolescents’ early pregnancy and school dropout in a cluster randomized controlled trial in rural Zambia.Methods/designThis was a case study design. We nested the study in the community dialogue intervention arm of the Research Initiative to Support the Empowerment of Girls trial in Zambia. Dialogue meetings were held and economic support was provided for a period of 27 months from September 2016 until November 2018. We held focus group discussions in November 2018 with guardians/parents in six schools in Chibombo District of Central Province. All the discussions were audio recorded and transcribed verbatim. Thematic analysis was used to analyze the data.ResultsThe guardians/parents perceived the community dialogue to be a relevant approach for addressing social and cultural norms regarding early pregnancy, marriage and school dropout. It was embraced for its value in initiating individual and collective change. The facilitators’ interactive approach and dialogue in the community meetings coupled with the use of films and role plays with the parents, lead to active participation and open discussions about sexual and reproductive health (SRH) topics during the community dialogue meetings. Group interactions and sharing of experiences helped parents clarify their SRH values and subsequently made them feel able to communicate about SRH issues with their children. However, cultural and religious beliefs among the parents regarding some topics, like the use of condoms and contraceptives, complicated the delivery of reproductive health messages from the parents to their children.ConclusionThe study indicated that the community dialogue was appreciated by the parents and helped in addressing cultural barriers to discussing SRH issues between generations.

Telehealth for sexual and reproductive health issues: a qualitative study of experiences of accessing care during COVID-19.

Medicare, the health insurance system underpinning free healthcare in Australia, introduced free telehealth items in 2020 in response to the coronavirus disease 2019 (COVID-19) pandemic. Their uptake among healthcare providers was significant, including among general practitioners and sexual health services. Here, we report people's experiences of accessing sexual and reproductive health (SRH)-related care via telehealth collected as part of a survey exploring the impact of COVID on SRH health. This study utilises qualitative data from two online surveys conducted in 2020. Surveys were advertised through social media and professional and personal networks. Anyone aged≥18years and living in Australia was eligible to participate. Respondents were asked whether they accessed care for their SRH via telehealth. A free-text question asking for further detail about their experience was analysed using content analysis. A total of 114/1070 respondents (10.7%) accessed healthcare services via telehealth for SRH-related reasons within the previous 4weeks. Three themes were identified from 78 free-text comments: (1) accessibility and convenience of telehealth; (2) appropriateness of telehealth for SRH issues; and (3) connecting and communicating with clinicians via telehealth. Respondents had a wide range of experiences. Telehealth improved access to services for some participants, and it was appropriate for some, but not all SRH issues. Difficulties connecting with clinicians on both an interpersonal and technical level was a key barrier to a satisfactory patient experience. Telehealth can offer a viable alternative to face-to-face care, providing patients can overcome key connection and communication barriers.

‘I can't go to her when I have a problem’: sexuality communication between South African adolescent girls and young women and their mothers

ABSTRACT Parent–adolescent sexuality communication, the process in which parents and their adolescent children discuss sexuality and sexual and reproductive health, is a key component for adolescents’ protective behaviours. Open communication with parents, particularly mothers, enables informed sexual and reproductive health (SRH) decision-making amongst adolescent girls and young women (AGYW). As part of a qualitative study evaluating a South African combination HIV prevention intervention for AGYW, we explored perspectives on SRH communication among AGYW and mothers of AGYW, and the effects of the intervention on sexuality communication as perceived by AGYW, mothers of AGYW, intervention facilitators and implementers, and community leaders. In-depth interviews and focus group discussions were conducted with 185 AGYW aged 15–24 years who had participated in the intervention, seven mothers of AGYW intervention recipients, 14 intervention facilitators, six community leaders, and 12 intervention implementers. Key themes that emerged in analysis were (1) Barriers to Sexuality communication, (2) Implications of Gaps in Sexuality Communication, and (3) Addressing Barriers to Sexuality communication. Barriers to sexuality communication included inability or unwillingness to discuss sex, a generation gap, proscriptive socio-cultural guidelines, and mothers’ discomfort, lack of knowledge and self-efficacy, and fear of encouraging promiscuity. AGYW described making poorly-informed SRH decisions alone, expressing a desire for more open communication with and support from parents/mothers. Framed within the social cognitive theory, these findings can help to guide efforts to address barriers around parent–adolescent sexuality communication, inform interventions aimed at targeting SRH issues amongst AGYW, such as unintended pregnancy and HIV, and support meaningful engagement of parents in supporting AGYW in navigating pathways to achieving their SRH goals.

