Factors influencing the use of reproductive health services among young women in Nepal: analysis of the 2016 Nepal demographic and health survey

Abstract Background: Utilization of reproductive health services is a key component for preventing young women from different sexual and reproductive health problems. Thus, the objective of this study is to determine the factors influencing the use of reproductive health services among young women in Nepal. Methods: Data have been extracted from the 2016 Nepal Demographic and Health Survey (NDHS) datasets wherein the weighted sample population size was restricted for modern contraceptive use to 1593 whereas for the antenatal care and skilled birth attendants to1606. This study has selected three reproductive health indicators as outcome variables of reproductive health service utilization for the analysis viz, modern contraceptive use, at least four antenatal care visits, and use of skilled birth attendants. Likewise, all calculations are based on standard sample weight of NDHS. Results: The study has found that 21% of young women used modern contraception, 71% attended at least four ANC visits, and 67% utilized a skilled birth attendant at delivery. Young Janajati women, women having 1-2, and 3 or more living children, women participating household decision-making, and the ones having exposure to media were more likely to use modern contraceptives, whereas the women who want more children were less likely to use them. Higher education attainments, higher wealth quintile, and lower birth order were associated with higher level of receiving at least four ANC visits and SBAs. However, the young women willing to have more children and having access to media have higher odds of receiving at least four ANC visits; and the women attending four and more ANC visits have higher odds of using SBAs. Conclusions: In order to improve the use of reproductive health services among young women, efforts should be made to enrich the young women of lower educational level, lower economic status, higher birth order, and lower exposure to media. Further research is required to detect the causes that affect the use of reproductive health services.

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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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Factors influencing utilization of reproductive health services among mothers in Meghalaya, India

Journal of Family Medicine and Primary Care ◽

10.4103/jfmpc.jfmpc_242_17 ◽

2018 ◽

Vol 7 (3) ◽

pp. 557

Author(s):

Navya Vyas ◽

Jurysha Nongdhar ◽

PArathi Rao ◽

Prakash Narayanan ◽

Star Pala

Keyword(s):

Reproductive Health ◽

Health Services ◽

Reproductive Health Services ◽

Factors Influencing

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Utilization of maternal health services among young women in Kenya: Insights from the Kenya Demographic and Health Survey, 2003

BMC Pregnancy and Childbirth ◽

10.1186/1471-2393-11-1 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 104

Author(s):

Rhoune Ochako ◽

Jean-Christophe Fotso ◽

Lawrence Ikamari ◽

Anne Khasakhala

Keyword(s):

Maternal Health ◽

Health Services ◽

Young Women ◽

Health Survey ◽

Maternal Health Services ◽

Demographic And Health Survey

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“That would be good but most men are afraid of coming to the clinic”: Men and women’s perspectives on strategies to increase male involvement in women’s reproductive health services in rural Uganda

Journal of Health Psychology ◽

10.1177/1359105316630297 ◽

2016 ◽

Vol 22 (12) ◽

pp. 1552-1562 ◽

Cited By ~ 7

Author(s):

Katelyn M Sileo ◽

Rhoda K Wanyenze ◽

Haruna Lule ◽

Susan M Kiene

Keyword(s):

Reproductive Health ◽

Health Services ◽

Male Involvement ◽

Reproductive Health Services ◽

Factors Influencing ◽

Multi Level ◽

Facility Level ◽

Women’S Reproductive Health ◽

Women's Reproductive Health

In Uganda, increasing male involvement in reproductive health services may improve women’s access to care. The purpose of this study was to explore factors influencing male support for women’s reproductive health services and to elicit suggestions for strategies to increase male involvement. In 2008–2009, focus groups ( N = 76) were conducted with men and women in a rural hospital in Uganda. A content analysis approach was used for data analysis. Our findings point to the need for multi-level approaches that educate and mobilize men, while improving quality of care at the facility level to increase male involvement in reproductive health services.

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Health Care Providers as Agents of Change: Integrating PrEP With Other Sexual and Reproductive Health Services for Adolescent Girls and Young Women

Frontiers in Reproductive Health ◽

10.3389/frph.2021.668672 ◽

2021 ◽

Vol 3 ◽

Author(s):

Gabrielle O'Malley ◽

Kristin M. Beima-Sofie ◽

Stephanie D. Roche ◽

Elzette Rousseau ◽

Danielle Travill ◽

...

Keyword(s):

Health Care ◽

Family Planning ◽

Reproductive Health ◽

Health Services ◽

Adolescent Girls ◽

Health Care Providers ◽

Young Women ◽

Care Providers ◽

Reproductive Health Services ◽

Care Worker

Background: Successful integration of pre-exposure prophylaxis (PrEP) with existing reproductive health services will require iterative learning and adaptation. The interaction between the problem-solving required to implement new interventions and health worker motivation has been well-described in the public health literature. This study describes structural and motivational challenges faced by health care providers delivering PrEP to adolescent girls and young women (AGYW) alongside other SRH services, and the strategies used to overcome them.Methods: We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) with HCWs from two demonstration projects delivering PrEP to AGYW alongside other SRH services. The Prevention Options for the Women Evaluation Research (POWER) is an open label PrEP study with a focus on learning about PrEP delivery in Kenyan and South African family planning, youth mobile services, and public clinics at six facilities. PrIYA focused on PrEP delivery to AGYW via maternal and child health (MCH) and family planning (FP) clinics in Kenya across 37 facilities. IDIs and FGDs were transcribed verbatim and analyzed using a combination of inductive and deductive methods.Results: We conducted IDIs with 36 participants and 8 FGDs with 50 participants. HCW described a dynamic process of operationalizing PrEP delivery to better respond to patient needs, including modifying patient flow, pill packaging, and counseling. HCWs believed the biggest challenge to sustained integration and scaling of PrEP for AGYW would be lack of health care worker motivation, primarily due to a misalignment of personal and professional values and expectations. HCWs frequently described concerns of PrEP provision being seen as condoning or promoting unprotected sex among young unmarried, sexually active women. Persuasive techniques used to overcome these reservations included emphasizing the social realities of HIV risk, health care worker professional identities, and vocational commitments to keeping young women healthy.Conclusion: Sustained scale-up of PrEP will require HCWs to value and prioritize its incorporation into daily practice. As with the provision of other SRH services, HCWs may have moral reservations about providing PrEP to AGYW. Strategies that strengthen alignment of HCW personal values with professional goals will be important for strengthening motivation to overcome delivery challenges.

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