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

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.

scholarly journals The role of partners in promoting self-care for misoprostol and sub-cutaneous DMPA in Pakistan

2021 ◽  
Author(s):  
Qudsia Uzma ◽  
Nausheen Hamid ◽  
Rizwana Chaudhry ◽  
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 countries facing protracted challenges in addressing maternal mortality with concomitant weak healthcare system complexed with inequities. Sexual and reproductive health & 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. Prospective qualitative study 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 use of misoprostol for postpartum hemorrhage and use of sub-cutaneous depomedroxyprogesterone acetate (DMPA) as injectable contraceptive method. Data collection was done through emails and telephonic follow-ups. Results Response was received from 9 out of total 13 partners consulted for the study. The two selected self-care interventions are mainly supported by private sector partners (national and international non-governmental organizations) having national or sub-national existence. Their mandates include all relevant areas like policy advocacy, field implementation, trainings, supervision and monitoring. More partners reported experience related to use of misoprostol; it was introduced more than a decade ago, is registered and being procured by both public and private sectors. Sub-cutaneous DMPA being a new intervention, is recently introduced while commodity availability remains a challenge. It is being delivered through health workers/providers and not promoted as 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 a lot, standalone or integrated with SRHR topics and duration varying between 1day to 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 and having leadership and governance role of the public sector. Standardization of trainings, community awareness, supervision, monitoring and reporting is required alongwith integration of self-care in routine capacity building activities (pre and in-service) on sexual and reproductive health in the country.

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

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.

scholarly journals Self-care and remote care during pregnancy: a new paradigm?

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
A. Metin Gülmezoglu ◽  
Anne Ammerdorffer ◽  
Manjulaa Narasimhan ◽  
Alyce N. Wilson ◽  
Joshua P. Vogel ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Healthcare Providers ◽  
Self Care ◽  
Reproductive Health Services ◽  
New Paradigm ◽  
Remote Care

Abstract Self-care interventions and remote care offer innovative and equitable ways to strengthen access to sexual and reproductive health services. Self-isolation during COVID-19 provided the opportunity for obstetric facilities and healthcare providers to integrate and increase the usage of interventions for self-care and remote care for pregnant women and to improve the quality of care overall.

scholarly journals Prevention of HIV Perinatal Transmission: The Role of Sexual and Reproductive Health Services for Women Living with HIV

2021 ◽  
Author(s):  
Marcela Gómez-Suárez
Keyword(s):  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Cost Effective ◽  
Perinatal Transmission ◽  
Reproductive Health Services ◽  
Women Living With Hiv ◽  
Promote Gender Equality ◽  
Health Organization ◽  
Living With Hiv

With the evolution in prevention, diagnosis, and treatment of HIV/AIDS, ending the infection as a public health threat worldwide has become a real possibility included within the United Nations Sustainable Development Goal Project 2030. However, some countries and even entire regions are not on track to reach this target due to increased new infections in young populations. Young women (15–24 years) represent 48% of the new HIV cases globally. Research shows these women have significant unmet sexual and reproductive health (SRH) needs, with high rates of unplanned pregnancies, increased HIV perinatal transmission (HIV-PT) risk, and higher maternal morbidity and mortality. Granting access to SRH services based on rights for women living with HIV is a cost-effective alternative to reducing new infections in children by promoting respect for women’s reproductive options. This chapter addresses the role of SRH services based on rights for women living with HIV within HIV-PT. It also summarizes the new “Consolidated Guideline on Sexual and Reproductive Health and Rights of Women Living with HIV”; designed by the World Health Organization as a global recommendation for SRH programs and services that promote gender equality and human rights for women living with HIV.

scholarly journals What do service providers in Southern Ethiopia say about barriers to using youth-friendly sexual and reproductive health services for adolescents?: Qualitative study

2021 ◽  
Author(s):  
Yitagesu Habtu ◽  
Mirgissa Kaba ◽  
Hussen Mekonnen
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Healthcare System ◽  
Sexual And Reproductive Health ◽  
Service Providers ◽  
Healthcare Providers ◽  
System Level ◽  
Southern Ethiopia ◽  
Reproductive Health Services ◽  
Youth Friendly

Abstract Background: In Ethiopia, the utilization coverage of adolescent-friendly health services (AFSRHs) ranged only from 9% to 55% and it was the lowest of all Sub-Saharan African countries in 2016. Little is known why adolescents were not accessing the existing services to the side of healthcare providers. Objective: The aim of this study is to explore contextual perceived and actual barriers to accessing AFSRHs by adolescents in Southern Ethiopia.Methods: Phenomenological study design supplemented with observation was used to explore perceived and actual barriers to accessing AFSRHs in 2020. Criterion sampling was used to select study participants. In-depth interviews with healthcare providers and non-specialist sexual and reproductive healthcare providers were conducted. Transcribed interviews and observations were imported to Open Code 4.02 for coding, categorizing, and creating themes. Finally, barriers to accessing existing services were explained using thematic analysis. Results: The study explores contextual barriers to accessing sexual and reproductive health services in five emergent themes. According to providers’ points of view, the barriers include ranging from providers (e.g poor providers’ competency), health facilities (e.g. supply constraints and unsupportive environment), adolescents (e.g perceived lack of information and attitude towards SRHs), community (e.g. lack of parental and social support), and broader health system (e.g. poor implementation and multi-sectorial engagement). Conclusion: As to providers, adolescents face multiple barriers to accessing youth friendly sexual and reproductive health services. Healthcare facilities and all levels of the healthcare system should implement varieties of approaches to increase access to the services for adolescents. Given the lack of progress in utilization of adolescents- youth friendly sexual and reproductive services, the existing strategy should be re-evaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.