The Trends and Experiences of Sexual and Reproductive Health among Late Female Adolescents in Bangladesh

Adolescence period is a very important transitional stage of human develoment as in this period a human being undergoes some major physical, emotional and social changes. Bangladesh has an adolescent population consisting one fifth of the total population. Among them almost half of them are girls. Among the adolescent girls who belong to the late adolescent age group are in the most exposed and disadvantaged situation in the context of Sexual and Reproductive Health (SRH) of Bangladesh. Therefore, the aim of this article is to concentrate on the SRH of adlescents girls (15-19 years) with an aim to reveal the trends and experieces of SRH among this group and some major challenges so that female adolescent SRH issues can receive proper attention in the policy making level.

Exploring Family Planning, Parenting, and Sexual and Reproductive Health Care Experiences of Men With Rheumatic Diseases.

To explore family planning, parenting, and sexual and reproductive health (SRH) care needs and experiences of men with rheumatic diseases. Men aged 18-45 years who were diagnosed with at least 1 rheumatic disease and used at least 1 antirheumatic drug were recruited from rheumatology clinics. Research coordinators engaged participants in semistructured phone interviews. A codebook was developed based on the interview transcripts and used to conduct an inductive thematic analysis. Participants ranged in age from 22 to 44 years (n = 20). Most were heterosexual and had at least 1 child. The most common disease diagnoses were spondyloarthritis, systemic lupus erythematosus, and rheumatoid arthritis. Four themes emerged from the interviews: (1) Men had family planning concerns, particularly related to the heritability of their diseases, their fertility, and potential effects of their medications on their offspring's health. (2) Men felt that fatigue, disability, and/or pain from their diseases either impaired or would impair their abilities to parent. (3) Men often did not discuss sexual dysfunction with their rheumatologists, even when they believed that it arose from their diseases or antirheumatic drugs. (4) Men rarely discussed any family planning, parenting, or SRH issues with their rheumatologists; gender discordance with rheumatologists did not affect men's comfort in discussing these issues. Men expressed concerns related to family planning, parenting, and SRH, which they rarely discussed with their rheumatologists. Our study suggests that some men's SRH information needs are incompletely addressed in the rheumatology clinical setting.

An analysis of Knowledge of Sexual and Reproductive Health among Adolescents and Young persons Living with HIV: The case of Chitungwiza, Harare, Zimbabwe

It has been decades into the HIV pandemic, the position of the disease has advanced significantly from death sentence to a chronically manageable disease that can be lived with for long time. This evolution was made possible with the advent of antiretroviral therapy which allowed HIV infected children to reach adulthood. However, sexual, and reproductive needs of these generations remain unattended in many countries. The study sought to highlight the sexual and reproductive health issues affecting young people living with HIV in Chitungwiza and Waterfalls communities, targeting HIV positive young people aged 15-24 years. A mixed methods approach was adopted in which, Qualitative and Quantitative research methods were employed. A survey was conducted with 113 young people to quantify sexual and reproductive health issues affecting young people living with HIV (YPLWH). To solicitate community perceptions and opinions on childbearing among the Adolescents and Young persons living with HIV, 8 focus group discussions and key informant interviews were conducted to qualify the data from the survey. The findings indicated that sexual and reproductive health (SRH) knowledge heavily impacts YPLWH’. Socio-cultural barriers are major inhibiting factors limiting YPLWH. The study recommends that academic research, NGOs, and other stakeholders with support from the Ministry of Health, should conduct more studies on emerging HIV and SRH issues which will help in addressing knowledge gaps and provide evidence-based knowledge in public health. Overall, this will improve the reproductive health outcomes of young people living with HIV.

