Reproductive Health Services and Intimate Partner Violence: Shaping a Pragmatic Response In Sub-Saharan Africa

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.

Download Full-text

Intimate Partner Violence against Women Living in Inadequate Conditions in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Survey Data

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph181910138 ◽

2021 ◽

Vol 18 (19) ◽

pp. 10138

Author(s):

Yaqing Gao ◽

Yinping Wang ◽

Xiaoyi Mi ◽

Mo Zhou ◽

Siyu Zou ◽

...

Keyword(s):

Intimate Partner Violence ◽

Partner Violence ◽

Meta Analysis ◽

Intimate Partner ◽

Living Conditions ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Major Public Health Problem ◽

Sub Saharan ◽

Country Specific

Intimate partner violence (IPV) against women is a major public health problem and is widespread in sub-Saharan Africa (SSA). However, little is known about its environmental determinants. This study aimed to investigate whether inadequate living conditions are associated with IPV victimization in women in SSA. We analyzed cross-sectional data for 102,714 women in 25 SSA countries obtained from the Demographic and Health Surveys Program. Logistic regression was used to estimate the country-specific effects of inadequate living conditions (housing with at least one of four characteristics of unimproved water, unimproved sanitation, insufficient space, and unfinished materials) on multiple forms of IPV. Random effects meta-analysis was used to combined the country-specific estimates. We found an association between inadequate living conditions and a higher likelihood of experiencing any (OR = 1.12, 95% CI 1.03 to 1.23, p = 0.012), sexual (OR = 1.18, 95% CI 1.05 to 1.34, p = 0.008), emotional (OR = 1.12, 95% CI 1.02 to 1.23, p = 0.023), and physical (OR = 1.15, 95% CI 1.03 to 1.28, p = 0.010) IPV. The associations were stronger for rural and less-educated women. These findings suggest that future research to establish a causal link between living conditions and IPV and to elucidate the underlying pathways is crucial to design IPV interventions in SSA.

Download Full-text

Challenges of Seeking Reproductive Health Care in People Experiencing Intimate Partner Violence

Journal of Interpersonal Violence ◽

10.1177/0886260520959627 ◽

2020 ◽

pp. 088626052095962

Author(s):

Carly O’Connor-Terry ◽

Danielle Burton ◽

Tejasvi Gowda ◽

Adrianne Laing ◽

Judy C. Chang

Keyword(s):

Health Care ◽

Intimate Partner Violence ◽

Reproductive Health ◽

Partner Violence ◽

Low Cost ◽

Intimate Partner ◽

Reproductive Health Services ◽

Structured Interviews ◽

Reproductive Health Care ◽

Title X

Title X is a federally funded family planning initiative that provides low-cost and confidential reproductive health services to its clients. In recent years, Title X has been the subject of debate as its core tenants have been revised by the current administration. Though advocates have fought against these changes, the voices of survivors on intimate partner violence are absent from this conversation. This study was designed to elicit the opinions and experiences on survivors of intimate partner violence on reproductive decision-making, their access to care, and their opinions about political efforts to restrict this access. Twenty-six semi-structured interviews were conducted with women who were seeking services for intimate partner violence. These interviews were audio-recorded, transcribed, and coded. Codes were then organized into themes. Participants endorsed the need for confidential services due to experiences of coercion from their partners and the fear of retaliation against them. Participants largely supported accessible contraception but reported the need for contraception to be reliable. Participants addressed pregnancy and its many complexities and advocated for nondirective options-counseling. Overall, participants spoke about their challenges with reproductive health care and their opinions on how best to service survivors of intimate partner violence. This study asserts the need for advocates for survivors to advocate for the preservation of Title X and establishes the need for future studies on the prevalence of intimate partner violence in Title X clinics.

Download Full-text

Integrated Intimate Partner Violence and Human Immunodeficiency Virus Interventions in Sub-Saharan Africa: A Systematic Review Targeting or Including Adolescents

Violence and Gender ◽

10.1089/vio.2018.0027 ◽

2019 ◽

Vol 6 (2) ◽

pp. 92-104 ◽

Cited By ~ 2

Author(s):

Mary Kirtley Righi ◽

Lindsay M. Orchowski ◽

Caroline Kuo

Keyword(s):

Systematic Review ◽

Human Immunodeficiency Virus ◽

Intimate Partner Violence ◽

Partner Violence ◽

Intimate Partner ◽

Sub Saharan Africa ◽

Immunodeficiency Virus ◽

Sub Saharan

Download Full-text

Barriers facing persons with disability in accessing sexual and reproductive health services in sub-Saharan Africa: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0238585 ◽

2020 ◽

Vol 15 (10) ◽

pp. e0238585

Author(s):

John Kuumuori Ganle ◽

Leonard Baatiema ◽

Reginald Quansah ◽

Anthony Danso-Appiah

Keyword(s):

Systematic Review ◽

Reproductive Health ◽

Health Services ◽

Sexual And Reproductive Health ◽

Sub Saharan Africa ◽

Reproductive Health Services ◽

Sub Saharan

Download Full-text

Intimate Partner Violence (IPV) Against HIV-Positive Women in Sub-Saharan Africa: A Mixed-Method Systematic Review and Meta-Analysis

Trauma Violence & Abuse ◽

10.1177/1524838020906560 ◽

2020 ◽

pp. 152483802090656 ◽

Cited By ~ 2

Author(s):

Eric Y. Tenkorang ◽

Michael Asamoah-Boaheng ◽

Adobea Y. Owusu

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Intimate Partner Violence ◽

Partner Violence ◽

Meta Analysis ◽

Intimate Partner ◽

Sub Saharan Africa ◽

Hiv Positive ◽

Hiv Positive Women ◽

Sub Saharan

Objectives: To systematically analyze and summarize the literature on intimate partner violence (IPV) against HIV-positive women in sub-Saharan Africa (SSA) and to identify their risk factors for IPV. Method: A comprehensive review of the literature using the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analyses of Observational Studies in Epidemiology (MOOSE) yielded 1,879 articles (PubMed = 1,251, Embase = 491, Web of Science = 132, and identified additional records = 5). Twenty were selected for quantitative and qualitative assessment and synthesis. We employed a random effects model with generic inverse variance method and estimated the odds ratios. Findings: Results indicated a high prevalence of physical, sexual, and emotional violence against women living with HIV/AIDS in SSA. Educational background, alcohol use, marital status, previous experiences with IPV, and employment status were identified as significant risk factors. We also assessed the methodological quality of the articles by examining publication bias and some heterogeneity statistics. Conclusion: There is limited research on IPV against HIV-positive women in SSA. However, the few existing studies agree on the importance of targeting HIV-positive women with specific interventions given their vulnerability to IPV and to address factors exacerbating these risks and vulnerabilities.

Download Full-text