scholarly journals Quick and collaborative response to teenage pregnancies in a poor semi-rural area of Belgium

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Déom ◽  
L Ben Abdelhafidh ◽  
N Annez ◽  
C Glorie ◽  
M Roland

Abstract Early pregnancies are often linked to precarious situations. Even if Belgium has seen a decrease in teenage pregnancies, in the former mining region of the Hainaut there are still twice as many births to young women under 20 compared to the national rate. Colfontaine is one of the poorest cities in Belgium. Last year, one of the local high schools counted 10 pregnant teenagers out of 450 students. Médecins du Monde was already present in the city at the time with a mobile health clinic called the Médibus. In response, we carried out a mapping of the local sexual and reproductive health actors. The lack of accessibility to social and health structures capable of welcoming teenagers anonymously and free of charge quickly emerged as a problem, the nearest family planning center being located 30 minutes away by bus. In September 2019, in partnership with 5 local health actors, we decided to reshape the Médibus into the Adobus in order to offer family planning consultations, health promotion and harm reduction activities at the high school once a week. In addition to offering health information services, we also aim to detect teenagers experiencing vulnerable situations such as addiction, violence, gender issues and refer them to appropriate services. Halfway through the project, we met 430 teenagers in 14 afternoons. The most common reasons for consultation (N = 310) were questions related to contraception for 29% and to sexually transmitted infections for 24,5%. 70,9% of teenagers received condoms and 13 girls were tested for pregnancy. One girl received a morning-after pill. 3 teenagers with addiction problems and 17 victims of violence were detected. The teams referred 18 teenagers to other services. The success of this outreach project confirms the need for information regarding sexual and reproductive health for teenagers living in precarious situations as well as the need to develop reachable and affordable sexual and reproductive health services in semi-rural areas. Key messages Outreach is an efficient approach to respond to teenagers’ needs in poor semi-rural areas. Outreach facilitated the detection of early pregnancies, addiction and violence issues among teenagers.

2018 ◽  
Vol 12 (4) ◽  
pp. 1074-1083 ◽  
Author(s):  
Megan Hamm ◽  
Elizabeth Miller ◽  
Lovie Jackson Foster ◽  
Mario Browne ◽  
Sonya Borrero

Despite demonstrable need, men’s utilization of sexual and reproductive health services remains low. This low utilization may particularly affect low-income men, given the disproportionate prevalence of unintended pregnancy in low-income populations. Bolstering men’s utilization of sexual and reproductive health services requires understanding the services that are most relevant to them. Semistructured interviews about fatherhood, fertility intention, and contraceptive use were conducted with 58 low-income Black and White men in Pittsburgh, Pennsylvania. The interviews were analyzed using content analysis to determine common themes that were most relevant to the men interviewed. The primacy of financial stability emerged as a dominant theme in men’s perceptions of fatherhood readiness, successful fathering, and fertility intentions. However, men had children despite feeling financially unprepared, and their contraceptive use was not always congruent with their stated fertility intentions. Some men described financial services as a feature of family planning services that they would find useful. Because of the salience of financial stability in preparation for fatherhood, integrating financial counseling and job skills training into the context of sexual and reproductive health services could be a useful structural intervention to increase men’s use of family planning services and to provide them with the support they say they need as fathers.


2018 ◽  
Vol 66 (4) ◽  
pp. 617-622
Author(s):  
Diana Marcela Hernández-Pérez ◽  
María Natalia Moreno-Ruíz ◽  
Anderson Iván Rocha-Buelvas ◽  
Arsenio Hidalgo-Troya

Introduction: Poverty and social inequalities together with sexually transmitted diseases have a negative impact on women’s health, which is considered to be a public health problem.Objective: To analyze barriers to accessing sexual and reproductive health services in cleaning workers.Materials and methods: A survey was administered to a sample of 37 female cleaning workers at a hospital in Bogotá D.C. A bivariate analysis was performed with chi-square test, as well as a multivariate analysis with binomial logistic regression.Results: Need factors showed greater association with non-use of sexual health services. All married women had accessed the service over the past 12 months, but there were 5.9 less possibilities of using sexual and reproductive health services when there was no awareness about risk behaviors of sexually transmitted diseases.Conclusion: The determining factor for the utilization of sexual health services is the health care need factor. Variables such as perception of risk behaviors and appropriateness of health care significantly influence the use of the service.


2020 ◽  
Author(s):  
Simon Binezero Mambo ◽  
Franck K. Sikakulya ◽  
Robinson Ssebuufu ◽  
Yusuf Mulumba ◽  
Henry Wasswa ◽  
...  

Abstract BackgroundThe COVID-19 pandemic threatens access to sexual and reproductive health services. With global health emergencies, there is often a total reversal of priorities and access to sexual and reproductive health services may become challenging. The aim of this study was to establish the problems related to sexual and reproductive health among Ugandan youths during the COVID-19 lockdown. MethodsThis was an online cross-sectional study carried out from April 2020 to May 2020 in Uganda. An online questionnaire was used and participants aged 18years to 30 years recruited using the snowballing approach. The statistical analysis was done using STATA version 14.2.Results Out of 724 participants, 203 (28%) reported not having information and/or education concerning sexual and reproductive health (SRH). About a quarter of the participants (26.9%, n=195) reported not having testing and treatment services of sexually transmitted infections available during the lockdown. Lack of transport means was the commonest (68.7%) limiting factor to access to SRH services during the lockdown followed by the long distance from home to SRH facility (55.2%), high cost of services (42.2%) and curfew (39.1%). Sexually transmitted infections were the commonest (40.4%) problem related to SRH during the lockdown followed by unwanted pregnancy (32.4%) and sexual abuse (32.4%). The multivariate regression analysis shows that problems were more prevalent among the co-habiting youth [APR: 2.3 (1.6 - 3.29), p<0.001] followed by unemployed (volunteer or unpaid) [APR: 1.6 (1.03 - 2.64), p: 0.037] than in other participants. ConclusionsThe findings of this study show that Ugandan youths have accessing SRH information and services during the COVID-19 lockdown. Cohabiting and unemployed participants were the most affected. Lack of transport means and high cost of services were the major limiting factors to access SRH services among the youths. The findings call for concerted efforts from the Uganda government and international non-governmental organisations to ensure access and availability of SRH services for Ugandan youths during the COVID-19 lockdown.


