scholarly journals Sexual and Reproductive Health Needs of Adolescent Girls and Young Women in Sub-Saharan Africa: Research, Policy, and Practice

SAGE Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 215824401985995 ◽  
Author(s):  
Kammila Naidoo ◽  
Oluwafemi Adeagbo ◽  
Melanie Pleaner
Keyword(s):  
Reproductive Health ◽  
Adolescent Girls ◽  
Young Women ◽  
Sexual And Reproductive Health ◽  
Research Policy ◽  
Good Health ◽  
Health Needs ◽  
Sub Saharan Africa ◽  
Gender Based Violence ◽  
Diverse Range

Seventeen articles make up this special collection, covering a range of different, but cross-cutting themes. These highlight contemporary concerns in African research and scholarship about the factors configuring the sexual and reproductive health needs of adolescent girls and young women (AGYW). The articles interrogate contextual and cultural impediments, problematic representations, perceptions of vulnerabilities and rights, experiences of gender-based violence, coercive sex, unplanned motherhood—and agency, resistance and strategic interventions. While a diverse range of issues, theories, and methodologies are evident, all the articles reflect on how the circumstances of young women in Africa can be effectively improved to engender empowerment, good health, and personal and sexual autonomy.

scholarly journals Situation analysis for delivering integrated comprehensive sexual and reproductive health services for displaced population of Kasaï, Democratic Republic of Congo: Protocol for a mixed method study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242046
Author(s):  
Jacques B. O. Emina ◽  
Parfait Gahungu ◽  
Francis Iyese ◽  
Rinelle Etinkum ◽  
Brigitte Kini ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Service Delivery ◽  
Adolescent Girls ◽  
Sexual And Reproductive Health ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Reproductive Age ◽  
Gender Based Violence ◽  
Reproductive Health Services ◽  
Republic Of Congo

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.

scholarly journals Uptake of Contraception Among Adolescent Girls and Young Women PrEP Clients: Leveraging the Opportunity to Strengthen HIV and Sexual and Reproductive Health Integration

2021 ◽  
Vol 3 ◽  
Author(s):  
Melanie Pleaner ◽  
Zukiswa Fipaza ◽  
Khuthala Mabetha ◽  
Letitia Greener ◽  
Sydney Ncube ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Adolescent Girls ◽  
Young Women ◽  
Sexual And Reproductive Health ◽  
Monitoring Data ◽  
Consistent Condom ◽  
Healthcare Facilities ◽  
Routine Monitoring ◽  
New Guidelines ◽  
Exposure Prophylaxis

The introduction of oral pre-exposure prophylaxis (PrEP) for HIV prevention was a major breakthrough in South Africa (SA). While the initial introduction focused on issues such as the development and implementation of new guidelines, supply, and the development of demand creation strategies, the need to integrate PrEP services with sexual and reproductive health (SRH) services has gained traction both globally and locally. Project PrEP was implemented in eight healthcare facilities and four mobile clinics in three provinces in SA. Using monitoring data from across the four project clusters, and 4,949 clients, over a 21-month period, we conducted an analysis of baseline routine monitoring data to examine contraceptive uptake in adolescent girls and young women (AGYW) initiating PrEP at project sites. Two-thirds of women (62.3%, n = 3,083) reported the current use of contraception at baseline, with the most commonly used methods being hormonal injectables (61.9%, n = 1,829) and male condoms (19.4%, n = 575). A third (32.3%, n = 603) of the non-contraceptive users accepted a method at PrEP initiation. From a total of 1,007 (32.7%) current contraceptive users at baseline, 865 (85.9%) chose the same or a different method at this visit. The method uptake at PrEP initiation increased the overall contraceptive prevalence by 12.2 to 74.5%. Data indicated that over a third (38.8%, n = 725) who were not using a method at baseline described themselves as consistent condom users. Although a major focus of the project was on PrEP service provision, all women were counseled and offered contraceptive services. The acceptance of a method by a third of non-users was promising; however, more understanding of those who did not take up a method is required. The need to leverage opportunities for the promotion of the integration of HIV and family planning at all levels of PrEP provision was highlighted.

scholarly journals Mental health outcomes of a pilot 2-arm randomized controlled trial of a HIV-prevention program for South African adolescent girls and young women and their female caregivers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Geri Donenberg ◽  
Katherine G. Merrill ◽  
Millicent Atujuna ◽  
Erin Emerson ◽  
Bethany Bray ◽  
...  
Keyword(s):  
Mental Health ◽  
Logistic Regression ◽  
Hiv Prevention ◽  
Reproductive Health ◽  
Health Outcomes ◽  
South African ◽  
Adolescent Girls ◽  
Young Women ◽  
Sexual And Reproductive Health

