A Systematic Review of School-based Programs to Improve Adolescent Sexual and Reproductive Health: Considering the Role of Social Connectedness

2020 ◽  
Vol 5 (3) ◽  
pp. 213-241
Author(s):  
Sophie G. E. Kedzior ◽  
Zohra S. Lassi ◽  
Tassia K. Oswald ◽  
Vivienne M. Moore ◽  
Jennifer L. Marino ◽  
...  
Keyword(s):  
Systematic Review ◽  
Reproductive Health ◽  
Social Connectedness ◽  
Sexual And Reproductive Health ◽  
School Based

scholarly journals The role of social capital in women’s sexual and reproductive health and rights in humanitarian settings: a systematic review of qualitative studies

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hannah Ireland ◽  
Nguyen Toan Tran ◽  
Angela Dawson
Keyword(s):  
Systematic Review ◽  
Social Capital ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Social Determinant ◽  
Qualitative Studies ◽  
Reproductive Health Services ◽  
Positive Health ◽  
Humanitarian Settings

Abstract Background Social capital is an important social determinant of women’s sexual and reproductive health and rights. Little research has been conducted to understand the role of social capital in women’s sexual and reproductive health and how this can be harnessed to improve health in humanitarian settings. We synthesised the evidence to examine the nexus of women’s sexual and reproductive health and rights and social capital in humanitarian contexts. Methods We undertook a systematic review of qualitative studies. The preferred reporting items for systematic review and meta-analysis guidelines were used to identify peer-reviewed, qualitative studies conducted in humanitarian settings published since 1999. We searched CINAHL, MEDLINE, ProQuest Health & Medicine, PubMed, Embase and Web of science core collection and assessed quality using the Critical Appraisal Skills Programme tool. We used a meta-ethnographic approach to synthesise and analyse the data. Findings Of 6749 initially identified studies, we included 19 studies, of which 18 were in conflict-related humanitarian settings and one in a natural disaster setting. The analysis revealed that the main form of social capital available to women was bonding social capital or strong links between people within groups of similar characteristics. There was limited use of bridging social capital, consisting of weaker connections between people of approximately equal status and power but with different characteristics. The primary social capital mechanisms that played a role in women’s sexual and reproductive health and rights were social support, informal social control and collective action. Depending on the nature of the values, norms and traditions shared by network members, these social capital mechanisms had the potential to both facilitate and hinder positive health outcomes for women. Conclusions These findings demonstrate the importance of understanding social capital in planning sexual and reproductive health responses in humanitarian settings. The analysis highlights the need to investigate social capital from an individual perspective to expose the intra-network dynamics that shape women’s experiences. Insights could help inform community-based preparedness and response programs aimed at improving the demand for and access to quality sexual and reproductive health services in humanitarian settings.

scholarly journals Effectiveness of school-based interventions in delaying sexual debut among adolescents in sub-Saharan Africa: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044398
Author(s):  
Beatrice W Maina ◽  
Kenneth Juma ◽  
Emmy Kageha Igonya ◽  
Jane Osindo ◽  
Hesborn Wao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Sexual Debut ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
School Based ◽  
School Based Interventions ◽  
Sub Saharan

IntroductionEarly sexual debut is associated with poor sexual and reproductive health outcomes across the life course. A majority of interventions aimed at delaying sexual debut among adolescents in sub-Saharan Africa (SSA) have been implemented in schools with mixed findings on the effectiveness of such interventions. This systematic review will summarise and synthesise existing evidence on the effectiveness of school-based interventions in delaying sexual debut among adolescents aged 10–19 years.Methods and analysisWe will conduct a comprehensive database search of peer-reviewed studies published in PubMed, Scopus, Science Direct, Web of Science, HINARI and EBSCO (PsycINFO, Global Health, CINAHL) and in Cochrane library, National Institute of Health and Turning Research into Practice databases for ongoing studies yet to be published. All studies conducted in SSA between January 2009 and December 2020, regardless of the study design, will be included. Two authors will independently screen all retrieved records and relevant data on sexual debut extracted.Data will be pooled using the random effects model. Dichotomous outcomes will be reported as risk ratios and continuous data as mean difference at 95% CI. Heterogeneity will be assessed using the I² statistic. Findings will be presented in tables and charts, while providing a description of all included studies, themes and concepts drawn from literature.Ethics and disseminationEthical approval is not required. The findings will be disseminated through peer-reviewed publications, presentations at relevant conferences and other convening focusing on adolescent sexual and reproductive health.

