scholarly journals Sexual and reproductive health self-care in humanitarian and fragile settings: where should we start?

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nguyen Toan Tran ◽  
Hannah Tappis ◽  
Pierre Moon ◽  
Megan Christofield ◽  
Angela Dawson
Keyword(s):  
Reproductive Health ◽  
System Approach ◽  
Sexual And Reproductive Health ◽  
Digital Health ◽  
Self Care ◽  
Global Community ◽  
Care Continuum ◽  
Service Package ◽  
Health Support ◽  
Context Specific

AbstractRecent crises have accelerated global interest in self-care interventions. This debate paper aims to raise the issue of sexual and reproductive health (SRH) self-care and invites members of the global community operating in crisis-affected settings to look at potential avenues in mainstreaming SRH self-care interventions. We start by exploring self-care interventions that could align with well-established humanitarian standards, such as the Minimum Initial Service Package (MISP) for Sexual and Reproductive Health in Crises, point to the potential of digital health support for SRH self-care in crisis-affected settings, and discuss related policy, programmatic, and research considerations. These considerations underscore the importance of self-care as part of the care continuum and within a whole-system approach. Equally critical is the need for self-care in crisis-affected settings to complement other live-saving SRH interventions—it does not eliminate the need for provider-led services in health facilities. Further research on SRH self-care interventions focusing distinctively on humanitarian and fragile settings is needed to inform context-specific policies and practice guidance.

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 self-care interventions on men’s health-seeking behaviours to advance their sexual and reproductive health and rights

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Manjulaa Narasimhan ◽  
Carmen H. Logie ◽  
Kevin Moody ◽  
Jonathan Hopkins ◽  
Oswaldo Montoya ◽  
...  
Keyword(s):  
Public Health ◽  
Reproductive Health ◽  
Social Norms ◽  
Sexual And Reproductive Health ◽  
Self Care ◽  
Men’S Health ◽  
Men's Health ◽  
Health Seeking ◽  
Digital Platforms ◽  
Care Practices

Abstract Background Self-care interventions are influencing people’s access to, expectation and understanding of healthcare beyond formal health delivery systems. In doing so, self-care interventions could potentially improve health-seeking behaviours. While many men proactively engage in maintaining and promoting their health, the focus on men’s health comes from the recognition, at least partially, that male socialization and social norms can induce men and boys to have a lower engagement in institutionalized public health entities and systems around their sexual and reproductive health and rights, that could impact negatively on themselves, their partners and children. Main text A research agenda could consider the ways that public health messaging and information on self care practices for sexual and reproductive health and rights could be tailored to reflect men’s lived realities and experiences. Three examples of evidence-based self-care interventions related to sexual and reproductive health and rights that men can, and many do, engage in are briefly discussed: condom use, HIV self-testing and use of telemedicine and digital platforms for sexual health. We apply four core elements that contribute to health, including men’s health (people-centred approaches, quality health systems, a safe and supportive enabling environment, and behaviour-change communication) to each intervention where further research can inform normative guidance. Conclusion Engaging men and boys and facilitating their participation in self care can be an important policy intervention to advance global sexual and reproductive health and rights goals. The longstanding model of men neglecting or even sabotaging their wellbeing needs to be replaced by healthier lifestyles, which requires understanding how factors related to social support, social norms, power, academic performance or employability conditions, among others, influence men’s engagement with health services and with their own self care practices.

scholarly journals Regulatory standards and processes for over-the-counter availability of hormonal contraception and drugs for medical abortion in five countries in the Eastern Mediterranean Region

2021 ◽  
Vol 19 (S1) ◽  
Author(s):  
Anne Ammerdorffer ◽  
Mark Laws ◽  
Arinze Awiligwe ◽  
Florence Erb ◽  
Wallada Im-Amornphong ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health System ◽  
Emergency Contraception ◽  
Sexual And Reproductive Health ◽  
Self Care ◽  
Medical Abortion ◽  
Health System Strengthening ◽  
World Health ◽  
Over The Counter ◽  
Regulatory Status

