Vivências de trabalho precoce de adolescentes em medida socioeducativa / Experience of child labor of adolescents complying with a social-educational measure / Vivencias de trabajo infantil de adolescentes en medidas socioeducativas

Este artigo tem como objetivo analisar a vivência de trabalho precoce de adolescentes e jovens em cumprimento de medida socioeducativa, no estado da Paraíba. Os instrumentos utilizados foram um Questionário Mosquito Diagnóstico e uma Entrevista Semiestruturada. A análise foi realizada com o software Iramuteq, (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires), através da Análise Hierárquica Descendente, que gerou seis classes: significado do trabalho; infância e escola; condições objetivas de vida; trabalho, drogas e ato infracional; consequências do trabalho infantil; e trabalho infantojuvenil. A perspectiva teórica utilizada foi a psicologia histórico-cultural e os dados discutidos a partir do conceito de vivência. Conclui-se que as vivências e situações sociais de desenvolvimento foram caracterizadas pelo trabalho precoce que oportunizou o envolvimento com atos infracionais e as instituições responsáveis pela garantia de direitos em vez de garantir a proteção social, criminalizaram por meio de medidas socioeducativas.(AU)

This article aims to analyze the experience of child labor of adolescents and youngsters that are complying a social-educational measure, in the State of Paraíba. The instruments utilized were a Questionnaire Mosquito Diagnóstico and a Semi-Structured Interview. The analysis was performed by using the Iramuteq software (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires), by using Descending Hierarchical Analysis, which generated six classes: meaning of labor; childhood and school; objective conditions of life; labor, drugs, and act of infraction; consequences of child labor; and child labor. The theoretical perspective used was historical-cultural psychology and the data were discussed from the concept of experience. It was concluded that the experiences and social situations of development were characterized by child labor, which enabled the involvement with acts of infraction; and the institutions responsible for guaranteeing rights, instead of guaranteeing social protection, criminalized by using social-educational measures.(AU)

Este artículo tiene como objetivo analizar la vivencia precoz de adolescentes y jóvenes que cumplen medidas socioeducativas en el estado de Paraíba (Brasil). Los instrumentos utilizados fueron un Cuestionario Mosquito Diagnóstico y una entrevista semiestructurada. El análisis se realizó con el software Iramuteq (Interface de R pour les Multidimensionnelles Analyzes de Textes et de Questionnaires), mediante análisis jerárquico descendente, que generó seis clases: Significado del trabajo; Infancia y escuela; Condiciones objetivas de vida; Trabajo, drogas y acto de infracción; Consecuencias del trabajo infantil; y Trabajo infantojuvenil. La perspectiva teórica que se utilizó fue la psicología histórico-cultural, y los datos se discutieron desde el concepto de vivencia. Se concluye que las vivencias y situaciones sociales de desarrollo se caracterizaron por trabajo infantil que permitió la participación en infracciones y que las instituciones responsables de garantizar los derechos en lugar de la protección social los criminalizaron mediante medidas socioeducativas.(AU)

Encarceramento feminino: um debate entre criminologia e perspectivas feministas / Female incarceration: a debate between criminology and feminist perspectives / Encarcelamiento femenino: un debate entre la criminología y las perspectivas feministas

Este ensaio teórico-reflexivo tem como objetivo discutir sobre as contribuições dos estudos da criminologia e sua crítica para as diversas formas de aprisionamento feminino, e mais atualmente para o encarceramento em massa no sistema prisional, além de abrir espaço para o debate sobre as diferentes perspectivas feministas e as relações com os estudos criminológicos, sobretudo com os posicionamentos da chamada criminologia crítica. Reconhecem-se importantes avanços e conquistas feministas no debate sobre a estruturação masculinizada do direito penal e do seu fazer jurídico, mas também a manutenção de diversas formas de violência de gênero que configuram um sistema penal antropocêntrico, seletivo, racista e discriminatório. Indica-se a urgência de estudos interseccionais que considerem as particularidades e reinvindicações das mulheres no cárcere e suas formas de militância, sobretudo diante de população carcerária feminina composta majoritariamente por mulheres negras, pobres e periféricas. Faz-se visível a necessidade de uma análise dos fatores que atravessam o encarceramento feminino por uma ótica feminista plural, adequada às realidades que se estudam e atenta às múltiplas perspectivas que podem existir dentro do feminismo.(AU)

This theoretical-reflexive essay aims to discuss the contributions of criminological studies and their critique of the various forms of imprisonment of women, and more recently of mass incarceration in the prison system, in addition to opening space for the debate on the different feminist perspectives and their relations with criminological studies, especially with the positions of the so-called critical criminology. Important feminist advances and conquests are recognized in the debate about the masculinized structure of penal law and its legal practice, but also the maintenance of diverse forms of gender violence that configure an anthropocentric, selective, racist, and discriminatory penal system. It indicates the urgency of intersectional studies that consider the particularities and claims of women in prison and their forms of militancy, especially in the face of the female prison population composed mostly of black, poor, and peripheral women. The need for an analysis of the factors that cross women's imprisonment from a plural feminist perspective, adequate to the realities under study and attentive to the multiple perspectives that may exist within feminism, becomes visible.(AU)

