Well-being Of Girls Research Articles

Sexual health counselling targeting girls and young women with female genital cutting in Sweden: mind–body dualism affecting social and health care professionals’ perspectives

Female genital mutilation (FGM), also referred to as female genital cutting (FGC), has become the subject of an intense debate exposing tensions between varying cultural values about bodies and sexuality. These issues are brought to the fore in settings where professionals provide sexual counselling to young circumcised women and girls in Western, multicultural societies. This article is based on interviews and focus group discussions with professionals in social and healthcare services. The aim of this study was to examine how professionals reflect upon and talk about sexuality and the promotion of sexual wellbeing in young circumcised women and girls. Policy documents guide their obligations, yet they are also influenced by culture-specific notions about bodies and sexuality and what can be called “the FGM standard tale”. The study found that professionals showed great commitment to helping the girls and young women in the best possible way. Their basic starting point, however, was characterised by a reductionist focus on the genitalia’s role in sexuality, thus neglecting other important dimensions in lived sexuality. In some cases, such an attitude may negatively affect an individual’s body image and sexual self-esteem. Future policy making in the field of sexual health among girls and young women with FGC would benefit from taking a broader holistic approach to sexuality. Professionals need to find ways of working that promote sexual wellbeing in girls, and must avoid messages that evoke body shame or feelings of loss of sexual capacity among those affected by FGC.

The Pervading Public Health Implications of Female Genital Mutilation among Women (20-40 Years) in a Rural Community in Southeastern Nigeria

Background: Female genital mutilation is a term used to describe the various traditional practices that involve the partial or total cutting off or removal of the external female genitalia for cultural and traditional reasons in many African societies. This research addressed the concept of this practice among the child bearing women (20-40 years old) of Amuzi, Obowo clan in the South Eastern part of Nigeria.Methods: Using a simple random sampling technique, 10% of the 1000 women present in the community, the sample size were determined. Thus, the study population of 100 women had structured questionnaire given to them to elicit data; by focusing on the experiences of the women who knew about the practice, by looking at their flashbacks, the prevalence, procedure, reasons for, health complications involved after the mutilation.Results: The research results indicated that female genital mutilation has complications that interrupt and disrupt the health and well-being of girls and women. It affects particularly their reproductive life and living.Conclusion: Female genital mutilation is a violation of women's right to health and wellbeing. It is recommended that empowering people in the community with more knowledge on the subject, and providing the necessary resources needed; will help considerably in stopping the practice of female genital mutilation.

Prioritizing and synthesizing evidence to improve the health care of girls and women living with female genital mutilation: An overview of the process.

Female genital mutilation (FGM) constitutes a harmful traditional practice that can have a profound impact on the health and well-being of girls and women who undergo the procedure. In recent years, due to international migration, healthcare providers worldwide are increasingly confronted with the need to provide adequate health care to this population. Recognizing this situation the WHO recently developed the first evidence-based guidelines on the management of health complications from FGM. To inform the guideline recommendations, an expert-driven, two-step process was conducted. The first step consisted of developing and ranking a list of priority research questions for the evidence retrieval. The second step involved conducting a series of systematic reviews and qualitative data syntheses. In the present paper, we first provide the methodology used in the development and ranking of the research questions (step 1) and then detail the common methodology for each of the systematic reviews and qualitative evidence syntheses (step 2).

A structural equation model of conflict-affected youth coping and resilience

ABSTRACTThis study tested a theoretical relationship between trauma exposure, youth coping strategies and peer, family and community level factors on psychological distress and well-being among 399 trauma-affected youth in the Democratic Republic of Congo. Structural equation modeling (SEM) was used to analyze paths and to assess differences in relationships by gender. Psychological distress was measured by self-reports of internalizing problems (depression and anxiety), externalizing problems (aggression and behavioral problems) and somatic complaints (pain without medical cause). Self-reports of happiness, hope and self-esteem were measures of well-being. Findings from this study suggest gender differences in how individual coping strategies and external factors explain mental health resilience in trauma-affected youth. Problem-focused coping strategies were associated with higher psychological distress in both boys and girls. Use of avoidance was associated with better well-being in girls and boys and use of faith-based coping strategies was associated with better well-being in boys. Use of both problem-focused and emotion-focused coping strategies (coping flexibility) resulted in lower psychological distress in boys and girls. The home environment including closeness to family, caregiver post traumatic stress disorder and violence in the home was associated with psychological distress and well-being. Having close peer relationships, village safety and enrollment in school benefited well-being. Results from these SEM of resilience suggest that interventions should (1) work to build the coping repertoire of youth, (2) support reduction in psychological distress through improved family relationships and caregiver mental health and (3) target improved well-being through support of positive peer and community relationships and school enrollment.