Abstract Background South African adolescent girls and young women (AGYW) report significant mental distress and sexual and reproductive health concerns. Mental health problems and trauma symptoms are consistently associated with sexual and reproductive health behavior. Despite their intersection, few interventions address them simultaneously or engage female caregivers (FC) as collaborators. This study presents findings from a pilot test of an empirically supported culturally adapted family-based HIV-prevention program, Informed Motivated Aware and Responsible Adolescents and Adults- South Africa (IMARA-SA), on AGYW anxiety, depression, and trauma. Methods Sixty 15–19-year-old AGYW (mean age = 17.1 years) and their FC from outside Cape Town were randomized to IMARA-SA or a health promotion control program. AGYW reported their anxiety using the GAD-7, depression using the PHQ-9, and trauma using the PC-PTSD-5 at baseline and follow-up (6–10 months post). Both interventions were delivered by Xhosa-speaking Black South African women in groups over 2 days for approximately 10 h. We examined intervention effects using zero-inflated negative binomial regression for anxiety, multinomial logistic regression for depression, and logistic regression for trauma. Results At baseline, groups did not differ in demographic characteristics but AGYW randomized to IMARA-SA had higher depression scores than controls (p = 0.04) and a greater proportion screened positive for PTSD (p = .07). Controlling for baseline mental health scores, AGYW who received IMARA-SA compared to controls had significantly fewer anxiety symptoms at follow-up (adjusted incidence rate ratio for count model = 0.54, 95% CI = 0.29–0.99, p = 0.05), were less likely to report at least one depressive symptom relative to no symptoms (relative risk ratio = 0.22, 95% CI = 0.05, 0.95, p = 0.04), and were less likely to report symptoms of PTSD relative to no symptoms, but this difference was not statistically significant. Conclusions Mental health is implicated in risky sexual behavior, and reducing emotional distress can mitigate exposure to poor sexual and reproductive health outcomes. This pilot study yielded promising findings for the mental health impact of IMARA-SA, justifying replication in a larger randomized trial. Trial registration ClinicalTrials.gov Number NCT04758390, accepted 17/02/2021.

scholarly journals Sexual and reproductive health among adolescent girls and young women in Mombasa, Kenya

2020 ◽  
Vol 28 (1) ◽  
pp. 1749341
Author(s):  
Andrea Wilson ◽  
Helgar Musyoki ◽  
Lisa Avery ◽  
Eve Cheuk ◽  
Peter Gichangi ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Adolescent Girls ◽  
Young Women ◽  
Sexual And Reproductive Health

scholarly journals Nature of, and responses to key sexual and reproductive health challenges for adolescents in urban slums in sub-Saharan Africa: a scoping review

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Yohannes Dibaba Wado ◽  
Martin Bangha ◽  
Caroline W. Kabiru ◽  
Garumma T. Feyissa
Keyword(s):  
Young People ◽  
Reproductive Health ◽  
Urban Space ◽  
Scoping Review ◽  
Sexual And Reproductive Health ◽  
Urban Slums ◽  
Sub Saharan Africa ◽  
Gender Based Violence ◽  
Scoping Reviews ◽  
Sub Saharan

Abstract Background Addressing adolescents’ sexual and reproductive health and rights (SRHR) requires an understanding of the socio-cultural and spatial settings within which they live. One setting of particular importance is the informal settlements or ‘slums’ that are gradually dominating the urban space. We undertook a scoping review and synthesis of existing evidence on adolescent SRHR in slums in sub-Saharan Africa (SSA) focusing on the characteristics and nature of existing evidence. Methods The scoping review was conducted based on Arksey and O’Malley framework and in accordance with the guidance on scoping reviews from the Joanna Briggs Institute (JBI) and using PRISMA reporting guidelines for scoping reviews. A comprehensive search was undertaken in PubMed, POPLINE, African Journals Online (AJOL), Bioline International and Google Scholar. The search was confined to studies published in peer reviewed journals and reports published online between January 2000 and May 2019. Studies were included in the review if they addressed SRHR issues among adolescents living in urban slums in SSA. Results The review included a total of 54 studies. The majority (79.5%) of studies were quantitative. The bulk of studies (85.2%) were observational studies with only eight intervention studies. While half (27) of the studies focused exclusively on adolescents (10–19 years), 12 studies combined adolescents with other young people (10–24 years). The studies were skewed towards sexual behavior (44%) and HIV/AIDS (43%) with very few studies focusing on other SRHR issues such as contraception, abortion, gender-based violence and sexually transmitted infections (STIs) other than HIV. Most of the studies highlighted the significantly higher risks for poor SRHR outcomes among adolescents in slums as compared to their peers in other settlements. Conclusion Young people growing up in slums face tremendous challenges in relation to their SRHR needs resulting in poor outcomes such as early and unintended pregnancy, STIs, and sexual violence. The results of this review point to several potential target areas for programming, policy, and research aimed at improved adolescent SRHR in slums in SSA.

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