Sexual And Reproductive Health Literacy Research Articles

Exploring Barriers to Accessing Adolescents Sexual and Reproductive Health Services in South Ethiopia Regional State: A Phenomenological Study Using Levesque's Framework.

Evidence suggests that adolescents face multiple barriers to accessing Sexual and Reproductive Health (SRH) services. However, there remains a notable gap in the literature regarding the nuanced interplay between supply-side and demand-side barriers. Therefore, this study aimed to examine barriers to accessing SRH services in the Gamo Zone of South Ethiopia Regional State. A descriptive phenomenology study was conducted from September 04 to October 15, 2023. A total of seven Focus Group Discussions (FGDs), four with girls and three with boys, with a total of 75 adolescents, and ten Key informant interviews (KIIs)with healthcare providers participated in the study. A semi-structured interview guide was used to explore their lived experiences. All interviews and discussions were audio-recorded. To analyze and manage data framework analysis approach was applied using ATLAS Ti version 7 software. The major barriers preventing adolescents from accessing SRH services are related to the interplay between supply and demand-side barriers across all five domains of the Levesque framework. Despite the high need for access to health care, lack of SRH literacy, lack of outreach activities, and integration of SRH information in health facilities often hampered adolescents' healthcare need. Additionally, fear of stigma from family and community, social norms, and lack of discussion of SRH issues hindered their ability to seek health care. Shortage of supplies and healthcare providers' behaviors further hindering adolescents' ability to access health care services. Furthermore, the limited involvement of adolescents in decision-making and the lack of effective coordination further complicate the appropriateness of services for adolescents. The finding of this study reveals that adolescents face multifaceted barriers. Therefore, there is a need for high-impact complex interventions, program and policy that address both supply and demand side barriers needs to give due intention to improve access to SRH services for adolescents.

Prevalence and factors associated with sexual and reproductive health literacy among youth living with HIV in Uganda: a cross-sectional study

BackgroundAdequate sexual and reproductive health literacy (SRHL) among young people has been linked to informed sexual behaviours. Studies on SRHL have largely been conducted among the general adolescent population. Little is known about youth aged 15-24 years living with human immunodeficiency virus (YLHIV). There is a possible lack of SRHL in this population, considering the high rate of teenage pregnancies and unprotected sex reported by YLHIV. This study aimed to assess the prevalence and associated personal and environmental factors for SRHL among YLHIV at a high-volume urban HIV Clinic in Uganda.MethodsThrough a cross-sectional survey, YLHIV receiving routine HIV care services at Baylor-Uganda HIV Clinic were interviewed using an adapted European Health Literacy Survey (HLS-EU). Using simple random sampling, eligible youth who received HIV care services between August and November 2019 were enrolled in the study. SRHL scores were computed using the HLS-EU index method; and individuals whose scores ranged from 34 to 50 were considered health literate. We used descriptive statistics to determine the prevalence. Potential associated personal and environmental factors (p<0.05) were identified by performing two-step inferential statistics, bivariate analysis and binary logistic regression. Odds ratios were calculated to estimate the likelihood of youth being health literate on sexual and reproductive health (SRH) issues in comparison with the reference categories, and 95% confidence intervals were determined to establish whether the relationships were statistically significant.ResultsOf the 267 YLHIV interviewed at Baylor-Uganda HIV Clinic, 167 (62.5%) were female with a mean age of 18.9 years (SD± 2.8), and the majority (242; 90.6%) were vertically infected with HIV. Only 52 (19.5%) were health literate on SRH issues. At the multivariate level, YLHIV who never had difficulty accessing SRH information were 0.391 times less likely to be health literate on SRH issues than their counterparts with challenges in accessing SRH information (Adjusted Odds Ratio [AOR] = 0.391, 95% CI =0.178 to 0.860; p= 0.019). YLHIV who did not find it easy to access SRH care service points were 2.929 times more likely to be literate in SRH than those who found it easy to access such services (Adjusted Odds Ratio [AOR] = 2.929, 95% CI =1.241 to 6.917; p=0.014). Additionally, YLHIV who did not listen to radio health talks were 2.406 times more likely to be health literate on SRH issues than those who did (AOR = 2.406, 95% CI =1.133 to 5.112; p=0.022).ConclusionsSRHL is an unmet need among YLHIV; only 19.5% were health literate on SRH issues. This could complicate the achievement of the UNAIDS sustainable development goal (SDG) of an HIV/AIDS-free generation by 2030 because low health literacy (HL) skills can affect the efficacy of almost all HIV disease prevention and health promotion efforts. Inaccessible SRH care service points and not listening to radio health talks were positively associated with SRHL, while having access to SRH information was negatively associated with SRHL.