scholarly journals The role of partners in promoting self-care for misoprostol and subcutaneous DMPA in Pakistan

2021 ◽  
Vol 19 (S1) ◽  
Author(s):  
Qudsia Uzma ◽  
Nausheen Hamid ◽  
Rizwana Chaudhri ◽  
Nadeem Mehmood ◽  
Atiya Aabroo ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Private Sector ◽  
Healthcare System ◽  
Sexual And Reproductive Health ◽  
Health Workers ◽  
Self Care ◽  
Essential Element ◽  
Scaling Up ◽  
Reproductive Health Services

Abstract Background Pakistan is among a number of countries facing protracted challenges in addressing maternal mortality with a concomitant weak healthcare system complexed with inequities. Sexual and reproductive health and rights (SRHR) self-care interventions offer the best solution for improving access to quality healthcare services with efficiency and economy. This manuscript documents country experience in introducing and scaling up two selected SRHR self-care interventions. A prospective qualitative study design was used and a semi-structured questionnaire was shared with identified SRHR private sector partners selected through convenience and purposive sampling. The two interventions include the use of misoprostol for postpartum hemorrhage and the use of subcutaneous depomedroxyprogesterone acetate (DMPA) as injectable contraceptive method. Data collection was done through emails and telephone follow-up calls. Results Nine of the 13 partners consulted for the study responded. The two selected self-care interventions are mainly supported by private sector partners (national and international nongovernmental organizations) having national or subnational existence. Their mandates include all relevant areas, such as policy advocacy, field implementation, trainings, supervision and monitoring. A majority of partners reported experience related to the use of misoprostol; it was introduced more than a decade ago, is registered and is procured by both public and private sectors. Subcutaneous DMPA is a new intervention, having been introduced only recently, and commodity availability remains a challenge. It is being delivered through health workers/providers and is not promoted as a self-administered contraceptive. Community engagement and awareness raising is reported as an essential element of successful field implementation; however, no beneficiary data was collected for the study. Training approaches differ considerably, are standalone or integrated with SRHR topics and their duration varies between 1 and 5 days, covering a range of cadres. Conclusion Pubic sector ownership and patronage is essential for introducing and scaling up self-care interventions as a measure to support the healthcare system in delivering quality sexual and reproductive health services. Supervision, monitoring and reporting are areas requiring further support, as well as the leadership and governance role of the public sector. Standardization of trainings, community awareness, supervision, monitoring and reporting are required together with integration of self-care in routine capacity building activities (pre- and in-service) on sexual and reproductive health in the country.

scholarly journals Are rhetorical commitments to adolescents reflected in planning documents? An exploratory content analysis of adolescent sexual and reproductive health in Global Financing Facility country plans

2021 ◽  
Vol 18 (S1) ◽  
Author(s):  
Asha S. George ◽  
Tanya Jacobs ◽  
Mary V. Kinney ◽  
Annie Haakenstad ◽  
Neha S. Singh ◽  
...  
Keyword(s):  
Content Analysis ◽  
Reproductive Health ◽  
Health Services ◽  
Adolescent Health ◽  
Teenage Pregnancy ◽  
Sexual And Reproductive Health ◽  
Democratic Republic Of Congo ◽  
Social Determinant ◽  
Project Appraisal ◽  
School Based

