Barriers to utilization of sexual and reproductive health services among young deaf persons in Ghana

Despite significant progress made to improve access to sexual and reproductive health (SRH) services to the general populace in Ghana, information on the accessibility of such services to deaf persons is limited. This study investigated access to and utilization of SRH services among young female deaf persons in Ghana. Sixty deaf persons were interviewed from six metropolis/municipalities/districts in three regions of Ghana. The data were collected using focus group discussion and one-on-one interviews. The data were subjected to content analysis, leading to the identification of two broad themes. The study identified barriers at two levels: point of service delivery and barriers at the individual level. For instance, at the point of service delivery, they were claims that deaf women were victims of negative attitudes from health workers. The study concludes on the need for health policymakers to consider collaborating with the Ghana National Association of the Deaf in an effort towards designing inclusive SRH programmes.

Perceived causes of change in Nigerian adolescent sexual risk behaviour ­ Results from semi-structured mobile instant messaging interviews

The study explores the perceived causes of change in sexual risk behaviour among Nigerian adolescents over the past years. By embedding the results into a theoretical context, the study aims to further develop interventions targeting adolescent sexual health. To do so, 23 semi-structured interviews are conducted through the mobile-instant-messaging tool WhatsApp. The interview sample consists of both female and male adolescents and adults from different regions in Nigeria. The interviews are conducted as simultaneous chats and analysed based on the qualitative content analysis approach. Respondents perceive a multitude of different factors as causes of change in sexual risk behaviour among Nigerian adolescents. They can be categorised into (1) individual actors, (2) structural factors, and (3) socio-cultural factors. Interrelations between the different factors can partly be observed. The other factors are mostly modifiable and can therefore contribute to reducing adolescent SRB.

Perceptions, knowledge and exercises of sexual and reproductive health rights and associated factors among adolescents in East Arsi Zone, Ethiopia: A sequential explanatory mixed method study

Sexual and reproductive health rights (SRHRs) are the rights of all people regardless of their age, sex and other characteristics to make choices about their own reproductive issues. This study aimed to explore and describe adolescents' perceptions, knowledge and exercises of SRHR and associated factors among going adolescents in Arsi zone, Ethiopia. This study was guided by;explanatory sequential mixed-method study design. Thus, a two-phase data collection approach was adopted. In Phase I, the quantitative data were collected from 800 adolescent (15-19 years) using pre tested and self-administrated questionnaires. In Phase II, a semi-structured interview guide was used to collect data from 12 key informant interviews with teachers and health care providers and 4 focus group discussions with adolescents who were not participated in quantitative phase. The findings from the phases I and II approaches were merged through a comparison of findings side by side. Quantitative data was cleaned and analysed using SPSS 25 while thematic analysis was used for qualitative data. In phase I of 827 total adolescents invited to the study, 800 (96.7%) respondents participated in the study. Overall, less than half (26.1%) had ability to exercises and (45.3%) knowledgeable about SRHRs. In this study, adolescents with 17-19 years (AOR=3.30, 95% CI: 2.17-5. 23), grades 11 to 12 (AOR=1.69, 95% CI: 1. 23-2.35) and knowledge (AOR=1.47, 95%CI: 1.05-2.05) were significantly associated with SRHRs exercises. The research found misperception, limited knowledge and exercises amongst adolescents about SRHRs in secondary schools emphasising the rights-based approach. It is urged to promote educational campaigns to reduce misconceptions and increase knowledge of SRH rights among adolescents

Autodétermination des femmes dans la santé sexuelle et reproductive à Lubumbashi, République Démocratique du Congo / NA