Student midwives' perspectives of women's sexual and reproductive health literacy in Turkey

ObjectiveThis study focused on the issues surrounding health literacy in the context of women’s sexual and reproductive health (SRH), the significance and availability of information for midwives and women; and the socio-cultural influences and barriers related to women’s level of health literacy. MethodsA cross sectional on-line survey was distributed to 280 student midwives in their 2nd 3rd and 4th year of a midwifery programme. This paper focuses on the responses from 138 students which were analysed using descriptive and non-parametric tests. ResultsStudent midwives indicated their level of agreement regarding women’s ability to access, understand, and appraise information they received verbally and in written form about the six main SRH topics (namely contraception, STIs, abortion, Pap tests and cervical cancer, and fertility and pregnancy), from their midwife but agreement was much lower regarding women’s access to SRH information from peers and their families. False beliefs were ranked as the most common barrier to accessing information and services. Students ranked being a refugee, being from a rural area, being educated to a primary school level or not formally educated, as having the greatest negative impact on women’s health literacy. ConclusionsFindings from this study indicate the role that the sociocultural background of Islamic culture plays in the disparities in sexual and reproductive health literacy (SRHL) for women from the perspective of student midwives. Our findings indicate the need for future research to focus on women as participants to gain their first-hand experiences of SRHL.

Health literacy needs and preferences for a technology-based intervention to improve college students’ sexual and reproductive health

Objective: To explore health literacy needs and preferences for a technology-based intervention (app) to improve sexual and reproductive health (SRH) among college students. Participants: In Spring 2019, in-depth interviews were conducted with 20 participants (10 male, 10 female) from a large, public university. Methods: Interview guide was developed based on Integrated Model of Health Literacy domains and Diffusion of Innovation constructs. Data were analyzed in MaxQDA using applied thematic analysis. Results: Dominant themes included accessing health information and services, evaluating options to make decisions, intervention utility and characteristics, and the emergent theme of credibility. Specific topics included accessing STI testing, contraceptive decision making, information on human papillomavirus (HPV) and the HPV vaccine, patient-provider communication, app design and function elements, and modifying the app to meet the SRH needs of diverse college students. Conclusions: Findings identified areas where an app could address college students’ SRH literacy, ultimately improving SRH outcomes among this population.

Validation of the Questionnaire on Sexual and Reproductive Health Literacy for Adolescents Age 15 to 19 Years in Lao People's Democratic Republic.

Background:Beyond sexual and reproductive health (SRH) knowledge, it is sexual and reproductive health literacy (SRHL) that reflects the capacity to deal with sexuality. Many interventions have been conducted to increase SRH knowledge in adolescents, but SRHL has rarely been measured, and a well-validated tool is needed to measure it. Objective: This study aimed to validate a tool to measure adolescent SRHL.Methods:Reliability, validity, and cultural equivalence were investigated using data from expert consultations, cognitive interviews, and two-pilot studies. Then adaptation was made to the SRHL questionnaire for correct use among Southeast Asian adolescents in Lao and in wider groups.Key Results:The SRHL tool was comprised of 39 question items focusing on teenage pregnancy, contraception, and abortion. Conceptual, item, and semantic equivalence were all met. Interviewer-administrated mode was found to be optimal. Each question offers the answer choices very difficult, difficult, easy, and very easy, with a good to excellent Cronbach's alpha (0.8–0.9); there were no missing items and no floor/ceiling effects. Construct validity was high as 6 of 7 hypotheses were confirmed.Conclusion:Validation was completed with good cross-cultural validity. The tool was shown to be effective in determining the level of SRHL in adolescents in Laos and potentially in other countries with similar cultures. [HLRP: Health Literacy Research and Practice. 2022;6(1):e37–e50.]Plain Language Summary:To find out how much adolescents know about sexual and reproductive health, an appropriate instrument of measurement is needed. Using different methods, we investigated the performance of a new tool, namely the SRHL questionnaire, which has 39 questions and should be used with an interviewer to assist in recording responses. This new tool could be used effectively to determine the level of literacy on sexual and reproductive health among adolescents.

