Sexual and reproductive health: progress and outstanding needs.
Ontology highlight
ABSTRACT:
SUBMITTER: Snow RC
PROVIDER: S-EPMC4318113 | biostudies-other | 2015
REPOSITORIES: biostudies-other
Similar Datasets
Project description:OBJECTIVES:Ensuring youth participation in policymaking that affects their health and well-being is increasingly recognized as a strategy to improve young people's reproductive health. This paper aimed to describe the policy context and analyze underlying factors that influence youth participation in sexual and reproductive health (SRH) policymaking in Malawi. METHODS:This critical, focused ethnographic study is informed by postcolonial feminism and difference-centered citizenship theory, based on data collected from October 2017 to May 2018. Multiple research methods were employed: document analysis, focus group discussions, and "moderate" participant observation. Semi-structured interviews were conducted with key informants and youth, supplemented by open-ended drawing exercises with youth. RESULTS:Progressive policies and the presence of youth in some policymaking structures indicate substantial headway in Malawi. However, underlying structural and societal factors circumscribe young people's lived experiences of participation. CONCLUSIONS:Despite recent progress in involving young people in SRH policymaking, notable gaps remain between policy and practice. Recognizing and integrating young people in all stages of SRH policymaking is critical to catalyzing the social and political changes necessary to ensure their reproductive health and well-being.
| S-EPMC7275026 | biostudies-literature
Project description:ObjectivesThis study explored the perceptions of adult stakeholders on adolescents sexual and reproductive health (SRH) needs, variations of perceived needs by different social stratifiers and adolescent's perceived interventions to address these needs. This will provide evidence that could be useful for policy and programme reviews for improving access and use of services in to meet the SRH needs of adolescents.DesignA qualitative cross-sectional study was conducted in Ebonyi state, Southeast, Nigeria. Data were analysed using thematic framework and content analysis approaches.Setting and participantsThis qualitative study was conducted in six selected local government areas in Ebonyi state, Nigeria. The study participants comprised of adult stakeholders including community leaders, adolescent boys and girls aged 13-18 years. Adolescents were purposively selected from schools, skill acquisition centres and workplaces. A total of 77 in-depth interviews, 6 (with community leaders) and 12 (with adolescents) focus group discussions were conducted using pretested question guides.ResultsAdolescent SRH needs were perceived to be unique and special due to their vulnerability, fragility and predisposition to explore new experiences. Recurring adolescent SRH needs were: SRH education and counselling; access to contraceptive services and information. These needs were perceived to vary based on sex, schooling and marital status. Adolescent girls were perceived to have more psychological needs, and more prone to negative health outcomes. Out-of-school adolescents were described as more vulnerable, less controlled, less supervised and more prone to sexual abuse. Unmarried adolescents were perceived more vulnerable to sexual exploitation and risks, while married were perceived to have more maternal health service needs.ConclusionsPerceptions of adolescents' SRH needs converge among stakeholders (including adolescents) and are thought to vary by gender, schooling and marital status. This calls for well-designed gender-responsive interventions that also take into consideration other social stratifiers and adolescent's perceived SRH intervention strategies.
| S-EPMC9185505 | biostudies-literature
Project description:ObjectivesWomen with substance use disorders have high unmet needs for HIV prevention and drug treatment and face challenges accessing care for other unique health issues, including their sexual and reproductive health.MethodsWe did a cross-sectional evaluation of sexual and reproductive health behaviors and outcomes among women with substance use disorders, who were enrolled in one of two concurrent clinical trials of pre-exposure prophylaxis for HIV prevention. Descriptive analyses and bivariate logistic regression were used to assess factors driving contraceptive use, and other essential sexual and reproductive health services utilization and outcomes.ResultsAmong 226 women, 173 (76.5%) were of reproductive age. Most women had histories of unintended pregnancy (79.2%) or miscarriage (45.1%) and high HIV risk behaviors (53.5%). Most (61%) participants did not use any form of contraception at the time of assessment, although few (15%) reported pregnancy intentions. In bivariate models, ongoing criminal justice involvement was associated with 2.22 higher odds of not using contraception (95% confidence interval = 1.09-4.53; p = 0.03) and hazardous drinking was protective against not using contraception (odds ratio = 0.33, 95% confidence interval = 0.13-0.81; p = 0.02). Contraception use was not significantly associated with any other individual characteristics or need factors.ConclusionsThis is the first study that identifies the unmet sexual and reproductive health needs of women with substance use disorders who are engaging with pre-exposure prophylaxis. We found that women accessed some health services but not in a way that holistically addresses the full scope of their needs. Integrated sexual and reproductive care should align women's expressed sexual and reproductive health intentions with their behaviors and outcomes, by addressing social determinants of health.