Este ensayo teórico-reflexivo pretende discutir las aportaciones de los estudios criminológicos y su crítica a las distintas formas de encarcelamiento femenino, y más recientemente de encarcelamiento masivo en el sistema penitenciario, además de generar debate sobre las distintas perspectivas feministas y sus relaciones con los estudios criminológicos, especialmente con las posiciones de la Criminología Crítica. Se reconocen importantes avances y logros feministas en el debate sobre la estructuración masculinizada del derecho penal y su práctica jurídica, además del mantenimiento de diversas formas de violencia de género que configuran un sistema penal antropocéntrico, selectivo, racista y discriminatorio. Se necesitan estudios interseccionales que consideren las particularidades y reivindicaciones de las mujeres en prisión y sus formas de militancia, principalmente ante la población penitenciaria femenina compuesta mayoritariamente por mujeres negras, pobres y periféricas. Se hace evidente la necesidad de analizar los factores que inciden en el encarcelamiento femenino desde una perspectiva feminista plural, adecuada a las realidades que se estudian y atenta a las múltiples perspectivas que pueden existir dentro del feminismo.(AU)

O inventário de envolvimento paterno revisado: inclusão de pais com filhos pré-escolares / The inventory of father involvement revised: inclusion of fathers with preschool children / El inventario de envolvimiento paterno revisado: inclusión de padres de preescolares

Apesar da importância do envolvimento paterno, sua avaliação persiste desafiadora. No Brasil, o Inventário de Envolvimento Paterno (IFI-BR) vem se mostrando adequado para uso com pais de crianças de 5 a 10 anos. Entretanto, do ponto de vista do desenvolvimento infantil e de intervenções preventivas, seria importante avaliar o envolvimento paterno quando as crianças são mais novas. Assim, este trabalho teve como objetivos: identificar limitações do IFI-BR, quando usado com pais de crianças entre 2 e 10 anos, e avaliar itens para o IFI-BR-revisado. No Estudo 1, 434 pais com filhos no Ensino Infantil ou Fundamental 1 responderam a um questionário sociodemográfico e ao IFI-BR. Com base em análises de dados omissos, estrutura interna e precisão, modificações foram sugeridas, visando à manutenção da estrutura interna original do instrumento. No Estudo 2, 572 pais com filhos na mesma faixa etária responderam a um questionário sociodemográfico e à versão modificada do IFI-BR. Foram comparadas as frequências de dados omissos e estimativas de precisão para os itens originais e modificados, selecionando aqueles que melhor representavam essa amostra de pais para compor a versão revisada do IFI-BR. Esses resultados indicaram evidências adequadas de validade, com base no conteúdo da versão revisada do IFI-BR, quando utilizada para avaliar a qualidade do envolvimento paterno de pais brasileiros com filhos do Ensino Infantil ao Fundamental 1. Após verificadas evidências de validade adicionais, essa versão revisada do IFI-BR poderá ser utilizada, por exemplo, em estudos longitudinais e na avaliação de intervenções precoces com pais.(AU)

Despite the importance assigned to father involvement, evaluating this construct remains a challenge. In Brazil, the Inventário de Envolvimento Paterno (IFI-BR) has showed satisfactory evidence of validity for fathers of children between 5 and 10 years old. From the perspective of child development and preventive interventions, however, evaluating father involvement with younger children is essential. Hence, this study sought to: identify limitations of the IFI-BR for fathers of children between 2 and 10 years old, and evaluate items for a revised IFI-BR. In Study 1, 434 fathers of children in early childhood and primary school settings answered a sociodemographic questionnaire and the IFI-BR. Based on analyses of missing data, internal structure, and reliability, modifications were suggested to maintain the original internal structure. In Study 2, 572 fathers of children in the same age range answered a sociodemographic questionnaire and the modified IFI-BR. After comparison between values for missing data and reliability of the original and modified items, the items that best represented the broader sample of fathers were selected to compose the revised IFI-BR. Results indicated adequate evidence of content validity for the revised IFI-BR when used to assess the involvement of Brazilian fathers with children in early childhood education and primary school settings. After additional evidence has been verified, this revised IFI-BR can be used, for example, in longitudinal studies and to evaluate early interventions with fathers.(AU)

La participación paterna es importante, pero su evaluación sigue siendo desafiadora. En Brasil, el Inventário de Envolvimento Paterno (IFI-BR) demuestra ser adecuado para aplicar a padres de niños de 5 a 10 años de edad. No obstante, desde la perspectiva del desarrollo infantil y de las intervenciones preventivas, sería importante evaluar la participación de los padres de niños más jóvenes. Este estudio tuvo como objetivos: identificar limitaciones del IFI-BR cuando se aplica a padres de niños entre los 2 y 10 años y evaluar ítems para el IFI-BR-revisado. En Estudio 1, 434 padres con hijos en el jardín de infantes o escuela primaria respondieron un cuestionario sociodemográfico y el IFI-BR. Con base en el análisis de datos faltantes, estructura interna y exactitud, se sugirieron modificaciones para mantener la estructura interna original del instrumento. En Estudio 2, 572 padres respondieron un cuestionario sociodemográfico y la versión modificada del IFI-BR. Se compararon las frecuencias de datos faltantes y estimaciones de exactitud para los ítems originales y modificados, seleccionando aquellos que representaban mejor a esta muestra de padres para la versión revisada del IFI-BR. Estos resultados indicaron evidencia adecuada de validez, basada en el contenido de la versión revisada del IFI-BR, cuando se utilizó para evaluar la calidad de la participación de padres brasileños con niños en el jardín de infantes y en la escuela primaria. Después de verificada la evidencia adicional de validez, la versión revisada del IFI-BR se puede utilizar, por ejemplo, en estudios longitudinales y en la evaluación de intervenciones precoz con los padres.(AU)

Engajamento com o trabalho e exaustão emocional de profissionais da socioeducação / Engagement with work and emotional exhaustion of socio-education professionals / Comprometimiento con el trabajo y agotamiento emocional de profesionales de la socioeducación

