scholarly journals Integrating reproductive health services into HIV care: strategies for successful implementation in a low-resource HIV clinic in Lilongwe, Malawi

2015 ◽  
Vol 42 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Sam Phiri ◽  
Caryl Feldacker ◽  
Thomas Chaweza ◽  
Linly Mlundira ◽  
Hannock Tweya ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Hiv Care ◽  
Successful Implementation ◽  
Reproductive Health Services ◽  
Low Resource

scholarly journals “They Just Tell Me to Abstain:” Variable Access to and Uptake of Sexual and Reproductive Health Services Among Adolescents Living With HIV in Kenya

2021 ◽  
Vol 3 ◽  
Author(s):  
Sarah Lawrence ◽  
Hellen Moraa ◽  
Kate Wilson ◽  
Immaculate Mutisya ◽  
Jillian Neary ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Reproductive Health Services ◽  
Sti Testing ◽  
Adolescent Autonomy ◽  
Facility Survey ◽  
Living With Hiv

Background: To improve holistic care for adolescents living with HIV (ALHIV), including integration of sexual and reproductive health services (SRHS), the Kenya Ministry of Health implemented an adolescent package of care (APOC). To inform optimized SRH service delivery, we sought to understand the experiences with SRHS for ALHIV, their primary caregivers, and health care workers (HCWs) following APOC implementation.Methods: We completed a mixed methods evaluation to characterize SRHS provided and personal experiences with access and uptake using surveys conducted with facility managers from 102 randomly selected large HIV treatment facilities throughout Kenya. Among a subset of 4 APOC-trained facilities in a high burden county, we conducted in-depth interviews (IDIs) with 40 ALHIV and 40 caregivers of ALHIV, and 4 focus group discussions (FGDs) with HCWs. Qualitative data was analyzed using thematic analysis. Facility survey data was analyzed using descriptive statistics.Results: Of 102 surveyed facilities, only 56% reported training in APOC and 12% reported receiving additional adolescent-related SRHS training outside of APOC. Frequency of condom provision to ALHIV varied, with 65% of facilities providing condoms daily and 11% never providing condoms to ALHIV. Family planning (FP) was provided to ALHIV daily in 60% of facilities, whereas 14% of facilities reported not providing any FP services to ALHIV. Screening and treatment for STIs for adolescents were provided at all clinics, with 67% providing STI services daily. Three key themes emerged characterizing experiences with adolescent SRHS access and uptake: (1) HCWs were the preferred source for SRH information, (2) greater adolescent autonomy was a facilitator of SRH discussions with HCWs, and (3) ALHIV had variable access to and limited uptake of SRHS within APOC-trained health facilities. The primary SRHS reported available to ALHIV were abstinence and condom use education. There was variable access to FP, condoms, pregnancy and STI testing, and partner services. Adolescents reported limited utilization of SRHS beyond education.Conclusions: Our results indicate a gap in SRHS offered within APOC trained facilities and highlight the importance of adolescent autonomy when providing SRHS and further HCW training to improve SRHS integration within HIV care for ALHIV.

scholarly journals Uterovaginal prolapse: the sociodemographic profile and reproductive health service uptake in a low resource setting, Calabar, Nigeria

2020 ◽  
Vol 9 (4) ◽  
pp. 1610
Author(s):  
Njoku Charles Obinna ◽  
Njoku A. N. ◽  
Efiok E. E. ◽  
Eyong E. M.
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Antenatal Care ◽  
Genital Prolapse ◽  
Uterovaginal Prolapse ◽  
Reproductive Health Services ◽  
Skilled Attendant ◽  
Duration Of Symptoms ◽  
Low Resource ◽  
The Mean

