Navigating a Complex Health System: the Perceptions of Psychiatric Residents in Addressing Sexual and Reproductive Health of Women with Severe Mental Illness

2020 ◽  
Vol 44 (4) ◽  
pp. 403-407
Author(s):  
Jesse P. Zatloff ◽  
Silke A. von Esenwein ◽  
Zoe Philip ◽  
Martha C. Ward
Keyword(s):  
Mental Illness ◽  
Reproductive Health ◽  
Health System ◽  
Severe Mental Illness ◽  
Sexual And Reproductive Health ◽  
Psychiatric Residents

scholarly journals Regulatory standards and processes for over-the-counter availability of hormonal contraception and drugs for medical abortion in five countries in the Eastern Mediterranean Region

2021 ◽  
Vol 19 (S1) ◽  
Author(s):  
Anne Ammerdorffer ◽  
Mark Laws ◽  
Arinze Awiligwe ◽  
Florence Erb ◽  
Wallada Im-Amornphong ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health System ◽  
Emergency Contraception ◽  
Sexual And Reproductive Health ◽  
Self Care ◽  
Medical Abortion ◽  
Health System Strengthening ◽  
World Health ◽  
Over The Counter ◽  
Regulatory Status

AbstractThe World Health Organization 2019 WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights includes recommendations on self-administration of injectable contraception, over-the-counter (OTC) oral contraception and self-management of medical abortion. A review of the regulatory status of these two self-care interventions can highlight processes required to ensure that the quality of the medicines and safety of individuals are safeguarded in the introduction and scale-up in countries. This review outlines the legal regulatory status of prescription-only medicine (POM) and OTC contraceptives, including emergency contraception, and drugs for medical abortion in Egypt, Jordan, Lebanon, Morocco and Tunisia using information obtained from internet searches, regulatory information databases and personal contacts. In addition, the review examines whether the national medicines regulatory authorities have documented procedures available to allow for a change in status from a POM to OTC to allow for increased accessibility, availability and uptake of self-care interventions recommended by WHO. Egypt, Jordan and Lebanon have a documented national OTC list available. The only contraceptive product mentioned in the OTC lists across all five countries is ellaOne (ulipristal acetate for emergency contraception), which is publicly registered in Lebanon. None of the five countries has an official documented procedure to apply for the change of POM to OTC. Informal procedures exist, such as the ability to apply to the national medicines regulatory authority for OTC status if the product has OTC status in the original country of manufacture. However, many of these procedures are not officially documented, highlighting the need for establishing sound, affordable and effective regulation of medical products as an important part of health system strengthening. From a public health perspective, it would be advantageous for licensed products to be available OTC. This is particularly the case for settings where the health system is under-resourced or over-stretched due to health emergencies. Readiness of national regulatory guidelines and OTC procedures could lead to increased access, availability and usage of essential self-care interventions for sexual and reproductive health and rights.

scholarly journals Competency of Psychiatric Residents in the Treatment of People With Severe Mental Illness Before and After a Community Psychiatry Rotation

2011 ◽  
Vol 35 (1) ◽  
pp. 15-20 ◽  
Author(s):  
M. Randall ◽  
M. Romero-Gonzalez ◽  
G. Gonzalez ◽  
A. Klee ◽  
P. Kirwin
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Community Psychiatry ◽  
Psychiatric Residents ◽  
Before And After

scholarly journals Zika outbreak, resilient health systems, and women’s sexual and reproductive health: a qualitative study in Colombia

2019 ◽  
Author(s):  
Juan Carlos Rivillas-García ◽  
Luz Janeth Forero-Martinez ◽  
Mariana Calderon-Jaramillo ◽  
Victoria Vargas-Pinzón ◽  
Rocío Murad-Rivera ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health System ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Technical Equipment ◽  
Care Providers ◽  
Data Set ◽  
National Response ◽  
The Government ◽  
The Impact

