scholarly journals Get Smart: Learning and partnership with Ethiopia’s Health Extension Programme to re-envision contraceptive service delivery to young couples

2019 ◽  
Vol 3 ◽  
pp. 1570
Author(s):  
Gabrielle Appleford ◽  
Claire Cole ◽  
Metsehate Ayenekulu ◽  
Sue Newport ◽  
Emma Mulhern
Keyword(s):  
Adolescent Pregnancy ◽  
Process Evaluation ◽  
Addis Ababa ◽  
Sampling Strategy ◽  
Married Couples ◽  
Early Marriage ◽  
Health Extension Workers ◽  
Barriers And Enablers ◽  
Health Extension Programme ◽  
Contextual Barriers

Background: Adolescents 360 (A360) implements the Smart Start (SS) programme through Ethiopia’s Health Extension Programme (HEP). SS is premised on financial planning as an entry point to discuss family planning (FP) with newly married couples and central to its delivery are the health extension workers (HEW). This article evaluates the A360 experience and learning from the process evaluation implemented by Itad to understand contextual barriers and enablers from the perspective of the HEW. Methods: A purposive sampling strategy was employed whereby 27 key stakeholders were identified from Oromia, Addis Ababa and Amhara, based on exposure to the SS programme. Findings from the action research were shared with A360 through a one day sounding workshop. Results: Findings revealed that many local government and communal respondents do not view adolescent pregnancy as a problem, unless out of wedlock, and adolescent pregnancy is closely linked to early marriage. As a result, some providers, including HEWs, acknowledged that married adolescent girls were previously ‘neglected’ by them, while husbands indicated that they had not previously been included in FP counselling. Findings also revealed some challenges with SS implementation as HEWs were ‘deprioritizing’ the intervention and many HEWs had been in situ for several years and were overworked and frustrated. Against this backdrop, A360 was viewed as adding to the HEW workload. While the programme design was focused on adolescent users, there was increasing recognition that HEWs also needed to be at the centre of solution design. Conclusions: Despite challenges associated with the HEP, Ethiopia FP2020 plans to support the ‘next generation’ of HEWs, including a focus on adolescents and youth. To gain deeper insight and put the HEW at the centre of design, A360 will continue to work with the process evaluation to understand contextual barriers and enablers from the perspective of the HEW.

scholarly journals POLA KOMUNIKASI PASANGAN SUAMI ISTRI DALAM TEKANAN PASCA MELAHIRKAN DI KOTA BANDAR LAMPUNG

2021 ◽  
Vol 8 (01) ◽  
pp. 1-10
Author(s):  
Kinantri Puspa Sari ◽  
Maulana Rezi Ramadhana
Keyword(s):  
Postpartum Period ◽  
Sampling Strategy ◽  
Married Couples ◽  
Communication Patterns ◽  
Transitional Period ◽  
Communication Pattern ◽  
Theory Approach ◽  
Snowball Sampling ◽  
Open Communication ◽  
Postpartum Stress