Buscou-se compreender a percepção dos profissionais das medidas socioeducativas acerca do seu engajamento e exaustão com o trabalho. Para isso, realizou-se um estudo qualitativo, descritivo e exploratório, por meio de uma entrevista semiestruturada a três integrantes da equipe técnica e dois coordenadores de segurança (idades entre 28 e 57 anos). A análise dos dados foi conduzida com o auxílio do software Iramuteq, que gerou cinco classes temáticas: a) rotina das unidades socioeducativas e as demandas do trabalho dos profissionais; b) gestão de conflitos nas unidades, da mediação à polícia; c) recursos pessoais e institucionais relacionados ao exercício da profissão; d) aspectos relacionados ao contexto de trabalho; e, por último, e) indicadores de esgotamento laboral, adversidades e adoecimento profissional. Os participantes descreveram diversas demandas relacionadas à exaustão física e psicológica (e.g. equipe reduzida, insalubridade, baixo salário e fragilidade do vínculo empregatício), mas também ressaltaram a relevância social de sua prática profissional junto aos adolescentes e o relacionamento positivo entre os profissionais como fatores que justificam o seu engajamento e permanência nas instituições socioeducativas. Conclui-se evidenciando que os contextos têm influência direta na saúde desses profissionais, o que sublinha a importância de se olhar para suas condições de trabalho e para aspectos ligados à saúde mental, promovendo, desse modo, avanços na realidade socioeducativa.(AU)

The aim was to understand the perception of professionals of socio-educational measures about their engagement and exhaustion with work. To that end, a qualitative, descriptive, and exploratory study was carried out by means of a semi-structured interview with three members of the technical team and two safety coordinators (ages between 28 and 57 years). Data analysis was conducted with the help of the IRAMUTEQ software, which generated five thematic classes: a) routine of socio-educational units and work demands of professionals; b) conflict management in the units, from mediation to the police; c) personal and institutional resources related to the exercise of the profession; d) aspects related to the work context; and, lastly, e) indicators of labor exhaustion, adversity, and occupational illness. Participants described several demands related to physical and psychological exhaustion (e.g. reduced team, insalubrity, low salary, and fragility of the employment relationship), but also emphasized the social relevance of their professional practice with adolescents and the positive relationship among professionals as factors that justify their engagement and permanence in socio- educational institutions. It is concluded that the contexts have a direct influence on the health of these professionals, which highlights the importance of looking at their working conditions and aspects related to mental health, thus promoting advances in the socio-educational reality.(AU)

Se procuró comprender la percepción de los profesionales que trabajan con medidas socioeducativas sobre su comprometimiento y el agotamiento en el trabajo. Para esto, se realizó un estudio cualitativo, descriptivo y exploratorio, por medio de una entrevista semiestructurada a tres integrantes del equipo técnico y dos coordinadores de seguridad (edades entre 28 y 57 años). El análisis de los datos fue conducido en el software IRAMUTEQ, que generó cinco clases temáticas: a) rutina de las unidades socioeducativas: demandas del trabajo de los profesionales; b) manejo de conflictos en las unidades: desde la mediación hasta la policía; c) recursos personales e institucionales relacionados al ejercicio de la profesión; d) aspectos relacionados al contexto del trabajo; e) indicadores de agotamiento laboral, adversidades y enfermedad del profesional. Los participantes describieron diversas demandas relacionadas al agotamiento físico y psicológico (por ej.: equipo reducido, insalubridad, bajos sueldos y fragilidad del vínculo laboral), pero también destacaron la importancia social de su práctica profesional junto a los adolescentes y el vínculo positivo entre los profesionales como factores que justifican su comprometimiento y permanencia en las instituciones socioeducativas. Se concluye que los contextos influyen directamente en la salud de estos profesionales, lo que rescata la importancia de verificar sus condiciones de trabajo y los aspectos relacionados a la salud mental, promoviendo, de este modo, avances en la realidad socioeducativa.(AU)

Políticas desenvolvimentistas e mulheres quebradeiras de coco babaçu: capturas contemporâneas / Developmentalist policies and babassu coconut-breaking women: contemporary catches / Políticas desarrollistas y las mujeres que rompen coco babaçu: capturas contemporáneas

Este estudo propõe analisar as relações e os processos de subjetivação de mulheres quebradeiras de coco babaçu decorrentes das intervenções de políticas desenvolvimentistas em seus territórios de vida e reverberações no Movimento Interestadual de Quebradeiras de Coco Babaçu (MIQCB). Sob a perspectiva ético-estético-política da Cartografia, acompanhamos as narrativas das histórias de vida de 24 mulheres, suas atividades cotidianas e eventos do MIQCB, também analisamos os documentos das políticas. Entendemos que, ao passo que tais políticas de desenvolvimento rural contribuem para a melhoria das condições de vida, em termos materiais e simbólicos, elas também produzem ressonâncias relacionadas ao modo de subjetivação do tipo "empresário de si", que agenciam seus modos de viver, de produzir e de se relacionar consigo e com os outros na lógica capitalista neoliberal. A resistência às capturas neoliberais também estão presentes ao ampliarem as mobilizações coletivas do próprio movimento, articulando com outros na produção de um "comum".(AU)

This study proposes to analyze the relations and the processes of subjectivation of babassu coconut-breaker women arising from developmental policy interventions in their territories of life and reverberations in the Babassu Coconut-breaker Interstate Movement (MIQCB). From the ethical-aesthetic-political perspective of Cartography, we followed the narratives of the life stories of 24 women, their daily activities and promoted events by MIQCB, we also analyzed the policy documents. We understand that while these policies of rural development contribute to improve the living conditions, in material and symbolic terms, they also produce resonances related to the "self-entrepreneur" mode of subjectivation, which has been handling their ways of living, producing, and relating to themselves and others in the neoliberal capitalist logic. Resistance to neoliberal captures is also present as they expand the collective mobilizations of the movement itself, articulating with others, in the production of a "common."(AU)