AbstractThe World Health Organization 2019 WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights includes recommendations on self-administration of injectable contraception, over-the-counter (OTC) oral contraception and self-management of medical abortion. A review of the regulatory status of these two self-care interventions can highlight processes required to ensure that the quality of the medicines and safety of individuals are safeguarded in the introduction and scale-up in countries. This review outlines the legal regulatory status of prescription-only medicine (POM) and OTC contraceptives, including emergency contraception, and drugs for medical abortion in Egypt, Jordan, Lebanon, Morocco and Tunisia using information obtained from internet searches, regulatory information databases and personal contacts. In addition, the review examines whether the national medicines regulatory authorities have documented procedures available to allow for a change in status from a POM to OTC to allow for increased accessibility, availability and uptake of self-care interventions recommended by WHO. Egypt, Jordan and Lebanon have a documented national OTC list available. The only contraceptive product mentioned in the OTC lists across all five countries is ellaOne (ulipristal acetate for emergency contraception), which is publicly registered in Lebanon. None of the five countries has an official documented procedure to apply for the change of POM to OTC. Informal procedures exist, such as the ability to apply to the national medicines regulatory authority for OTC status if the product has OTC status in the original country of manufacture. However, many of these procedures are not officially documented, highlighting the need for establishing sound, affordable and effective regulation of medical products as an important part of health system strengthening. From a public health perspective, it would be advantageous for licensed products to be available OTC. This is particularly the case for settings where the health system is under-resourced or over-stretched due to health emergencies. Readiness of national regulatory guidelines and OTC procedures could lead to increased access, availability and usage of essential self-care interventions for sexual and reproductive health and rights.

scholarly journals Self-care interventions for sexual and reproductive health and rights for advancing universal health coverage

2020 ◽  
Vol 28 (2) ◽  
pp. 1778610
Author(s):  
Manjulaa Narasimhan ◽  
Carmen H. Logie ◽  
Alice Gauntley ◽  
Rodolfo Gomez Ponce de Leon ◽  
Karima Gholbzouri ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Universal Health Coverage ◽  
Sexual And Reproductive Health ◽  
Self Care ◽  
Health Coverage ◽  
Universal Health

scholarly journals Self care interventions for sexual and reproductive health and rights: costs, benefits, and financing

BMJ ◽  
2019 ◽  
pp. l1228 ◽  
Author(s):  
Michelle Remme ◽  
Manjulaa Narasimhan ◽  
David Wilson ◽  
Moazzam Ali ◽  
Lavanya Vijayasingham ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Self Care

scholarly journals An overview of the sexual and reproductive health status and service delivery among Syrian refugees in Jordan, nine years since the crisis: a systematic literature review

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Mirwais Amiri ◽  
Ieman M. El-Mowafi ◽  
Tala Chahien ◽  
Hind Yousef ◽  
Loulou Hassan Kobeissi
Keyword(s):  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Grey Literature ◽  
Free Text ◽  
Syrian Refugees ◽  
Humanitarian Crisis ◽  
Service Package ◽  
Syrian Refugee ◽  
Services Delivery ◽  
Gender Based