The postpartum period is a transitional period experienced by married couples who require adjustments to the presence of changes in their relationship, especially when the wife is experiencing postpartum stress (depression) during that period. The postpartum period causes changes in conditions followed by changing roles and responsibilities, which can affect the communication relationship between partners. This study focuses on communication patterns of married couples in postpartum pressure using the Interpersonal Communication Patterns Theory approach which is supported by the theory of relationship turbulence. The research method used is a qualitative method with data collection techniques in the form of interviews with four husband and wife couples who live in the city of Bandar Lampung, the determination of the informants is obtained through a snowball sampling strategy (multistage method) with expert informants as data confirmation. The results show that all couples have a separate balanced communication pattern (balanced split pattern) during the face of postpartum stress, which is marked by the division of responsibilities in different roles. In a balanced split communication pattern, all informants experience interferences as well as communication supports, and some experience relationship uncertainty, while constructive strategies are used as approaches in conflict management strategies between partners, characterized by open communication and negotiation. Conflicts related to childcare tasks and lack of quality interactions were the findings of this study. Abstrak Periode pasca melahirkan adalah periode transisi yang dialami oleh pasangan suami istri yang membutuhkan upaya penyesuaian dalam hubungan relasi, terlebih saat pihak istri mengalami tekanan/depresi pasca melahirkan selama periode tersebut. Periode pasca melahirkan menimbulkan perubahan kondisi, berupa perubahan peran dan tanggung jawab, yang dapat mempengaruhi hubungan komunikasi di antara pasangan. Penelitian ini berfokus pada pola komunikasi suami-istri dalam tekanan pasca melahirkan dengan metode penelitian kualitatif. Teknik pengambilan data berupa wawancara terhadap empat pasangan suami istri di Bandar Lampung yang didapat dari teknik pengambilan sample snowball sampling, Hasil menunjukkan bahwa seluruh pasangan memiliki pola komunikasi seimbang terpisah selama menghadapi tekanan pasca melahirkan, yang ditandai dengan adanya pembagian tanggung jawab pada peran yang berbeda. Dalam pola komunikasi seimbang terpisah, seluruh informan mengalami hambatan juga dukungan komunikasi, dan sebagian mengalami ketidakpastian hubungan. Sementara, strategi konstruktif digunakan sebagai pendekatan dalam strategi manajemen konflik di antara pasangan, ditandai dengan adanya keterbukaan komunikasi dan negosiasi. Konflik terkait dengan tugas pengasuhan anak dan kurangnya kualitas interaksi menjadi temuan dalam penelitian ini.

scholarly journals Process evaluation of co-designed interventions to improve communication of positive newborn bloodspot screening results

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050773
Author(s):  
Jane Chudleigh ◽  
Pru Holder ◽  
Louise Moody ◽  
Alan Simpson ◽  
Kevin Southern ◽  
...  
Keyword(s):  
Newborn Screening ◽  
Process Evaluation ◽  
Healthcare Professionals ◽  
Normalisation Process Theory ◽  
Future Research ◽  
Health Service Provider ◽  
Laboratory Staff ◽  
Newborn Bloodspot Screening ◽  
Screening Result ◽  
Contextual Barriers

ObjectiveTo implement and evaluate co-designed interventions to improve communication of positive newborn bloodspot screening results and make recommendations for future research and practice.DesignA process evaluation underpinned by Normalisation Process Theory.SettingThree National Health Service provider organisations in England.ParticipantsTwenty-four healthcare professionals (7 newborn screening laboratory staff and 24 clinicians) and 18 parents were interviewed.InterventionsThree co-designed interventions were implemented in practice: standardised laboratory proformas, communication checklists and an email/letter template.Primary outcome measuresAcceptability and feasibility of the co-designed interventions.ResultsAuditing the implementation of these interventions revealed between 58%–76% of the items on the laboratory proforma and 43%–80% of items on the communication checklists were completed. Interviews with healthcare professionals who had used the interventions in practice provided positive feedback in relation to the purpose of the interventions and the ease of completion both of which were viewed as enhancing communication of positive newborn bloodspot screening results. Interviews with parents highlighted the perceived benefit of the co-designed interventions in terms of consistency, pacing and tailoring of information as well as providing reliable information to families following communication of the positive newborn bloodspot screening result. The process evaluation illuminated organisational and contextual barriers during implementation of the co-designed interventions in practice.ConclusionVariations in communication practices for positive newborn bloodspot screening results continue to exist. The co-designed interventions could help to standardise communication of positive newborn screening results from laboratories to clinicians and from clinicians to parents which in turn could improve parents’ experience of receiving a positive newborn bloodspot screening result. Implementation highlighted some organisational and contextual barriers to effective adoption of the co-designed interventions in practice.Trial registration numberISRCTN15330120.

scholarly journals Developing Reproductive Health Communication in Early Marriage

2020 ◽  
Vol 15 (3) ◽  
pp. 441-449
Author(s):  
Najib Najib ◽  
Alfiana Ainun Nisa ◽  
Efa Nugroho ◽  
Evi Widowati ◽  
Chia En Yang
Keyword(s):  
Reproductive Health ◽  
Health Communication ◽  
Intervention Group ◽  
Married Couples ◽  
Early Marriage ◽  
Control Group ◽  
Communication Model ◽  
Access To Information ◽  
Community Based ◽  
Quasi Experimental