Este estudio tiene como objetivo analizar los procesos de subjetivación de las mujeres que rompen coco babaçu que surgen de las intervenciones de las políticas de desarrollo en sus territorios de vida y las reverberaciones en el Movimiento Interestadual de las Mujeres que Rompen Coco Babaçu (MIQCB). Desde la perspectiva ético-estético-política de la Cartografía, seguimos las narraciones de las historias de vida de 24 mujeres, sus actividades diarias y eventos del MIQCB, y también analizamos los documentos de las políticas. Si bien estas políticas han contribuido a mejorar las condiciones de vida de las mujeres, en términos materiales y simbólicos, también han producido resonancias del modo de subjetivación "autoempresarial", que ha agenciado sus formas de vivir, producir y relacionarse consigo mismas y con los demás en la lógica capitalista neoliberal. La resistencia a las capturas neoliberales también está presente cuando amplían las movilizaciones colectivas del propio movimiento, articulándose con otros en la producción de un "común".(AU)

Políticas sociais direcionadas às famílias com chefia feminina: um estudo da literatura no Brasil e em Portugal / Social policies aimed at families with female heads: a study of literature in Brazil and Portugal

O artigo apresenta parte dos resultados de uma investigação relativa ao projeto de cooperação internacional, envolvendo Brasil e Portugal, referente às diferenças e similitudes entre as políticas familiares de conciliação entre trabalho profissional e o trabalho familiar direcionadas as famílias com chefia feminina. A partir de levantamento bibliográfico, a revisão sistemática da literatura na área, identificam-se pontos de aproximação e distanciamento entre os autores estudados, como: à discussão da implantação das políticas restritivas de cariz neoliberal e desigualdades entre homens e mulheres; o debate sobre centralidade da família nas políticas sociais nos dois países em análise; as diferentes concepções de famílias e os novos arranjos familiares que se mesclam com o antigo padrão de família patriarcal e, finalmente, aborda as dificuldades da mulher chefe de família em conciliar formação, trabalho profissional e trabalho familiar no atual contexto econômico

The article presents part of the results of an investigation related to the international cooperation project, involving Brazil and Portugal, referring to the differences and similarities between family policies to reconcile professional work and family work directed at families with female heads. From a bibliographic survey, a systematic review of the literature in the area, points of approximation and distance between the authors studied are identified, such as: the discussion of the implementation of neoliberal restrictive policies and inequalities between men and women; the debate on the centrality of the family in social policies in the two countries under analysis; the different conceptions of families and the new family arrangements that blend with the old patriarchal family pattern and, finally, it addresses the difficulties of the female head of household in reconciling training, professional work and family work in the current economic context

A twenty year experience with the use of intrauterine contraceptive device (IUCD) in a university teaching hospital in South- south Nigeria

Context: Contraceptive prevalence in Nigeria is low at 17%. Amongst Nigerian women and couples who accept to use contraception, the IUCD is the most commonly used contraceptive method with variation in rates of use between geographical areas and among Health Institutions. Factors that determine decision making on IUCD use are not well understood. Aims: To study the use, effectiveness, complications and discontinuation rates for intrauterine contraceptive device received at the University of Benin Teaching Hospital from 1997 to 2016 and analyzed in January, 2019. Study Design: This was a retrospective cross sectional study. Methodology: The case notes of all 3326 new clients who accepted Copper T intrauterine contraceptive device at the UBTH Family Planning Clinic during the review period were retrieved and analyzed. Data regarding acceptors socio-demographic characteristics, side effects, effectiveness, complications, duration of use and reasons for discontinuation were extracted and entered into SPSS for windows version 22.0 and analyzed. Results: Out of the 8203 clients that accepted to commence a family planning method, 3326 (40.55%) accepted to use IUCD. The mean age of IUCD acceptors at commencement was 33.4±5.60 and the mean age of their husbands was 39.85±6.91. The mean parity was 3.73±1.87 (range 0-12), while the mean number of living children was 3.56±1.66 (range 0-10). The mean duration of use (in months) was 40.43±40.13. Women with 5 or more children (P Value 0.000) and at least a minimum of secondary education (P Value 0.000), were significantly associated with IUCD use duration of > or more than 2 years. Also, women who reported satisfaction with IUCD (P Value 0.000) and no complications (P Value 0.000) were also associated with longer duration of use. Conclusion: IUCD is a common family planning method used by women at UBTH. Its duration of use is higher among clients with more children, at least a minimum of secondary school education and no complications from its use. This information is relevant for family planning service providers to increase contraceptive uptake by women in Nigeria

Planning for child and adolescent mental health interventions in a rural district of South Africa: a situational analysis

Objective: The aim of this study was to conduct a situational analysis as part of formative work to inform the development of community-based mental health services for children and adolescents at a district level. The purpose of the situational analysis was to determine the current state of child and adolescent mental health (CAMH), the available resources for CAMH, the range of services provided, and the existing pathways to CAMH care in a low-resource district with a view to developing a district mental health plan to improve access to CAMH services.Methods: Data for this situational analysis was collected from a rural district in the KwaZulu-Natal province using mixed methods. The qualitative component explored various stakeholders' (n = 26) perspectives using semi-structured interviews. The quantitative data for the study was collected using an adaptation of the situation analysis tool developed by the PRIME consortium.Results: The findings revealed the need to strengthen all the basic building blocks of the health system due to the weaknesses identified in the current CAMH care system in the district. The result of the situational analysis revealed that the provision of CAMH services in the district is sparse, uncoordinated, and not prioritised.Discussion: The findings of the study highlighted a severe shortage of specialised CAMH services in the district, poor integration of CAMH services into primary health care, and at the community platform there are deficits in the integrated school health programme. Further, the lack of a coordinated intersectoral collaborative system and well-defined referral pathways were revealed.Conclusion: The study highlights various challenges facing CAMH services at the Amajuba district. While these are not new, the study contributes to our understanding of the district level factors that may hinder the development of a district CAMH plan

