DESENVOLVIMENTO DAS POLÍTICAS E DOS CUIDADOS DE SAÚDE SEXUAL E REPRODUTIVA EM PORTUGAL

Resumo O entendimento sobre o conceito de saúde sexual e reprodutiva (SSR) é relativamente recente e tem conhecido transformações substanciais ao longo do tempo, resultado de um conjunto de fatores socioculturais, políticos e médico-científicos, que permitiram reconhecer que os indivíduos têm o direito a desfrutar da sexualidade de uma forma livre e esclarecida. As mudanças no contexto histórico, social e cultural que atravessaram todo o século XIX e XX influenciaram claramente a SSR em Portugal. Mudanças que foram mais significativas na segunda metade do século XX, observando-se nas décadas de 1960 e 1970 a promoção da contraceção e planeamento familiar, a legislação sobre sexualidade juvenil e o acesso dos jovens às consultas de planeamento familiar. Na década de 1980 e seguintes, a generalização do acesso à contraceção e os debates sobre a sexualidade juvenil e políticas de educação sexual. Nestas décadas, surgem novas preocupações relacionadas com pandemia do VIH/SIDA, que obrigam a equacionar os comportamentos sexuais como fator de risco para a saúde. Entre 2000 e 2010, assiste-se à integração da educação sexual em todos os níveis de ensino, com exceção do pré-escolar, numa aceção verdadeiramente democrática da educação sexual. Mais recentemente, realidades emergentes como a democratização do uso da internet e das redes sociais, levantam novos desafios e novos riscos para a saúde que não devem ser negligenciados. Com este artigo pretendemos descrever e analisar o desenvolvimento político-social e dos cuidados na SSR em Portugal, como garantia do direito à informação e a serviços de saúde de qualidade, acessíveis a todos os cidadãos. Palavras-chave: Cuidados de saúde; Políticas; Saúde Sexual e Reprodutiva. Abstract The understanding of the concept of sexual and reproductive health (SRH) is relatively recent and has undergone substantial transformations over time, as a result of a set of sociocultural, political and medical-scientific factors that have allowed the recognition that individuals have the right to enjoy of sexuality in a free and enlightened way. Changes in historical, social and cultural context that crossed all the nineteenth and twentieth century clearly influenced the SRH in Portugal. Changes that were most significant in the second half of the twentieth century saw the promotion of contraception and family planning and legislation on youth sexuality in the 1960s and 1970s. In the 1980s and beyond, the generalization of access to contraception and debates on youth sexuality and sexual education policies In recent decades, new concerns about the HIV/AIDS pandemic have arisen, and there is a need to address risky sexual behavior. Between 2000 and 2010, the integration of sex education at all levels of education, with the exception of preschool, in a truly democratic sense of sex education is observed. More recently, emerging realities such as the democratization of the use of the Internet and media, pose new challenges and new risks to health that should not be neglected. With this article we intend to describe and analyze the socio-political development and care in the SRH in Portugal, as a guarantee of the right to information and quality health services, accessible to all citizens. Keywords: Care Health; Policies; Sexual and Reproductive Health.

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Using Social Ecological Theory to Identify Factors Associated With Risky Sexual Behavior in Cambodian Adolescent Girls and Young Women Aged 10 to 24 Years: A Systematic Review

Asia Pacific Journal of Public Health ◽

10.1177/1010539520911493 ◽

2020 ◽

Vol 32 (2-3) ◽

pp. 71-80 ◽

Cited By ~ 2

Author(s):

Farwa Rizvi ◽

Joanne Williams ◽

Humaira Maheen ◽

Elizabeth Hoban

Keyword(s):