Abstract Background The Global Financing Facility (GFF) offers an opportunity to close the financing gap that holds back gains in women, children’s and adolescent health. However, very little work exists examining GFF practice, particularly for adolescent health. As momentum builds for the GFF, we examine initial GFF planning documents to inform future national and multi-lateral efforts to advance adolescent sexual and reproductive health. Methods We undertook a content analysis of the first 11 GFF Investment Cases and Project Appraisal Documents available on the GFF website. The countries involved include Bangladesh, Cameroon, Democratic Republic of Congo, Ethiopia, Guatemala, Kenya, Liberia, Mozambique, Nigeria, Tanzania and Uganda. Results While several country documents signal understanding and investment in adolescents as a strategic area, this is not consistent across all countries, nor between Investment Cases and Project Appraisal Documents. In both types of documents commitments weaken as one moves from programming content to indicators to investment. Important contributions include how teenage pregnancy is a universal concern, how adolescent and youth friendly health services and school-based programs are supported in several country documents, how gender is noted as a key social determinant critical for mainstreaming across the health system, alongside the importance of multi-sectoral collaboration, and the acknowledgement of adolescent rights. Weaknesses include the lack of comprehensive analysis of adolescent health needs, inconsistent investments in adolescent friendly health services and school based programs, missed opportunities in not supporting multi-component and multi-level initiatives to change gender norms involving adolescent boys in addition to adolescent girls, and neglect of governance approaches to broker effective multi-sectoral collaboration, community engagement and adolescent involvement. Conclusion There are important examples of how the GFF supports adolescents and their sexual and reproductive health. However, more can be done. While building on service delivery approaches more consistently, it must also fund initiatives that address the main social and systems drivers of adolescent health. This requires capacity building for the technical aspects of adolescent health, but also engaging politically to ensure that the right actors are convened to prioritize adolescent health in country plans and to ensure accountability in the GFF process itself.

Understanding sexual and reproductive health needs of immigrant adolescents in Canada: A scoping review

2021 ◽  
pp. e20210006
Author(s):  
Samantha Louie-Poon ◽  
Mehnaz Rehmani ◽  
Megan Kennedy ◽  
Shannon Scott ◽  
Bukola Salami ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Scoping Review ◽  
Cultural Sensitivity ◽  
Information Needs ◽  
Sexual And Reproductive Health ◽  
Careful Consideration ◽  
Future Research ◽  
Immigrant Adolescents ◽  
School Based ◽  
Strength Based

Despite the large number of immigrant adolescents in Canada, research on their knowledge of sexual and reproductive health and rights (SRHR) and information needs is nearly nonexistent. A scoping review was undertaken following the PRISMA-ScR statement to identify and assess the existing literature regarding SRHR needs of immigrant adolescents in Canada. Of the 1514 articles retrieved from our search strategy, 15 studies met our inclusion criteria. The results from our review identifies three unique themes related to immigrant adolescents’ SRHR needs: knowledge needs, access to SRHR education and services, and approaches to SRHR education and services. Immigrant adolescents’ knowledge needs includes needs on HIV/STI transmission and protection, unintended pregnancy, sexual activity, family planning, pubertal education, navigating the health care system, and confidentiality legislations. Our results revealed that immigrant adolescents’ access SRHR education and services through both school-based and community-based settings. Lastly, approaches to SRHR education and services for immigrant adolescents should include cultural sensitivity, an intersectional approach, interactive learning, a strength-based approach, and reassuring confidentiality rights. The multi-faceted SRHR needs of immigrant adolescents in Canada demonstrates that future research, program development, and policymaking requires careful consideration of these intersecting forces. Inclusive SRHR education and services can be achieved through the employment of a critical cultural approach and intersectional strategies.

scholarly journals Sexual behavior among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012)

2014 ◽  
Vol 17 (suppl 1) ◽  
pp. 116-130 ◽  
Author(s):  
Maryane Oliveira-Campos ◽  
Marília Lavocart Nunes ◽  
Fátima de Carvalho Madeira ◽  
Maria Goreth Santos ◽  
Silvia Reise Bregmann ◽  
...  
Keyword(s):  
Substance Use ◽  
Sexual Behavior ◽  
Reproductive Health ◽  
Sexual Intercourse ◽  
Risky Sexual Behavior ◽  
Sexual And Reproductive Health ◽  
Social Inequalities ◽  
Unprotected Sex ◽  
Psychoactive Substances ◽  
School Based

OBJECTIVE: This study describes the sexual behavior among students who participated in the National Adolescent School-based Health Survey (PeNSE) 2012 and investigates whether social inequalities, the use of psychoactive substances and the dissemination of information on sexual and reproductive health in school are associated with differences in behavior. METHODOLOGY: The response variable was the sexual behavior described in three categories (never had sexual intercourse, had protected sexual intercourse, had unprotected sexual intercourse). The explanatory variables were grouped into socio- demographic characteristics, substance use and information on sexual and reproductive health in school. Variables associated with the conduct and unprotected sex were identified through multinomial logistic regression, using "never had sexual intercourse" as a reference. RESULTS: Over nearly a quarter of the adolescents have had sexual intercourse in life, being more frequent among boys. About 25% did not use a condom in the last intercourse. Low maternal education and work increased the chance of risky sexual behavior. Any chance of protected and unprotected sex increased with the number of psychoactive substances used. Among those who don't receive guidance on the prevention of pregnancy in school, the chance to have sexual intercourse increased, with the largest magnitude for unprotected sex (OR = 1.41 and OR = 1.87 ). CONCLUSION: The information on preventing pregnancy and STD/AIDS need to be disseminated before the 9th grade. Social inequalities negatively affect risky sexual behavior. Substance use is strongly associated with unprotected sex. Information on the prevention of pregnancy and STD/AIDS need to be disseminated early.