Engaging dads to increase physical activity and well-being in girls: The DADEE (Dads And Daughters Exercising and Empowered) RCT

Engaging dads to increase physical activity and well-being in girls: The DADEE (Dads And Daughters Exercising and Empowered) RCT

Epidemiologic Study on Social Determinants of Health: What's Next?

Epidemiologic Study on Social Determinants of Health: What's Next?

Altering the Parenting Role: Parents’ Experience of Supporting the Health and Well-Being of Their Adolescent Girls

BackgroundIn research the relationships between parents and their adolescent daughters have been viewed from problem oriented perspectives, usually exploring negative effects and health-related problems. Health and well-being are complex phenomena and knowledge is needed on how parents can support the health and well-being of their daughter.ObjectivesThe aim of this study was to illuminate parents’ experiences of supporting the health and well-being of their adolescent girls.MethodsA descriptive design with a phenomenological approach including interviews, individually or in group with ten mothers and five fathers was conducted.ResultsSupporting the health and well-being of adolescent girls was experienced as challenging. The parents needed to altering the parenting role: from being the one who had previously set the limits they needed to rethink and be available for support. In this process interplay, communication and trust were important to support the health and well-being of the girls in an efficient way. This meaning was further illuminated by four constituents: Balancing the need for control, maintaining a trusting relationship, interplay to facilitate their daughters’ transition to independence, and an ambiguous parenting role.ConclusionsThis study highlights the importance of parents being involved in the everyday life of their adolescent daughter to support her health and well-being. The parents’ ability to contribute to the health and well-being of their girl seemed in this study dependent on their ability to communicate and alter the parenting role with sensitivity to the lifeworld of the adolescent girl.

Protecting students from female genital mutilation

Female genital mutilation (FGM) presents important risks to the physical and mental health and wellbeing of girls and women affected. The practice of FGM is still an issue in the UK despite being illegal. School nurses can play an important role in raising awareness on the subject, protecting at-risk girls and young women, and offer them the support they need. This article looks at the types of FGM, their risks, and the role school nurses can play in raising awareness.

Commentary: Bashful Boys and Coy Girls: A Review of Gender Differences in Childhood Shyness

In this commentary we argue that subjective reviews of gender differences, as opposed to empirical meta-analyses, can be more affected by influences which may not yield an objective evaluation of the available evidence, including the potential overrepresentation of articles that do versus do not find gender differences and lack of a systematic evaluation of factors that influence findings. We consider theoretical bases for considering shyness to be detrimental to the development and wellbeing of girls. These include perspectives that characterize girls as being particularly affected by their personal relationships and children of both genders as influenced by patterns of same-gender interaction. Some perspectives are helpful in conceptualizing why gender difference patterns can be nuanced over the course of development, across different outcomes, contexts, and historical periods. We also briefly consider the utility of diathesis × stress and differential susceptibility models in understanding gendered patterns of adjustment. We argue that reviews of gender differences in childhood shyness should address the gender difference paradox in childhood shyness and anxiety. That is, why are gender differences in the prevalence of shyness typically absent in early to middle childhood (as concluded in the review article), but girls and women consistently demonstrate higher rates of anxiety disorders, including social anxiety disorder, than their male counterparts in adolescence and adulthood? Finally, we conclude with comments encouraging researchers to consider the potential consequences of how they convey messages about gender differences in childhood shyness. We suggest how such information can be communicated in a responsible manner.

