Adolescent Sexual and Reproductive Health in Ethiopia and Rwanda: A Qualitative Exploration of the Role of Social Norms

This article seeks to address the dearth of evidence on early adolescent understandings and experiences of sexual and reproductive health (SRH) in Ethiopia and Rwanda, drawing on a multisite qualitative research study with 10- to 12-year-old and 14- to 15-year-old male and female adolescents and a range of adult participants. The article is informed by a conceptual framework that draws on Amartya Sen’s capability approach, which calls for investments in a broad set of assets that expand individuals’ capacity to “be” and to “do.” Using SRH as a focal lens, the article considers the role played by gendered social norms in adolescents’ experiences of SRH-related understandings and experiences. Three key interrelated gender themes emerge from our thematic analyses of qualitative evidence generated by our multimethods approach: puberty transitions, sexuality, and victim blaming. In our analyses, we pay attention to diversity (e.g., age, gender, place of residence) among adolescents within and across the two focal countries and consider how discriminatory gendered social norms play a role in hindering the effective uptake of expanding health services. We conclude by emphasizing the need for program designers and implementers to address the role of underlying social norms in a more strategic and context-specific way to help young people navigate their sexual and reproductive lives.

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

Health Research Policy and Systems ◽

10.1186/s12961-021-00714-0 ◽

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.

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The role of self-care interventions on men’s health-seeking behaviours to advance their sexual and reproductive health and rights

Health Research Policy and Systems ◽

10.1186/s12961-020-00655-0 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Manjulaa Narasimhan ◽

Carmen H. Logie ◽

Kevin Moody ◽

Jonathan Hopkins ◽

Oswaldo Montoya ◽

...

Keyword(s):

Public Health ◽

Reproductive Health ◽

Social Norms ◽

Sexual And Reproductive Health ◽

Self Care ◽

Men’S Health ◽

Men's Health ◽

Health Seeking ◽

Digital Platforms ◽

Care Practices

Abstract Background Self-care interventions are influencing people’s access to, expectation and understanding of healthcare beyond formal health delivery systems. In doing so, self-care interventions could potentially improve health-seeking behaviours. While many men proactively engage in maintaining and promoting their health, the focus on men’s health comes from the recognition, at least partially, that male socialization and social norms can induce men and boys to have a lower engagement in institutionalized public health entities and systems around their sexual and reproductive health and rights, that could impact negatively on themselves, their partners and children. Main text A research agenda could consider the ways that public health messaging and information on self care practices for sexual and reproductive health and rights could be tailored to reflect men’s lived realities and experiences. Three examples of evidence-based self-care interventions related to sexual and reproductive health and rights that men can, and many do, engage in are briefly discussed: condom use, HIV self-testing and use of telemedicine and digital platforms for sexual health. We apply four core elements that contribute to health, including men’s health (people-centred approaches, quality health systems, a safe and supportive enabling environment, and behaviour-change communication) to each intervention where further research can inform normative guidance. Conclusion Engaging men and boys and facilitating their participation in self care can be an important policy intervention to advance global sexual and reproductive health and rights goals. The longstanding model of men neglecting or even sabotaging their wellbeing needs to be replaced by healthier lifestyles, which requires understanding how factors related to social support, social norms, power, academic performance or employability conditions, among others, influence men’s engagement with health services and with their own self care practices.

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Sexual and reproductive health risks amongst female adolescents who use amphetamine-type stimulants and sell sex: a qualitative inquiry in Yunnan, China

Harm Reduction Journal ◽

10.1186/s12954-015-0065-y ◽

2015 ◽

Vol 12 (1) ◽

Cited By ~ 9

Author(s):

Xu-Dong Zhang ◽

Angela Kelly-Hanku ◽

Jia-Jia Chai ◽

Jian Luo ◽

Marleen Temmerman ◽

...

Keyword(s):

Reproductive Health ◽

Health Risks ◽

Sexual And Reproductive Health ◽

Qualitative Inquiry ◽

Female Adolescents

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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

10.21203/rs.2.22326/v1 ◽

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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