Zika outbreak, resilient health systems, and women’s sexual and reproductive health: a qualitative study in Colombia

2020 ◽  
Author(s):  
Juan Carlos Rivillas-García ◽  
Luz Janeth Forero-Martinez ◽  
Mariana Calderon-Jaramillo ◽  
Victoria Vargas-Pinzón ◽  
Rocío Murad-Rivera ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health System ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Technical Equipment ◽  
Care Providers ◽  
Data Set ◽  
National Response ◽  
The Government ◽  
The Impact

Abstract Background There is substantial evidence of the profound consequences of Zika on women's Sexual and Reproductive Health. Health system resilience begins by measuring critical capacities ahead of a crisis such as Zika outbreak. Even though Zika as vector-borne disease is well documented, there is dearth of studies linking Zika with women's Sexual and Reproductive Health. The main objective of this study was to analyze the national response to the Zika epidemic and its relation to women’s sexual and reproductive health matters through key implementation mechanisms in order to promote resilience of the health system in five cities in Colombia.Methods This study used a qualitative design to enable an in-depth exploration of the national response to the Zika epidemic and sexual and reproductive health matters through key implementation mechanisms (based on facilitators and gaps) within the health system. The overall data set was comprised of 31 semi-structured individual interviews (23 women and 8 men), 25 interviews with key informants responsible for the implementation of the Zika Virus Response Plan; six interviews with pregnant women diagnosed with Zika; and five focus groups discussions with communities (n=122 participants) in five cities in Colombia: Barranquilla, Cucuta, Los Patios, San Andres and Soledad. Results The findings revealed the three major facilitators that promoted the implementation of actions to address the Zika epidemic: i) the role of health care providers; ii) the development of technical equipment capabilities; and iii) inter-institutional coordination. The study also identified implementation gaps: i) absence of a human rights and sexual and reproductive health approach; ii) focus on territorial actions centered on mosquito management; and iii) limited attitudes, behaviors and knowledge at the community level.Conclusion This study provided a comprehensive insight of critical facilitating processes and gaps in the implementation of the government response during the Zika epidemic in Colombia. This study reveals that the lack of understanding of the intersection between gender, the Zika epidemic and Sexual and Reproductive Health limited the adoption, development and implementation of a more comprehensive responses to address the impact on women’s sexual and reproductive health.

scholarly journals Zika outbreak, resilient health systems, and women’s sexual and reproductive health: a qualitative study in Colombia

2019 ◽  
Author(s):  
Juan Carlos Rivillas-García ◽  
Luz Janeth Forero-Martinez ◽  
Mariana Calderon-Jaramillo ◽  
Victoria Vargas-Pinzón ◽  
Rocío Murad-Rivera ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health System ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Technical Equipment ◽  
Care Providers ◽  
Data Set ◽  
National Response ◽  
The Government ◽  
The Impact

Abstract Background There is substantial evidence of the profound consequences of Zika on women's Sexual and Reproductive Health. Health system resilience begins by measuring critical capacities ahead of a crisis such as zika outbreak. Even though zika as vector-borne disease is well documented, there is dearth of studies linking Zika with women's Sexual and Reproductive Health. The main objective of this study was to analyze the national response to the Zika epidemic and its relation to women’s sexual and reproductive health matters through key implementation mechanisms in order to promote resilience of the health system in five cities in Colombia.Methods This study used a qualitative design to enable an in-depth exploration of the national response to the Zika epidemic and sexual and reproductive health matters through key implementation mechanisms (based on facilitators and gaps) within the health system. The overall data set was comprised of 31 semi-structured individual interviews (23 women and 8 men), 25 interviews with key informants responsible for the implementation of the Zika Virus Response Plan; six interviews with pregnant women diagnosed with Zika; and five focus groups discussions with communities (n=122 participants) in five cities in Colombia: Barranquilla, Cucuta, Los Patios, San Andres and Soledad.Results The findings revealed the three major facilitators that promoted the implementation of actions to address the Zika epidemic: i) the role of health care providers; ii) the development of technical equipment capabilities; and iii) inter-institutional coordination. The study also identified implementation gaps: i) absence of a human rights and sexual and reproductive health approach; ii) focus on territorial actions centered on mosquito management; and iii) limited attitudes, behaviors and knowledge at the community level.Conclusion This study provided a comprehensive insight of critical facilitating processes and gaps in the implementation of the government response during the Zika epidemic in Colombia. This study reveals that the lack of understanding of the intersection between gender, the Zika epidemic and Sexual and Reproductive Health limited the adoption, development and implementation of a more comprehensive responses to address the impact on women’s sexual and reproductive health.