Knowledge, attitudes and practices of female genital mutilation/cutting among health care professionals in The Gambia: a multiethnic study

BackgroundFemale genital mutilation/cutting (FGM/C) is a harmful traditional practice with severe consequences for the health and well-being of girls and women. Health care professionals (HCPs) are therefore expected to be aware of how to identify and manage these consequences in order to ensure that those affected by the practice receive quality health care. Moreover, their integration and legitimacy within the communities allow them to play a key role in the prevention of the practice. Nevertheless, the perception of HCPs on FGM/C has been barely explored in African contexts. This study seeks to contribute to this field of knowledge by examining the knowledge, attitudes, and practices regarding FGM/C among HCPs working in rural settings in The Gambia.MethodsA cross-sectional descriptive study was designed through a quantitative methodology, following a multiethnic approach. A pre-tested questionnaire with open and closed-ended questions was created. Forty medical students from the Community-based Medical Programme were trained to administer the questionnaire, face to face, at village health facilities in rural areas of The Gambia. A final sample of 468 HCPs included all nurse cadres and midwives.ResultsA significant proportion of Gambian HCPs working in rural areas embraced the continuation of FGM/C (42.5%), intended to subject their own daughters to it (47.2%), and reported having already performed it during their medical practice (7.6%). However, their knowledge, attitudes, and practices were shaped by sex and ethnic identity. Women showed less approval for continuation of FGM/C and higher endorsement of the proposed strategies to prevent it than men. However, it was among ethnic groups that differences were more substantial. HCPs belonging to traditionally practicing groups were more favourable to the perpetuation and medicalisation of FGM/C, suggesting that ethnicity prevails over professional identity.ConclusionsThese findings demonstrate an urgent need to build HCP’s capacities for FGM/C-related complications, through strategies adapted to their specific characteristics in terms of sex and ethnicity. A culturally and gender sensitive training programme might contribute to social change, promoting the abandonment of FGM/C, avoiding medicalisation, and ensuring accurate management of its health consequences.

Physical activity and screen-based media use: cross-sectional associations with health-related quality of life and the role of body satisfaction in a representative sample of German adolescents

Purpose: Although it is widely accepted that physical activity (PA) positively, and screen-based media use (SBM) negatively, affects well-being, there is a lack of studies relating PA and SBM to health-related quality of life (HRQoL) in adolescents. We examined these associations in German adolescents for different HRQoL subdomains and explored the role of body satisfaction as a possible mediator. Methods: The 11–17-year-old subsample of the German Health Interview and Examination Survey (2003–2006) was analysed (N = 6813; 51.3% male). Cross-sectional associations of self-reported PA frequency and amount of daily SBM with HRQoL subscale scores (according to KINDL-R) were examined by hierarchical linear regression models, adjusting for the clustering of the sample and for a variety of possible confounders. The size and significance of indirect effects via body (dis)satisfaction (BDS) were examined by mediation analyses. Results: Higher PA frequency was significantly associated with higher HRQoL on nearly all subscales and dose–response-relationships were observable. Variations were greatest in terms of social well-being in boys (effect size d = 0.59) and physical well-being in girls (d = 0.43). Higher SBM was related to lower HRQoL on all subscales in girls and on some subscales in boys, with the largest effects for school functioning in both genders (d = 0.31 and 0.37, respectively). The mediated effects for PA and SBM were significant in both genders, but the sizes and the proportions of total effects mediated by body satisfaction were rather small. Conclusions: Higher PA frequency was associated with higher self-reported HRQoL, and higher SBM was associated with lower self-reported HRQoL in both genders, even after adjusting for relevant covariates. The results support the assumption of independent health impacts of both behaviours, although no causal relationship can be confirmed with these cross-sectional data. Mechanisms other than body satisfaction must largely account for the effects of PA and SBM on well-being.

Female genital mutilation/cutting: the secret world of women as seen by men.

Efforts aimed at the abandonment of Female Genital Mutilation/Cutting (FGM/C) in the communities where it is deeply rooted have extensively considered and addressed women's perceptions on the issue, leaving those of men barely acknowledged. Although the practice is generally confined to the secret world of women, it does not mean that men cannot be influential. Indeed, men can play an important role in prevention. In order to address this gap, and having as background an extensive ethnographic field work, a transversal descriptive study was designed to explore Gambian men's knowledge and attitudes towards FGM/C, as well as related practices in their family/household. Results show ethnic identity, more than religion, as the decisive shaping factor on how men conceive and value FGM/C. The greater support towards the practice is found among traditionally practicing groups. A substantial proportion of men intend to have it performed on their daughters, although reporting a low involvement in the decision making process, with very few taking alone the final decision. Only a minority is aware of FGM/C health consequences, but those who understand its negative impact on the health and well-being of girls and women are quite willing to play a role in its prevention.