Sexual Behavior ◽

Reproductive Health ◽

Sex Education ◽

Risky Sexual Behavior ◽

Sexual And Reproductive Health ◽

Sexual Debut ◽

Modern Contraceptive ◽

Unintended Pregnancies ◽

Social Ecological ◽

Increased Risk

There is an increase in risky sexual behavior (RSB) in Cambodian female youth aged 10 to 24 years, which can contribute to detrimental sexual and reproductive health due to the increased risk of acquiring sexually transmitted infections, unintended pregnancies, or abortions. Bronfenbrenner’s social ecological model was used to identify factors at personal, microenvironment, and macroenvironment levels potentially associated with RSB. A systematic literature review employing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was conducted to search 8 databases for articles published between 1994 and 2019. A risk of bias tool was applied for methodological quality of the 4 included studies. RSB is associated with multiple factors including sexual debut at young age, alcohol and substance abuse, multiple partners, living away from parents or orphan status, peer delinquency, non-use of condoms by partners, transactional sex, low education and socioeconomic status, and no access to sexual and reproductive health services. Multipronged preventive strategies operating at different levels are recommended in terms of including sex education and increasing reproductive health literacy programs at the schools and community programs for safe sex, condom use and sexual negotiation skills, and access to modern contraceptive methods.

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Adolescents’ Communication on Sexual and Reproductive Health Matters with Their Parents and Associated Factors among Secondary and Preparatory School Students in Ambo Town, Oromia, Ethiopia

International Journal of Reproductive Medicine ◽

10.1155/2021/6697837 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Tesfaye Shibiru Bikila ◽

Nagasa Dida ◽

Gizachew Abdissa Bulto ◽

Bikila Tefera Debelo ◽

Kababa Temesgen

Keyword(s):

Reproductive Health ◽

Sex Education ◽

Risky Sexual Behavior ◽

Private School ◽

Associated Factors ◽

Sexual And Reproductive Health ◽

Systematic Sampling ◽

School Students ◽

Cross Sectional ◽

Preparatory School

Background. Sexual and reproductive health (SRH) communication is most likely to promote healthy sexual practices and to reduce risky sexual behavior among adolescents. Communication is the principal means for parents to transmit sexual values and knowledge to their children. Although there are few studies conducted on parent-adolescent communication, there is no study conducted in the town of Ambo. This study was aimed at assessing the level of parent-adolescent communication on SRH issues and its associated factors among school students in Ambo town, Oromia, Ethiopia. Method. An institution-based concurrent mixed-method cross-sectional study was conducted among 591 secondary and preparatory school students in Ambo town from February 24th to March 9th, 2019. A systematic sampling technique was used to select the study subject. Data were collected through self-administered questionnaires, and FGD was conducted with parents of students. Data was entered using EpiData version 3.1 and exported to SPSS version 23.0 for statistical analysis. Binary and multivariable logistic regression analyses were used to ascertain the association using a 95% confidence interval (CI) and p value (<0.05). Results. The proportion of students who had communication on sexual and reproductive health issues with their parents was 222 (37.6%). Being female ( AOR = 2.07 , 95% CI: 1.40-3.07), private school ( AOR = 2.77 , 95% CI: 1.17-3.69), a father with secondary education ( AOR = 2.93 , 95% CI: 1.05-8.12) and diploma and above ( AOR = 3.27 , 95% CI: 1.23-8.71), considering sex education necessary ( AOR = 2.83 , 95% CI: 1.22-6.57), got information about SRH issues from school ( AOR = 2.01 , 95% CI: 1.06-2.36) and media ( AOR = 2.92 , 95% CI: 1.49-3.71), and mother’s openness to communicate about SRH issues ( AOR = 3.30 , 95% CI: 1.31-4.05) were found to be significantly associated with parent-adolescent communication on SRH issues. Conclusions. The study showed that parent-adolescent communication on SRH issues is low. Being female, those from a private school, father’s education, perceived importance of sex education, source of information about SRH issues (school and media), and mother’s openness to communicate about SRH issues were identified to be factors associated with the communication. Therefore, the concerned body should consider the identified factors to improve the current level of parent-adolescent communication and adolescent reproductive health.

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Sexual behavior among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012)

Revista Brasileira de Epidemiologia ◽

10.1590/1809-4503201400050010 ◽

2014 ◽

Vol 17 (suppl 1) ◽

pp. 116-130 ◽

Cited By ~ 15

Author(s):

Maryane Oliveira-Campos ◽

Marília Lavocart Nunes ◽

Fátima de Carvalho Madeira ◽

Maria Goreth Santos ◽

Silvia Reise Bregmann ◽

...

