Sexual And Reproductive Health Of Young People Research Articles

The sexual and reproductive health needs of school-going young people in the context of COVID-19 in rural KwaZulu-Natal, South Africa

Background: The impact of school closures due to COVID-19 raised widespread concerns about children’s health and well-being. We examine the impact on the sexual health needs of learners in the context of COVID-19 related lockdowns in rural KwaZulu-Natal, South Africa. Methods: In july–November 2020 and August–November 2021 we conducted 24 in-depth interviews and 8 group discussions with teachers and learners from 4 schools, community members and key education stakeholders. All interviews were conducted by telephone. We used a thematic analysis approach and Nvivo 12 software to manage the data. Results: Four main themes related to the COVID-19 pandemic emerged from the data: the sexual and reproductive health (SRH) of learners in the lead-up to the pandemic; the impact of COVID-19 on learners’ SRH and wellbeing; the opportunities schools provided to support sexual well-being of learners during the pandemic; and the role of schools in supporting SRH for learners during the pandemic. Learners and stakeholders reported that the SRH of young people was affected by alcohol misuse, poor SRH knowledge and few pathways to link learners with services. Stakeholders working with schools reported that a lack of access to biomedical interventions (e.g., contraception) increased learner pregnancies. Gender-based violence in learners’ households was reported to have increased during the COVID-19 pandemic related to loss of income. School closures disrupted the provision of a safe space to provide SRH and HIV-education through Life Orientation lessons and school nurse talks. This loss of a safe space also left learners vulnerable to sexual and physical violence. However, once schools re-opened, daily COVID-19 screening in schools provided the opportunity to identify and support vulnerable children who had other social needs (food and uniforms). Conclusion: The COVID-19 pandemic may have increased SRH needs and vulnerability of school-going children in a high HIV-burden rural setting. School shutdowns reduced the opportunity for schools to provide a vital safe space and information to enhance SRH for adolescents. Schools play a vital health promotion and social protection role.

Virðing: Lykilþáttur í kynheilbrigði ungs fólks

Í íslenskum og erlendum samfélögum bendir margt til þess að vanvirðingar gæti gagnvart kynverund einstaklingsins og er MeToo-byltingin dæmi um viðbragð við þeim vanda. Tilgangur þessarar rannsóknar er að varpa ljósi á hugtökin virðingu og vanvirðingu í sambandi við kynheilbrigði ungs fólks og út frá rétti þess til kynheilbrigðis. Gerð var endurgreining á tveimur eigindlegum rannsóknum sem byggðust á viðtölum við unga menn. Einnig var byggt á MeToo-frásögnum af kynferðisofbeldi gagnvart unglingsstúlkum. Gögnin voru greind út frá virðingu og vanvirðingu. Niðurstöður sýna að sjálfsvirðing er ungum karlmönnum mikilvæg í jafningjahópum en einnig við kaup og notkun smokka. Þeim finnst mikilvægt að virða samþykki hins aðilans og telja virðingu vera einn af lykilþáttum góðs kynlífs. Vanvirðing ungra manna birtist í umræðu um ráðandi karlmennsku en einnig þegar samþykki fyrir samförum er hunsað. Lýsingar á nauðgun unglingsstúlkna sýna fram á mikla vanvirðingu gagnvart rétti þeirra til kynheilbrigðis. Niðurstöðurnar benda til þess að virðing sé mikilvæg fyrir vellíðan einstaklingsins sem kynveru og hið gagnstæða gildi um vanvirðingu. Fræða þarf ungt fólk um rétt þess til kynheilbrigðis og um einkennandi þætti heilbrigðs kynferðislegs sambands.

Using mobile phones to improve young people\u2019s sexual and reproductive health in low- and middle-income countries: a systematic review protocol to identify barriers, facilitators and reported interventions

BackgroundDue to a growing reliance on mobile phone technology and decreasing mobile phone costs, the use of mobile phones is on the rise, especially among the youth population. Young people are responsive and enthusiastic to use novel approaches such as mHealth to access sexual and reproductive health information and services. Globally, reproductive health programs have used mHealth to provide sexual and reproductive health education and services to young people, through diverse communication channels. However, few attempts have been made to systematically review the mHealth programs for young people sexual and reproductive health (SRH) in low- and middle-income countries (LMICs). In addition, very little is known regarding the potential barriers and facilitators to the uptake of mobile phone interventions for improving young people SRH. This review aims to highlight facilitators and inhibitors to implementing and increasing uptake of mHealth interventions for young people’s SRH, in LMICs specifically. Additionally, the review will identify the range of mHealth solutions which can be used for improving young people’s SRH in LMICs.MethodsThe review will focus on comparing the various types of mHealth interventions/strategies that are used to improve young people’s SRH services in LMICs. PubMed, CINAHL Plus, Science Direct, Cochrane, and gray literature will be explored using a detailed search strategy. The studies involving young people (adolescents and youth) aged 10–24 years to which mHealth interventions were delivered for improving their SRH outcomes will be included in this review. LMICs will be selected according to the World Bank’s (WB) 2018 Country Classification list. Studies published between January 2005 and March 2018 will be included as the field of mHealth has emerged over the last decade. English language articles will be included as the authors are proficient in this language.DiscussionThe systematic review will assist researchers and SRH professionals in understanding facilitators and barriers to implementing and increasing the uptake of mHealth interventions for SRH in LMICs. Finally, this review will provide more detailed information about embracing the use of mobile phones at different levels of the healthcare system for improving young people’s SRH outcomes.Systematic review registrationPROSPERO CRD42018087585