Guía Nacional de Anticoncepción para Adolescentes / National Guide to Contraception for Adolescents

Abordada desde la perspectiva del MSPAS que es consciente de que el embarazo en adolescentes afecta su salud, desarrollo y proyecto de vida, y que ha contribuido al logro de avances importantes, para garantizar los derechos sexuales y reproductivos de los adolescentes que son atendidos en las redes de servicios de salud. Además, el documento refleja los compromisos adquiridos en torno a disminuir: embarazos en adolescentes y muertes maternas, además de la prevención del VIH/Sida, las ITS y la violencia sexual. Esta guía está dirigida al personal de salud de los tres niveles de atención del MSPAS con la finalidad de fortalecer las competencias técnicas y orientarles para que brinden atención de forma integral y con calidad, garantizando la información, orientación, consejería balanceada y provisión de métodos anticonceptivos y porque además el ministerio, aporta atención desde espacios amigables y clínicas integrales hospitalarias para adolescentes, así como la provisión de métodos anticonceptivos (y clínicas de planificación familiar).

Plan nacional de prevención de embarazos en adolescentes en Guatemala: PLANEA 2018 - 2022 / Title: National plan for the prevention of teenage pregnancies in Guatemala: PLANEA 2018 - 2022

El presente plan busca definir un modelo de intervención interinstitucional, que toma las recomendaciones internacionales y propone una forma de abordar algunas de ellas con el fin de formular una acción integrada para resolver esta problemática. En él cita que, el embarazo adolescente es resultado de la pobreza, la desigualdad de género, la discriminación, la falta de acceso a los servicios de salud sexual y reproductiva que incluya la provisión de anticonceptivos, baja escolaridad, dificultades para el acceso a educación integral en sexualidad adecuada a la edad (en la escuela y comunidad), opiniones y valoraciones negativas sobre las niñas, adolescentes y las mujeres. Además señala que, a nivel mundial, el 11% de los nacimientos proceden de madres adolescentes, de los cuales el 95% ocurre en países en desarrollo (OMS, 2012). La región de América Latina tiene la segunda tasa más alta de embarazos en adolescentes del mundo (75.67 por cada 1,000 mujeres entre 15 y 19 años). En Guatemala se ha reportado un registro de embarazo en mujeres menores de 20 años desde el 2009, que correspondía al 18%, y que presentó un incremento en el 2012 al ubicarse en 22%. Estas cifras, que para el 2016 continúan aún en un 18% (INE, 2016b), se sitúan en la media establecida de la región (18%).

Emergência e institucionalização da sexologia em Portugal: processos, atores e especificidades / The emergence and institutionalization of sexology in Portugal: processes, actors, and specificities / Emergencia e institucionalización de la sexología en Portugal: procesos, actores y especificidades

Resumo: Com base na teoria dos campos de Bourdieu, este artigo analisa a emergência e a institucionalização da sexologia enquanto ciência e profissão em Portugal, identificando instituições, atores e práticas profissionais, e discutindo as suas relações e especificidades. Começa por contextualizar o surgimento da sexologia moderna ocidental para uma compreensão do caso português no contexto sexológico internacional. Numa segunda parte, descreve os fatores de natureza social, cultural e institucional que têm impulsionado a profissionalização da sexologia. Na terceira, descreve a emergência da sexologia portuguesa e os seus principais marcos históricos, instituições e atores em jogo. Por fim, discute algumas implicações desse processo para o papel da sexologia como ciência e profissão. Esta pesquisa revela as dinâmicas entre processos nacionais e internacionais no campo, na transição de uma perspectiva holística da sexologia para a hegemonia da medicina sexual, e clarifica os seus mecanismos de legitimação como ciência transdisciplinar da sexualidade, sugerindo perspectivas futuras.

Abstract: Based on Bourdieu's field theory, this article analyzes the emergence and institutionalization of sexology as a science and profession in Portugal, identifying relevant institutions, actors, and professional practices and discussing its relations and specificities. The analysis begins by contextualizing the emergence of modern Western sexology in order to comprehend the Portuguese case in the international sexology context. The second section describes the social, cultural, and institutional factors that have driven the professionalization of sexology. The third section describes the emergence of Portuguese sexology and its principal historical milestones, institutions, and actors. Finally, the article discusses some implications of this process for the role of sexology as a science and profession. The study reveals the dynamics of national and international processes in the field, in the transition from a holistic perspective of sexology to the hegemony of sexual medicine, and sheds light on its mechanisms of legitimation as a transdisciplinary science of sexuality, suggesting future perspectives.

Resumen: En base a la teoría de los campos de Bourdieu, este artículo analiza la emergencia y la institucionalización de la sexología como ciencia y profesión en Portugal, identificando instituciones, actores y prácticas profesionales, y discutiendo sus relaciones y especificidades. Comienza por contextualizar el surgimiento de la sexología moderna occidental para una comprensión del caso portugués en el contexto sexológico internacional. En una segunda parte, se describen los factores de naturaleza social, cultural e institucional que han impulsado la profesionalización de la sexología. En la tercera parte, se describe la emergencia de la sexología portuguesa y sus principales marcos históricos, instituciones, y actores en juego. Finalmente, discute algunas implicaciones de este proceso para el papel de la sexología como ciencia y profesión. Esta investigación revela las dinámicas entre procesos nacionales e internacionales en el campo, en la transición de una perspectiva holística de la sexología para la hegemonía de la medicina sexual, y clarifica sus mecanismos de legitimización como ciencia transdisciplinaria de la sexualidad, sugiriendo perspectivas futuras.

