Multiple realities around sexual and reproductive health and rights (SRHR) among adolescents in Ghana

2021 ◽  
pp. 1-12
Author(s):  
Joshua Amo-Adjei

Abstract The multiple realities around the sexual and reproductive health of Ghanaian adolescents are explored in this paper. Female and male adolescents (aged 10–19 years, N=298) participated in 40 focus group discussions in 20 communities. A comparative inductive approach has been used to present, analyse and document the sexual and reproductive realities of adolescents in their communities. The findings reveal commonalities as well as differences in the realities among participants. Common realities, regardless of age and sex, were teenage pregnancy and abortion, sexual violence (defilement, rape and coercive sex) and parental neglect. These aside, there were divergent realities for older adolescent girls in particular, e.g. lack of access to contraceptives and understanding of the fertility cycle, and the influences and pressures of social media and varied notions about sexual harassment between female and male adolescents. The findings, overall, underscore the complexity and nuanced lives of adolescents in traversing the sexual and reproductive maturation processes. These events unfold in communities where adolescents are ‘required’ to be silent and ‘play’ innocent regardless of their daily struggles, compounded by limited opportunities to learn and unlearn embedded norms about sexual and reproductive functioning. Some implications for sexual health promotion programmes are outlined.

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Rayan Korri ◽  
Sabine Hess ◽  
Guenter Froeschl ◽  
Olena Ivanova

Abstract Background The war in Syria caused the forced displacement of millions of Syrians to neighboring countries. Lebanon is the host country with the largest overall number of Syrian refugees per capita. Adolescent refugee girls experience a unique level of vulnerability during human emergencies and are at increased risk of suffering from poor sexual and reproductive health (SRH) outcomes. We conducted an exploratory qualitative study to learn about the SRH perceptions and experiences of refugee adolescent girls living in Bourj Hammoud, an urban setting in Lebanon. Methods We employed a qualitative design with eight focus group discussions (FGDs) conducted with 40 Syrian Arab and Syrian Kurdish adolescent girls between January and March 2020. Every FGD consisted of five participants aged 13 to 17 years. A semi-structured guide was used covering multiple themes: menstruation, puberty, SRH awareness, and sexual harassment. FGDs were transcribed and analyzed using thematic analysis. Findings The participants discussed adolescent girls’ health and named six elements of good health, such as healthy activities and self-protection. The majority of the FGD participants reported a lack of awareness about menstruation when they experienced it for the first time and the social stigma associated with menstruation. When defining puberty, they indicated its social link to a girl’s readiness for marriage and her need to become cautious about sexual harassment. Most FGD participants had very poor knowledge of the female reproductive system. Mothers were the most approached persons to receive information on SRH issues; however, the girls indicated a wish to receive advice from specialists in a comfortable and private atmosphere. All the girls reported that either they themselves, or an acquaintance, had experienced some type of sexual harassment. The girls rarely reported those incidents due to fear of being blamed or subjected to mobility restrictions, or forced to drop out of school. Conclusions The findings show the refugee girls need for satisfactory knowledge on SRH issues and interventions to prevent sexual and gender-based violence that take into consideration the complexity of urban settings.


2021 ◽  
Vol 31 (5) ◽  
pp. 983-998
Author(s):  
L’Emira Lama El Ayoubi ◽  
Sawsan Abdulrahim ◽  
Maia Sieverding

Providing adolescent girls with sexual and reproductive health (SRH) information protects them from risks and improves their well-being. This qualitative study, conducted in Lebanon, examined Syrian refugee adolescent girls’ access to SRH information about and experiences with puberty and menarche, sex, marriage, contraception, and pregnancy. We gathered data through three focus group discussions (FGDs) with unmarried adolescent girls, 11 in-depth interviews with early-married adolescents, and two FGDs with mothers. Our findings highlighted that adolescent participants received inadequate SRH information shortly before or at the time of menarche and sexual initiation, resulting in experiences characterized by anxiety and fear. They also revealed discordance between girls’ views of mothers as a preferred source of information and mothers’ reluctance to communicate with their daughters about SRH. We advance that mothers are important entry points for future interventions in this refugee population and offer recommendations aimed to improve adolescent girls’ SRH and rights.