Abstract Background There is substantial evidence of the profound consequences of Zika on women's Sexual and Reproductive Health. Health system resilience begins by measuring critical capacities ahead of a crisis such as zika outbreak. Even though zika as vector-borne disease is well documented, there is dearth of studies linking Zika with women's Sexual and Reproductive Health. The main objective of this study was to analyze the national response to the Zika epidemic and its relation to women’s sexual and reproductive health matters through key implementation mechanisms in order to promote resilience of the health system in five cities in Colombia.Methods This study used a qualitative design to enable an in-depth exploration of the national response to the Zika epidemic and sexual and reproductive health matters through key implementation mechanisms (based on facilitators and gaps) within the health system. The overall data set was comprised of 31 semi-structured individual interviews (23 women and 8 men), 25 interviews with key informants responsible for the implementation of the Zika Virus Response Plan; six interviews with pregnant women diagnosed with Zika; and five focus groups discussions with communities (n=122 participants) in five cities in Colombia: Barranquilla, Cucuta, Los Patios, San Andres and Soledad.Results The findings revealed the three major facilitators that promoted the implementation of actions to address the Zika epidemic: i) the role of health care providers; ii) the development of technical equipment capabilities; and iii) inter-institutional coordination. The study also identified implementation gaps: i) absence of a human rights and sexual and reproductive health approach; ii) focus on territorial actions centered on mosquito management; and iii) limited attitudes, behaviors and knowledge at the community level.Conclusion This study provided a comprehensive insight of critical facilitating processes and gaps in the implementation of the government response during the Zika epidemic in Colombia. This study reveals that the lack of understanding of the intersection between gender, the Zika epidemic and Sexual and Reproductive Health limited the adoption, development and implementation of a more comprehensive responses to address the impact on women’s sexual and reproductive health.

scholarly journals Predictors of young people’s use of sexual and reproductive health services in Nigeria: a mixed-method approach

2020 ◽  
Author(s):  
Amelia Ngozi Odo ◽  
Justina Ifeoma OFUEBE ◽  
Anthony Ifeanyi ANIKE ◽  
Efiong S Samuel
Keyword(s):  
Young People ◽  
Reproductive Health ◽  
Health Services ◽  
Health System ◽  
Mixed Method ◽  
Sexual And Reproductive Health ◽  
Demographic Factors ◽  
Reproductive Health Services ◽  
System Factors ◽  
Socio Demographic Factors

Abstract Background Sexual and Reproductive health Services (SRHS) are essential for the prevention and control of SRH problems among young people and the achievement of sustainable development goal 3. These services may be available but certain factors interfere with their access and utilization by the young people. This study sought to determine factors that predict the utilization of SRHS among young people in Enugu State, Nigeria. Methods The study adopted mixed-method research employing a cross-sectional research design. The population of the study comprised young people between the ages of 12 and 22 years. A multi-stage sampling procedure was used to select 1,447 young people used for the study. A questionnaire, in-depth interview, and focus group discussion were used for data collection. Percentages, Chi-square, and logistic regression were used to analyse quantitative data, while qualitative data were thematically analysed using NVivo software.ResultsSocio-demographic factors of gender, age, education, income, and living status (p = < .05) were significant predictors of utilization of SRHS. Psycho-cultural and health system factors (p = < .05) were also significant predictors of utilization of SRHS.Conclusion The study concluded that some socio-demographic factors (of gender, age, level of education, income, and living status), psycho-cultural, and health system factors can be used to predict young people’s utilization of SRHS. These predictors could be addressed through home sex education, regular training of health care providers on youth-friendly services delivery, and policy reforms.

scholarly journals Predictors of young people’s use of sexual and reproductive health services in Nigeria: a mixed-method approach

2020 ◽  
Author(s):  
Amelia Ngozi Odo ◽  
Justina Ifeoma OFUEBE ◽  
Anthony Ifeanyi ANIKE ◽  
Efiong S Samuel
Keyword(s):  
Young People ◽  
Reproductive Health ◽  
Health Services ◽  
Health System ◽  
Mixed Method ◽  
Sexual And Reproductive Health ◽  
Demographic Factors ◽  
Reproductive Health Services ◽  
System Factors ◽  
Socio Demographic Factors

Abstract Background: Sexual and Reproductive health Services (SRHS) are essential for prevention and control of SRH problems among young people and the achievement of sustainable development goal 3. These services may be available but certain factors interfere with their access and utilization by the young people. This study sought to determine factors that predict the utilization of SRHS among young people in Enugu State, Nigeria. Methods: The study adopted mixed method research employing cross-sectional research design. The population of the study comprised young people within the ages of 12 and 22 years. Multi-stage sampling procedure was used to select 1,447 young people used for the study. Questionnaire, in-depth interview, and focus group discussion were used for data collection. Percentages, Chi-square, and logistic regression were used to analyse quantitative data, while qualitative data were thematically analysed using NVivo software. Results: Socio-demographic factors of gender, age, education, income and living status ( p = < .05) were significant predictors of utilization of SRHS. Psycho-cultural and health system factors ( p = < .05) were also significant predictors of utilization of SRHS. Conclusion: The study concluded that some socio-demographic factors (of gender, age, level of education, income and living status), psycho-cultural and health system factors can be used to predict young people’s utilization of SRHS. These predictors could be addressed through home sex education, regular training of health care providers on youth-friendly services delivery and policy reforms

Zika outbreak, resilient health systems, and women’s sexual and reproductive health: a qualitative study in Colombia

