scholarly journals Gendered power dynamics and threats to sexual and reproductive autonomy among adolescent girls and young adult women: A cross-sectional survey in three urban settings

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0257009
Author(s):  
Michele R. Decker ◽  
Shannon N. Wood ◽  
Meagan E. Byrne ◽  
Nathalie Yao-N’dry ◽  
Mary Thiongo ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Contraceptive Use ◽  
Social Systems ◽  
Transactional Sex ◽  
Relationship Power ◽  
Reproductive Autonomy ◽  
Cross Sectional ◽  
Reproductive Coercion ◽  
Relational Power ◽  
Gendered Power

Background Gendered economic and social systems can enable relational power disparities for adolescent girls and young women (AGYW), and undercut autonomy to negotiate sex and contraceptive use. Less is known about their accumulation and interplay. This study characterizes relationship power imbalances (age disparity, intimate partner violence [IPV], partner-related fear, transactional sex, and transactional partnerships), and evaluates associations with modern contraceptive use, and sexual/reproductive autonomy threats (condom removal/“stealthing”, reproductive coercion, ability to refuse sex, and contraceptive confidence). Methods Cross-sectional surveys were conducted with unmarried, currently-partnered AGYW aged 15–24 recruited via respondent-driven sampling in Abidjan, Côte d’Ivoire (n = 555; 2018–19), Nairobi, Kenya (n = 332; 2019), and Lagos, Nigeria (n = 179; 2020). Descriptive statistics, Venn diagrams, and multivariate regression models characterized relationship power imbalances, and associations with reproductive autonomy threats and contraceptive use. Findings Relationship power imbalances were complex and concurrent. In current partnerships, partner-related fears were common (50.4%Nairobi; 54.5%Abidjan; 55.7%Lagos) and physical IPV varied (14.5%Nairobi; 22.1%Abidjan; 9.6%Lagos). IPV was associated with reproductive coercion in Nairobi and Abidjan. Age disparate relationships undermined confidence in contraception in Nairobi. In Nairobi and Lagos, transactional sex outside the relationship was associated with condom stealthing. Interpretation AGYW face simultaneous gendered power differentials, against the backdrop of gendered social and economic systems. Power imbalances were linked with coercive sexual/reproductive health experiences which are often underrecognized yet represent a potent link between gendered social systems and poor health. Pregnancy prevention efforts for AGYW must address reproductive autonomy threats, and the relational power imbalances and broader gendered systems that enable them.

scholarly journals Social ecological factors associated with experiencing violence among urban refugee and displaced adolescent girls and young women in informal settlements in Kampala, Uganda: a cross-sectional study

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Carmen H. Logie ◽  
Moses Okumu ◽  
Simon Mwima ◽  
Robert Hakiza ◽  
Kibathi Peter Irungi ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Food Insecurity ◽  
Childhood Abuse ◽  
Adolescent Girls ◽  
Ecological Factors ◽  
Sexual Relationship ◽  
Relationship Power ◽  
Cross Sectional ◽  
Factors Associated ◽  
Social Ecological

Abstract Background Research on violence targeting urban forcibly displaced adolescent girls and young women (AGYW) is limited, particularly regarding polyvictimization (exposure to multiple forms of violence). Yet there is a global trend of refugee urbanization, and urban AGYW are at the nexus of violence disparities among adolescents, forcibly displaced persons, and slum dwellers. This study explored factors associated with young adulthood violence (> 16 years) (YAV) and intimate partner violence (IPV) among forcibly displaced AGYW in Kampala, Uganda. Methods We conducted a cross-sectional survey with forcibly displaced AGYW aged 16–24 from five informal settlement (slum) communities across Kampala (Kabalagala, Rubaga, Kansanga, Katwe, Nsambya) using peer network sampling. We assessed YAV (experienced at age 16 or above) (sexual, physical, emotional violence) and recent (past 12-month) IPV (physical, sexual, control violence). We conducted descriptive statistics, followed by multinomial logistic regression analyses to explore social ecological factors (e.g., intrapersonal: depression; interpersonal: sexual relationship power, community: food insecurity) associated with experiencing YAV and YAV polyvictimization, and IPV and IPV polyvictimization. Results Over half of participants (n = 333; mean age = 19.31; SD = 2.56, range = 16–24) reported YAV (n = 179; 53.7%) and 9.3% (n = 41) reported YAV polyvictimization. Most participants that were in an intimate relationship in the last 12 months (n = 200; 85.8%) reported IPV, among these, 45.5% reported one form of IPV and 54.5% reported IPV polyvictimization. In adjusted analyses, experiencing any YAV was significantly associated with: adolescent sexual and reproductive health (SRH) stigma; sexual relationship power; mobile app usage; depressive symptoms; childhood abuse; and childhood polyvictimization. In adjusted analyses YAV polyvictimization was associated with: depressive symptoms; childhood polyvictimization; sexual relationship power; and food insecurity. Recent IPV polyvictimization in adjusted analyses was associated with owning/using a mobile phone and depressive symptoms. Participants with higher sexual relationship power had lower odds of recent IPV polyvictimization. Conclusion Findings suggest that YAV and IPV polyvictimization require urgent attention among forcibly displaced AGYW in Kampala. Multi-level strategies are required to address intrapersonal e.g. (depression), interpersonal (e.g. childhood abuse, sexual relationship power) and community (e.g. adolescent SRH stigma, food insecurity) factors associated with experiencing violence. Future research can tailor approaches to advance health, agency and human rights among urban forcibly displaced AGYW.