scholarly journals What do service providers in Southern Ethiopia say about barriers to using youth-friendly sexual and reproductive health services for adolescents?: Qualitative study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yitagesu Habtu ◽  
Mirgissa Kaba ◽  
Hussein Mekonnen
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Healthcare System ◽  
Sexual And Reproductive Health ◽  
Service Providers ◽  
Healthcare Providers ◽  
System Level ◽  
Southern Ethiopia ◽  
Reproductive Health Services ◽  
Youth Friendly

Abstract Background In Ethiopia, the utilization coverage of adolescent-friendly health services (AFSRHs) ranged only from 9 to 55% and it was the lowest of all Sub-Saharan African countries in 2016. Little is known why adolescents were not accessing the existing services to the side of healthcare providers. Objective The aim of this study is to explore contextual perceived and actual barriers to accessing AFSRHs by adolescents in Southern Ethiopia. Methods Phenomenological study design supplemented with observation was used to explore perceived and actual barriers to accessing AFSRHs in 2020. Criterion sampling was used to select study participants. In-depth interviews with healthcare providers and non-specialist sexual and reproductive healthcare providers were conducted. Transcribed interviews and observations were imported to Open Code 4.02 for coding, categorizing, and creating themes. Finally, barriers to accessing existing services were explained using thematic analysis. Results The study explores contextual barriers to accessing sexual and reproductive health services in five emergent themes. According to providers’ points of view, the barriers include ranging from providers (e.g. poor providers’ competency), health facilities (e.g. supply constraints and unsupportive environment), adolescents (e.g. perceived lack of information and attitude towards SRHs), community (e.g. lack of parental and social support), and broader health system (e.g. poor implementation and multi-sectorial engagement). Conclusion As to providers, adolescents face multiple barriers to accessing youth friendly sexual and reproductive health services. Healthcare facilities and all levels of the healthcare system should implement varieties of approaches to increase access to the services for adolescents. Given the lack of progress in utilization of adolescents- youth friendly sexual and reproductive services, the existing strategy should be re-evaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.

scholarly journals The role of social capital in women’s sexual and reproductive health and rights in humanitarian settings: a systematic review of qualitative studies

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hannah Ireland ◽  
Nguyen Toan Tran ◽  
Angela Dawson
Keyword(s):  
Systematic Review ◽  
Social Capital ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Social Determinant ◽  
Qualitative Studies ◽  
Reproductive Health Services ◽  
Positive Health ◽  
Humanitarian Settings

Abstract Background Social capital is an important social determinant of women’s sexual and reproductive health and rights. Little research has been conducted to understand the role of social capital in women’s sexual and reproductive health and how this can be harnessed to improve health in humanitarian settings. We synthesised the evidence to examine the nexus of women’s sexual and reproductive health and rights and social capital in humanitarian contexts. Methods We undertook a systematic review of qualitative studies. The preferred reporting items for systematic review and meta-analysis guidelines were used to identify peer-reviewed, qualitative studies conducted in humanitarian settings published since 1999. We searched CINAHL, MEDLINE, ProQuest Health & Medicine, PubMed, Embase and Web of science core collection and assessed quality using the Critical Appraisal Skills Programme tool. We used a meta-ethnographic approach to synthesise and analyse the data. Findings Of 6749 initially identified studies, we included 19 studies, of which 18 were in conflict-related humanitarian settings and one in a natural disaster setting. The analysis revealed that the main form of social capital available to women was bonding social capital or strong links between people within groups of similar characteristics. There was limited use of bridging social capital, consisting of weaker connections between people of approximately equal status and power but with different characteristics. The primary social capital mechanisms that played a role in women’s sexual and reproductive health and rights were social support, informal social control and collective action. Depending on the nature of the values, norms and traditions shared by network members, these social capital mechanisms had the potential to both facilitate and hinder positive health outcomes for women. Conclusions These findings demonstrate the importance of understanding social capital in planning sexual and reproductive health responses in humanitarian settings. The analysis highlights the need to investigate social capital from an individual perspective to expose the intra-network dynamics that shape women’s experiences. Insights could help inform community-based preparedness and response programs aimed at improving the demand for and access to quality sexual and reproductive health services in humanitarian settings.

Sign in / Sign up

Export Citation Format

Share Document