| S-EPMC8771433 | biostudies-literature
Project description:ObjectiveDespite the reproductive health needs of youth having been supported by different organizations, youths continue to fall victim to sexual and reproductive health problems, and utilization of those services remains low. All efforts have not been felt across the Ethiopian learning institutions as is evidenced by persistent reproductive health problems. This study was aimed to determine sexual and reproductive health service needs among preparatory school youths of Debre Tabor town, Ethiopia.MethodsFacility-based cross-sectional study design was conducted in Debre Tabor town from 15 to 30 February 2020. A simple random sampling technique was used to access a total of 850 preparatory school students. The data were collected using pre-tested, structured, and self-administered questionnaires. Data were entered into EpiData v. 4.6 and exported to SPSS version 25 software for analysis. Binary logistics regression was used for analysis. Adjusted odds ratio along with 95% confidence interval was estimated to measure the strength of the association. The level of statistical significance was declared at a p value of 0.05.ResultsThe overall magnitude of sexual and reproductive health service needs was found 61.5% at 95% confidence interval (58.2%, 64.8 %). Being married (adjusted odds ratio = 2.24; 95% confidence interval: 1.10, 4.55), having information about sexual and reproductive health (adjusted odds ratio = 2.56; 95% confidence interval: 1.85, 3.55), youth discussion with families on sexual and reproductive health (adjusted odds ratio = 1.52, 95% confidence interval: 1.11, 2.10), and having a history of sexual intercourse (adjusted odds ratio = 2.19; 95% confidence interval: 1.53, 3.13) were found significantly associated with sexual and reproductive health service needs of youths.Conclusionthe overall need for sexual and reproductive health services among youths was found high. Therefore, managers and health workers need to prioritize an intervention that can improve youth-friendly service, information dissemination, and counseling, promoting discussion among family members on the sexual and reproductive health needs of the youths.
| S-EPMC9326834 | biostudies-literature
Project description:Constitutional mandates require access to medical testing and treatment in correctional settings, including sexual and reproductive health (SRH) care services. These same mandates do not apply to youth supervised in the community, who represent the majority of justice-involved youth. Waiting until youth are in detention settings to provide access to SRH services misses an opportunity to improve health outcomes for youth who have earlier points of contact with the system. This mixed-methods study explored structural intervention development and policy geared toward increasing access to and uptake of SRH prevention, treatment, care, and support services for court-involved, nonincarcerated (CINI) youth. Data were collected from a nationwide survey (N = 226) and qualitative interviews (N = 18) with juvenile justice (JJ) and public health (PH) system stakeholders between December 2015 and January 2017. Results suggest both PH and JJ stakeholders perceive CINI youth as having substantial, largely unmet SRH care needs due to a lack of services, policies, or procedures to address these needs. Barriers to implementing programs and policies to improve SRH services for this population include limited resources (e.g., staffing, time); perceived irrelevance for juvenile court, probation, or other community supervision settings; and concerns about confidentiality, privacy, and information sharing. Recommendations for effective intervention included colocating services, justice-to-community referrals, and service linkages (e.g., through a community health navigator), and staff education around youth SRH confidentiality and information-sharing practices. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
| S-EPMC9208729 | biostudies-literature
Project description:OBJECTIVE:To explore international migrant sex workers' experiences and narratives pertaining to the unmet need for and access to sexual and reproductive health (SRH) at the Mexico-Guatemala border. METHODS:An inductive qualitative analysis was conducted based on ethnographic fieldwork (2012-2015) including participant observation and audio-recorded in-depth interviews. The participants were female sex workers aged 18 years or older and international migrants working at the Mexico-Guatemala border. RESULTS:In total, 31 women were included. The greatest areas of unmet need included accessible, affordable, and nonstigmatizing access to contraception and treatment of sexually transmitted infections. On both sides of the border, poor information about the health systems, services affordability, and perceived stigma resulted in barriers to access SRH services, with women preferring to access private doctors in their destination country or delaying uptake of until their next trip home. Financial barriers prevented women from accessing needed services, with most only receiving SRH services in their destination country through public health regulations surrounding sex work or as urgent care. CONCLUSIONS:There is a crucial need to avoid prioritizing vertical disease-specific services and to promote access to rights-based SRH services for migrant sex workers in both home and destination settings.