Background: Uterovaginal prolapse is a common gynaecological condition in low resource countries because of high prevalence of grand multiparity, low skilled attendant at delivery and low contraceptive usage. Objective of this study was to determine the prevalence, sociodemographic profiles, utilization of reproductive health services and delay in seeking medical care of patient with uterovaginal prolapse in Calabar, Nigeria.Methods: This was a retrospective study of women who presented with uterovaginal prolapse at University of Calabar Teaching Hospital, Calabar, Nigeria between 1st May 2009 and 1st June 2019. Patients case records were retrieved and analyzed. Statistical analysis was done using SPSS version 22.Results: The prevalence of genital prolapse was 0.3%. The mean age and parity were 60.19±8.71 years and 6.31±2.80, respectively. The mean duration of symptoms before presentation was 3.19±2.16 years. Genital prolapse was commonest among age group 60-79 years (52.8%), parity 5-9 (66.7%), post-menopausal (97.2%), primary education (55.6%) and farmers (47.2%). Grade 3 uterovaginal prolapse was the commonest grade (58.3%). Most patients (86.1%) had symptoms of genital prolapse for less than 5 years before seeking medical treatment. The majority of patients had no antenatal care during their pregnancies (80.6%), no skilled attendant at deliveries (86.1%) and no contraceptive use during their reproductive years (77.8%). Participants with lower parity (1-4) (p=0.03), higher educational level (p˂0.001) and teachers/civil servants (p=0.043) presented earlier (less than 1 year) to the hospital.Conclusions: There is poor utilization of reproductive health services among women who develop uterovaginal prolapse in study environment. Women with higher social status sought for help earlier. Increasing awareness of this condition and providing antenatal care, skilled birth attendants and contraceptive services will reduce the burden of this condition. 

Focus on Women: Linking HIV Care and Treatment with Reproductive Health Services in the MTCT-Plus Initiative

2005 ◽  
Vol 13 (25) ◽  
pp. 136-146 ◽  
Author(s):  
Landon Myer ◽  
Miriam Rabkin ◽  
Elaine J Abrams ◽  
Allan Rosenfield ◽  
Wafaa M El-Sadr
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Hiv Care ◽  
Reproductive Health Services ◽  
Care And Treatment

Multi-level Barriers for Utilization of Youth Friendly Reproductive Health Services (YFRHS) among Youths

2020 ◽  
Vol 8 ◽  
pp. 95-108
Author(s):  
Shanti Prasad Khanal
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Health System ◽  
System Level ◽  
Mixed Method Research ◽  
Reproductive Health Services ◽  
Group Discussions ◽  
Personal Level ◽  
Multi Level ◽  
Youth Friendly

 The present study aims to examine the multi-level barriers to utilize by the youth-friendly reproductive health services (YFRHS) among the school-going youths of the Surkhet valley of Nepal. This study is based on the sequential explanatory research design under mixed-method research. The quantitative data were collected using the self- administered questionnaire from the 249 youths, aged between the 15-24 years, those selected by using random sampling. The qualitative data were collected using the Focus Group Discussions (FGDs) from the 12 participants who were selected purposively. The study confirmed that school-going youths do not have appropriate utilization of YFHS due to multi-layered barriers. However, the utilization of the service was higher among females, those the older age group, studying in the upper classes, the upper castes, and married youths. The key findings and themes are recognized as multi-layered barriers including personal-level, health system-level, community-level, and policy-level on the entire socio-ecological field. Among them, the existing health system is the foremost barrier. Multi-level interventions are, therefore, required to increase the YFRHS utilization and improve concerns for school-going-youths.  

Ensuring Reproductive Rights of Women in Nepal: Law and Praxis

2020 ◽  
Vol 4 (1) ◽  
pp. 41-62
Author(s):  
D. N. Parajuli
Keyword(s):  
Human Rights ◽  
Reproductive Health ◽  
Health Services ◽  
Reproductive Rights ◽  
School Curriculum ◽  
Fundamental Rights ◽  
Reproductive Health Services ◽  
Women And Girls ◽  
The Right ◽  
Health Rights

 Reproductive rights are fundamental rights and freedoms relating to reproduction and reproductive health that vary amongst countries around the world, but have a commonality about the protection, preservation and promotion of a woman‘s reproductive health rights. Reproductive rights include the right to autonomy and self-determination , the right of everyone to make free and informed decisions and have full control over their body, sexuality, health, relationships, and if, when and with whom to partner, marry and have children , without any form of discrimination, stigma, coercion or violence. The access and availability of reproductive health services are limited due to geography and other issues, non-availability and refusal of reproductive health services may lead to serious consequences. The State need to ensure accessibility, availability, safe and quality reproductive health services and address the lifecycle needs of women and girls and provide access of every young women and girls to comprehensive sexuality education based on their evolving capacity as their human rights, through its inclusion and proper implementation in school curriculum, community-based awareness program and youth led mass media. It is necessary for strengthening compliance, in a time-bound manner, with international human rights standards that Nepal has ratified that protect, promote, and fulfill the basic human rights and reproductive health rights in Nepal and also need to review standards and conventions that Nepal has had reservations about or those that have been poorly implemented in the country.

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