Adolescent fertility is an important health and social problem because it is related to the level of morbidity and mortality of mothers and children. The results of the 2017 IDHS show that 7% of women aged 15-19 are already mothers, 5% have given birth, and 2% are pregnant with their first child. The data shows that adolescents are already sexually active, but still have an understanding of low reproductive health. The purpose of this study was to determine the effectiveness of community-based health communication models that developed to improve access to information and public knowledge related to contraceptive methods in young married couples in Rembang Regency in 2019. This research  used Research and Development design with a quasi-experimental data collection method. The population in this study were adolescents who married at a young age in Rembang District, while the sample was adolescents who married young in Sedan and Kragan villages (intervention group), Menoro and Ngasinan (control group). Quantitative data analysis uses univariate, bivariate, and multivariate, while for qualitative data use grounded theory. The effectiveness test showed significant data for knowledge (p = 0,000), attitudes (p = 0.003), access to information (0.012), preferences (p = 0.001), and access to contraception (p = 0,000). It can be concluded that the community-based health communication model can improve knowledge, attitudes, access to information, preferences, and access related to contraception in early married couples

Failing the rights: sexual vulnerability, access to services and barriers to contraceptives among adolescents in Narok County, Kenya

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Griffins Manguro ◽  
Jefferson Mwaisaka ◽  
Dan Okoro ◽  
Kigen Korir ◽  
Patricia Owira ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Young People ◽  
Sexual Activity ◽  
Adolescent Pregnancy ◽  
Health Workers ◽  
Peer Pressure ◽  
Mixed Methods Study ◽  
Early Marriage ◽  
Content Type ◽  
Significant Difference

Purpose Around one in five girls in Kenya, aged 15 to 19 years old are either pregnant or have given birth. Of 47 counties, adolescent pregnancy is highest in Narok, where about 40% of girls aged 15 to 19 years old have begun childbearing. This study aims to explore drivers to sexual activity, access to sexual and reproductive health (SRH) services and barriers to contraceptive use among adolescents in Narok County, Kenya to inform the design of SRH interventions and safeguard young people’s rights to sexual health. Design/methodology/approach A cross-sectional mixed methods study was conducted in December 2019. Quantitative data were collected through structured questionnaires among girls aged 15 to 19 years old who were either pregnant or had given birth and those who had not and boys aged 15 to 19 years old. Qualitative data were collected through focus group discussions with adolescent girls and boys and through structured key informant interviews with parents, community leaders and health workers. Findings The mean age at first sexual intercourse for both genders was 15 years. While the majority of girls and boys knew where to access SRH services, few used contraception during their last sexual activity. There was no significant difference in the condom or other contraceptive methods use between girls who had begun child bearing and those who had not (p = 0.549 and p = 0.563, respectively). Key drivers for sexual activity among young people were poverty and peer pressure. Cultural practices such as female genital mutilation and early marriage contributed to early sex. Community attitudes toward contraception discouraged young people from taking up contraceptives. Originality/value This mixed methods study explores the drivers of adolescent pregnancy in Narok, Kenya, the county with the highest rates of adolescent pregnancy; twice the national pregnancy rates. Understanding the drivers of pregnancy and the underlying human rights violations will help policymakers and health leaders to design interventions which will improve outcomes.

Problematika Pernikahan Dini Di Kota Banjarmasin

2019 ◽  
Vol 10 (2) ◽  
pp. 622-633
Author(s):  
Esti Yuandari ◽  
Fakhruddin Razy ◽  
R. Topan Aditya Rahman
Keyword(s):  
Problem Solving ◽  
Reproductive Health ◽  
Infant Health ◽  
Sampling Technique ◽  
Married Couples ◽  
Active Role ◽  
Reproductive Organs ◽  
Early Marriage ◽  
The Government ◽  
The Impact