Visualizing patterns and gaps in transgender sexual and reproductive health: A bibliometric and content analysis of literature (1990–2020)

Background Transgender people face numerous obstacles to accessing adequate, affordable, and appropriate sexual and reproductive health (SRH) services as outlined by the UN’s Sustainable Development Goal 3.7 target of achieving universal access to SRH services by 2030. However, transgender SRH sits as a poorly researched area within public health that makes it difficult to understand the current dilemmas facing transgender SRH. This article reports the findings of a study aimed at taking stock of global research in transgender SRH. Methods A bibliometric analysis, used to gain insights from the retrieved literature’s metadata, alongside a content analysis were utilized to examine the growth, impact, and content of retrieved articles. Results Nine hundred fourteen journal articles were retrieved, predominately in English (884; 96.7%). These involved 3653 authors from 46 affiliated countries. Most frequent keywords included HIV, PrEP, and gender identity; corresponding to the SRH issues studied, namely HIV/AIDs and gender reassignment. Top cited and overall articles originated heavily from US affiliated authors. Content analysis outlined the articles’ inclusion of the transgender community to largely have a mixed focus with cisgender people in research, these articles largely disease-focused and conducted within cities in the United States. Conclusions Growth in transgender SRH research was minimal until the early-2010s, after which a steep rise can be observed. Research retrieved has a disproportionate clinical and biomedical focus around HIV and related STI issues suggesting a failure to engage with reproductive justice and more comprehensive rights-based understanding of SRH. The sustained use of derogative language suggests a need for greater inclusion and awareness of trans identities within research and publishing. The dominance of the United States in authorship and as a site of research establishes the need for more geographically diverse research, trans, and LMIC-led research enquiry and creating greater opportunities for cross-cultural, comparative, and collaborative scholarly work.

A Cross-Sectional Quantitative Study on Sexual and Reproductive Health Knowledge and Access to Services of Arab and Kurdish Syrian Refugee Young Women Living in an Urban Setting in Lebanon.

Since data on the sexual and reproductive health (SRH) of young refugee women living in urban settings in Lebanon are particularly scarce, we aim through this exploratory study to assess the SRH knowledge and access to services of Arab and Kurdish Syrian refugee young women living in Bourj Hammoud. From January to March 2020, a cross-sectional survey was conducted among 297 Syrian Arab and Kurdish participants and aged 18–30 years old. It was found that participants coming from Syrian urban areas or who completed an education above secondary level have higher overall knowledge on SRH issues. Only a total of 148 out of the 297 participants (49.8%) knew a health facility in Bourj Hammoud that provides SRH services and among them 36.4% did not know which type of services are available there. The Syrian refugee young women’s access to SRH services is inadequate due to different obstacles. The overall knowledge level on different SRH topics is limited. The context of multiple crises in Lebanon should be taken into consideration when delivering future SRH services.

A neglected population: Sexual and reproductive issues among adolescent and young Venezuelan migrant women at the northwestern border of Brazil.

Adolescent and young women (10-24years old) are a neglected group in humanitarian settings and their sexual and reproductive health (SRH) needs are habitually ignored. Our study aims to assess main SRH issues affecting migrant Venezuelan adolescents and young women in Boa Vista, Roraima at the northwestern border of Venezuela-Brazil. A cross-sectional study with a self-responded questionnaire with information about SRH was conducted in 153Venezuelan adolescent and young migrant women at Boa Vista, from January 18 to 23, 2021. A descriptive analysis was performed. Mean age was 17.7years and two-thirds were under 20years old. The majority (84%) were living on the streets. Most of them (54%) reported that they had at least one previous childbirth, 10% were pregnant at the time of the interview, 30% of them were not attending prenatal care. The main SRH concern was contraception (35%); however, 75% of those interviewed who went to a healthcare service were unable to obtain the method of their choice and for 91% no other contraceptive was offered. Migrant Venezuelan adolescents and young women in Boa Vista have their SRH needs overlooked. Efforts to address these SRH needs, especially during the pandemic, require urgent attention.