Capabilities and the global challenges of girls’ school enrolment and women’s literacy

The education Millennium Development Goals have been highly influential on the priorities for education and concentrated policy efforts on numbers of girls enrolled in public sector schools offering basic education. This focus has been justified by human capital calculations of the social rates of return to basic schooling. This concern with quantities has met criticism from more qualitative researchers concerned with understanding not only why girls are not enrolled in school, but also why they may be irregular attenders and poor performers in public examinations even if they are enrolled. Alongside the efforts to achieve the education Millennium Development Goals have been initiatives to improve adult women’s literacies, often combined with an empowerment objective. This paper uses Sen’s capability approach to argue that improving deliberative processes is relevant for the well-being of girls and women of all ages.

Protecting pupils from female genital mutilation

Female genital mutilation (FGM) presents important risks to the physical and mental health and wellbeing of girls and women affected. The practice of FGM is still an issue in the UK depite being despite being illegal. School nurses can play an important role in raising awareness on the subject, protecting at-risk girls and young women, and offer them the support they need. This article looks at the types of FGM, their risks, and the role school nurses can play in raising awareness.

Food insecurity and age at menarche among adolescent girls in Jimma Zone Southwest Ethiopia: a longitudinal study

BackgroundAge at menarche is the reflection of cumulative pre-adolescent exposure of girls to either adverse environment such as food insecurity or affluent living conditions. Food insecurity could result in inadequate nutrient intake and stress, both of which are hypothesized to have opposing effects on the timing of menarche through divergent pathways. It is not known whether food insecure girls have delayed menarche or early menarche compared with their food secure peers. In this study we test the competing hypothesis of the relationship between food insecurity and age at menarche among adolescent girls in the Southwest Ethiopia.MethodsWe report on 900 girls who were investigated in the first two rounds of the five year longitudinal survey. The semi-parametric frailty model was fitted to determine the effect of adolescent food insecurity on time to menarche after adjusting for socio-demographic and economic variables.ResultsFood insecure girls have menarche one year later than their food secure peer (median age of 15 years vs 14 years). The hazard of menarche showed a significant decline (P = 0.019) as severity of food insecurity level increased, the hazard ratio (HR) for mild food insecurity and moderate/severe food insecurity were 0.936 and 0.496, respectively compared to food secure girls. Stunted girls had menarche nearly one year later than their non-stunted peers (HR = 0.551, P < 0.001).ConclusionFood insecurity is associated with delay of age at menarche by one year among girls in the study area. Stunted girls had menarche one year later than their non-stunted peers. Age at menarche reflects the development of girls including the timing of sexual maturation, nutritional status and trajectory of growth during the pre-pubertal periods. The findings reflect the consequence of chronic food insecurity on the development and well-being of girls in the study area.

Prenatal Sex Selection and Girls’ Well‐Being: Evidence from India

In this paper, we study the impact of prenatal sex selection on the well-being of girls by analyzing changes in children's nutritional status and mortality during the years since the diffusion of prenatal sex determination technologies in India. We further examine various channels through which prenatal sex selection might affect girls' outcomes. Using repeated cross-sections from a rich survey dataset, we show that high sex ratios at birth reflect the practice of sex selective abortion. We then exploit the large regional and time variations in the incidence of prenatal sex selection to analyze whether changes in girls' outcomes relative to boys within states and over time are associated with changes in sex ratios at birth. We find that an increase in the practice of prenatal sex selection appears to be associated with a reduction in the incidence of malnutrition among girls. The negative association is stronger for girls born in rural households and at higher birth parities. An examination of the various mechanisms linking between prenatal sex selection and children outcomes suggests that prenatal sex selection does not lead to a selection of girls into better endowed families, but there is some evidence of a larger reduction in family size for girls relative to boys. We also find an increase in girls' breastfeeding duration suggesting an improvement in parental care and treatment. On the other hand, prenatal sex selection does not appear to be associated with a reduction in excess female child mortality, or a reduction in son preference.

