scholarly journals A forgotten group during humanitarian crises: a systematic review of sexual and reproductive health interventions for young people including adolescents in humanitarian settings

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Lauren Jennings ◽  
Asha S. George ◽  
Tanya Jacobs ◽  
Karl Blanchet ◽  
Neha S. Singh
Keyword(s):  
Systematic Review ◽  
Young People ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Grey Literature ◽  
Safe Abortion ◽  
Humanitarian Settings ◽  
Abortion Care ◽  
Humanitarian Crises ◽  
Urogenital Fistulae

Abstract Background Young people including adolescents face barriers to healthcare and increased risk of poor sexual and reproductive health (SRH), which are exacerbated in humanitarian settings. Our systematic review assessed the evidence on SRH interventions for young people including adolescents in humanitarian settings, strategies to increase their utilisation and their effects on health outcomes. Methods We searched peer-reviewed and grey literature published between 1980 and 2018 using search terms for adolescents, young people, humanitarian crises in low- and middle- income countries and SRH in four databases and relevant websites. We analysed literature matching pre-defined inclusion criteria using narrative synthesis methodology, and appraised for study quality. Findings We found nine peer-reviewed and five grey literature articles, the majority published post-2012 and mostly high- or medium-quality, focusing on prevention of unintended pregnancies, HIV/STIs, maternal and newborn health, and prevention of sexual and gender-based violence. We found no studies on prevention of mother-to-child transmission (PMTCT), safe abortion, post-abortion care, urogenital fistulae or female genital mutilation (FGM). Thirteen studies reported positive effects on outcomes (majority were positive changes in knowledge and attitudes), seven studies reported no effects in some SRH outcomes measured, and one study reported a decrease in number of new and repeat FP clients. Strategies to increase intervention utilisation by young people include adolescent-friendly spaces, peer workers, school-based activities, and involving young people. Discussion Young people, including adolescents, continue to be a neglected group in humanitarian settings. While we found evidence that some SRH interventions for young people are being implemented, there are insufficient details of specific intervention components and outcome measurements to adequately map these interventions. Efforts to address this key population’s SRH needs and evaluate effective implementation modalities require urgent attention. Specifically, greater quantity and quality of evidence on programmatic implementation of these interventions are needed, especially for comprehensive abortion care, PMTCT, urogenital fistulae, FGM, and for LGBTQI populations and persons with disabilities. If embedded within a broader SRH programme, implementers and/or researchers should include young people-specific strategies, targeted at both girls/women and boys/men where appropriate, and collect age- and sex-disaggregated data to help ascertain if this population’s diverse needs are being addressed.

scholarly journals Systematic review of the evidence on the effectiveness of sexual and reproductive health interventions in humanitarian crises

BMJ Open ◽  
2015 ◽  
Vol 5 (12) ◽  
pp. e008226 ◽  
Author(s):  
Emily Warren ◽  
Nathan Post ◽  
Mazeda Hossain ◽  
Karl Blanchet ◽  
Bayard Roberts
Keyword(s):  
Systematic Review ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Health Interventions ◽  
Humanitarian Crises

scholarly journals A long way to go: a systematic review to assess the utilisation of sexual and reproductive health services during humanitarian crises

2018 ◽  
Vol 3 (2) ◽  
pp. e000682 ◽  
Author(s):  
Neha S Singh ◽  
Sarindi Aryasinghe ◽  
James Smith ◽  
Rajat Khosla ◽  
Lale Say ◽  
...  
Keyword(s):  
Systematic Review ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Reproductive Age ◽  
Service Utilisation ◽  
Health Providers ◽  
Reproductive Health Services ◽  
Community Based ◽  
Humanitarian Crises ◽  
Women And Girls