COVID-19 and Sexual and Reproductive Health Care: Findings From Primary Care Providers Who Serve Adolescents

PurposeAmong U.S. primary care physicians who delivered sexual and reproductive health (SRH) services to adolescents before the COVID-19 pandemic, we examine (1) changes in availability of in-person SRH services; (2) changes in accessibility and utilization of SRH services; and (3) use of strategies to support provision of SRH services during the pandemic. MethodsData were from the DocStyles provider survey administered September–October 2020. Descriptive analyses were restricted to family practitioners, internists, and pediatricians whose main work setting was outpatient and whose practice provided family planning or sexually transmitted infection services to ≥ one patient aged 15–19 years per week just before the COVID-19 pandemic (n = 791). ResultsAmong physicians whose practices provided intrauterine device/implant placement/removal or clinic-based sexually transmitted infection testing before the COVID-19 pandemic, 51% and 36% indicated disruption of these services during the pandemic, respectively. Some physicians also reported reductions in walk-in hours (38%), evening/weekend hours (31%), and adolescents seeking care (43%) in the past month. At any point during the pandemic, 61% provided contraception initiation/continuation and 44% provided sexually transmitted infection services via telehealth. Among these physicians, about one-quarter reported confidentiality concerns with telehealth in the past month. There were small increases or no changes in other strategies to support contraceptive care. ConclusionsFindings suggest disruption of certain SRH services and issues with access because of the pandemic among primary care providers who serve adolescents. There are opportunities to enhance implementation of confidential telehealth services and other service delivery strategies that could help promote adolescent SRH in the United States.

Sexual and reproductive health of Syrian refugee adolescent girls: a qualitative study using focus group discussions in an urban setting in Lebanon

BackgroundThe war in Syria caused the forced displacement of millions of Syrians to neighboring countries. Lebanon is the host country with the largest overall number of Syrian refugees per capita. Adolescent refugee girls experience a unique level of vulnerability during human emergencies and are at increased risk of suffering from poor sexual and reproductive health (SRH) outcomes. We conducted an exploratory qualitative study to learn about the SRH perceptions and experiences of refugee adolescent girls living in Bourj Hammoud, an urban setting in Lebanon.MethodsWe employed a qualitative design with eight focus group discussions (FGDs) conducted with 40 Syrian Arab and Syrian Kurdish adolescent girls between January and March 2020. Every FGD consisted of five participants aged 13 to 17 years. A semi-structured guide was used covering multiple themes: menstruation, puberty, SRH awareness, and sexual harassment. FGDs were transcribed and analyzed using thematic analysis.FindingsThe participants discussed adolescent girls’ health and named six elements of good health, such as healthy activities and self-protection. The majority of the FGD participants reported a lack of awareness about menstruation when they experienced it for the first time and the social stigma associated with menstruation. When defining puberty, they indicated its social link to a girl’s readiness for marriage and her need to become cautious about sexual harassment. Most FGD participants had very poor knowledge of the female reproductive system. Mothers were the most approached persons to receive information on SRH issues; however, the girls indicated a wish to receive advice from specialists in a comfortable and private atmosphere. All the girls reported that either they themselves, or an acquaintance, had experienced some type of sexual harassment. The girls rarely reported those incidents due to fear of being blamed or subjected to mobility restrictions, or forced to drop out of school.ConclusionsThe findings show the refugee girls need for satisfactory knowledge on SRH issues and interventions to prevent sexual and gender-based violence that take into consideration the complexity of urban settings.

Sexual and reproductive health information and referrals for resettled refugee women: A survey of resettlement agencies in the United States.