Abstract Background The Syrian refugee crisis has led to massive displacement into neighboring countries including Jordan. This crisis has caused a significant strain on the sexual and reproductive health (SRH) services to the host communities and Syrian refugees. The Minimum Initial Service Package (MISP) is a standard package of services that should be implemented at the onset of an emergency. Due to their importance in protracted humanitarian crisis, this systematic review aimed to assess the utilization of SRH and MISP after 9 years of the crisis. Methods We searched PubMed, Medline/Ovid and Scopus for both quantitative and qualitative studies from 1 January 2011 to 30 November 2019. Our search included both free text key words and Medical Subject Headings (MeSH) for various forms and acronmym of the following terms: (Sexual and) Reproductive Health, Sexual/Gender-based/Family/Intimate partner violence, Minimum Initial Service Package, MISP, Women, Girls, Adolescents, Syrian, Refugee, Jordan, Humanitarian crisis, War, (armed) conflict, and Disaster. Boolean operators and star truncation (*) were used as needed. We further conducted an in-depth review of the available grey literature published during the same timeframe. Using a narrative synthesis approach, two authors independently extracted and analyzed data from published papers. After removal of duplicates, screening, and assessing for eligibility of 161 initially identified citations, 19 papers were selected for review. Results Findings from this review indicated a number of barriers to access, utilization, and implementation of SRH services, including lack of reliable information on sexual and gender-based violence (SGBV), aggravation of early marriages by crisis setting, gaps in the knowledge and use of family planning services, inadequate STIs and HIV coverage, and some issues around the provision of maternal health services. Conclusion The findings from this review are suggestive of a number of barriers pertaining to access, utilization, and implementation of SRH services. This is especially true for transitioning from MISP to comprehensive SRH services, and particularly for refugees outside camps. Following are needed to address identified barriers: improved inter-agency coordination, better inclusion/engagement of local initiatives and civil societies in SRH services delivery, improved quality of SRH services, adequate and regular training of healthcare providers, and increased awareness of Syrian women and adolescent girls. Also, more implementing research is required to identify ways to transition SRH provision from the MISP to comprehensive care for the Syrian refugee population in Jordan.

Preparation for sexual and reproductive self-care in Iranian adolescent girls: a qualitative study

2017 ◽  
Vol 30 (1) ◽  
Author(s):  
Zainab Alimoradi ◽  
Nourossadat Kariman ◽  
Fazlollah Ahmadi ◽  
Masoumeh Simbar
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Reproductive Health ◽  
Data Collection ◽  
Qualitative Study ◽  
Adolescent Girls ◽  
Sexual Behaviors ◽  
Sexual And Reproductive Health ◽  
Self Care ◽  
Main Theme

AbstractBackgroundAdolescence is one of the most important stages in every individual’s life. Pubertal changes and acquiring reproduction capability require adolescents to perform special health care processes. Also the possibility of involvement in high-risk sexual behaviors endangers adolescent girls’ sexual and reproductive health.ObjectiveIncrease and deepen the understanding and knowledge of the factors affecting Iranian adolescent girls’ readiness to take care of their sexual and reproductive health.Materials and methodsThe present qualitative study was conducted using conventional content analysis method. The participants included 18 adolescents who were aged 13–19 years old, single, studying at high school, art school, or university and had no history of chronic medical or psychological diseases; further, most of them had the experience of menstruation. Purposive sampling was initiated and continued until data saturation. Data collection were performed using in-depth and unstructured interviews. Qualitative content analysis of the interviews was conducted simultaneously with data collection using the Graneheim and Lundman approach .MAXQDA 2010 software was used for storage, retrieval, and management of the data.FindingsPreparation for care was the main theme that emerged in this study along with 19 subcategories and four main categories, including desirable interaction between families and adolescents, readiness for puberty and menstruation, life skills and spiritual self-monitoring.ConclusionThe education and health care systems’ authorities of the country can exploit the results of this study for making policies and interventions expedient to the society’s cultural conditions in order to improve the reproductive and sexual self-care status of adolescents’ girls.

scholarly journals Factors affecting the implementation of the Minimum Initial Service Package (MISP) for reproductive health during crisis: the case of Eritrean refugees in northern Ethiopia

2020 ◽  
Author(s):  
Alemayehu Bayray Kahsay ◽  
Alemshet Teshale Haftu ◽  
Afewerki Tesfahunegn Nigusse
Keyword(s):  
Reproductive Health ◽  
Sexual Violence ◽  
Sexual And Reproductive Health ◽  
Home Country ◽  
Refugee Camp ◽  
Health Needs ◽  
Reproductive Age ◽  
Factors Associated ◽  
Service Package ◽  
Women And Girls