IntroductionWomen and girls are affected significantly in both sudden and slow-onset emergencies, and face multiple sexual and reproductive health (SRH) challenges in humanitarian crises contexts. There are an estimated 26 million women and girls of reproductive age living in humanitarian crises settings, all of whom need access to SRH information and services. This systematic review aimed to assess the utilisation of services of SRH interventions from the onset of emergencies in low- and middle-income countries.MethodsWe searched for both quantitative and qualitative studies in peer-reviewed journals across the following four databases: EMBASE, Global Health, MEDLINE and PsychINFO from 1 January 1980 to 10 April 2017. Primary outcomes of interest included self-reported use and/or confirmed use of the Minimum Initial Service Package services and abortion services. Two authors independently extracted and analysed data from published papers on the effect of SRH interventions on a range of SRH care utilisation outcomes from the onset of emergencies, and used a narrative synthesis approach.ResultsOf the 2404 identified citations, 23 studies met the inclusion criteria. 52.1% of the studies (n=12) used quasi-experimental study designs, which provided some statistical measure of difference between intervention and outcome. 39.1% of the studies (n=9) selected were graded as high quality, 39.1% moderate quality (n=9) and 17.4% low quality (n=4). Evidence of effectiveness in increasing service utilisation was available for the following interventions: peer-led and interpersonal education and mass media campaigns, community-based programming and three-tiered network of community-based reproductive and maternal health providers.ConclusionsDespite increased attention to SRH service provision in humanitarian crises settings, the evidence base is still very limited. More implementation research is required to identify interventions to increase utilisation of SRH services in diverse humanitarian crises settings and populations.

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.

scholarly journals From words to actions: systematic review of interventions to promote sexual and reproductive health of persons with disabilities in low- and middle-income countries

2020 ◽  
Vol 5 (10) ◽  
pp. e002903
Author(s):  
Shaffa Hameed ◽  
Alexander Maddams ◽  
Hattie Lowe ◽  
Lowri Davies ◽  
Rajat Khosla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Reproductive Health ◽  
Observational Studies ◽  
Sexual And Reproductive Health ◽  
Risk Of Bias ◽  
Safe Abortion ◽  
Middle Income ◽  
Persons With Disabilities ◽  
Middle Income Countries ◽  
Low And Middle Income

IntroductionPersons with disabilities have the same sexual and reproductive health and rights (SRHR) as non-disabled persons. Yet they face numerous barriers in their access to sexual and reproductive health services and their rights are often not met. Evidence on SRHR for persons with disabilities is sparse, particularly evaluations of interventions demonstrating ‘what works.’ This systematic review assessed interventions to promote SRHR for persons with disabilities in low- and middle-income countries.MethodsWe searched for qualitative, quantitative or mixed method observational studies representing primary research, published between 2010 and 2019, using MEDLINE, Embase, PubMed, Global Health and CINAHL Plus. Search strings were compiled for different elements of SRHR and for all forms of disability. 24,919 records were screened, leading to over 380 relevant papers, most of which were descriptive, focussing on needs and barriers to SRHR needs being fulfilled. Of the 33 full-text articles assessed for eligibility, 18 were included in the synthesis. All included studies were assessed for bias and quality of evidence, using STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) and RATS (relevance, appropriateness, transparency andsoundness) tools. Among the 16 interventions (from 18 articles), 25% had low risk of bias, 31% had moderate risk of bias and 44% had high risk of bias. Data analysis used narrative synthesis; a method suited for systematic reviews with heterogeneous studies. We used Levesque healthcare access model to analyse the focus of interventions.Results11 interventions were from upper middle-income settings; two from lower-income settings; only one operated in rural areas. Interventions addressed intellectual impairment (6), visual impairment (6), hearing impairment (4), mental health conditions (2) and physical impairments (2). Most interventions (15/16) focus on information provision and awareness raising. We could not identify any intervention promoting access to maternal health, family planning and contraception, or safe abortion for people with disabilities.ConclusionThis systematic review has highlighted stark gaps in evidence. More rigorous evaluations are needed.