50 años de planificación familiar en Chile, 1965-2015: Experiencias de las primeras generaciones de mujeres urbanas usuarias del programa / 50 años de planificación familiar en Chile, 1965-2015. Experiencias de las primeras generaciones de mujeres urbanas usuarias del programa

ANTECEDENTES: En el año 1965, el Servicio Nacional de Salud chileno comenzó la ejecución directa de acciones sanitarias destinadas a implementar programas de planificación familiar, evento considerado hito fundacional que inició formalmente una política nacional de planificación familiar de carácter público y con respaldo gubernamental. OBJETIVO: Analizar la experiencia de las primeras generaciones de mujeres urbanas usuarias del programa de planificación familiar durante la década de 1960. MÉTODO: Estudio cualitativo con enfoque biográfico, realizado en 64 mujeres adultas mayores urbanas pertenecientes a las primeras generaciones usuarias del programa. Para la recolección de datos se utilizaron entrevistas con enfoque biográfico. RESULTADOS: Se identificaron cuatro dimensiones: contexto familiar y social de la sexualidad femenina en infancia y adolescencia; proyecciones frente a la maternidad; experiencia personal de la usuaria en el programa y valoraciones de la usuaria en torno al programa. El programa impulsó el ejercicio del derecho de la mujer de decidir libremente y sin presiones el número de hijos que deseaba procrear. No obstante, por ser un derecho inédito hasta ese momento, su ejercicio fue instalándose progresivamente desde una construcción cultural de maternidad que no poseía dominio sobre sus eventos reproductivos, hacia una nueva construcción cultural que reconocía incipientemente mayores grados de decisión en la propia vida reproductiva. CONCLUSIÓN: Se proponen tres perfiles tipo que ilustran las experiencias de las mujeres usuarias a partir de los componentes condición de fertilidad probada como requisito para el ingreso al programa de planificación familiar, número de hijos totales y espaciamiento entre nacimientos.

BACKGROUND: In 1965, the Chilean National Health Service began the direct implementation of sanitary measures to implement family planning programs; considered foundational milestone event formally launched a national family planning policy of public and government-backed. AIMS: To analyze the experience of the first generation of urban women users of family planning program during the 1960s. METHOD: Qualitative study with biographical approach, conducted in 64 elderly women in urban users belonging to the first generations of the program users. For data collection interviews were used to biographical approach. RESULTS: We identified four dimensions: family and social context of female sexuality in childhood and adolescence; projections toward motherhood; personal experience of the user in the program and ratings of the user around the program. The program promoted the exercise of the right of woman to decide freely and without pressure the number of children they wanted to procreate. However, being an unpublished right so far, the exercise was settled progressively from a cultural construction of motherhood did not have control over their reproductive events, to a new cultural construction incipient recognized higher levels of decision itself reproductive life. CONCLUSION: It propose three kinds profiles that illustrate the experiences of women users from components proven fertility status as a requirement for admission to the program of family planning, total number of children and birth spacing.

Plan nacional para la reducción de la mortalidad materna y neonatal: 2015 ­ 2020 / National plan for the reduction of maternal and neonatal mortality: 2015 - 2020

El plan de reducción de muerte materna 2015-2020 establece acciones estratégicas técnicas/normativas que deben tomarse en cuenta en la prestación de servicios de salud y otros espacios afines, que deben redundar en pro de la salud reproductiva de mujeres y hombres. El plan de reducción de muerte materna 2015-2020 responde a cuatro áreas estratégicas del plan de acción para acelerar la reducción de muerte materna y la morbilidad materna grave 2012-2017 de la OPS/OMS, establece acciones estratégicas técnicas/normativas que deben tomarse en cuenta en la prestación de servicios de salud y otros espacios afines, que deben redundar en pro de la salud reproductiva de mujeres y hombres. El referido documento, orienta acerca de la implementación de acciones de promoción, prevención, atención, recuperación y rehabilitación, en cumplimiento al marco legal político y en respuesta a la sala situacional de salud reproductiva identificada en cada uno de los campos y niveles de intervención, entre los criterios para la implementación de dichas acciones se incluyen: facilitar la accesibilidad cultural, económica y geográfica que permitan superar, pero sobre todo, prevenir, las crisis por complicaciones; promover ambientes favorables y amigables en busca de la atención y resolución del evento obstétrico, en forma que la atención sea adecuada para la mujer y el recién nacido.

Barriers to Utilisation of Maternal Health Services in a Semi-urban Community in Northern Nigeria: The Clients' Perspective

Low level of utilisation of maternal health services is a major factor responsible for high maternal mortality in northwestern region of Nigeria. This study was aimed at determining the barriers to utilisation of maternal health services from the perspective of mothers in northwestern Nigeria. Materials and Methods: A cross-sectional study of 150 mothers; selected through multistage technique; was conducted. Data were collected using a structured interviewer-administered questionnaire; and analysed using SPSS statistics 17.0. Results: Only 2.7 utilised preconception service; 98.7 antenatal care service (ANC); 24.0 delivery; 35.3 postnatal care and 14.0 utilised family planning service. Major reasons for non-utilisation of delivery service were not having a delivery complication in the past (57 (CI = 47.4-66.1)) and negative provider attitude (23.7(CI = 16.4-32.7)). For non-utilisation of postnatal care; the major reasons were also not having a postnatal complication in the past (60.8 (CI = 50.4-70.4)) and negative provider attitude (27.8 (CI = 19.4-38.0)). As for non-utilisation of family planning service; the major reason was desire to have more children (32.6 (CI = 24.7-41.4)). Reasons for non-use of preconception care and ANC were not computed because respondents to these questions were not enough; only 6 (4.0) were aware of preconception care in the first place and only 2 (1.3) were aware of preconception care in the first place and only 2 (1.3) were not using ANC. Conclusion: Despite living near a health facility; most of the mothers were not using maternal health services. It is recommended that while there is the need to raise awareness on the utilisation of maternal health services; bring it closer to the mothers and make it more affordable; there is a more pressing need to improve its quality; especially through the alleviation of negative attitude of health care providers

value of family planning for improving maternal health in rural Afghanistan: the example of Kandahar