Abstract Background: The Minimum Initial Service Package (MISP) is a series of crucial actions required to respond to reproductive health needs at the onset of every humanitarian crisis. Moreover, MISP is a coordinated priority activity to prevent and manage the consequences of sexual violence; prevent excess maternal and newborn morbidity and mortality; reduce HIV transmission; and plan for comprehensive RH services beginning in the early days and weeks of an emergency. During conflicts, natural disasters and public health emergencies, sexual and reproductive health needs are often overlooked. Women and girls may lose access to family planning services, exposing them to unintended pregnancy in dangerous conditions. Women and girls also become more vulnerable to sexual violence, exploitation and HIV infection. In this article we document the practices and factors associated with availability and implementation of services as measured by the MISP for reproductive health in the Eritrean refugee camp, Northwestern zone of Tigray, Ethiopia. Methods: we conducted an institution based cross sectional study from October 07- 30, 2019 among female reproductive age groups (15-49yrs) who arrived and lived in the refugee camp from June 01 to October 07, 2019. A systematic random sampling method was applied to recruit 422 participants. We collected the data through face-to-face interview using a structured questionnaire. Binary Logistic regression was applied to assess factors associated with MISP implementation. Results: About 38% of the refugees utilized Minimum Initial Service Package of reproductive health during their stay in the camp. Factors like age of 15–24 years [AOR = 0.38(95% CI,0.20-0.73)], being rural residents in home country [AOR =0 .53(95% CI,0.34-0.83], short time length of stay in the refugee camp [AOR = 0 .56(95% CI,0.33-0.95)] were negative predictors, while previous exposure to health information[ AOR = 2.24(95% CI1.44-3.48)] was a positive predictor of MISP services utilization among the refugees in the reproductive age. Conclusion: The MISP of reproductive health utilization in the refugee camp is relatively high . Previous information on reproductive health helped the refugees in utilizing the service, while a short stay in the refugee camp, being rural residents in their home country and being young age were barriers to utilization of MISP of RH. Strengthening and introducing sexual and reproductive health services for the youth during early crisis would prevent morbidity in refugees. Key words: MISP, RH, Eritrean Refugee camp, Ethiopia

scholarly journals Adolescent Sexual and Reproductive Health in Ethiopia and Rwanda: A Qualitative Exploration of the Role of Social Norms

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401983358 ◽  
Author(s):  
Ernestina Coast ◽  
Nicola Jones ◽  
Umutoni Marie Francoise ◽  
Workneh Yadete ◽  
Roberte Isimbi ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Social Norms ◽  
Sexual And Reproductive Health ◽  
Female Adolescents ◽  
Qualitative Research Study ◽  
Adult Participants ◽  
Attention To Diversity ◽  
Context Specific ◽  
Qualitative Exploration

This article seeks to address the dearth of evidence on early adolescent understandings and experiences of sexual and reproductive health (SRH) in Ethiopia and Rwanda, drawing on a multisite qualitative research study with 10- to 12-year-old and 14- to 15-year-old male and female adolescents and a range of adult participants. The article is informed by a conceptual framework that draws on Amartya Sen’s capability approach, which calls for investments in a broad set of assets that expand individuals’ capacity to “be” and to “do.” Using SRH as a focal lens, the article considers the role played by gendered social norms in adolescents’ experiences of SRH-related understandings and experiences. Three key interrelated gender themes emerge from our thematic analyses of qualitative evidence generated by our multimethods approach: puberty transitions, sexuality, and victim blaming. In our analyses, we pay attention to diversity (e.g., age, gender, place of residence) among adolescents within and across the two focal countries and consider how discriminatory gendered social norms play a role in hindering the effective uptake of expanding health services. We conclude by emphasizing the need for program designers and implementers to address the role of underlying social norms in a more strategic and context-specific way to help young people navigate their sexual and reproductive lives.

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