scholarly journals The association between early in marriage fertility pressure from in-laws’ and family planning behaviors, among married adolescent girls in Bihar and Uttar Pradesh, India

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anvita Dixit ◽  
Nandita Bhan ◽  
Tarik Benmarhnia ◽  
Elizabeth Reed ◽  
Susan M. Kiene ◽  
...  
Keyword(s):  
Family Planning ◽  
Family Size ◽  
Adolescent Girls ◽  
Sexual And Reproductive Health ◽  
Contraceptive Use ◽  
Uttar Pradesh ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Couple Communication ◽  
Multivariable Regression

Abstract Background Married adolescent girls are vulnerable to risky sexual and reproductive health outcomes. We examined the association of fertility pressure from in-laws’ early in marriage with contraceptive use ever, parity, time until first birth, and couple communication about family size, among married adolescent girls. Methods Data were taken from a cross-sectional survey with married girls aged 15–19 years (N = 4893) collected from September 2015 to July 2016 in Bihar and Uttar Pradesh, India. Multivariable regression assessed associations between in-laws’ fertility pressure and each outcome, adjusting for sociodemographic covariates. Results We found that 1 in 5 girls experienced pressure from in-laws’ to have a child immediately after marriage. In-laws’ fertility pressure was associated with lower parity (Adj. β Coef. − 0.10, 95% CI − 0.17, − 0.37) and couple communication about family size (AOR = 1.77, 95% CI 1.39, 2.26), but not contraceptive use or time until birth. Conclusions Our study adds to the literature identifying that in-laws’ pressure on fertility is common, affects couple communication about family size, and may be more likely for those yet to have a child, but may have little effect impeding contraceptive use in a context where such use is not normative.

scholarly journals The Association Between Early in Marriage Fertility Pressure from in-laws’ and Family Planning Behaviors, Among Married Adolescent Girls in Bihar and Uttar Pradesh, India.

2020 ◽  
Author(s):  
Anvita Dixit ◽  
Nandita Bhan ◽  
Tarik Benmarhnia ◽  
Elizabeth Reed ◽  
Susan M. Kiene ◽  
...  
Keyword(s):  
Family Size ◽  
Adolescent Girls ◽  
Sexual And Reproductive Health ◽  
Contraceptive Use ◽  
Uttar Pradesh ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Couple Communication ◽  
Multivariable Regression

Abstract Background: Married adolescent girls are vulnerable to risky sexual and reproductive health outcomes. We examined the association of fertility pressure from in-laws’ early in marriage with contraceptive use ever, parity, time until first birth, and couple communication about family size, among married adolescent girls. Methods: Data were taken from a cross-sectional survey study with married girls aged 15-19 years (N=4,893) collected from September 2015 to July 2016 in Bihar and Uttar Pradesh, India. Multivariable regression assessed associations between in-laws’ fertility pressure and each outcome, adjusting for sociodemographic covariates. Results: We found that 1 in 5 girls experienced pressure from in-laws’ to have a child immediately after marriage. In-laws’ fertility pressure was associated with lower parity (Adj. β Coef. -0.10, 95% CI -0.17, -0.37) and couple communication about family size (AOR=1.77, 95% CI 1.39, 2.26), but not contraceptive use or time until birth. Conclusions: Our study adds to the literature identifying that in-laws’ pressure on fertility is common, affects couple communication about family size, and may be more likely for those yet to have a child, but may have little effect impeding contraceptive use in a context where such use is not normative.

scholarly journals Child marriage among Somali refugees in Ethiopia: a cross sectional survey of adolescent girls and adult women