The Hidden Impact of COVID-19 on Sexual and Reproductive Health and Rights of Women in India

2021 ◽  
Vol 17 ◽  
Author(s):  
Vijayan Sharmila ◽  
Thirunavukkarasu Arun Babu
Keyword(s):  
Reproductive Health ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
World Health ◽  
Care Providers ◽  
Safe Abortion ◽  
Sexually Transmitted ◽  
Coronavirus Infection ◽  
Health Organization ◽  
The Impact

: Coronavirus (COVID-19) outbreak was first reported from China in December 2019, and World Health Organization declared the outbreak as a pandemic on 11 March 2020. The number of confirmed cases is rising alarmingly in most countries across all continents over the past few months. The current COVID-19 pandemic has an immense impact on Sexual and reproductive health and rights (SRHR) with disruptions in regular provision of Sexual and reproductive health (SRH) services such as maternal care, safe abortion services, contraception, prevention and treatment of HIV/AIDS and other sexually transmitted diseases. Other aspects that merit attention include probable increase in domestic violence, sexual abuse, and effects of stigma associated with coronavirus infection on SRH clients and health care providers. Furthermore, as the coronavirus infection is relatively new, only minimal data is available to understand the impact of this disease on SRH, including coronavirus infection complicating pregnancies, and in people with STI/HIV-related immunosuppression. There is a serious necessity for the medical fraternity to generate psycho-social and clinico-epidemiological correlations between coronavirus disease and SRHR outcomes. The article reviews the hidden impact of coronavirus pandemic on sexual and reproductive health and rights of women, particularly in India

scholarly journals Predictors of adolescents’ use of sexual and reproductive health services in Nigeria: a mixed-method approach

2020 ◽  
Author(s):  
Amelia Ngozi Odo ◽  
Justina Ifeoma OFUEBE ◽  
Anthony Ifeanyi ANIKE ◽  
Efiong S Samuel
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Health System ◽  
Health Care Providers ◽  
Mixed Method ◽  
Sexual And Reproductive Health ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Services Delivery ◽  
System Factors

Abstract Sexual and Reproductive health Services (SRHS) are essential for prevention and control of SRH problems among adolescents and the achievement of sustainable development goal 3. These services may be available but certain factors interfere with their access and utilization by the adolescents. This study sought to determine factors that predict adolescents’ utilization of SRHS in Enugu State, Nigeria.MethodsThe study adopted mixed method research employing cross-sectional research design. The population of the study comprised adolescents (12-22 years). Multi-stage sampling procedure was used to select 1,447 adolescents used for the study. Questionnaire, in-depth interview and focus group discussion were used for data collection. Percentages, Chi-square, and logistic regression were used to analyse quantitative data, while qualitative data were thematically analysed using NVivo software.ResultsSocio-demographic factors of gender, age, education, location and living status (p = < .05) were significant predictors of utilization of SRHS. Psycho-cultural and health system factors (p = < .05) were also significant predictors of utilization of SRHS.ConclusionThe study concluded that some socio-demographic, psycho-cultural and health system factors are predictors of adolescents’ access to and utilization of SRHS. These predictors could be addressed through home sex education, regular training of health care providers on youth-friendly services delivery and policy reforms

scholarly journals Mapping and assessing sexual and reproductive health policy changes over time in Colombia: measuring their impact on pregnancy terminations

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
José Ignacio Nazif-Munoz ◽  
Rose Chabot
Keyword(s):  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
Data Set ◽  
The Government ◽  
Changes Over Time ◽  
The Impact ◽  
Over Time

AbstractSexual and reproductive health and rights policies (SRHRPs) and their association with reproductive and non-reproductive behavior require precise theoretical and methodological frames. By studying the case of Colombia, we move forward with a comprehensive framework that considers simultaneously multiple SRHRP conceptualizations and their impacts over time on induced pregnancy terminations (IPT). With a mixed-method approach, we first map the evolution of SRHRPs and then analyze their direct and indirect effects on IPTs, using the provision of contraceptive methods by the government, female use of contraceptive methods, and conversations with health professionals in a mediation approach. We build a unique data set from more than 2100 policy documents, and then use data on 81,760 women (20–40 years) from four waves (2000–2015) of Colombia’s Demographic and Health Surveys. We find that SRHRPs are directly associated with an 18% reduction in reported IPTs. Associations between these variables are explained by the increased use of modern contraceptive methods (6%), and the government’s provision of those contraceptive methods (13%). Studies interested in the impact of SRHRPs need to consider not only the direct effects of legal changes on abortion outcomes but also show changes over time may operate through different sub-programs embedded in these policies, such as access to contraceptive methods and family planning. This will add further nuances to how SRHRPs are both multilayered and implemented.