Latar Belakang: Pernikahan dini atau usia remaja antara dibawah 20 tahun di Indonesia masih tinggi, sehingga hal ini akan menimbulkan masalah, tidak hanya bagi pasangan tetapi juga bagi pemerintah. Masalah bagi pasangan yang menikah adalah belum kuatnya mental untuk menjalani biduk rumah tangga serta bahaya bagi kesehatan reproduksi khususnya pada pasangan wanita karena belum sempurnanya organ reproduksi, yang dapat menyebabkan gangguna kesehatan baik kesehatan ibu maupun bayinya, karena kelompok usia yang dianggap matang untuk melahirkan adalah usia 21-25 tahun. Sedangkan bagi pemerintah adalah meningkatnya angka kelahiran pada usia dibawah 20 tahun, perceraian, serta kekerasan dalam rumah tangga. Banyak faktor yang menyebabkan terjadinya pernikahan dini.Tujuan: Penelitian ini bertujuan untuk mengkaji penyebab terjadinya pernikahan dini, dampak pernikahan dini serta mengetahui solusi atau program pemecahan masalah pernikahan dini.Metode: Penelitian ini menggunakan metode kualitatif dengan sampel adalah pasangan yang menikah dini, sedangkan teknik pengambilan sampel pada penelitian adalah dengan menggunakan purposive sampling.Hasil: pernikahan dini dikota Banjarmasin disebabkan oleh beberapa factor diantaranya factor pendidikan, ekonomi, pergaulan, keinginan sendiri, dan married by accident. Pernikahan dini juga berdampak pada fisik, psikologis, dan ekonomi. Oleh karena itu langkah strategis untuk pemecahan masalah adalah melalui kerjasama dengan Kantor Urusan Agama (KUA)Simpulan: untuk menekan angka pernikahan dini perlu ada dukungan dari semua pihak serta peran aktif dari masyarakat terutama dari keluarga. KUA diharapkan mampu menjadi filterisasi agar pernikahan dini tidak terjadi.Kata Kunci: Problematika, Pernikahan Dini, Remaja, Kesehatan ReproduksiBackground: Early marriage or adolescence between under 20 years old in Indonesia is still high, so this will cause problems, not only for couples but also for the government. The problem for married couples is that they are not mentally strong enough to undergo household hygiene and the dangers to reproductive health, especially in female partners due to incomplete reproductive organs, which can cause health problems both in maternal and infant health, because the age group considered ripe for childbirth is age 21-25 years old. As for the government is the increase in birth rates under the age of 20 years, divorce, and domestic violence. Many factors cause early marriage.Objective: This study aims to examine the causes of early marriage, the impact of early marriage and find out solutions or early marriage problem solving programs.Methods: This study used a qualitative method with the sample being a couple who married early, while the sampling technique in the study was to use purposive sampling.Results: Early marriage in the city of Banjarmasin is caused by several factors including factors in education, economy, relationships, one's own desires, and married by accident. Early marriage also impacts on the physical, psychological, and economic. Therefore a strategic step for problem solving is through collaboration with the Office of Religious Affairs (KUA)Conclusion: to reduce the number of early marriage there needs to be support from all parties and the active role of the community, especially from the family. KUA is expected to be able to filter so that early marriage does not occur.Keywords: Problems, Early Marriage, Adolescents, Reproductive Health  

Perceived burden, causes and consequences of adolescent pregnancy in the rural Maharashtra: a cultural domain analysis

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Shiv H. Joshi ◽  
Abhishek V. Raut ◽  
Sourav Goswami ◽  
Subodh S. Gupta
Keyword(s):  
Adolescent Pregnancy ◽  
Teenage Pregnancy ◽  
Educational Status ◽  
Domain Analysis ◽  
Early Marriage ◽  
Excessive Bleeding ◽  
Cross Sectional ◽  
Perceived Burden ◽  
Cultural Domain ◽  
Cultural Domain Analysis