Author(s):  
Juliet Iwelunmor ◽  
Sarah Blackstone ◽  
Ucheoma Nwaozuru ◽  
Donaldson Conserve ◽  
Patricia Iwelunmor ◽  
...  

Abstract Background Adolescent girls in Nigeria experience a disproportionately high burden of sexual and reproductive health disparities that affect their well-being. Yet, little is known about adolescent girls’ own unique perspectives of the sexual and reproductive health challenges they face, and possible solutions to these challenges. Aims To explore top sexual and reproductive health concerns of female adolescents in Nigeria and their perceptions regarding potential solutions to these issues. Methods Eighty adolescent girls attending two public secondary schools in Lagos, Nigeria completed individual free-listing interviews. Items assessed their perceptions of the most important sexual and reproductive health issues and potential solutions to these issues at the individual and societal level. Data were analyzed using Anthropac 4.98 to sort the lists by item frequency as well as to determine Smith’s salience index (S). Results The top five sexual and reproductive health concerns identified by participants were human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), followed by menstrual pain, vaginal infections, sexual abuse and teenage pregnancy. Adolescent girls stated that youth empowerment programs that provide access to skills-building opportunities and mentors was one potential strategy for addressing their sexual and reproductive health priorities. Other solutions identified were access to medical checkups, general health talks focused on their sexual and reproductive health concerns as well as access to health facilities and opportunities to build self-efficacy skills. Conclusion Adolescent girls in Nigeria need to be engaged in becoming powerful agents in improving their own sexual and reproductive health, and in crafting solutions that may be effective in enabling them to achieve their full potential and rights to health and well-being. The findings will be used to develop an intervention targeting the sexual and reproductive health priorities of adolescent girls in Lagos, Nigeria.


2021 ◽  
Author(s):  
Gunta Lazdane ◽  
◽  
Dace Rezeberga ◽  
Ieva Briedite ◽  
Elizabete Pumpure ◽  
...  

Qualitative research is focused on the influence of COVID-19 pandemic and restriction measures on sexual and reproductive health in Latvia. Results of the anonymous online survey (I-SHARE) of 1173 people living in Latvia age 18 and over were used as a background in finalization the interview and the focus group discussion protocols ensuring better understanding of the influencing factors. Protocols included 9 parts (0.Introduction. 1. COVID-19 general influence, 2. SRH, 3. Communication with health professionals, 4.Access to SRH services, 5.Communication with population incl. three target groups 5.1. Pregnant women, 5.2. People with suspected STIs, 5.3.Women, who require abortion, 6. HIV/COVID-19, 7. External support, 8. Conclusions and recommendations. Data include audiorecords in Latvian of: 1) 11 semi-structures interviews with policy makers including representatives from governmental and non-governmental organizations involved in sexual and reproductive health, information and health service provision. 2) 12 focus group discussions with pregnant women (1), women in postpartum period (3) and their partners (3), people living with HIV (1), health care providers involved in maternal health care and emergency health care for women (4) (2021-02-18) Subject: Medicine, Health and Life Sciences Keywords: Sexual and reproductive health, COVID-19, access to services, Latvia


