A review of interventions addressing structural drivers of adolescents’ sexual and reproductive health vulnerability in sub-Saharan Africa: implications for sexual health programming

Abstract Background Improving adolescent sexual and reproductive health continues to be a global public health need. Effective parent–adolescent communication on sexual health issues has been cited as a factor that could influence adolescents towards adopting safer sexual behaviour. The current review synthesises qualitative literature to understand the nature and relevance of parent–adolescent sexual and reproductive health communication and the barriers to effective communication in sub-Saharan Africa. Methods We systematically searched and synthesised qualitative literature published between 1st January 1990 to December 2019 and searched from CINAHL, PsycINFO, MEDLINE, Global Health, EMBASE, PubMed, and Google Scholar. We assessed the methodological quality of included studies using the Critical Appraisal Skills Programme (CASP) checklist. We thematically analysed qualitative data from the included primary studies. Results Fifteen studies were included. Social and physiological events act as triggers for initiating discussions. Fear of personal, social, and economic consequences of high-risk sexual behaviours act as drivers for communication but also carry a negative framing which hinders open discussion. Lack of parental self-efficacy and cultural and religious norms create an uncomfortable environment leaving peers, media, teachers, and siblings as important and sometimes preferred sources of sexual health information. Conclusions While mothers recognise their own role in adolescent sexual and reproductive health and school-based interventions can act as useful prompts for initiating discussion, fathers are mainly absent from home-based dialogue. Fear dominates the narrative, and the needs of adolescents remain unarticulated.

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Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review

Reproductive Health ◽

10.1186/s12978-021-01183-y ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Lesley Rose Ninsiima ◽

Isabel Kazanga Chiumia ◽

Rawlance Ndejjo

Keyword(s):

Reproductive Health ◽

Health Services ◽

Sexual And Reproductive Health ◽

Health Workers ◽

Sub Saharan Africa ◽

Inclusion Criteria ◽

Reproductive Health Services ◽

Factors Influencing ◽

Sub Saharan ◽

Youth Friendly

Abstract Background Despite the global agreements on adolescents’ sexual and reproductive health and rights, access to and utilisation of these services among the youth/adolescents remain unsatisfactory in low- and middle-income countries which are a significant barrier to progress in this area. This review established factors influencing access and utilisation of youth-friendly sexual and reproductive health services (YFSRHS) among the youth in sub-Saharan Africa to inform programmatic interventions. Methodology A systematic review of studies published between January 2009 and April 2019 using PubMed, Web of Science, EMBASE, Medline, and Cochrane Library, and Google Scholar databases was conducted. Studies were screened based on the inclusion criteria of barriers and facilitators of implementation of YFSRHS, existing national policies on provision of YFSRHS, and youth’s perspectives on these services. Findings A total of 23,400 studies were identified through database search and additional 5 studies from other sources. After the full-text screening, 20 studies from 7 countries met the inclusion criteria and were included in the final review. Structural barriers were the negative attitude of health workers and their being unskilled and individual barriers included lack of knowledge among youth regarding YFSRHS. Facilitators of utilisation of the services were mostly structural in nature which included community outreaches, health education, and policy recommendations to improve implementation of the quality of health services and clinics for adolescents/youth to fit their needs and preferences. Conclusion Stakeholder interventions focusing on implementing YFSRHS should aim at intensive training of health workers and put in place quality implementation standard guidelines in clinics to offer services according to youth’s needs and preferences. In addition, educating the youth through community outreaches and health education programs for those in schools can facilitate utilisation and scale up of the service.

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Silence sexual and reproductive health discussions and we fuel the rise of HIV/AIDS in sub-Saharan Africa

Reproductive Health ◽

10.1186/s12978-017-0395-1 ◽

2017 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Janet M. Wojcicki

Keyword(s):

Reproductive Health ◽

Sexual And Reproductive Health ◽

Sub Saharan Africa ◽

Sub Saharan ◽

Hiv Aids

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The Principle of Sexual and Reproductive Health and Why It Is Central to Broad Advancements in Human Health and Development in Sub-Saharan Africa

Sexual and Reproductive Health and Rights in Sub-Saharan Africa ◽

10.1007/978-981-15-8502-9_2 ◽

2020 ◽

pp. 7-29

Author(s):

Nana K. Poku

Keyword(s):

Reproductive Health ◽

Human Health ◽

Sexual And Reproductive Health ◽

Sub Saharan Africa ◽

Health And Development ◽

Sub Saharan

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Barriers facing persons with disability in accessing sexual and reproductive health services in sub-Saharan Africa: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0238585 ◽

2020 ◽

Vol 15 (10) ◽

pp. e0238585

Author(s):

John Kuumuori Ganle ◽

Leonard Baatiema ◽

Reginald Quansah ◽

Anthony Danso-Appiah

Keyword(s):

Systematic Review ◽

Reproductive Health ◽

Health Services ◽

Sexual And Reproductive Health ◽

Sub Saharan Africa ◽

Reproductive Health Services ◽

Sub Saharan

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Finnish Official Development Aid for Sexual and Reproductive Health and Rights in Sub-Saharan Africa