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shatha Elnakib ◽  
Kara Hunersen ◽  
Janna Metzler ◽  
Hailu Bekele ◽  
W. Courtland Robinson
Keyword(s):  
Adolescent Girls ◽  
Contraceptive Use ◽  
Health Indicators ◽  
Evidence Base ◽  
Child Marriage ◽  
Adult Women ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Humanitarian Settings ◽  
Multi Stage

Abstract Background Despite child marriage receiving increased attention over the past two decades, research on child marriage in humanitarian settings remains scarce. This study sought to quantify child marriage among Somali adolescent girls residing in Kobe refugee camp in Ethiopia and to identify its correlates and consequences. Methods A cross-sectional survey was conducted using multi-stage cluster-based sampling with probability proportional to size. We randomly sampled households that have at least one female aged 15–49 and at least one adolescent female aged 10–19. In addition to calculating the proportion of girls married under age 18, we used survival methods – namely Kaplan Meier graphs and Cox proportional hazard models – to identify risk factors associated with child marriage in this context. We also used descriptive statistics to describe marital age preferences among female adults and presented measures of important sexual and reproductive health indicators among married adolescent girls. Results A total of 603 adult women were surveyed and a household roster was created with information on 3319 household members, of whom 522 were adolescent girls aged 15–19. Of those, 14% were currently married (95% Confidence Interval [CI] 0.11–0.18), and 11% were ever married under age 18 (95% CI 8–15%). Several variables were found to be significantly associated with hazard of child marriage including schooling, sex and employment status of head of household, as well as number of girls under age 18 in the childhood home.. Adult women tended to incorrectly identify minimum legal age at marriage and preferred low marital age for boys and girls – particularly in households of child brides. Among married adolescent girls, contraceptive use was very low (11%; 95% CI 4.94–22.40), and early childbearing was common (60%; 95% CI 45.56–72.89). Conclusions This research contributes to the evidence base on child marriage in humanitarian settings. Insights generated from this study have the potential to inform programs and interventions aiming to prevent and mitigate the impacts of this harmful practice.

scholarly journals Determinants of contraceptive use among sexually active unmarried adolescent girls and young women aged 15–24 years in Ghana: a nationally representative cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043890
Author(s):  
Felix Boakye Oppong ◽  
Divine Darlington Logo ◽  
Senyo Yao Agbedra ◽  
Anthony Agyapong Adomah ◽  
Seidu Amenyaglo ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Young Women ◽  
Contraceptive Use ◽  
Household Wealth ◽  
Secondary Outcome ◽  
Sexually Active ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
History Of ◽  
Nationally Representative

ObjectiveThere is a decline in contraceptive use among sexually active unmarried young women in Ghana. This study assessed the prevalence of contraceptive knowledge and use, and the determinant of contraceptive use among sexually active unmarried young women in Ghana.DesignThis was a nationally representative cross-sectional survey, using data from the 2017 Ghana Maternal Health Survey. Weighted logistic regression was used to assess the association between background and obstetric characteristics of young women and contraceptive use.SettingGhana.ParticipantsA total of 809 sexually active unmarried adolescent girls (15–19 years) and young women (20–24 years).Primary and secondary outcome measuresKnowledge and use of both modern and traditional contraceptive methods.ResultsKnowledge of at least one modern and traditional contractive method was 99.8% and 95.0%, respectively. The prevalence of contraceptive use was 43%—with 34% modern and 9% traditional methods. From the unadjusted analyses, age (p=0.002), past pregnancy (p<0.001), abortion in the past 5 years (p=0.007) and history of childbirth (p=0.025) were independently associated with contraceptive use, whereas education (p=0.072), place of residence (p=0.702), household wealth (p=0.836) and age at first sex (p=0.924) were not independently associated with contraceptive use. In the adjusted analysis, contraceptive use was significantly higher among respondents with secondary education compared with those with primary education (OR 2.43, 95% CI 1.31 to 4.49, p=0.017), and was higher among respondents with a history of pregnancy (OR 2.13, 95% CI 1.48 to 3.06, p<0.001).ConclusionThere is a significant gap between knowledge and use of contraceptives among the study population. While intensifying knowledge of adolescents and young women on contraceptives, adolescent-friendly corners should be established at vantage points to increase utilisation and to prevent societal stigma on young women who access contraceptives services.