Using mobile phones to improve young people sexual and reproductive health in low and middle income countries: A systematic review

2020 ◽  
Author(s):  
Anam Feroz ◽  
Naureen Akber Ali ◽  
Adeel Khoja ◽  
Armish Hussain ◽  
Sarah Saleem
Keyword(s):  
Systematic Review ◽  
Young People ◽  
Reproductive Health ◽  
Mobile Phones ◽  
Sexual And Reproductive Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Change Communication ◽  
Client Education ◽  
And Behavior

Abstract Background: Globally, reproductive health programs have used mHealth to provide sexual and reproductive health (SRH) education and services to young people, through diverse communication channels. However, few attempts have been made to systematically review the mHealth programs targeted to improve young people SRH in low-and-middle-income countries (LMICs). This review aims to identify a range of different mHealth solutions which can be used for improving young people SRH in LMICs and highlight facilitators and barriers for adopting mHealth interventions designed to target SRH of young people. Methods: Databases including PubMed, CINAHL Plus, Science Direct, Cochrane and grey literature were searched between January 01, 2005 and March 31, 2018 to identify various types of mHealth interventions that are used to improve SRH services for young people in LMICs. Of 2,181 titles screened after duplication, 207 potentially relevant abstracts were obtained. Out of 207 abstracts, 70 abstracts were shortlisted. Full text of 70 studies were reviewed using a pre-defined data extraction sheet. A total of 11 full text studies were included in the final analysis. Results: The final 11studies were categorized into three main mHealth applications including; client education and behavior change communication, data collection and reporting and financial transactions and incentives. The most reported use of mHealth was for client education and behavior change communication [n = 10, 91%]. This categorization provided the understanding that the potential of other mHealth applications has yet to be explored. Most studies showed, that mHealth interventions have proven to be effective in improving SRH services and outcomes through addressing barriers of provider prejudice, stigmatization, discrimination, fear of refusal, lack of privacy and confidentiality. Yet, the review also identified barriers to uptake of mHealth interventions for SRH including decreased technological literacy, inferior network coverage, and lower linguistic competency. Conclusion: The review provides detailed information about the implementation of mobile phones at different levels of healthcare system for improving young people SRH outcomes. This systematic review recommends that barriers to uptake mHealth interventions be adequately addressed to increase the potential use of mobile phones for improving access to SRH awareness and services.

scholarly journals Parent-young communication on sexual and reproductive health issues and its association with sex and perceptions of young people in Ethiopia, 2020: a systematic review and meta-analysis

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Melaku Yalew ◽  
Bezawit Adane ◽  
Bereket Kefale ◽  
Yitayish Damtie ◽  
Mastewal Arefaynie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Young People ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Health Issues ◽  
Pooled Prevalence ◽  
Registration Number ◽  
The Government

Abstract Background There is no national representative and conclusive data regarding parent-young communication. Therefore, this study aimed to estimate the pooled prevalence of parent-young communication on sexual and reproductive health issues and its association with sex and perceptions of young people about its importance in Ethiopia, 2020. Methods The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) was used during systematic review and meta-analysis. The study included both published and gray literatures which were searched using appropriate key terms. The articles were searched from different databases: PubMed, Cochrane Library, PsycINFO, CINAHL, Global Health, HINARI and Google scholar. Data were extracted in a Microsoft Excel sheet and STATA/SE 14 was used for meta-analysis. I2 and Egger test statistics were used to test heterogeneity and publication bias respectively. Results Twenty-nine articles were included in this systematic review and meta-analysis. The pooled prevalence of parent-young communication on sexual and reproductive health issues in Ethiopia was 42.96% [95% CI: (36.91, 49.02)]. Positive perception of young people towards parent-young communication [AOR = 3.72, 95% CI: (2.87, 4.86)] and female sex [AOR = 1.62, 95% CI: (1.12, 2.34)] were significantly associated with parent-young communication on sexual and reproductive health issues. Conclusions The prevalence of parent-young communication on sexual and reproductive health issues in Ethiopia was low as compared to other literatures conducted outside Ethiopia. Both perceptions of young people towards parent-young communication and sex were significantly associated with parent-young communication on sexual and reproductive health issues. Interventions targeting males and young who had negative perceptions regarding parent-young communication should be the primary focus of the government and their parents. Review registration The protocol of this systematic review and meta-analysis was registered in the PROSPERO International prospective of systematic reviews with a specific registration number: CRD42020161252.

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