BackgroundRefugee resettlement offices are the first point of contact for newly arrived refugees and play a significant role in helping refugees acclimate and settle into life in the United States. Available literature suggests that refugee women are vulnerable to poor sexual and reproductive health (SRH) outcomes, including sexually transmitted infections and HIV infections as well as adverse pregnancy outcomes, but little is known about the role that refugee resettlement offices play in supporting refugee women’s SRH. This study examines the capacity and interest of resettlement offices in providing SRH information and referrals to newly arrived refugees.Methods and findingsThe research team conducted an online survey of staff members at refugee resettlement offices throughout the US in 2018 to determine (1) available SRH resources and workshops; (2) referrals to and assistance with making appointments for SRH and primary care appointments; (3) barriers to addressing SRH needs of clients; and (4) interest in building the capacity of office staff to address SRH issues. The survey was created for this study and had not been previously used or validated. Survey data underwent descriptive analysis. A total of 236 resettlement offices were contacted, with responses from 100 offices, for a total response rate of 42%. Fifteen percent (N = 15) of refugee resettlement agencies (RRAs) who responded to the survey provide materials about SRH to clients, and 49% (N = 49) incorporate sexual health into the classes they provide to newly arrived refugee clients. Moreover, 12% (N = 12) of responding RRAs screen clients for pregnancy intention, and 20% (N = 20) directly refer to contraceptive care and services. This study is limited by the response rate of the survey; no conclusions can be drawn about those offices that did not respond. In addition, the survey instrument was not validated against any other sources of information about the practices of refugee resettlement offices.ConclusionsIn this study, we observed that many resettlement offices do not routinely provide information or referrals for SRH needs. Responding offices cite lack of time and competing priorities as major barriers to providing SRH education and referrals to clients.

Disparities in Sexual and Reproductive Health Service Utilization and Associated Factors among Adolescents with and without Disability in Southern Ethiopia

Background. 1 in 4 people in Ethiopia are adolescents, and around 1% of them are affected by one form of disability. However, there is little knowledge about factors affecting sexual and reproductive health service utilization to the adolescent with or without disabilities. This study aimed to assess the disparities of sexual and reproductive health (SRH) service utilization and factor associated among adolescents with or without disabilities in southern Ethiopia. Methods. Institutional-based cross-sectional study was conducted among 422 adolescents (211 with disabilities and 211 without disabilities). Multistage sampling was conducted. Data were collected by four diploma health workers, and one of the data collectors could communicate with sign languages. Multivariable logistic regression was used to identify sociodemographic factors associated with outcome variables. Result. The SRH utilization among students with and without disabilities was 40.52% and 69.1%, respectively. Having an open discussion with peers (AOR = 2.5; 95% CI: 1.60–3.94), having good knowledge (AOR = 1.9; 95% CI: 1.21–3.09), and participating in a school club (AOR = 1.9; 95% CI: 1.19–3.19) were factors positively associated with SRH services utilization. Conclusion. The overall SRH utilization was found to be low for students both with and without disabilities. Variables like having good knowledge, ever having discussions on SRH issues with peers, and participating in school clubs were found to be significantly associated. Therefore, governmental and NGOs should strengthen their SRH friendly service with a special focus on peer discussion and awareness creations.

Health care professionals\u2019 attitudes towards youth-friendly sexual and reproductive health services in Jordan: a cross-sectional study of physicians, midwives and nurses

BackgroundYouth-friendly sexual and reproductive health (SRH) services are thought to make such services for adolescents more accessible and acceptable; however, provider attitudes may still present an important barrier. Improving youth SRH service utilization has been recognized as a national priority in Jordan; however, existing services remain underutilized. Previous studies found that youth perceive SRH services to be inadequate and that providers are not supportive of their needs. The purpose of this study is measure provider attitudes towards youth-friendly SRH services and explore their variation according to individual characteristics among health care professionals in Jordan.MethodsWe measured provider attitudes towards youth-friendly SRH services using a scale that was developed and validated in Jordan. The scale consists of three subscales: (1) Attitudes towards SRH information and services offered to youth, (2) Norms and personal beliefs, and (3) Attitudes towards the policy and clinical environment. Possible scores range between 1 and 4, with higher scores reflecting more youth-friendly attitudes. Physicians, midwives and nurses working at either primary health centers, comprehensive care centers, or women’s and children’s health centers where services to adolescents are or should be offered were recruited from four governorates in Jordan using a two-stage, cluster sampling scheme. Differences in attitudes were assessed using simple and multivariable linear regression analysis.ResultsThe sample consisted of 510 providers from four governorates in Jordan. The mean provider score on the full scale was 2.7, with a range of 2.0 to 3.8. On Subscales 1 and 2, physicians exhibited significantly more youth-friendly attitudes than nurses by scoring 0.17 points higher than nurses on Subscale 1 (95% CI: 0.02–0.32; p < 0.05) in adjusted analyses. Providers who had been previously trained in SRH issues scored 0.10 points higher (95% CI: 0.00—0.20; p < 0.05) than those who had not on Subscale 3. No differences were found according to provider characteristics on Subscale 2. Providers exhibited the lowest scores related to items referencing youth sexual behavior.ConclusionsProvider attitudes towards youth-friendly SRH service delivery highlight context-specific, cultural concerns. The limited variation in attitudes related to norms and personal beliefs may be a reflection that such beliefs are deeply held across Jordanian society. Last, as past training on SRH was significantly associated with higher scores, our results suggest opportunity for intervention to improve providers’ confidence and knowledge.