ntroduction.La santé reproductive est caractérisée par une vie sexuelle satisfaisante, sûre et la capacité de se reproduire et de prendre des décisions. La vie de beaucoup de femmes estmarquée par les capacités d'action réduites quant aux décisions portant sur leur propre vie. L'objectif était d'évaluer l'autodétermination des femmes en matière de la santésexuelle et reproductive.Matérieletméthodes.Il s'agit d'une étude descriptive transversale effectuée dans 5 maternités de la ville de Lubumbashi au mois de juillet 2021 au près des 46 accouchées ayant accepté librement de participer à cette étude basée sur le questionnaire préétabli. Résultats.L'analyse des données montre que la moyenne d'âge était de 27,8 ± 3,6 ans avec les extrêmes entre 17 et 41 ans, dont 58,7% d'entre elles avaient le niveau de secondaire et paucipares dans 52,17%. La décision des rapports sexuels revenait au couple dans 58,70%. La décision d'avoir les enfantsrevenait au couple alors que celle de nommer les enfants revenait au mari dans 45,65% et 45,65%. Le nombre d'enfants était déterminé par le couple dans 45,65%. L'espacement des naissances était déterminé par la femme dans 45,65%. Le début de la CPN était décidé par la femme dans 86,6% et le choix du lieu des consultation prénatales(CPN) étaient décidés par la femme dans 89,13%. Le moment de se rendre à la maternité était décidé par la femme dans 73,91%. Le retour à domicile était décidé par le couple dans 39,13% et la décision des rapports sexuels après l'accouchement revenait à l'homme dans 52,17%.Conclusion.La femme congolaise n'a pas toujours une autodétermination maximale dans la santé reproductive. Ainsi des efforts supplémentaires sont nécessairespour laisser la liberté aux femmes de prendre des décisions qui conviennent mieux pour leur santé

Maternal and neonatal complications of childbirth among adolescents at the Sylvanus Olympio University Hospital Centre (CHU-SO), Lomé

Objective: To determine maternal and neonatal complications occurring at childbirth among adolescents.Materials and methods: This is a retrospective, descriptive study conducted from 1st July to 31st December 2019 at the maternity ward of the Sylvanus Olympio University Hospital Centre (CHU- SO), Lomé, Togo. The socio- demographic parameters of the mothers, details of prenatal and perinatal events and the clinical profile of the newborns at birth were studied. Results: The records of 332 adolescent mothers were studied. The average age of the mothers was 17.4 ± 1.5 years, with a range of 13-19 years. The pregnancies in two-thirds (66.3%) were supervised in centres without surgical facilities and by midwives in 83.1% of cases. A little over half of the mothers (53.3%) attended at least four antenatal clinic sessions, while 3.6% attended none. The modes of delivery were spontaneous vaginal (62.3%) and Caesarean section (35.2%). Complications of pregnancy were recorded in 12.9% of the mothers. There were statistically significant associations between the referred status of the mothers and haemorrhages, retained placenta and sepsis (p = 0.001, 0.038 and 0.011, respectively). There were no maternal deaths. The newborn babies required resuscitation in 6.3% of cases, while 7.0% were stillborn.There was a statistically significant relationship between the referred status of mothers and the occurrence of perinatal deaths (p =0.0001). Conclusion: Adolescent mothers are at risk of complications during childbirth, and these risks are increased by poor antenatal care and attempted deliveries in centres without surgical facilities.

Adolescent­parent communication on sexual and reproductive health issues amongst secondary school students in Western Region 1 of The Gambia

Background: Adolescent­parent communication about sexual issues is a challenging issue worldwide. In The Gambia, many traditional communities limit such communication and this can have an adverse influence on sexual and reproductive health (SRH) outcomes and behaviours in adolescents. Aim: The study assessed adolescent­parent communication on selected SRH issues amongst secondary school students. Setting: The study was conducted in selected secondary schools in Western Region 1 of The Gambia. Methods: This descriptive cross-sectional study utilised mixed methods. For the questionnaire survey, secondary school students were selected using a multistage sampling technique whilst parents for focus group discussions were purposively selected. Results: A total of 600 adolescents and 48 parents were studied. Only 360 (60.0%) of the students had heard of SRH. One-third (67.3%) knew about sexually transmitted infection (STIs) such as human immunodeficiency virus and acquired immunodeficiency syndrome (56.5%), gonorrhoea (40.5%) and syphilis (2.5%). Social media (31.0%) were the predominant source of information regarding SRH issues, followed by television (22.0%), school (14.0%) and parents (9.0%). Half (50.8%) of the adolescents discussed sexual intercourse with their parents ­ mostly with their mothers. Parental and cultural factors, fear, shyness and ignorance were the main reasons why adolescents did not discuss specific SRH issues with their parents. Conclusion: This study showed that adolescent­parent communication on SRH issues was poor. Programmes supporting parents to effectively communicate SRH matters with their children should be designed and implemented