AbstractObjectivesThe existing level of the early age pregnancy necessitates in-depth discussions and study. The objective of this study is to explore the perception of rural population regarding adolescent pregnancy with reference to the perceived burden, causes and consequences.MethodsA cross-sectional study through cultural domain analysis using free listing and participatory learning and action (PLA) tool of ten seed analysis was used for exploring the perceptions of the community. Cognitive salience was estimated using the Sutrop (Su) index.ResultsThe perceived burden of adolescent pregnancy was around 18%. Early marriage (Su index = 0.274), love/relationship (Su index = 0.246), pre-marital sex (Su index = 0.215), rape/incest (Su index = 0.162), and poor educational status (Su index = 0.152) were the salient causes of adolescent pregnancy. The salient consequences identified were weak baby (Su index = 0.170), social stigma (Su index = 0.124), excessive bleeding during delivery (Su index = 0.114), mother may die (Su index = 0.112) and abortion (Su index = 0.109).ConclusionsTeenage pregnancy is perceived as a problem by the community. The causes of teenage pregnancy in this setting are multi-dimensional and are deeply embedded in the system of local values, beliefs and practices.

scholarly journals PENYELESAIAN KASUS KEKERASAN DALAM RUMAH TANGGA (KDRT) DI LUAR PENGADILAN

2019 ◽  
Vol 5 (1) ◽  
pp. 21
Author(s):  
Irwan Niza ◽  
Abdul Sakban
Keyword(s):  
Domestic Violence ◽  
Dispute Resolution ◽  
Final Stage ◽  
Qualitative Method ◽  
Married Couples ◽  
Early Marriage ◽  
Religious Leaders ◽  
Internal Factors ◽  
Interactive Analysis ◽  
Descriptive Approach

Kekerasan yang terjadi dalam rumah tangga lebih banyak dialami perempuan yang berkedudukan sebagai seorang istri, sedangkan pelakunya didominasi oleh laki-laki yang berkedudukan sebagai seorang suami. Hal ini desebabkan oleh faktor internal antara lain yaitu karakter pelaku kekerasan yang cenderung emosi, ketergantungan ekonomi, pihak ketiga dalam rumah tangga. Faktor eksternal  antara lain perbedaan budaya/kebiasaan, perbedaan agama atau keyakinan pasangan suami-istri dan keduanya tidak saling memahami satu sama lain. Dalam kasus ini proses penyelesaianya yaitu melalui jalur mediasi atau diselesaikan di luar pengadilan. Metode yang digunakan dalam penelitin ini adalah metode kualitatif dengan pendekatan diskriptif. Subjek penelitian ini adalah Tokoh adat, tokoh agama, kepala desa kepala dusun dan masyarakat setempat. Metode pengumpulan data menggunakan observasi, wawancara, dan dokumentasi. Sedangkan jenis data yang digunakan adalah data kualitatif dengan metode analisis interaktif. Hasil penelitian ini menyebutkan bahwa 1) Faktor-faktor pendorong terjadinya  kasus Kekerasan Dalam Rumah Tangga adanya orang ketiga atau pelaku melakukan perselingkuhan, adanya pernikahan di bawah umur (pernikahan dini), ikut campurnya mertua dan pihak lain dan kesenjangan ekonomi. 2) Proses penyelesaian kasus Kekerasan Dalam Rumah Tangga di luar Pengdilan yaitu tahap sebelum penyelesaian sengketa (pra mediasi), tahap penyelesaian sengketa (tahap mediasi), tahap akhir penyelesaian sengketa (tahap akhir mediasi). Violence that occurs in the household is more experienced by women who are domiciled as wives, while the perpetrators are dominated by men who are domiciled as husbands. This is caused by internal factors, among others, namely the character of the perpetrators of violence who tend to be emotional, economic dependency, third parties in the household. External factors include differences in culture / habits, differences in religion or beliefs of married couples and both do not understand each other. In this case the settlement process is through mediation or resolved outside the court. The method used in this research is a qualitative method with a descriptive approach. The subjects of this study were adat leaders, religious leaders, village heads, hamlet heads and local communities. Methods of collecting data using observation, interviews, and documentation. While the type of data used is qualitative data with interactive analysis methods. The results of this study state that 1) Factors driving the occurrence of cases of Domestic Violence are third people or perpetrators of infidelity, the existence of underage marriages (early marriage), interference from in-laws and other parties and economic disparities. 2) The process of resolving cases of domestic violence outside Pengdilan namely the stage before dispute resolution (pre mediation), the stage of dispute resolution (mediation stage), the final stage of dispute resolution (the final stage of mediation).

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