Women in Afghanistan face some of the highest risks of maternal mortality and morbidity globally. The situation in rural parts of the country is particularly troubling, with women and girls residing in these areas suffering from much higher rates of death due to pregnancy-and delivery-related complications compared to urban areas. With a goal of increasing the contraceptive prevalence rate, particularly to assist in birth spacing, the Basic Package of Health Services seeks to provide access to family planning services equitably, regardless of ability to pay and with a special focus on rural and hard-to-reach populations. Using Maywand district in Kandahar province as a representative example of rural areas, we evaluate the benefits and assess the value [i.e., cost-effectiveness] of family planning for birth spacing and limiting, and to prevent pregnancy-related deaths. We synthesize the best available data to adapt a previously validated maternal mortality model to the situation of maternal health in Kandahar. Outcomes include total fertility rate [TFR], pregnancy-related complications, unsafe abortions, pregnancy-related deaths, maternal mortality ratio [MMR], lifetime risk of maternal death, and proportionate mortality ratio [proportion of deaths among women 15-49 years that are pregnancy-related]. We also estimate the life expectancy gains, years of life saved [YLS], and lifetime costs in order to assess the cost-effectiveness of family planning interventions. We compute the reduction in total fertility rate and pregnancy-related deaths and estimate the economic impact and cost-effectiveness of family planning interventions. Model-generated estimates of maternal mortality indicators, total fertility rate, and distribution of maternal death by cause closely approximated empiric data. Increasing family planning coverage from a baseline of 8% in rural Kandahar to 30% and 50%, would be expected to reduce the total fertility rate from 6.6 to 5.1 and 3.9, respectively, reduce maternal deaths by 21% and 40%, respectively, and reduce the proportionate mortality ratio from 45% to 38% and 31%, respectively. Incremental cost-effectiveness ratios of family planning strategies were below $145 per YLS, representing just a fraction of the per capita gross domestic product [GDP]. Extrapolating our results in rural Kandahar to the country as a whole, these strategies would prevent between 166,000 and 210,000 maternal deaths for a very modest investment and in the context of the current infrastructure. Of importance, further gains will require improvements in skilled birth attendants, care during labor and delivery, and access to emergency obstetrical care. Increasing access to family planning will improve the health of Afghan women, save lives and provide high value for the resources invested. Through the efficient use of public health resources, enhanced family planning efforts will improve the public health sector capacity to make necessary investments in skilled attendants, care during labor and delivery, and emergency obstetric care. These results provide strong support for the high value of family planning investments included in the Basic Package of Health Services

The German Social Democratic Party(SPD) and the Debate on the Fertility Decline in the German Empire (1870~1918) / 의사학

This paper aimed to examine the debate over the fertility decline in the German Empire, focusing on the role of the SPD. During the German Empire, the fertility rate dramatically declined and the growing awareness of a continuous decline in the birth rate prompted a massive debate among politicians, doctors, sociologists, and feminist activists. The fertility decline was negatively evaluated and generated consciousness of crisis. However, it was not the only way to face this new phenomenon. Indeed, the use of birth control among the upper class was interpreted as a part of a modernizing process. As the same phenomenon reached the working class, it suddenly became a social problem and was attributed to the SPD. The debate over the fertility decline in imperial German society ridden with a fierce class conflict was developed into a weapon against the SPD. Contrary to the assumption of conservative politicians, the SPD had no clear-cut position on this issue. Except for a few politicians like Kautsky and the doctors who came into frequent contact with the workers, the "birth strike" was not listed as the main interest of the SPD. Even Clara Zetkin, the leader of the Social Democratic women's organization viewed it as a concern of the individual person which could not be incorporated in the party program. The women's organization of the SPD put priority on class conflict rather than issues specific to women. As a result, the debate over the birth rate decline within the SPD was not led by the women themselves. There could have been various means to stimulate the birth rate. Improvement in the welfare system, such as tax relief for large families, better housing conditions, and substantial maternity protection, could have been feasible solutions to the demographic crisis. However, Germany chose to respond to this crisis by imposing legal sanctions against birth control. In addition to paragraphs 218-220 of the German criminal law enacted in 1872 which prescribed penal servitude for anyone who had an abortion or people who helped to practice it, Paragraph 184.3 of the civil code was enacted in order to outlaw the advertising, display, and publicizing of contraceptives with an 'indecent' intention, although selling or manufacturing contraceptives was not forbidden. Such a punitive approach was especially preferred by the government and conservative parties because it was easy to implement and "cheap" in comparison with the comprehensive social welfare program. What made the SPD different from other conservative parties was the fact that the SPD opposed the government's attempt to prohibit contraception by means of strengthening a penal code. According to the SPD, it was not only morally unacceptable, but also technically impossible for the government to intervene in family limitation. Moreover, politicians from the SPD criticized that such a punitive policy targeted the working class because the upper echelon of the society could easily evade the ban on contraceptives. However, the SPD did not proceed to draft comprehensive social welfare measures in order to fight the fertility decline. The miserable condition of working class women remained as an invisible social phenomenon even within the SPD. The German women who could not find the proper means to practice contraception were driven to have abortions. Annually, hundreds of the women were accused of practicing abortion and imprisoned. In sum, German society ran about in confusion and did not know how to properly respond to the unprecedented decline in fertility. By defining the fertility decline just as a social disease due to moral decay and influence of socialism, German society lost a chance to rationalize itself. Given that women, the main actors, had no way to take part in the debate over this issue, it is not surprising that German society fought against the symptom of the disease, not against its root.