scholarly journals Men’s perceptions of sexual and reproductive health education within the context of pregnancy and HIV in Zambia: a descriptive qualitative analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tulani Francis L. Matenga ◽  
Joseph Mumba Zulu ◽  
Sharon Nkwemu ◽  
Perfect Shankalala ◽  
Karen Hampanda
Keyword(s):  
Reproductive Health ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Decision Makers ◽  
Care Providers ◽  
Convenience Sample ◽  
Essential Information ◽  
Women Living With Hiv ◽  
The Family

Abstract Background Although health care providers are beginning to focus on men’s roles as fathers and husbands, there is limited understanding of how men view their ability to promote sexual and reproductive health in families affected by HIV and their experiences with receiving education through antenatal care. This paper aims to explore men’s perceptions of the education they need regarding sexual and reproductive health within the family in the context of HIV. Methods We interviewed a convenience sample of 18 male partners of pregnant women living with HIV in Lusaka, Zambia. Atlas.ti was used to facilitate data management and content analysis. Results Men reported being the primary decision-makers regarding sexual and reproductive issues in the family; however, they admitted far-reaching unmet needs in terms of information on sexual and reproductive health in the context of HIV. Most men felt that antenatal care was not a conducive setting to fully educate men on sexual and reproductive health because it is a woman’s space where their health concerns were generally neglected. There was a strong desire for more education that was specific to men’s sexual and reproductive health, especially because all the couples were affected by HIV. Men especially requested education on sexual preparedness, safe sex, the use of condoms in sero-concordant and sero-discordant relationships and general health information. Although men stated they were the main decision-makers regarding sexual and reproductive issues such as pregnancy, most men were not confident in their ability to promote sexual and reproductive health in the family because of limited knowledge in this area. Conclusion There is need to change the environment and messaging of antenatal care, as well as offer relevant education opportunities outside health facility settings to empower men with essential information for meaningful involvement in sexual and reproductive health in the context of HIV.

scholarly journals In everybody’s interest but no one’s assigned responsibility: midwives’ thoughts and experiences of preventive work for men’s sexual and reproductive health and rights within primary care

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Maria Grandahl ◽  
Maja Bodin ◽  
Jenny Stern
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Care Providers ◽  
Focus Group Interviews ◽  
Care Recipients ◽  
Preventive Work ◽  
Group Interviews

Abstract Background Sexual and reproductive health and rights (SRHR) have historically been regarded as a woman’s issue. It is likely that these gender norms also hinder health care providers from perceiving boys and men as health care recipients, especially within the area of SRHR. The aim of this study was to explore midwives’ thoughts and experiences regarding preventive work for men’s sexual and reproductive health and rights in the primary care setting. Methods An exploratory qualitative study. Five focus group interviews, including 4–5 participants in each group, were conducted with 22 midwives aged 31–64, who worked with reproductive, perinatal and sexual health within primary care. Data were analysed by latent content analysis. Results One overall theme emerged, in everybody’s interest, but no one’s assigned responsibility, and three sub-themes: (i) organisational aspects create obstacles, (ii) mixed views on the midwife’s role and responsibility, and (iii) beliefs about men and women: same, but different. Conclusions Midwives believed that preventive work for men’s sexual and reproductive health and rights was in everybody’s interest, but no one’s assigned responsibility. To improve men’s access to sexual and reproductive health care, actions are needed from the state, the health care system and health care providers.

scholarly journals Brief Intervention to prevent HIV, STI and unintended pregnancies: preliminary results of a feasibility study from the perspective of healthcare providers in Peru

2021 ◽  
Author(s):  
Jean Pierre Jiron ◽  
Clara Sandoval ◽  
Juan Carlos Enciso ◽  
Ana Sofía Vasconcelos ◽  
Karel Blondeel ◽  
...  
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Feasibility Study ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Health Problems ◽  
Northern Coast ◽  
Health Providers ◽  
Care Providers ◽  
Unintended Pregnancies