Engaging students to improve sexual and reproductive health: a report of the university leadership for change initiative in Niger

Few development projects have addressed the sexual and reproductive health (SRH) needs of university students in West Africa or sought to promote student leadership to extend SRH benefits to others. This report presents results from the Evidence-to-Action Project's University Leadership for Change Initiative in Niger which had the goal to begin filling this gap. The Initiative used an innovative behavior change methodology with students at Abdou Moumouni University in Niamey, Niger and subsequently expanded it to three additional universities by applying ExpandNet scale-up approaches. 200 students trained as peer leaders reached almost 8,000 youths with SRH information and counseling, student leaders and university clinic staff distributed nearly 80,000 condoms and the project achieved national policy change through its collaboration with the Ministry of Public Health and the Ministry of Higher Education, Research and Innovations. The report concludes with key lessons about the benefits of student engagement and creativity in this effort

Sexual and reproductive health among high school adolescents in West Shoa zone, Oromia Region in Ethiopia

Adolescent's sexual and reproductive health is a challenge in many low and middle-income countries. We assessed the knowledge and attitude towards sexual and reproductive health among adolescents in West Shoa zone, Oromia region, Ethiopia. The study was cross-sectional using simple multi-stage random sampling and a structured questionnaire was used to collect data among adolescents aged 15 ­ 19 years. Frequency distribution of dependent and independent variables were computed and Odds ratios were calculated to determine association between variables. Most participants were from poor and illiterate families. Slightly over half of them had heard about sexual and reproductive health and the knowledge of emergency contraceptive was limited. About 80% of the girls who had become pregnant ended the pregnancy with an abortion and discussion between parents and adolescents on sexuality issues were poor. Effort to empower adolescents and communities with correct sexual and reproductive health is required; academic curricula should be reviewed and health facilities should be engaged to provide sexuality education

Evaluation of the ELIMIKA Pilot Project: improving ART adherence among HIV positive youth using an eHealth intervention in Mombasa, Kenya

Adolescents and young people are arguably the most dynamic and challenging group among populations living with HIV. The adherence to anti-retroviral treatment (ART) is often low among HIV-positive youth, thus creative and context specific interventions are necessary. We aimed at evaluating the usability and effectiveness of the pilot digital peer support platform ­ ELIMIKA, implemented in Mombasa, Kenya. We applied a pre-post-test design. Data collection consisted of two parts: pre- and post-online knowledge and behavior questionnaires, and a mid-term usability survey. From 90 recruited participants, 81 completed the pre- and post-questionnaires. Overall, the participants were satisfied with the main features of the web platform and stated that they would use it again (95%). However, there was not a significant change in knowledge and behavior, but adherence intentions after 3 months intervention period have improved. This study provides valuable information on feasibility, evaluation and challenges of eHealth intervention in Kenya that supports further research in this area

Sexual and reproductive health of adolescents in schools for people with disabilities

Introduction: persons with disabilities have the same sexual and reproductive health (SRH) needs as the abled people but they often face barriers to SRH information and services which are necessary for healthy and safe relationships, protection from HIV and other sexually transmitted infections (STIs). This study sought to access the SRH services among adolescents with disabilities in four Special Needs Schools in Ghana. Methods: the study adopted a cross-sectional study design with a quantitative approach to data collection between the months of January to March, 2018. A structured and pretested questionnaire was used to collect data from adolescents with disabilities from selected schools in Ghana. Both descriptive and inferential statistics were performed using chi-square test and multivariate logistic regression.Results: majority of participants had hearing disability (52.1%). The average age at menarche among females was 13 years whiles the age at which puberty was attained among boys was 14 years. School teachers were the major source of information on SRH for the respondents (63.7%) followed by parents (12.2%). A majority (67.1%) of respondents had good knowledge of SRH. Factors which were significantly associated with knowledge level were age (p=0.026), religion (p=0.034), sources of information (p<0.001), guardians (p=0.049).Conclusion: the majority of participants had good knowledge of SRH, although their knowledge of contraceptive and access were poor. Only condoms were mostly known. There is the need for increased awareness on the availability of other contraceptives methods and the removal of barriers to contraceptive methods