‘My mom was my left arm’: The lived experience of ableism for girls with Spina Bifida

In many cultures, people deemed different, deficient or of lesser value are socially marginalized, disempowered, devalued and face innumerable barriers to health and quality of life. Persons deemed dis-abled are one such group. Through oppression, discrimination, and constant degradation, marginalized groups are denied the basic human right of dignity. For five girls with Spina Bifida, the experience of societal ableism, i.e. the belief that being able bodied is normal, eroded their sense of self worth, impinged upon their human rights, and isolated them in their own degradation – until they came together and spoke.‘My Mom Was My Left Arm’ illuminates the impact of ableism on the health and well-being of girls living with Spina Bifida. Several focus groups with five girls concerning their lives, anger and health yielded compelling reasons for today’s contemporary nurse to explicitly practice from a social justice framework. In being deemed other, less than and viewed as their disability, the young women interviewed believed they had never reached their actual life potential. The relationship between health and ableist discrimination as lived by young women with Spina Bifida will be explored. The paper will close with nursing’s ethical imperative to advocate for social justice, equity, fairness and dignity.

Influences of Family Structure and Parental Conflict on Children's Well-Being

Influences of Family Structure and Parental Conflict on Children's Well-Being* Elizabeth A. Vandewater** and Jennifer E. Lansford Relative effects of membership in one of two family structures (married-never divorced vs. divorced-not remarried) and interparental conflict (high vs. low) on children's well-being (internalizing, externalizing behavior, and trouble with peers) are examined for a sample of 10- to 17-year-old children and their parents from the National Survey of Families and Households (N = 618). Findings support the hypothesis that conflict influences children's well-being regardless of family structure. Children in high conflict families showed lower levels of well-being on all outcomes, but no well-being differences were found between family structure groups. Analyses of child gender indicated that warmth toward the child mediated the relationship between conflict and well-being for girls. For boys, both conflict and warmth were directly related to well-being independently. Implications of results for theory, research, and policy are discussed. Key Words: child well-being, family structure, conflict. In this study we compare the relative influences of family structure and conflict on different aspects of children's well-being. To know why and to what extent family structure and conflict affect children's well-being is of obvious practical importance to parents, to family and marital practitioners, to those who set family-relevant policies, and to researchers hoping to assist the decision making of such groups (Peterson & Zill, 1986). In his influential review, Emery (1982) argued that it is critical to understand whether separation from a parent per se or interparental conflict is more influential for predicting children's adjustment . . because it bears on such issues as whether parents should stay together for the children's sake (p. 313). Despite arguments such as Emery's (1982; see also Demo & Acock, 1988), there is a large body of research focusing on the negative effects of divorce on children. This research is largely based on two long-standing assumptions: separation is always traumatic for children; and two-parent families ipso facto provide a better environment for children than do single-parent families (see Amato & Keith, 1991; Demo & Acock, 1988; Emery, 1982, for reviews). Such studies are the basis for warnings about the devastating effects of divorce on children, and the damage of living in single-parent families for children's adjustment and wellbeing (e.g., Wallerstein & Kelly, 1980). However, this parental absence has been criticized for neglecting the influence of family processes on children's well-being in two-parent as well as in single-parent families (e.g., Amato & Keith, 1991; Emery, 1982; Scanzoni, Polonko, Teachman, & Thompson, 1989). Based upon such critiques, the importance of identifying potentially important family processes that affect children's adjustment and wellbeing within all types of family structures is now well recognized (Allison & Furstenberg, 1989; Amato & Keith, 1991; Bronfenbrenner, 1986). Several theoretical perspectives have been proposed to account for processes bv which family structure may affect children's well-being (see Amato, 1993; McLanahan & Sandefur, 1994; Webster, Orbuch, & House, 1995 for reviews). One such explanation focuses on economic hardship facing single mothers and their children that often follows divorce. According to this perspective, it is not family structure per se, but rather a decrease in the family's standard of living following divorce that is related to children's well-being. Another explanation focuses on life stress and parents' adjustment following divorce. This perspective holds that divorce is stressful for both parents and children and that how well parents cope with divorce is directly related to how well their children can be expected to cope. …