Sexual and Reproductive Health Literacy, Misoprostol Knowledge and Use of Medication Abortion in Lagos State, Nigeria: A Mixed Methods Study

Little is known about the link between health literacy and women's ability to safely and successfully use misoprostol to self‐induce an abortion. While abortion is only allowed to save a woman's life in Nigeria, misoprostol is widely available from drug sellers. We interviewed 394 women in 2018 in Lagos State, Nigeria, who induced abortion using misoprostol obtained from a drug seller to determine their sexual and reproductive health literacy (SRHL) and misoprostol knowledge levels; and how these were associated with ending the pregnancy successfully or seeking care for (perceived) complications. Our results show that women's misoprostol knowledge (measured both quantitatively and qualitatively) was low, but that almost all women were nevertheless able to use the drug effectively and safely. Higher SRHL was associated with being more likely to end the pregnancy successfully and also seeking postabortion health care. Our study is the first to examine this association and adds to the scarce literature examining the relationship between health literacy and self‐use of misoprostol to induce abortions in restrictive settings.

Exploring contraception myths and misconceptions among young men and women in Kwale County, Kenya

BackgroundMyths and misconceptions around modern contraceptives have been associated with low contraceptive uptake in sub-Saharan Africa and Kenya in particular. Addressing persistent contraceptive knowledge gaps can make a significant contribution towards improved contraceptive uptake among young women. This qualitative study therefore sought to explore and understand young people’s knowledge of modern contraception and to identify their key concerns regarding these methods.MethodsWe used focus group discussions (FGD) with vignette and writing activities to explore key myths and misconceptions around the use of contraceptives. Six FGDs (three for young men and three for young women) were conducted with a total of 28 young women and 30 young men from Kwale County, Kenya. We included 10 discussants aged 18–24 per FGD, one FGD had 8 participants. Predefined codes reflecting the discussion guides and emerging issues in the FGDs were used to develop the thematic coding framework. Our analysis followed a pattern of association on the key preset themes focusing on myths and misconceptions around contraceptive use.ResultsResults are presented under four key themes: awareness of contraception, myths and misconceptions around contraception, males’ contraceptive narratives and young people’s preferred sources of contraceptives. Both men and women participants reported basic awareness of contraceptives. A mixture of biological and social misconceptions were discussed and included perceptions that modern contraception: jeopardized future fertility, could result in problems conceiving or birth defects, made women promiscuous, was ‘un-African’, and would deny couples their sexual freedom. Compared to female respondents in the study, young men appeared to be strong believers of the perceived socio-cultural effects of contraceptives. On preferred sources of contraceptives, respondents reported on two main sources, pharmacies and public hospitals, however, they could not agree on which one was suitable for them.ConclusionsThis study revealed the presence of a mixture of biological and social myths and misconceptions around contraception, with young men also strongly adhering to these misconceptions. The low level of contraceptive knowledge, particularly on contraceptive fears as revealed by the study demonstrate critical gaps in sexual and reproductive health (SRH) knowledge among young people. Improved SRH literacy to address contraceptives’ fears through appropriate and gender specific interventions to reach out to young men and women with factual SRH information may therefore contribute to increased uptake of SRH services including modern contraceptive methods.

The cultural context of sexual and reproductive health support: an exploration of sexual and reproductive health literacy among female Asylum Seekers and Refugees in Glasgow