Abstract Background Brief interventions have proven to be valuable instruments for the treatment and care of clients with diverse health needs, due to their potential to impact both the individual and the population. In this regard, the Brief Sexuality-Related Communication (BSC) is presented as a viable and effective alternative for addressing sexual and reproductive health problems, assessing risk behaviors and motivating clients to generate behavioral change. Since health providers are key actors in treatment and prevention, it is essential to know their perceptions about the BSC intervention, as well as its acceptability in different contexts, with diverse client populations. Thus, the following paper reflects the findings of the perceptions and experiences of health providers in Peru from the first phase of the Feasibility study of a BSC intervention to prevent STIs and unintended pregnancies. Methods This is the first phase of a multisite and multiphase study of the feasibility of a BSC intervention. We conducted twenty in-depth interviews (IDI) with health care providers (physicians, obstetricians, psychologists, nurses and peer counselors) recruited from three health care institutions in Peru: The Tahuantinsuyo Bajo Maternal and Child Center (CMI) and the San José Maternal and Child Center, both located in the capital city, Lima; and La Caleta Hospital located in Chimbote, northern coast of Peru. Participating health providers included those working at the HIV/STI Reference service and the family planning/reproductive health service. The IDI addressed three domains: 1) Acceptability of the BSC intervention; 2) Perceived willingness to implement the BSC intervention; and 3) Considerations for the Implementation of the BSC intervention. Results Health providers expressed high acceptance of the BSC intervention, considering it as a useful and effective instrument to address sexual and reproductive health problems with all clients; however, some providers had some concerns about the real impact of the intervention to achieve significant behavior change. On the other hand, health providers showed high willingness to learn and implement the BSC intervention, affirming their commitment to learn new techniques and strategies that could allow them to improve their knowledge and the quality of their care. Health care providers consider it necessary to take into account the barriers that arise in the implementation of the BSC intervention, such as the structural limitations to access, the providers’ abilities to deliver the intervention effectively, and the participants’ reception of the intervention. Finally, providers consider it essential to establish the BSC intervention in a normative framework that allows it to receive the support of the health departments and eventually enforces implementation. Conclusions Health providers consider the BSC intervention as an interesting and exciting behavioral intervention to deal with the sexual and reproductive health issues existing in different populations, and seemed highly willing to adapt and implement it, hoping that it become beneficial to all client populations to prevent HIV/STIs and unintended pregnancies.

scholarly journals ANALISIS IMPLEMENTASI PROGRAM JAMINAN KESEHATAN NASIONAL BERDASARKAN ANGGOTA KEPESERTAAN BPJS (STUDI DI PUSKESMAS WIYUNG, KOTA SURABAYA TAHUN 2017)

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Satriya Wijaya
Keyword(s):  
Health Insurance ◽  
Health Center ◽  
Health Care Providers ◽  
Secondary Data ◽  
Care Providers ◽  
Cross Sectional ◽  
Stake Holder ◽  
The Government ◽  
Document Review ◽  
The Impact

Abstrak Pelaksanaan JKN di Indonesia menghadapi berbagai tantangan, dari sisi pemberi layanan kesehatan, pengelola jaminan kesehatan, masyarakat sebagai pengguna, serta pemerintah sebagai regulator program. Berbagai studi telah dilakukan untuk menelaah dampak JKN pada pelayanan kesehatan di Indonesia, namun pemanfaatan hasil studi tersebut untuk menyempurnakan kebijakan masih terbatas. Jenis penelitian ini adalah penelitian deskriptif eksploratif, yang menggunakan metode deskriptif kualitatif serta penelaahan dokumen. Desain penelitian adalah cross-sectional dengan pendekatan retrospektif. Sampel penelitian ini adalah seluruh stakeholder kunci yang berada di wilayah kerja Puskesmas Wiyung yang terkait erat dengan pelaksanaan JKN. Analisa dan pengumpulan data dilakukan untuk memvalidasi: informasi dari institusi responden, indepth interview dengan stake holder kebijakan dan pelaksana program, kemudian cek silang oleh enumerator lapangan ke beberapa responden untuk temuan yang memerlukan, dan refleksi tim dalam bentuk pertemuan validasi data. Informasi yang diperoleh dari hasil indepth interview stake holder kebijakan dan pelaksana program, informasi cek silang dari enumerator lapangan maupun data sekunder akan diintegrasikan dengan informasi kualitatif yang terkumpul. Hasil analisis menunjukkan tidak semua pengunjung Puskesmas Wiyung telah menjadi peserta BPJS. Sistem administrasi dianggap rumit untuk dipahami dengan mudah oleh masyarakat.  Perlu sosialisasi kepada masyarakat tentang kepesertaan BPJS dan penguatan koordinasi dengan pihak BPJS apabila ada masalah anggota kepesertaan pasien BPJS.   Kata kunci: implementasi JKN, program JKN, kepesertaan BPJS Abstract   Implementation of National Health Insurance (JKN) in Indonesia faces various challenges, from the side of health care providers, health insurance managers, the community as users, and the government as the program regulator. Various studies have been conducted to examine the impact of JKN on health services in Indonesia, but the use of the results of these studies to improve policies is still limited. This type of research is explorative descriptive research, which uses qualitative descriptive methods and document review. The study design was cross-sectional with a retrospective approach. The sample of this study is all key stakeholders in the Wiyung Health Center working area which are closely related to JKN implementation. Analysis and data collection were carried out to validate: information from the respondent's institution, in-depth interviews with policy stakeholders and program implementers, then cross-check by field enumerators to several respondents for findings that needed, and team reflection in the form of data validation meetings. Information obtained from the results of an in-depth interview of policy stakeholders and program implementers, cross check information from field enumerators and secondary data will be integrated with qualitative information collected. The results of the analysis showed that not all visitors to the Wiyung Health Center had become BPJS participants. The administrative system is considered complicated to be easily understood by the community. Need to disseminate information to the public about BPJS membership and strengthening coordination with BPJS if there are problems with membership of BPJS patients.  Keywords: implementation of JKN, JKN program, BPJS membership