Author(s):  
Oka Obono ◽  
Modupe Mohammed

Most investigations and programmes addressing adolescent sexual and reproductive health in Nigeria tend to concentrate on the untenable dichotomy between in-school and out-of-school adolescents, as though there were no intermediary phase between these cohorts. The studies proceed as though the identities and behaviour of adolescents can be understood exclusively in terms of the formal structures of modern education. The present paper examines adolescent sexual and reproductive health among 1,458 in-school, out-of-school and between-school respondents in Ibadan metropolis. It concludes that this latter liminal phase in the educational lives of adolescents – the between-school phase – is distinct enough to generate its own special vulnerabilities. Focus group discussions were held with discussants from the three groups. They show that between-school male adolescents (i.e. those seeking entry into higher educational institutions or who aspire to do so) are more sexually active than the other two groups. Condom use and contraceptive knowledge are also lowest among this cohort. Between-school adolescents have poorer health seeking behaviour and partner communication patterns than in-school and out-of-school adolescents. Results like these point to disturbances in social structure, the emergence of an anti-structure, and the dynamics of vulnerability associated with liminal lives in a predominantly indigenous metropolis. They provide evidence of the need to expand programme focus in adolescent health research, advocacy and intervention and to direct policy attention to adolescents living in a phase further complicated by difficult choices.


2021 ◽  
Vol 2 (4) ◽  
pp. 224-227
Author(s):  
Netty Taribuka ◽  
Wa Ode Ningko

Education on sexual and reproductive health for adolescents in Indonesia has not been fully accepted by the community. This is influenced by the complex environment of social, cultural and religious life. Many people consider that sexual and reproductive health education is a taboo subject to discuss among adolescents. These conditions make adolescents confused in determining their reproductive health behavior. However, over time, the influence of Western culture has brought freedom and open access to information so as to provide opportunities for adolescents to have negative behaviors in reproductive health. The prevalence of sexually active behavior in male adolescents (56.6%) is higher when compared to adolescent girls (43.7%). The problem of abortion in adolescents needs to be seriously addressed, because this problem occurs mostly in developing countries such as Indonesia due to the lack of access to information about abortion. This is evident from many studies which state that the high number of unsafe abortions that causes death is due to the lack of knowledge of young women about the dangers of abortion.Keywords: danger of abortion


2021 ◽  
Vol 18 (S1) ◽  
Author(s):  
Asha S. George ◽  
Tanya Jacobs ◽  
Mary V. Kinney ◽  
Annie Haakenstad ◽  
Neha S. Singh ◽  
...  

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.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242046
Author(s):  
Jacques B. O. Emina ◽  
Parfait Gahungu ◽  
Francis Iyese ◽  
Rinelle Etinkum ◽  
Brigitte Kini ◽  
...  

Introduction Delivering integrated sexual and reproductive health services (SRHS) in emergencies is important in order to save lives of the most vulnerable as well as to combat poverty, reduce inequities and social injustice. More than 60% of preventable maternal deaths occur in conflict areas and especially among the internally displaced persons (IDP). Between 2016 and 2018, unprecedented violence erupted in the Kasaï’s region, in the Democratic Republic of Congo (DRC), called the Kamuina Nsapu Insurgency. During that period, an estimated three million of adolescent girls and women were forced to flee; and have faced growing threat to their health, safety, security, and well-being including significant sexual and reproductive health challenges. Between August 2016 and May 2017, the “Sous-Cluster sur les violences basées sur le genre (SC-VBG)” in DRC (2017) reported 1,429 Gender Based Violence (GBV) incidents in the 49 service delivery points in the provinces of Kasaï, Kasaï Central and Kasaï Oriental. Rape cases represented 79% of reported incidents whereas sexual assault and forced marriage accounted for respectively 11% and 4% of Gender Based Violence (GBV) among women and adolescent girls. This study aims to assess the availability of SRHS in the displaced camps in Kasaï; to evaluate the SRHS needs of young girls and women in the reproductive age (12–49). Studies of sexual and reproductive health (SRH) in the Democratic Republic of Congo (DRC) have often included adolescent girls under the age of 15 because of high prevalence of child marriage and early onset of childbearing, especially in the humanitarian context. According to the 2013 Demographic and Health Survey (DHS), about 16% of surveyed women got married by age 14 while the prevalence of early child marriage (marriage by 15) was estimated at 30%; to assess the use of SRHS services and identify barriers as well as challenges for SRH service delivery and use. Findings from this study will help provide evidence to inform towards more needs-based and responsive SRH service delivery. This is hoped for ultimately improve the quality and effectiveness of services, when considering service delivery and response in humanitarian settings. Data and methods We will conduct a mixed-methods study design, which will combine quantitative and qualitative approaches. Based on the estimation of the sample size, quantitative data will be drawn from the community-based survey (500 women of reproductive age per site) and health facility assessments will include assessments of 45 health facilities and 135 health providers’ interviews. Qualitative data will comprise materials from 30 Key Informant Interviews (KII) and 24 Focus Group Discussions (FGDs), which are believed to achieve the needed saturation levels. Data analysis will include thematic and content analysis for the KIIs and FGDs using ATLAS.ti software for the qualitative arm. For the quantitative arm, data analysis will combine frequency and bivariate chi-square analysis, coupled with multi-level regression models, using Stata 15 software. Statistic differences will be established at the significance level of 0.05. We submitted this protocol to the national ethical committee of the ministry of health in September 2019 and it was approved in January 2020. It needs further approval from the Scientific Oversee Committee (SOC) and the Provincial Ministry of Health. Prior to data collection, informed consents will be obtained from all respondents.