Purpose Sexual and reproductive health (SRH) incorporates prevention of unplanned pregnancies, unsafe abortions, and sexually transmitted infections (STIs). The sourcing, understanding and application of related information are important for health and this defines sexual and reproductive health literacy (SRHL). Health care utilization rates among Asylum Seekers and Refugees (ASRs) may not be high and they are unlikely to seek sufficient SRH information and care in their host countries, leaving some needs unmet. No SRHL research related to Scotland’s Asylum Seeking and Refugee Women (ASRW) exists. In this qualitative study, the purpose of this paper is to explore the SRHL-related views and experiences of adult ASRW living in Glasgow and their views on assistance required to improve their SRHL. Design/methodology/approach In total, 14 semi-structured interviews were audio-recorded and transcribed and qualitative thematic analysis employed. Findings Five themes and 13 sub-themes with four key findings highlighted: experience of unmet SRHL needs, similarities and differences in the source of SRH information, SRH views and behaviours influenced by cultural and religious factors, barriers and facilitators to accessing SRH information/care and developing SRHL. Research limitations/implications This was a small scale qualitative study affording limited transferability. The work addressed a highly sensitive topic among women from conservative home country cultures. Practical implications Routine collection of sexual and reproductive health data by the NHS should be explored for this group. NHS staff should be aware of the rights of asylum seekers, Refugees and failed asylum seekers, to NHS healthcare free at the point of delivery in Scotland (National Health Service, 2019; Scottish Government, 2018), and be well trained in the likely religious and cultural norms of these groups. Host communities should consider improving access to SRH information and care in ASRWs first languages. Social implications The study identified weaknesses in the opportunities for social integration afforded this group and the coordination of existing social opportunities. The stigmatization of immigrants in the UK is well understood and has repercussions for many individuals and societal organizations implicated in the promotion of this. Originality/value This paper addresses a very sensitive topic with women from conservative cultures. With few publications in this area, and none pertaining to Scotland, the paper makes a small but original contribution that might be considered a starting point for researchers and relevant services in Scotland.

Sexual and reproductive health literacy of school adolescents in Lao PDR.

RationaleAdolescent pregnancy in Lao PDR is the highest in Southeast Asia. It leads to negative health and social consequences in young people. It is anticipated that this problem is partly caused by limited sexual and reproductive health literacy (SRHL), leading to poor sexual and reproductive health (SRH) decisions. Based on the concept of health literacy, SRHL goes beyond knowledge and behavior and is the self-perceived ability of an individual to access the needed information, understand the information, appraise and apply the information into informed decision making for a good way to contribute to sexual and reproductive health. It is not only knowing (knowledge) and doing (behavior), but it is the process of individual’s thought on an SRH problem before taking an action. The aim of this study was to measure SRHL among school-going adolescents aged 15–19 and to determine factors associated with SRHL.MethodWe conducted a cross-sectional study in rural and urban areas of Lao PDR in 2017. Respondents completed a self-administered questionnaire with five parts: socio-demographic, personal health, SRH knowledge and behavior, SRHL, and functional literacy. We calculated the SRHL score based on the HL-EU index and used descriptive statistics to determine the score and levels. Then we used bivariate statistics and multiple linear regression to identify factors associated with SRHL in these adolescents.ResultAmong 461 respondents, 65.5% had inadequate SRHL. Scores were positively and significantly associated with several factors, including: school location (β: 3.218; p<0.001), knowledge on SRH and attending SR class in school (p:0.010—p<0.001), and functional literacy on condoms, which reflected how respondents understood the use of condoms (β: 0.871; p<0.001).ConclusionBecause most school adolescents had inadequate SRHL, comprehensive sexual education and enabling information as well as service access for adolescents are essential to ensure that adolescents can access, understand, appraise and apply good SRH knowledge in decision-making to benefit their own health.

Exploring college students’ sexual and reproductive health literacy

Objective: To assess college students’ sexual and reproductive health (SRH) literacy experiences, specific to contraception use and STI prevention. Participants: In Spring 2015, participants (n = 43) from a large institution participated in six focus groups (two male and four females groups). Methods: Focus groups were guided by the health literacy domains (access; understand; appraise; apply); data were analyzed in MaxQDA using the constant comparative method. Results: The Internet was the most commonly accessed source for SRH information. Participants discussed facilitators (eg, use of visuals) and barriers (eg, medical jargon) to understanding information; and personal lifestyle, advice from family/friends, symptoms, and sexual partners as appraisal factors. Participants applied information by communicating with friends/providers and seeking healthcare. However, findings were not linear nor mutually exclusive, representing the interaction of health literacy skills. Conclusion: Findings suggest that a patient-centered intervention capitalizing on technology and trusted individuals (providers/peer educators) may facilitate college students’ SRH literacy.