Factors Associated With Parent-Adolescent Communication on Sexual and Reproductive Health Issues in Urban Slums of Ibadan, Southwest Nigeria.

In Nigeria, adolescents in urban slums are increasingly at risk of adverse sexual and reproductive health (SRH) outcomes. However, little is known about how individual factors predict parent-adolescent communication on SRH issues in a resource-poor urban setting in Ibadan. Thus, this study investigated individual factors associated with parent-adolescent communication on SRH issues in urban slums of Ibadan, southwest, Nigeria. This study is part of a larger project that explores the socio-ecological factors influencing parent-adolescent communication on SRH issues in selected slums in Ibadan, Nigeria. Within this broader framework, this paper relies on the quantitative data obtained in 10 selected slums. Interviewer-administered structured questionnaire [scripted on open data kits (ODK)] was utilized to collect data from a sample of 796 parent-adolescent dyads. Six SRH topics were investigated to describe the issues discussed. Analytical techniques utilized include; frequency counts, chi-square, and multinomial logistic regression. Parent-adolescent communication regarding SRH issues is not uncommon in urban slums of Ibadan but characterized by indirect communication, threat and warning. Parents and adolescents' age, gender, marital/relationship status, educational attainments and religion played influential role in parent-adolescent communication regarding SRH issues. These factors were identified to be significantly associated with the pattern of parent-adolescent discussion of SRH issues. Age-specific SRH education should be available to adolescents and parents need to be educated on appropriate SRH information and the best way to engage their adolescents on SRH issues.

Adolescents' Communication on Sexual and Reproductive Health Matters with Their Parents and Associated Factors among Secondary and Preparatory School Students in Ambo Town, Oromia, Ethiopia.

Background Sexual and reproductive health (SRH) communication is most likely to promote healthy sexual practices and to reduce risky sexual behavior among adolescents. Communication is the principal means for parents to transmit sexual values and knowledge to their children. Although there are few studies conducted on parent-adolescent communication, there is no study conducted in the town of Ambo. This study was aimed at assessing the level of parent-adolescent communication on SRH issues and its associated factors among school students in Ambo town, Oromia, Ethiopia. Method An institution-based concurrent mixed-method cross-sectional study was conducted among 591 secondary and preparatory school students in Ambo town from February 24th to March 9th, 2019. A systematic sampling technique was used to select the study subject. Data were collected through self-administered questionnaires, and FGD was conducted with parents of students. Data was entered using EpiData version 3.1 and exported to SPSS version 23.0 for statistical analysis. Binary and multivariable logistic regression analyses were used to ascertain the association using a 95% confidence interval (CI) and p value (<0.05). Results The proportion of students who had communication on sexual and reproductive health issues with their parents was 222 (37.6%). Being female (AOR = 2.07, 95% CI: 1.40-3.07), private school (AOR = 2.77, 95% CI: 1.17-3.69), a father with secondary education (AOR = 2.93, 95% CI: 1.05-8.12) and diploma and above (AOR = 3.27, 95% CI: 1.23-8.71), considering sex education necessary (AOR = 2.83, 95% CI: 1.22-6.57), got information about SRH issues from school (AOR = 2.01, 95% CI: 1.06-2.36) and media (AOR = 2.92, 95% CI: 1.49-3.71), and mother's openness to communicate about SRH issues (AOR = 3.30, 95% CI: 1.31-4.05) were found to be significantly associated with parent-adolescent communication on SRH issues. Conclusions The study showed that parent-adolescent communication on SRH issues is low. Being female, those from a private school, father's education, perceived importance of sex education, source of information about SRH issues (school and media), and mother's openness to communicate about SRH issues were identified to be factors associated with the communication. Therefore, the concerned body should consider the identified factors to improve the current level of parent-adolescent communication and adolescent reproductive health.