2018 ◽  
Vol 5 (2) ◽  
pp. 105
Author(s):  
Susana Sabarni ◽  
Lidia Laksana Hidajat

Latar Belakang : Pesatnya perkembangan teknologi informasi, memudahkan remaja mengakses semua hal yang berhubungan dengan informasi seputar seks. Dengan kemudahan yang dimiliki untuk mengakses teknologi informasi ini, remaja seringkali terekspos oleh konten-konten pornografi. Secara langsung maupun tidak langsung akan memengaruhi sikap remaja terhadap perilaku seks pranikah.Tujuan : Mengetahui peran nilai pribadi, nilai budaya dan nilai religius dikaitkan dengan sikap remaja perempuan di Maumere dan Larantuka terhadap perilaku seks pranikah serta mengetahui sikap remaja perempuan terhadap perilaku seks pranikah.Metode : Penelitian menggunakan pendekatan mixed method, pengukuran sikap melalui pengisian kuesioner dan diskusi kelompok terarah (FGD) untuk mengetahui gambaran sikap remaja perempuan terhadap perilaku seks pranikah yang dikaitkan dengan nilai pribadi, nilai budaya dan nilai religius. Kegiatan penelitian dilakukan pada empat SMA di Maumere dan Larantuka. Jumlah partisipan 120 orang, diperoleh dengan teknik accidental sampling. Sebagai informasi tambahan dilakukan wawancara dengan tokoh budaya di Maumere dan tokoh agama di Larantuka. Hasil dan pembahasan : Berdasarkan pengolahan data terhadap pengukuran skala sikap diperoleh gambaran bahwa pada dasarnya remaja perempuan di Maumere dan Larantuka tidak menyetujui hubungan seks pranikah, meskipun telah terjadi pergeseran nilai. Sikap ini berdasarkan pada nilai-nilai pribadi yang diyakini remaja yaitu pertimbangan etika dan moral, dampak kehamilan, aborsi atau penyakit menular seksual. Dalam konteks budaya, pertimbangan remaja adalah sanksi sosial yang akan diperoleh dari kehamilan di luar nikah. Sedang dalam konteks religius, remaja mempertimbangkan tentang dosa. Berdasarkan diskusi kelompok terarah (FGD) disimpulkan bahwa nilai religius dirasakan sangat penting oleh partisipan karena dapat menumbuhkan iman dan memberi dorongan,arah dalam bertingkah laku. Nilai-nilai religius juga berperan dalam memberi motivasi dan membimbing seseorang untuk melakukan perbuatan yang baik. Dalam konteks budaya, para partisipan berpendapat bahwa budaya sangat penting karena dalam budaya diajarkan tentang perilaku yang pantas dan tidak pantas dilakukan. Oleh karena itu dibutuhkan pendampingan orangtua dalam mendidik dan menanamkan nilai-nilai moral dan etika.Kesimpulan : Pernyataan sikap tidak setuju terhadap perilaku seks pranikah merupakan internalisasi nilai-nilai budaya dan religius yang akhirnya membentuk sikap remaja di Maumere dan Larantuka Kata kunci : Peran nilai pribadi, nilai budaya dan nilai religius, sikap remaja perempuan, perilaku seks pranikah, Maumere dan Larantuka, Nusa Tenggara Timur Susana Sabarni, Lidia Laksana HidajatABSTRACT Background: The rapid development of information technology, making it easier for teenagers to access all things related to information about sex. With the ease they have to access this information technology, teenagers are often exposed to pornographic content. Directly or indirectly will influence teen attitudes towards premarital sex behavior.Objective: To acknowlegde the role of personal values, cultural values and religious values associated with the attitudes of adolescent girls in Maumere and Larantuka towards premarital sex behavior and also to acknowlegde  the attitudes of teenage girls to premarital sex behavior.Methods: The study used a mixed method approach, attitude measurement through filling out questionnaires and focus group discussions (FGD) to describe the attitudes of adolescent girls towards premarital sex behavior which is associated with personal values, cultural values and religious values. Research activities were carried out on four high schools in Maumere and Larantuka. The number of participants 120 people, obtained by accidental sampling technique. For additional information, interviews with cultural leaders in Maumere and religious leaders in Larantuka were conducted.Results and discussion: Based on data processing on attitude scale measurement obtained an illustration that basically girls in Maumere and Larantuka do not approve premarital sex, even though there has been a shift in values. This attitude is based on personal values believed by adolescents, namely ethical and moral considerations, the impact of pregnancy, abortion or sexually transmitted diseases. In the context of culture, adolescent considerations are social sanctions that will be obtained from pregnancy outside of marriage. While in a religious context, teenagers consider sin. Based on focus group discussions (FGD) it was concluded that religious values were felt to be very important by participants because they could foster faith and give encouragement, direction in behaving. Religious values also play a role in motivating and guiding someone to do good deeds. In the cultural context, the participants thought that culture was very important because in the culture it was taught about appropriate and inappropriate behavior. Therefore, parents are needed to assist in educating and instilling moral and ethical values.Conclusion: A statement of disagreement with premarital sex behavior is an internalization of cultural and religious values that ultimately shape their attitudes Keywords: The role of personal values, cultural values and religious values, attitudes of adolescent girls, premarital sexual behavior, Maumere and Larantuka, Nusa Tenggara Timur