Ruta crítica para la realización de ligadura tubaria: estudio en un hospital público en la ciudad de Buenos Aires / Critical route for the realization of tubal ligation: study at a public hospital in the city of Buenos Aires

La existencia de brechas entre el marco legal en salud sexual y reproductiva y la puesta en práctica en las realidades sanitarias locales de las políticas públicas relativas a la ligadura tubaria en particular constituye un tema crucial para la Salud Pública de la Argentina. Objetivo general: describir los factores que impulsaron u obstaculizaron la ruta crítica que realizaron las mujeres gran multíparas para ejercer el derecho a solicitar la ligadura tubaria. Material y métodos: el diseño fue exploratorio descriptivo. Se realizaron entrevistas en profundidad y se administró un cuestionario sociodemográfico a una muestra intencional de 30 usuarias gran multíparas que solicitaron la anticoncepción quirúrgica durante el período: agosto de 2009 - enero de 2010, en el Área de Salud Sexual y Reproductiva del Hospital Materno Infantil Ramón Sardá de la Ciudad Autónoma de Buenos Aires. Resultados: 17 de las entrevistadas había solicitado la ligadura tubaria previamente. Del total, 22 entrevistadas iniciaron el recorrido cursando un embarazo no deseado y 9 pensaron en recurrir a un aborto inseguro, entre las cuales 5 averiguaron al respecto y 1 lo intentó. Conclusiones: Se espera que los resultados sean de utilidad para el diseño de estrategias intersectoriales efectivas que permitan monitorear el cumplimiento de la ley nacional Nº 26.130 con el fin de garantizar el acceso oportuno a la ligadura tubaria, y disminuir las iniquidades relativas a brechas territoriales, institucionales y obstáculos simbólicos y epistemológicos, a nivel sanitario, en la Argentina.

The existence of great gaps between the legal frame of the sexual and reproductive health system and the implementation of public policies in relation to tubal sterilization within the reality of local health institutions is a matter of crucial issue for Public Health of Argentina. General objective: To describe the factors that motivate or prevent the beginning of the critical path that grand multiparous women took in order to excercise their right to petition tubal sterilization. Methods and materials: The design was descriptive exploratory. Interviews in depth were conducted and a sociodemographic questionnaire was used over an in tentional sample of thirty grand multiparous women who arrived to the Reproductive and Sexual Health Area of the Ramón Sardá Hospital in the City of Buenos Aires asking for tubal sterilization during August 2009-January 2010. Results: 17 women had preaviously asked for tubal sterilization, and 22 out of the total number initiated the whole process with an unwanted pregnancy; and 9 women considered an unsafe abortion, 5 of them did research about it and 1 tried it. Conclusions: It is expected that the results shall be useful for the design and implementation of effective strategies that allow to monitor the enforcement of the national law N° 26.130 for the purpose of guaranteeing access to tubal sterilization, and to decrease inequality in relation to territorial and institutional gaps, as well as symbolic obstacles in Argentina.

Factors Affecting Unmet Need for Family Planning in Southern Nations; Nationalities and Peoples Region; Ethiopia

BACKGROUND: High fertility and low contraceptive prevalence characterize Southern Nations; Nationalities and Peoples Region. In such populations; unmet needs for contraception have a tendency to be high; mainly due to the effect of socio-economic and demographic variables. However; there has not been any study examining the relationship between these variables and unmet need in the region. This study; therefore; identifies the key socio- demographic determinants of unmet need for family planning in the region. METHODS: The study used data from the 2000 and 2005 Ethiopian Demographic and Health Surveys. A total of 2;133 currently married women age 15-49 from the 2000 survey and 1;988 from the 2005 survey were included in the study. Unmet need for spacing; unmet need for limiting and total unmet need were used as dependent variables. Socio- demographic variables (respondent's age; age at marriage; number of living children; sex composition of living children; child mortality experience; place of residence; respondent's and partner's education; religion and work status) were treated as explanatory variables and their relative importance was examined on each of the dependent variables using multinomial and binary logistic regression models. RESULTS: Unmet need for contraception increased from 35.1in 2000 to 37.4in 2005. Unmet need for spacing remained constant at about 25; while unmet need for limiting increased by 20between 2000 and 2005. Age; age at marriage; number of living children; place of residence; respondent's education; knowledge of family planning; respondent's work status; being visited by a family planning worker and survey year emerged as significant factors affecting unmet need. On the other hand; number of living children; education; age and age at marriage were the only explanatory variables affecting unmet need for limiting. Number of living children; place of residence; age and age at marriage were also identified as factors affecting total unmet need for contraception. CONCLUSION: unmet need for spacing is more prevalent than unmet need for limiting. Women with unmet need for both spacing and limiting are more likely to be living in rural areas; have lower level of education; lower level of knowledge about family planning methods; have no work other than household chores; and have never been visited by a family planning worker. In order to address unmet need for family planning in the region; policy should set mechanisms to enforce the law on minimum age for marriage; improve child survival and increase educational access to females. In addition; the policy should promote awareness creation about family planning in rural areas