Parent-adolescent communication on sexual and reproductive health and the utilization of adolescent-friendly health services in Kailali, Nepal.

BackgroundAdolescents are vulnerable to various sexual and reproductive health (SRH) problems such as unintended pregnancy, HIV or other sexually transmitted infections (STIs), and unsafe abortion. Adolescent-friendly health services offer SRH services such as SRH counseling, contraceptive services, STI and HIV services, and abortion-related services, which may help prevent these risks. Parent–adolescent communication about SRH prevents adolescents from adopting unhealthy SRH practices. However, its association with the utilization of SRH services is less known. Therefore, this study examined the association between parent–adolescent communication on SRH issues and the utilization of adolescent-friendly health services in Nepal.MethodsThis was a school-based, cross-sectional study conducted in Kailali district, Nepal, among students aged 15–19 years in Grade 11 and 12 from seven schools. We used multivariable logistic regression analysis to examine the association between parent–adolescent communication and service utilization.ResultsWe analyzed the data from 594 students. Students with a higher score of parent–adolescent communication on SRH were significantly more likely to use adolescent-friendly health services (adjusted odds ratio, AOR: 1.70, 95% Confidence Interval, CI: 1.29–2.23, p<0.001). Those who reported having engaged in sexual intercourse in the past year were more likely to use services than those who did not (AOR: 29.11, 95% CI: 13.65–62.08, p<0.001). Those who belonged to the Janajati ethnic group were more likely to use these services than those from the Brahmin/Chhetri ethnic group (AOR: 2.86, 95% CI: 1.28–6.42, p = 0.01). Those living alone were less likely to use services than those living with both parents (AOR: 0.12, 95% CI: 0.02–0.66, p = 0.01).ConclusionStudents with a higher score on parent–adolescent communication on SRH were more likely to use adolescent-friendly health services. Thus, parental involvement in SRH communication could contribute to the use of adolescent-friendly health services and ultimately prevent negative SRH outcomes among students in late adolescence.

The Role of Culture and Religion on Sexual and Reproductive Health Indicators and Help-Seeking Attitudes amongst 1.5 Generation Migrants in Australia: A Quantitative Pilot Study.

In Australia, 1.5 generation migrants (those who migrated as children) often enter a new cultural and religious environment, with its own set of constructs of sexual and reproductive health (SRH), at a crucial time in their psychosexual development—puberty/adolescence. Therefore, 1.5 generation migrants may thus have to contend with constructions of SRH from at least two cultures which may be at conflict on the matter. This study was designed to investigate the role of culture and religion on sexual and reproductive health indicators and help-seeking amongst 1.5 generation migrants. An online survey was completed by 111 participants who answered questions about their cultural connectedness, religion, sexual and reproductive health and help-seeking. Kruskall-Wallis tests were used to analyse the data. There was no significant difference between ethnocultural groups or levels of cultural connectedness in relation to sexual and reproductive health help-seeking attitudes. The results do suggest differences between religious groups in regard to seeking help specifically from participants’ parents. Notably, participants who reported having ‘no religion’ were more likely to seek help with sexual and reproductive health matters from their parent(s). Managing cross-cultural experiences is often noted in the extant literature as a barrier to sexual and reproductive health help-seeking. However, while cultural norms of migrants’ country of origin can remain strong, it is religion that seems to have more of an impact on how 1.5 generation migrants seek help for SRH issues. The findings suggest that 1.5 generation migrants may not need to adapt their religious beliefs or practices, despite entering a new ethnocultural environment. Given that religion can play a role in the participants’ sexual and reproductive health, religious organizations are well-placed to encourage young migrants to adopt help-seeking attitudes.