scholarly journals Rationale and design of a complex intervention measuring the impact and processes of social accountability applied to contraceptive programming: CaPSAI Project

2020 ◽  
Vol 4 ◽  
pp. 26 ◽  
Author(s):  
Petrus S Steyn ◽  
Victoria Boydell ◽  
Joanna Paula Cordero ◽  
Heather McMullen ◽  
Ndema Habib ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Contextual Factors ◽  
Social Accountability ◽  
Control Group ◽  
Service Users ◽  
Care Providers ◽  
The Impact

Background: There are numerous barriers leading to a high unmet need for family planning and contraceptives (FP/C).  These include limited knowledge and information, poor access to quality services, structural inefficiencies in service provision and inadequately trained and supervised health professionals. Recently, social accountability programs have shown promising results in addressing barriers to accessing sexual and reproductive health services. As a highly complex participatory process with multiple and interrelated components, steps and actors, studying social accountability poses methodological challenges. The Community and Provider driven Social Accountability Intervention (CaPSAI) Project study protocol was developed to measure the impact of a social accountability process on contraceptive uptake and use and to understand the mechanisms and contextual factors that influence and generate these effects (with emphasis on health services actors and community members). Methods: CaPSAI Project is implementing a social accountability intervention where service users and providers assess the quality of local FP/C services and jointly identify ways to improve the delivery and quality of such services. In the project, a quasi-experimental study utilizing an interrupted time series design with a control group is conducted in eight intervention and eight control facilities in each study country, which are Ghana and Tanzania. A cross-sectional survey of service users and health care providers is used to measure social accountability outcomes, and a cohort of women who are new users of FP/C is followed up after the completion of the intervention to measure contraceptive use and continuation. The process evaluation utilizes a range of methods and data sources to enable a fuller description of how the findings were produced. Conclusion: This complex study design could provide researchers and implementers with the means to better measure and understand the mechanisms and contextual factors that influence social accountability processes in reproductive health, adding important findings to the evidence base.

scholarly journals Sexual Minority Women’s Sexual and Reproductive Health Literacy: A Qualitative Descriptive Study

2020 ◽  
Vol 47 (5) ◽  
pp. 728-739
Author(s):  
Margaret M. Paschen-Wolff ◽  
Madelyne Z. Greene ◽  
Tonda L. Hughes
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Sexual Minority ◽  
Sexual And Reproductive Health ◽  
Descriptive Study ◽  
Access To Information ◽  
Care Providers ◽  
Qualitative Descriptive

Although sexual minority women (SMW) are at risk for cervical cancer and sexually transmitted infections (STIs), they may not seek preventative sexual and reproductive health care at the same rates as their heterosexual peers. We conducted a qualitative descriptive study of 22 adult SMW, a subsample of participants enrolled in the Chicago Health and Life Experiences of Women study. The aim was to describe the sexual and reproductive health literacy of this community sample based on qualitative themes, using an integrated model of health literacy. This model considers not only access to information but also understanding, appraisal, and application of information. We found that family of origin, health care providers, and school-based sexual education were the most important sources of sexual and reproductive health information. Participants described their understanding, appraisal, and application of sexual and reproductive health information as interdependent concepts. Pap test literacy and decision making were strongly independent, with SMW seeking various sources of information, or were driven by health care providers, with SMW following instructions and trusting provider advice. STI-related literacy hinged on whether the participant perceived SMW as at risk for STIs. Our findings reinforce that simply having access to information is insufficient to enact health behaviors that reflect full literacy. Findings have implications for health care providers, who should provide evidence-based recommendations for their SMW clients, and for public health practitioners and educators, who could make sexual health education more inclusive of and specific to the needs of SMW.

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