MORBIDITY PATTERN AMONG ADOLESCENT SCHOOL GIRLS IN RURAL AND URBAN SCHOOL OF JHANSI (U.P.)- A COMPARATIVE CROSS-SECTIONAL SURVEY

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Shubhanshu Gupta ◽  
Sanjeev Kumar ◽  
Piyush D Swami ◽  
Anjana Niranjan
Keyword(s):  
Health Status ◽  
Adolescent Girls ◽  
Low Socioeconomic Status ◽  
Optimal Level ◽  
Cross Sectional Study ◽  
World Health ◽  
World Population ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Rural And Urban

Background: According to World Health Organization, adolescents constitute about one fifth of the world population, and in India they constitute about 21% of the total population. Most of the surveys show that health status of adolescent girls is at sub-optimal level. Objectives: To assess nutritional status and morbidity pattern among the adolescent girls and to suggest measures for improvement of health status of adolescent girls.  Method: A community based cross-sectional study was carried out among 250 adolescent schoolgirls in Rural and urban field practice area of Jhansi school from January 2017 to July 2014. Results: Among the various morbidities eye problem was seen in maximum no of adolescent girls. Eye problem was present in 44.8% of adolescent girls followed by respiratory 14.7% and ear 13.06% disease. Skin disease was present in 3.2% of adolescent girls, which was more in rural girls 6.7% than in urban girls 1.7%, may be due to better hygienic practice in urban schoolgirls. Conclusions: Rural background, low socioeconomic status, illiteracy, birth rate and order, income and number of members in a family have shown to be significant determinants of morbidity pattern in the adolescent girls. Keywords: Adolescent, anemia, morbidity, vaginal discharge.

Kesediaan Vaksinasi HPV pada Remaja Putri Ditinjau dari Faktor Orang Tua

2020 ◽  
Vol 7 (2) ◽  
pp. 213-222
Author(s):  
Nonik Ayu Wantini ◽  
Novi Indrayani
Keyword(s):  
Adolescent Girls ◽  
Emotional Support ◽  
Parental Support ◽  
Hpv Vaccination ◽  
Information Support ◽  
Bivariate Analysis ◽  
P Value ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Cross Sectional

Infeksi HPV dan pre kanker serviks (sel-sel abnormal pada leher rahim yang dapat menyebabkan kanker) telah menurun secara signifikan sejak vaksin HPV digunakan.Cakupan vaksinasi HPV masih rendah di Indonesia.Orang tua adalah pemegang tanggung jawab dan kewajiban utama di dalam penjaminan pemenuhan hak dasar anak untuk mendapatkan vaksinasi. Tujuan penelitian adalah untuk mengetahui faktor yang berhubungan (sikap, kepercayaan, dukungan orang tua) dengan kesediaan vaksinasi pada remaja putri. Jenis penelitian adalah survey analitik dengan pendekatan cross sectional. Penelitian dilaksanakan di SD Muhammadiyah Macanan, Ngemplak dan SMPN 1 Berbah, Sleman pada Mei-Juli 2019. Jumlah sampel 127 remaja putri beserta orang tuanya dipilih dengan accidental sampling. Instrumen kuesioner dan telah dilakukan uji validitas. Analisis bivariat dengan uji chi square (dukungan instrumen, emosional, kepercayaan orang tua) dan uji fisher exact (dukungan informasi dan sikap). Hasil penelitian menunjukkan 92,9% orang tua tidak memberikan dukungan informasi, 85% tidak memberikan dukungan instrumen, 75,6% memberikan dukungan emosional kepada putrinya terkait vaksinasi. Faktor yang berhubungan dengan kesediaan vaksinasi adalah dukungan instrumen (p-value = 0,048). Faktor yang menjadi pertimbangan terbanyak orang tua untuk mengijinkan anaknya di vaksinasi adalah keamanan vaksin (81,1%). Kesimpulan: Ada hubungan dukungan instrumen orang tua dengan kesediaan vaksinasi HPV pada remaja putri. HPV infections and cervical precancers (abnormal cells on the cervix that can lead to cancer) have dropped significantly since HPV vaccine has been in use. HPV vaccination coverage is still low in Indonesia. Parents are the main responsibility and obligation in guaranteeing the fulfillment of the child's basic rights to get a vaccination. The purpose of this study was to determine the related factors (attitudes, beliefs, parental support) with the willingness to participate in HPV vaccination among adolescent girls. This type of the study was analytic survey with cross sectional approach. The study was conducted at SD Muhammadiyah Macanan, Ngemplak and SMPN 1 Berbah, Sleman in May-July 2019. The sample was 127 adolescent girl and their parents selected by accidental sampling. The instrument used questionnaire and already undergone validity test. The bivariate analysis used chi square test (instrument and emotional support, parental trust) and fisher exact test (information support and attitude). The results showed 92.9% of parents did not provide information support, 85% did not provide instrument support, 75.6% provided emotional support to their daughters related to vaccination. Factors related to the willingness of vaccinations were instrument support (p-value = 0.048). The factor that was considered by most parents to allow their children to be vaccinated was vaccine safety (81.1%). Conclusion: There was a correlation between parental instrument support and HPV vaccination willingness of adolescent girls.