Prevalence and Determinants of the Utilization of Sexual and Reproductive Health Services in the Teen Health Kiosk of a Public Secondary School in the City of Dasmariñas

Objective. Despite the provision of local health policies promoting the utilization of sexual and reproductive health (SRH) services of adolescents, SRH services utilization remains very low and little information is known concerning the factors which may influence adolescents’ use of these SRH services. This study aimed to determine the prevalence and determinants of school-based SRH services utilization among secondary school students. Materials and Methods. This is a cross-sectional study that used a self-administered questionnaire to gather data among students in one public secondary school in the City of Dasmarinas. A total of 24 sections from Grades 8 to 12 were randomly selected using stratified cluster sampling. Both descriptive and inferential statistics were used to analyze the data using Epi Info version 7.3.2.1. Results. Among 1,218 students who answered the questionnaire, 168 students (13.8%) utilized the SRH services in the Teen Health Kiosk (THK) during SY 2019-20. Students with favorable attitudes towards SRH issues (predisposing factor) were twice more likely to utilize the SRH services (Adjusted odds ratio, AOR 1.75, 95% CI 1.12–2.74) and those who have positive perceived accessibility on the SRH services (enabling factor) were 2.5 times more likely to utilize the SRH services (AOR 2.46, 95% CI 1.66 – 3.66). Conclusion. Attitudes towards SRH issues and perceived accessibility to SRH services were found to be determinants of SRH services utilization in the THK of the selected public secondary school in the City of Dasmarinas. Even with the marked increase in the utilization of SRH services in the THK from 0.2% in SY 2018–19 to 13.8% in SY 2019–20, intensified efforts are still needed in order to target students’ attitudes on SRH and accessibility of THK and the SRH services it offers to its clients. It is recommended that the existing THK Club be strengthened as this will play a significant role in changing the attitudes of students towards SRH issues, thus increasing the utilization of SRH services. Additionally, formulating an SRH policy at the school level targeting THK’s accessibility will be helpful in increasing the utilization of school-based SRH services. For one, a policy mandating THK service providers to deliver services beyond school hours may be discussed such that it can also cater students who are attending the school during weekends (i.e. ALS students, Open High students). Likewise, policy makers in the City Schools Division Office including their top management and personnel from the Health and Nutrition Unit as well as school administrators must endeavor to provide a more conducive THK where privacy and confidentiality can be maintained at all times and clients can freely discuss SRH issues with the THK service provider. An initiative to provide a separately detached room for the THK is encouraged in order to provide a more suitable counselling area and to ensure privacy and confidentiality of student clients and their shared information.

Pregnancy and childbearing among Adolescents and Young Persons Living with HIV: The Case of Chitungwiza, Harare

It is almost four decade into the HIV pandemic, the outlook of the disease has advanced significantly from death sentence to a chronically manageable disease that can be lived with for long time. This evolution was made possible with the advent of antiretroviral therapy which allowed HIV infected children to reach adulthood. However, sexual, and reproductive needs of these generations remain unattended in many countries. The study sought to highlight the sexual and reproductive health issues affecting young people living with HIV in Chitungwiza and Waterfalls communities, targeting HIV positive young people aged 15-24 years. A mixed methods approach was adopted in which, Qualitative and Quantitative research methods were employed. A survey was conducted with 113 young people to quantify sexual and reproductive health issues affecting young people living with HIV (YPLWH). To solicitate community perceptions and opinions on childbearing among the Adolescents and Young persons living with HIV, 8 focus group discussions and key informant interviews were conducted to qualify the data from the survey. The findings indicated that sexual and reproductive health (SRH) knowledge heavily impacts YPLWH’ decision to have children. The sources of information may also affect decisions made by YPLWH. Socio-cultural barriers are major inhibiting factors limiting YPLWH and it was also observed that sero-status disclosure has direct impact on decision for condom use. The study recommends that academic research, NGOs, and other stakeholders with support from the Ministry of Health, should conduct more studies on emerging HIV and SRH issues which will help in addressing knowledge gaps and provide evidence-based knowledge in public health. Overall, this will improve the reproductive health outcomes of young people living with HIV.