Author(s):  
Saili U. Jadhav ◽  
Shubhada S. Avachat

Background: Adolescents comprise one-fifth of India's total population. Knowledge on reproductive health at adolescent age is essential to build their foundation of healthy reproductive practices in the future and to lower the risk of sexually transmitted diseases.Methods: An interventional study was done on 51 adolescent girls at a shelter home (Snehalaya). Informed consent was obtained from the concerned authorities. Data was collected by interview technique with the help of a structured questionnaire prepared by literature search. Response of adolescents was recorded through their answers to the questionnaires. Intervention was done in the form of sensitization lecture with the help of audio visuals and educational posters. The same questionnaire was again interviewed and the impact of intervention was assessed. Statistical analysis of data was done using percentage, proportion and appropriate tests of significance.Results: In our study we found the average age of menarche of the girls to be 12-14 years, but as several of the girls came from unhealthy backgrounds, they had several menstrual problems like dysmenorrhea, irregular menses. Three of the girls had not experienced menses after 14 years of age. After the sensitization lecture, 56% of the girls were able to write the names of the reproductive organs in the female genital tract. 85% of the girls were able to name the hazards of teenage pregnancy. All adolescents need access to quality youth-friendly services provided by clinicians trained to work with this population. Sex education programs should offer accurate, comprehensive information while building skills for negotiating sexual behaviors.Conclusions: Hence from our project we identified the unmet need of awareness regarding reproductive health amongst adolescent girls and we tried to meet those needs by providing sensitization.


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