Study of epidemiological determinants of undernutrition among adolescent girls in urban slums of Berhampur, Odisha: a cross-sectional study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Sambedana Mohanty ◽  
Manasee Panda
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Adolescent Girls ◽  
Folic Acid Supplementation ◽  
Cross Sectional Study ◽  
Urban Slums ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nutritional Needs ◽  
Structured Questionnaire

AbstractBackgroundAdolescent girls are vulnerable to many problems, undernutrition being the most common. This results in growth restriction resulting in stunting, wasting, underweight and last but not the least iron-deficiency anaemia. Nutritional needs are high during puberty which later leads to complications during pregnancy and its outcomes.Materials and methodsA field based cross-sectional study was carried out to assess the nutritional status of the girls and to determine the various factors responsible for undernutrition. After clearance from the Institution Ethical Committee (IEC) and permission from Child Development Programme Officer (CDPO), the study was conducted in the anganwadi centres (AWC) of urban slums in the field practice area of the Department of Community Medicine from the 1st October 2014 to the 31st October 2016. All the adolescent girls enlisted in the seven anganwadi centres were included as study subjects with their consent. A pre-designed, pre-tested and semi-structured questionnaire was used to collect data on following sections. (a) socio-demographic profile and (b) nutritional status. Dietary intake was taken using the 24-h recall method. Anthropometry was measured and haemoglobin (Hb) was estimated. SPSS version 21 was used for descriptive and analytic statistics.ResultsAmong the 160 girls 98(61.3%), 69(43.1%), 53(33.1%) were underweight, stunted and wasted, respectively. Anaemia was present among 144(90%) of the girls.ConclusionStrict monitoring of weekly iron and folic acid supplementation (WIFS) as well as nutrition education are essential measures to solve the problem of undernutrition among adolescent girls.

scholarly journals Balanced diet related knowledge, attitude and practices (KAP) among adolescent school girls in Noakhali district, Bangladesh: a cross sectional study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Susmita Ghosh ◽  
Md Ruhul Kabir ◽  
Mohammad Rahanur Alam ◽  
Akibul Islam Chowdhury ◽  
Md Abdullah Al Mamun
Keyword(s):  
Adolescent Girls ◽  
Sexual Maturation ◽  
Cross Sectional Study ◽  
Good Knowledge ◽  
Sectional Study ◽  
Cross Sectional ◽  
Government School ◽  
Balanced Diet ◽  
Positive Attitudes ◽  
School Girls

AbstractObjectivesAdolescence, a crucial period for growth velocity including sexual maturation, is an important period of life and young adolescent girls need to have proper knowledge, positive attitudes and practice of balanced diet to achieve optimum growth and development. Considering its importance this study attempts to assess the knowledge, attitude and practice (KAP) of balanced diets among adolescent schoolgirls in Noakhali district, Bangladesh.MethodsA descriptive cross-sectional study was conducted in three secondary schools in Noakhali district, Bangladesh. A multistage sampling techniques was used to select schools and study participants. A total of 485 adolescent school girls participated and a pre-designed, validated and structured questionnaire was used for data collection. In addition to descriptive statistics, chi-square test and logistic regression were employed for analysis.ResultsThe results from the study revealed that more than half of the students did not have good knowledge about a balanced diet, 42.8% had a positive attitude, whereas the practice of consuming a balanced diet was rather low (only 4.5%). Students studying in government schools had better knowledge and attitudes than non-government school students. Moreover, 41.1% of students were underweight; more than 60% of respondent’s mothers did not have an education higher than secondary school and were mostly unemployed housewives. Parent’s education, mother’s occupation, and types of school have a strong association with KAP; however, father’s education and occupation showed an association of varying degrees. Being knowledgeable was related to positive attitudes, and students with good knowledge had (OR: 1.828; 95% CI: 1.270–2.631) more likely to have positive attitudes towards a balanced diet.ConclusionsThus, proper knowledge about a balanced diet should be introduced with basic nutritional knowledge to all levels of public education. Interventions and programs can be designed to improve knowledge, attitude, and more specifically the practice at the household level so that adolescent girls can have a proper diet during their sexual maturation phase.

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