scholarly journals School-Based Health Clinics: Improving Adolescent Sexual and Reproductive Health in British Columbia – An Integrative Literature Review

2020 ◽  
Author(s):  
◽  
Carmen Schalles
Keyword(s):  
British Columbia ◽  
Reproductive Health ◽  
Health Services ◽  
Literature Review ◽  
Sexual Health ◽  
Sexual And Reproductive Health ◽  
Societal Implications ◽  
Health Clinics ◽  
School Based ◽  
Reproductive And Sexual Health

This integrative literature review strives to determine if the delivery of reproductive and sexual health services provided through high school-based primary care clinics can improve BC adolescent sexual and reproductive health. Adolescent sexual and reproductive health not only impacts life-long health; it also has significant societal implications. Although BC has begun to focus on adolescent health, innovative health service solutions are needed to improve adolescents’ health. Systematic search through the University of Northern British Columbia online library databases and Google scholar and the evaluation of the literature using CASP analysis tools resulted in the inclusion of 10 articles. Findings suggest school-based health clinics (SBHCs) decrease barriers that adolescents experience when accessing health services as well as public health system costs. Moreover, SBHCs are an effective mechanism to support adolescent reproductive and sexual health needs, especially in those populations with elevated levels of sexual and reproductive risk factors. However, for SBHCs to be effective, sustainable funding needs to be sourced, and barriers adolescents experience when accessing services need to be evaluated and addressed. SBHCs can complement current adolescent-friendly services to meet this unique population’s needs; however, further research is needed. More robust research on various demographics, health outcomes, and Canadian-based examination is required to strengthen SBHC implementation recommendations.

The role of culture and religion on sexual and reproductive health indicators and help-seeking behaviour amongst 1.5 generation migrants in Australia: A quantitative pilot study

2020 ◽  
Author(s):  
Tinashe Dune ◽  
David Ayika ◽  
Jack Thepsourinthone ◽  
Virginia Mapedzahama ◽  
Zelalem Mengesha ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Help Seeking ◽  
Online Survey ◽  
Sexual And Reproductive Health ◽  
Health Indicators ◽  
1.5 Generation ◽  
Cultural Connectedness ◽  
Significant Difference ◽  
Help Seeking Behaviour

Abstract Background: 1.5 generation migrants in Australia (those who migrate as children) often enter a new cultural and religious environment, with its own set of constructs of sexual and reproductive health (SRH), at a crucial time in their psychosexual development—puberty/adolescence. 1.5 generation migrants may thus have to contend with constructions of SRH from at least two cultures which may be at conflict on the matter. This study was designed to investigate the role of culture and religion on sexual and reproductive health indicators and help-seeking behaviour amongst 1.5 generation migrants.Methods: 111 participants completed an online survey which included questions about their cultural connectedness, religion, sexual and reproductive health and help-seeking behaviour. Kruskall-Wallis tests were used to analyse the data. Results: There was no significant difference between ethnocultural groups or levels of cultural connectedness in relation to sexual and reproductive health help-seeking behaviours. The results do suggest differences between religious groups in regards to seeking help specifically from young peoples’ parents. Notably, youth who reported having ‘no religion’ were more likely to seek help with sexual and reproductive health matters from their parent(s). Conclusions: Managing cross-cultural experiences are often noted in extant literature as a barrier to sexual and reproductive health help-seeking. However, while cultural norms of migrants’ country of origin can remain strong it is religion that seems to have more of an impact on how 1.5 generation migrants seek help for SRH issues. This suggests that while 1.5 generation migrants may need to adapt to a new ethnocultural environment little about their religious beliefs or practices may require adaptation in Australia. Given that religion can play a role in young peoples’ sexual and reproductive health religious organisations are well placed to encourage young people’s help-seeking behaviours.

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