2020 ◽  
Author(s):  
Juan Carlos Rivillas-García ◽  
Luz Janeth Forero-Martinez ◽  
Mariana Calderon-Jaramillo ◽  
Victoria Vargas-Pinzón ◽  
Rocío Murad-Rivera ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health System ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Technical Equipment ◽  
Care Providers ◽  
Data Set ◽  
National Response ◽  
The Government ◽  
The Impact

Abstract Background There is substantial evidence of the profound consequences of Zika on women's Sexual and Reproductive Health. Health system resilience begins by measuring critical capacities ahead of a crisis such as Zika outbreak. Even though Zika as vector-borne disease is well documented, there is dearth of studies linking Zika with women's Sexual and Reproductive Health. The main objective of this study was to analyze the national response to the Zika epidemic and its relation to women’s sexual and reproductive health matters through key implementation mechanisms in order to promote resilience of the health system in five cities in Colombia.Methods This study used a qualitative design to enable an in-depth exploration of the national response to the Zika epidemic and sexual and reproductive health matters through key implementation mechanisms (based on facilitators and gaps) within the health system. The overall data set was comprised of 31 semi-structured individual interviews (23 women and 8 men), 25 interviews with key informants responsible for the implementation of the Zika Virus Response Plan; six interviews with pregnant women diagnosed with Zika; and five focus groups discussions with communities (n=122 participants) in five cities in Colombia: Barranquilla, Cucuta, Los Patios, San Andres and Soledad. Results The findings revealed the three major facilitators that promoted the implementation of actions to address the Zika epidemic: i) the role of health care providers; ii) the development of technical equipment capabilities; and iii) inter-institutional coordination. The study also identified implementation gaps: i) absence of a human rights and sexual and reproductive health approach; ii) focus on territorial actions centered on mosquito management; and iii) limited attitudes, behaviors and knowledge at the community level.Conclusion This study provided a comprehensive insight of critical facilitating processes and gaps in the implementation of the government response during the Zika epidemic in Colombia. This study reveals that the lack of understanding of the intersection between gender, the Zika epidemic and Sexual and Reproductive Health limited the adoption, development and implementation of a more comprehensive responses to address the impact on women’s sexual and reproductive health.

scholarly journals Integrating sexual and reproductive health into health system strengthening in humanitarian settings: a planning workshop toolkit to transition from minimum to comprehensive services in the Democratic Republic of Congo, Bangladesh, and Yemen

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Nguyen Toan Tran ◽  
Alison Greer ◽  
Brigitte Kini ◽  
Hassan Abdi ◽  
Kariman Rajeh ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health System ◽  
Collaborative Design ◽  
Sexual And Reproductive Health ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Health System Strengthening ◽  
World Health ◽  
Republic Of Congo ◽  
Humanitarian Settings

Abstract Background Planning to transition from the Minimum Initial Service Package for Sexual and Reproductive Health (SRH) toward comprehensive SRH services has been a challenge in humanitarian settings. To bridge this gap, a workshop toolkit for SRH coordinators was designed to support effective planning. This article aims to describe the toolkit design, piloting, and final product. Methods Anchored in the Health System Building Blocks Framework of the World Health Organization, the design entailed two complementary and participatory strategies. First, a collaborative design phase with iterative feedback loops involved global partners with extensive operational experience in the initial toolkit conception. The second phase engaged stakeholders from three major humanitarian crises to participate in pilot workshops to contextualize, evaluate, validate, and improve the toolkit using qualitative interviews and end-of-workshop evaluations. The aim of this two-phase design process was to finalize a planning toolkit that can be utilized in and adapted to diverse humanitarian contexts, and efficiently and effectively meet its objectives. Pilots occurred in the Democratic Republic of Congo for the Kasai region crisis, Bangladesh for the Rohingya humanitarian response in Cox’s Bazar, and Yemen for selected Governorates. Results Results suggest that the toolkit enabled facilitators to foster a systematic, participatory, interactive, and inclusive planning process among participants over a two-day workshop. The approach was reportedly effective and time-efficient in producing a joint work plan. The main planning priorities cutting across settings included improving comprehensive SRH services in general, healthcare workforce strengthening, such as midwifery capacity development, increasing community mobilization and engagement, focusing on adolescent SRH, and enhancing maternal and newborn health services in terms of quality, coverage, and referral pathways. Recommendations for improvement included a dedicated and adequately anticipated pre-workshop preparation to gather relevant data, encouraging participants to undertake preliminary study to equalize knowledge to partake fully in the workshop, and enlisting participants from marginalized and underserved populations. Conclusion Collaborative design and piloting efforts resulted in a workshop toolkit that could support a systematic and efficient identification of priority activities and services related to comprehensive SRH. Such priorities could help meet the SRH needs of communities emerging from acute humanitarian situations while strengthening the overall health system.

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