Finnish Yearbook of Population Research ◽

10.23979/fypr.45058 ◽

2010 ◽

pp. 143-170

Author(s):

Riikka Shemeikka

Keyword(s):

Reproductive Health ◽

Development Policy ◽

Sexual And Reproductive Health ◽

Health Sector ◽

Development Aid ◽

Sub Saharan Africa ◽

Sub Saharan ◽

And Gender ◽

Almost All ◽

Hiv Aids

Finland is one of the donor countries that is most supportive in family planning (FP), Sexual and Reproductive Health and Rights (SRHR) and gender issues. This study examines Finnish ODA for FP and SRHR: its decision-making structure, other stakeholders and funding levels. Data consists of documents from the Ministry for Foreign Affairs (MFA) and interviews conducted at the MFA and with other experts. While Parliament decides on the overall level of ODA funding, the Minister for Foreign Trade and Development has considerable autonomy. Other stakeholders such as the All-Party Parliamentary Group on Population and Development and the Family Federation of Finland (Vestliitto) engage in advocacy work and have influenced development policy. Although the Development Policy 2007 mentions the importance of health and SRHR issues and HIV/AIDS is a cross-cutting issue, interviewees stated that the importance of health and SRHR in ODA has declined and that the implementation of cross-cutting issues is challenging. Multilateral funding for UNFPA, UNAIDS and GFATM, and thus the proportion of SRHR funding within the health sector, is however currently rising. Funding for population-related activities has increased and represented 4.8% of Finlands total ODA in 2009. Almost all of this funding is directed towards basic reproductive health and HIV/AIDS issues and the majority is directed through multilateral channels (78% in 2009), mainly UNFPA and UNAIDS. IPPF, Ipas and Marie Stopes International also receive support.

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Effective Adolescent Sexual and Reproductive Health Education Programs in Sub-Saharan Africa

Californian Journal of Health Promotion ◽

10.32398/cjhp.v11i2.1529 ◽

2013 ◽

Vol 11 (2) ◽

pp. 32-42 ◽

Cited By ~ 2

Author(s):

Fatch W. Kalembo ◽

Maggie Zgambo ◽

Du Yukai

Keyword(s):

Health Education ◽

Reproductive Health ◽

Condom Use ◽

Sexual And Reproductive Health ◽

Positive Impact ◽

Sub Saharan Africa ◽

Transmitted Infection ◽

Reproductive Health Education ◽

Sub Saharan ◽

Hiv Aids

Background: The objective of this review was to explore and identify feasible, socially acceptable and effective adolescent sexual and reproductive health education (ASRHE) programs in sub-Saharan Africa. Methods: Four databases were searched to identify studies conducted within the past 15 years which evaluate the effectiveness of ASRHE programs in sub-Saharan Africa. The databases searched were Embase, Medline, CINAHL, PyscINFO. A further search for relevant articles was made in the Google scholar website. The title and abstract of each article were analyzed for relevance by applying inclusion and exclusion criteria. Further scrutiny and extraction of the studies was completed by selecting only those studies which met the criteria for inclusion. Results: Fifteen studies were identified. School, peer, mass media, health facility and community based ASRHE programs showed positive impact in one or more of the following outcomes in adolescents in sub-Saharan Africa: ( i) knowledge of HIV transmission; (ii) perceived personal risk of contracting HIV/ AIDS; (iii) self-efficacy to negotiate condom use; (iv) discussion with others about HIV/AIDS or condom use; (v) abstinence from sexual relations; (vi) reduction in high-risk sexual behavior; (vii) condom use (vii) testing for sexually transmitted infection (STI) and (viii) treatment seeking behavior. Conclusion: ASRHE programs of diverse forms can produce positive change in adolescent sexual and reproductive health (ASRH). There is need for rigorous research to assess long term behavioral effects of culturally tailored comprehensive ASRHE programs in sub-Saharan Africa.

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Adolescent sexual and reproductive health

Oxford Textbook of Global Health of Women, Newborns, Children, and Adolescents ◽

10.1093/med/9780198794684.003.0012 ◽

2018 ◽

pp. 60-64

Author(s):

Saiqa Mullick ◽

Melanie Pleaner ◽

Mopo Radebe ◽

Chelsea Morroni

Keyword(s):

Public Health ◽

Reproductive Health ◽

Adolescent Health ◽

Sexual And Reproductive Health ◽

Sub Saharan Africa ◽

Evidence Based ◽

Barriers To Access ◽

Health Relevance ◽

Sub Saharan ◽

High Level

This chapter provides a high level overview of key sexual and reproductive health (SRH) issues in adolescent health with a focus on sub-Saharan Africa. The chapter begins by providing an overview of key targets and definitions relating to adolescent SRH and then goes on to describe the heterogenous nature of SRH needs of adolescents, highlighting their often overlapping and multiple needs as well as challenges and barriers to access. The chapter then provides a synopsis of selected SRH issues, including prevalence and public health relevance, as well as a summary of evidence-based interventions. The chapter ends with controversies and challenges, as well as recommendations for future areas for research. It should be read in conjunction with Chapter 31 on HIV in adolescents.

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