Prevalence and predictors of Implanon uptake in Ugu (Ugu North Sub District) 2016/17

Background: The contraceptive implant (Implanon) has been recognised as one of the most effective family planning methods and is a healthier choice for women in Africa due to its efficacy and convenience. Despite the evidence of effectiveness and safety of the implant, the actual uptake for Implanon use in the Ugu district of KwaZulu-Natal is relatively low. The aim of the study was to determine factors associated with Implanon uptake in Ugu North Sub District 2016/17.Methods: An observational cross-sectional study with an analytical component using self-administered questionnaires to collectinformation from 385 participants using randomised systematic sampling was conducted at family planning clinics at GJ Crookes Hospital and seven surrounding primary health care clinics. The chi-square test and multivariate logistic regression was used to determine associations.Results: Some 16% (n = 60) of the participants utilised Implanon. Despite having the correct knowledge 65.7% (n = 220) were not willing to use Implanon if it were offered. In addition, 55% of participants (n = 177) believed Implanon had more side effects. Parity (< 4 children) was found to be a statistically significant protective factor against (p < 0.05) Implanon uptake.Conclusion: Implanon is a highly unattractive method of contraception for women residing in the Ugu North Sub District. Fear of side effects and invasive method of insertion were identified as the major barriers to Implanon use. Education and increased patient awareness are strategies to increase the desirability and uptake of Implanon

Dating violence and self-efficacy for delayed sex among adolescents in Cape Town, South Africa

In South Africa, dating violence is known to be widespread among adolescents, and is therefore a major public health issue because of its association with sexual risk behaviours. The objective of the study was to examine the relationship between dating violence and self-efficacy for delayed sex among school-going adolescents in Cape Town, South Africa. The study is based on analyses of data from a school-based health education programme targeting sexual and reproductive health issues.The study involved 3,655 school-going adolescents aged between 12 and 17 in Cape Town, South Africa. The data was collected by means of a self-administered questionnaire composed of 153 items on sexual and reproductive health, dating violence as well as socio demographic characteristics. The results indicated that males showed a higher percentage of both dating violence victimization and perpetration, as compared to females. It was also found that adolescents from lower socio-economic backgrounds were more likely to be the victims of dating violence as compared to those from a higher socio-economic background. Female learners showed higher levels of self-efficacy for delayed sex than their male counterparts. Although the result revealed that there was a significant association between self-efficacy for delayed sex and socio-economic status, this link decreased with age. It is concluded that educational programmes aimed solely at improving self-efficacy for delayed sex is insufficient. Such programmes must also aim at preventing dating violence and equipping adolescents with the skills to negotiate their way out of dating violence. Afr J Reprod Health 2014; 18[2]: 46-57)

Directrizes e opcoes para estrategia de comunicacao em saude sexual e reprodutica integrada

Este documento apresenta as directrizes e opcoes para estrategias de comunicacao em saude sexual e reprodutiva integrada que deverao ser desenhadas e implementadas nos niveis nacional; provincial; distrital e mesmo no nivel local

Estudo CAP nas escolas: conhecimento; atitudes; praticas e comportamento em saude sexual e reprodutiva em uma era de SIDA; Maputo

Objectivos do estudo: 1. Ter um diagnostico da situacao de adolescentes e jovens do sexo feminino e masculino que frequente a escola no que se refere a seus conhecimentos sobre saude sexual e reprodutiva; contracepcao; doencas transmitidas sexualmente incluindo HIV/SIDA; suas fontes de informacoes; suas atitudes sobre essas questoes; assim como seus padroes de comportamento sexual; 2-Estabelecer dados de base que poderao ser usados para monitorar e avaliar junto aos adolescentes e jovens os seus conhecimento; atitudes e comportamento sexual durante a vida do projecto; 3-Fortalecer as intervencoes do projecto com base nas necessidades identificadas de adolescentes e jovens; 4-Desenvolver programas apropriados e aceitaveis em conjunto com a comunidade alvo; 5-Proporcionar os conteudos necessarios e adequados para o desenvolvimento tanto das actividades clinico-educativas como dos materiais IEC; 6-Subsidiar a formulacao de politicas e estrategias na area de saude sexual e reprodutiva para adolescentes e jovens