| S-EPMC6043415 | biostudies-literature
Project description: Not available
| S-EPMC1618430 | biostudies-literature
Project description:Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities).
| S-EPMC4318007 | biostudies-other
Project description:Background:The sexual and reproductive health (SRH) needs of men have received little attention in Iran's healthcare system. Developing appropriate strategies to meet men's needs requires careful assessment and recognition of their health needs. Objective:The objective of this study is to assess men's SRH needs and satisfaction with received services. Materials and Methods:This descriptive cross-sectional study was conducted with 1068 adult men aged between 20 and 60 years in Ahvaz in 2014. For obtaining the SRH services needs of men, in addition to the self-reported felt needs, expressed needs and unmet needs, a need assessment was also done using a questionnaire that was developed for the research; its validity and reliability were assessed. Results:The men's perceived, expressed and unmet needs for SRH services were, priority-wise, screening and diagnosis of male genital cancers (63.3%), receiving contraceptive methods (36%), diagnosis, and treatment of male sexual dysfunction (86.9%), respectively. Preventing sexually transmitted disease/AIDS (72.1%), using contraceptives correctly (39.5%), and resisting peer pressure (86.6%) were, respectively, the first felt, expressed, and unmet skills men needed. The results of multivariate logistical regression showed that there was a significant statistical correlation between men's SRH needs and their socio-demographic factors (age, marital/educational status, income) ( p<0.05 ). Conclusion:Iranian men have many unmet SRH needs. Felt and expressed SRH needs were different. Educational and counseling services are as important as clinical services.
| S-EPMC6600284 | biostudies-literature
Project description:BackgroundYoung people in Uganda face various sexual and reproductive health risks, especially those living in urban slums. The aim of this study was to examine factors associated with comprehensive categories of sexual and reproductive health, including sexual behaviours; sexual education and access to contraceptive services; family planning; prevention of STDs; sexual consent as a right; gender based violence; as well as HIV testing, counselling, disclosure and support.MethodsThe study was cross-sectional in design and was carried out in July 2014 in Makindye and Nakawa Divisions of Kampala City, Uganda. Using systematic random sampling, data were collected on 663 participants aged between 13 and 24 years in Kampala's urban slums.ResultsSixty two percent of participants reported having ever had sex and the mean age of sexual debut was 16 years (95%CI: 15.6, 16.4 years, range: 5-23 years). The odds of reporting ever having had sexual intercourse were higher among respondents living alone (OR: 2.75; 95%CI: 1.35, 5.61; p<0.01) than those living in a nuclear family. However, condom use was only 54%. The number of sexual partners in the last 12 months preceding the survey averaged 1.8 partners (95%CI: 1.7, 1.9; range 1-4) with 18.1% reporting an age gap of 10 years or older. More than three quarters (80.6%) of sexually active participants reported that their first sexual encounter was consensual, suggesting that most young people are choosing when they make their sexual debut. Low prevalence of willing first sexual intercourse was associated with younger age (OR = 0.48, 95%CI: 0.25, 0.90, p<0.05), having a disability (OR = 0.40, 95%CI: 0.16, 0.98, p<0.05), living with non-relatives (OR = 0.44, 95%CI: 0.16, 0.97, p<0.05), and being still at school (OR = 0.29, 95%CI: 0.12, 0.67, p<0.01). These results remained significant after adjusting for covariates, except for disability and the age of participants. The proportion of unwilling first sexual intercourse was significantly higher among women for persuasion (13.2% vs. 2.4%, p<0.001), being tricked (7.1% vs 2.9%, p<0.05) and being forced or raped (9.9% vs 4.4%, p<0.05) than men. A high level of sexual abuse emerged from the data with 34.3% affirming that it was alright for a boy to force a girl to have sex if he had feelings for her; 73.3% affirming that it was common for strangers and relatives to force young females to have sexual intercourse with them without consent; 26.3% indicating that it was sometimes justifiable for a boy to hit his girlfriend, as long as they loved each other.ConclusionThis study has explored current sexual practice among young people in a specific part of urban Kampala. Young people's sexual and reproductive health remains a challenge in Uganda. To address these barriers, a comprehensive and harmonised sexual and reproductive health system that is youth friendly and takes into account local socio-cultural contexts is urgently needed.
| S-EPMC5249247 | biostudies-literature