2020 ◽  
Author(s):  
Mulekya Francis Bwambale ◽  
Paul Bukuluki ◽  
Cheryl A. Moyer ◽  
Bart H.W Van den Borne

Abstract Background While the nexus of migration and health outcomes is well acknowledged, the effect of rural-urban migration on uptake of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural-rural urban migration on uptake of SRH services and whether there is a difference in uptake of SRH services among migrant and non-migrant street children. Methods Data were collected among 513 street children aged 12-24 years using face‐to‐face interviews. Participants were recruited by venue-based time-space sampling (VBTS). Using STATA 16.00, we performed multivariate binary logistic regression to identify correlates of SRH service uptake with migration status as the main predictor while controlling for confounding. In this study, migrants are defined as children who had moved to settle in the city for at least 24 months preceding the survey. Results Overall, two-thirds (66.82%) of children had moved to the city in the last 2 years, 20% in the last 3-5 years and 13.18% in 6 years or longer. Only 18.13% of the street children had ever used contraception/family planning, 45.89% had ever tested for HIV and knew their status while 34.70% had ever been screened for sexually transmitted infections. Multivariate analysis shows that migrant street children had reduced odds of using sexual and reproductive health services (HIV testing, use of contraception and screening for STIs) compared to the lifelong native street children (aOR=0.59, 95%CI 0.36- 0.97). Other factors associated with use of SRH services among street children include age (aOR=4.51; 95%CI 2.78-7.33), schooling status (aOR=0.34; 95%CI -1.830 0.15-0.76), knowledge of place of care (OR=3.37,95%CI 2.04-5.34) and access to SRH education information (aOR=2.7, 95%CI 1.67- 4.53). Conclusion Rural-urban migration is associated with low SRH service uptake. Access to and use of SRH services among migrant street children is low compared to non-migrant street children. Our findings point to the need for urban health systems to design effective interventions to improve equitable access to and use of quality SRH services among street children while taking into consideration their migration patterns.


2019 ◽  
Vol 2 (4) ◽  
Author(s):  
Djidonou Anselme ◽  
Gansou Grégoire Magloire ◽  
Tognon Tchegnonsi Francis ◽  
Sidi Imorou Rachidi ◽  
Chabi Yasmine Gloria Mondoukpè ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Ellen Abrafi Boamah-Kaali ◽  
Seyram Kaali ◽  
Grace Manu ◽  
Stephaney Gyaase ◽  
Elisha Adeniji ◽  
...  

Introduction. Tailoring sexual and reproductive health programs and services to the needs of adolescents will help adolescents make informed decisions and choices regarding their sexual and reproductive health. Objective. To assess the opinions of service providers on tailoring sexual and reproductive health services to the needs of adolescents. Method. A qualitative study using indepth interviews was held among eight decision-makers and service providers in two hospitals within the Kintampo North Municipality and Kintampo South District as well as the Municipal and District Health Directorates in Kintampo North and South between April and May 2011. Results. All respondents expressed the opinion that it is a good idea to tailor sexual and reproductive health services to the needs of adolescents. They admitted that very limited sexual and reproductive health programs targeting adolescent needs were available in the study area. Service providers also reported very low levels of health facilities use by adolescents for sexual and reproductive health information and services. Health professionals attributed the poor sexual and reproductive health services utilization by adolescents to stigma from the society and attitudes of service providers. Conclusion. There are no targeted sexual and reproductive health programmes and services for adolescents. Services providers indicated that it is important to tailor sexual and reproductive health services to the needs of adolescents to prevent stigma, unwanted pregnancy, abortion, and sexually transmitted infections.


Author(s):  
Shireen Parker ◽  
Vera Scott

Background: The United Nations Political Declaration on HIV and AIDS of 2006 stressed the need to strengthen policy and programme linkages between HIV and Sexual and Reproductive Health (SRH). However, the effectiveness and best practices for strengthening SRH and HIV linkages are poorly researched in the context of family-planning services. In Cape Town, HIV-prevention services have been integrated into family-planning services. There are two models of service configuration: dedicated stand-alone reproductive health clinics and family planning services located in comprehensive primary-care facilities.Objective: To describe how reproductive health services are integrating HIV prevention and care strategies and to measure the coverage and quality of these integrated services.Methods: A cross-sectional study was conducted using structured interviews with facility managers; a facility-based checklist; and a patient record review to assess the availability of resources, training, access, quality and integration.Results: Facilities in Cape Town are equipped adequately to offer integrated HIV-prevention and SRH services. Overall there was poor coverage of integrated services with 54% of family planning clients having a known HIV status; 47% being screened for a sexually transmitted infection and 55% being offered HIV counselling and testing and receiving condoms. Quality and continuity of care seemed better at the dedicated clinics than at the comprehensive facilities,supported by better training coverage.Conclusion: Engaging middle-level management is crucial with regard to improving integration within a well-resourced setting.


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