Sexual and Reproductive Health Among Ugandan Youth: 2003-04 to 2012

PurposeSuboptimal sexual and reproductive health (SRH) increases morbidity, mortality, and gender inequity and slows development. In Uganda, youths represent 20% of the population, and the burden of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), is substantial. MethodsWe analyzed survey data collected using the lot quality assurance sampling (LQAS) technique from two time periods, 2003–2004 and 2012. We assessed knowledge, behaviors, and access to SRH services of youths aged 15–24 years. Using logistic regression, we examined factors associated with these indicators. ResultsAll indicators have improved between the early and later time period. Youths knowing where to get HIV tests increased from <40% to 80% (both sexes); the number of youths reporting ever having an HIV test increased from 8% to 48% (males) and 10% to 64% (females). Knowledge of other STIs improved but remains low; only half of respondents know signs and symptoms of STIs, and less than half know what action to take when infected. In the late period, 85% of female youths, compared with 93% of males reported knowing where to obtain condoms. The proportion of youths reporting sexual debut before age 15 years decreased, less so for males than that for females. Increased age and level of education are associated with positive change for most indicators. ConclusionsOver the last decade, progress has been made toward improving the SRH of young people in Uganda. Further efforts are required to ensure universal access and sufficient health education to facilitate the continued improvement of safe sexual behaviors among youth aged 15–24 years.

Young people's perception of sexual and reproductive health services in Kenya.

BackgroundAddressing the Sexual and Reproductive Health (SRH) needs of young people remains a big challenge. This study explored experiences and perceptions of young people in Kenya aged 10–24 with regard to their SRH needs and whether these are met by the available healthcare services.Methods18 focus group discussions and 39 in-depth interviews were conducted at health care facilities and youth centres across selected urban and rural settings in Kenya. All interviews were tape recorded and transcribed. Data was analysed using the thematic framework approach.ResultsYoung people’s perceptions are not uniform and show variation between boys and girls as well as for type of service delivery. Girls seeking antenatal care and family planning services at health facilities characterise the available services as good and staff as helpful. However, boys perceive services at health facilities as designed for women and children, and therefore feel uncomfortable seeking services. At youth centres, young people value the non-health benefits including availability of recreational facilities, prevention of idleness, building of confidence, improving interpersonal communication skills, vocational training and facilitation of career progression.ConclusionProviding young people with SRH information and services through the existing healthcare system, presents an opportunity that should be further optimised. Providing recreational activities via youth centres is reported by young people themselves to not lead to increased uptake of SRH healthcare services. There is need for more research to evaluate how perceived non-health benefits young people do gain from youth centres could lead to improved SRH of young people.

Experiences and conceptualizations of sexual debut from the narratives of South African men and women in the context of HIV/AIDS

Given the pivotal role of first sex in the development of sexual and reproductive health (SRH) practices, there is a need for more contextualised and nuanced understandings of young people's early sexual debut experiences. This study used sexual history narratives to investigate how South African men and women experience and attribute meaning to their sexual debut, and their SRH practices. In light of the gendered disparities among young people's SRH awareness and risk, differences between men and women's narratives of sexual debut were assessed. Fifty sexual history interviews were conducted with men and 25 sexual history interviews with women, with participants purposively sampled from three age categories, a range of cultural and racial backgrounds and urban and rural sites across five provinces. Narrative interviews were designed to elicit stories around participants’ early knowledge of sex and sexual experimentation, their range of sexual relationships and SRH practices. The data were analysed using a thematic approach. Participants generally reflected on their early sexual experiences with feelings of inadequacy and disappointment. While men appeared to hold greater decision-making power than women at sexual debut, descriptions of men's early sexual experiences were often characterised by respect, intimacy and vulnerability. Many men attributed the timing of their sexual debut to peer pressure, which typically generated higher social status and rarely included consideration of the need to practice safer sex. Several women felt pressured by their partner to sexually debut, which could have informed their perceptions of men being sexually controlling and aggressive. The study demonstrates the value of a narrative approach for generating insights on young people's sexual debut experiences and SRH practices, and the underlying gendered norms and expectations that shape these. The findings indicate the need for gender transformative HIV interventions to take into the diversity of young people's SRH needs and social realities.

‘Sex education should be taught, fine…but we make sure they control themselves’: teachers' beliefs and attitudes towards young people's sexual and reproductive health in a Ugandan secondary school

Although schools have been identified as important settings in which young people's sexual and reproductive health (SRH) can be promoted, there has been limited research into the role of teachers in delivering sex education programmes. This paper describes findings from a qualitative study of teachers' beliefs and attitudes towards young people's SRH in a Ugandan secondary school, and discusses the ways in which conservative attitudes to young people's sexual activity and an adherence to gender stereotypes can limit students' access to SRH information and services. Teachers' attitudes, beliefs and often superstitions relating to young people's sexual activity inevitably affect the content and nature of school-based sex education. Findings from this preliminary study suggest that, rather than assuming teachers act as neutral delivery mechanisms in schools, these attitudes and beliefs must be taken into consideration and addressed in the development of school-based sex education programmes.