Keyword(s):

Substance Use ◽

Sexual Behavior ◽

Reproductive Health ◽

Sexual Intercourse ◽

Risky Sexual Behavior ◽

Sexual And Reproductive Health ◽

Social Inequalities ◽

Unprotected Sex ◽

Psychoactive Substances ◽

School Based

OBJECTIVE: This study describes the sexual behavior among students who participated in the National Adolescent School-based Health Survey (PeNSE) 2012 and investigates whether social inequalities, the use of psychoactive substances and the dissemination of information on sexual and reproductive health in school are associated with differences in behavior. METHODOLOGY: The response variable was the sexual behavior described in three categories (never had sexual intercourse, had protected sexual intercourse, had unprotected sexual intercourse). The explanatory variables were grouped into socio- demographic characteristics, substance use and information on sexual and reproductive health in school. Variables associated with the conduct and unprotected sex were identified through multinomial logistic regression, using "never had sexual intercourse" as a reference. RESULTS: Over nearly a quarter of the adolescents have had sexual intercourse in life, being more frequent among boys. About 25% did not use a condom in the last intercourse. Low maternal education and work increased the chance of risky sexual behavior. Any chance of protected and unprotected sex increased with the number of psychoactive substances used. Among those who don't receive guidance on the prevention of pregnancy in school, the chance to have sexual intercourse increased, with the largest magnitude for unprotected sex (OR = 1.41 and OR = 1.87 ). CONCLUSION: The information on preventing pregnancy and STD/AIDS need to be disseminated before the 9th grade. Social inequalities negatively affect risky sexual behavior. Substance use is strongly associated with unprotected sex. Information on the prevention of pregnancy and STD/AIDS need to be disseminated early.

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Community Pharmacists’ Perceptions, Barriers, and Willingness for Offering Sexual and Reproductive Health Services

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182010735 ◽

2021 ◽

Vol 18 (20) ◽

pp. 10735

Author(s):

Ali Mofleh Alshahrani ◽

Mona Y. Alsheikh

Keyword(s):

Reproductive Health ◽

Sex Education ◽

Professional Education ◽

Sexual And Reproductive Health ◽

Community Pharmacists ◽

Reproductive Health Services ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Positive Attitudes ◽

Patient Health

The role of community pharmacists is crucial for promoting health and providing consultation related to sexual and reproductive health. This study measured the perception of community pharmacists in the Kingdom of Saudi Arabia (KSA) towards the provision of counselling services on sex education and reproductive health, including barriers to and proficiency in the delivery of services. A cross-sectional survey was developed and distributed electronically to pharmacists, and responses were analyzed using SPSS version 26. Graphical representations for various opinions on perception, proficiency and barriers were created. More than 80% of pharmacists placed a high value on counselling patients on sex and reproductive health, about 90% counselled their patients very often (74.6%) or often (22.2%), and 3.2% of pharmacists did not counsel patients. Most respondents believed counselling was very important (65.3%) or important (15.1%), with only 19.6% of respondents indicating it was not important. Barriers to offering services included fear from responsibility and liability (M = 4.8), lack of information about patient health (M = 4.7), gender differences (M = 4.7), and lack of social acceptability (M = 4.6). Community pharmacists in KSA possessed positive attitudes, professional education, and willingness to provide counselling to patients on sex education and reproductive health. Apart from the existing barriers that require augmented community pharmacists’ soft skills, clear policies and authorization for offering this type of service are also needed.

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Perceptions of students regarding the delivery of Sexual and Reproductive Health Education in schools in Fiji

10.21203/rs.3.rs-42255/v1 ◽

2020 ◽

Author(s):

Sharan Ram ◽

Masoud Mohaammadnezhad

Keyword(s):

Reproductive Health ◽

Sex Education ◽

Sexual Behaviors ◽

Sexuality Education ◽

Sexual And Reproductive Health ◽

Information Need ◽

Group Discussions ◽

Perceptions Of Students ◽

Age Appropriate ◽

Age Range

Abstract Background: Adolescent Sexual and Reproductive Health (SRH) remains a challenge globally. High school youths without Comprehensive Sexuality Education (CSE), are more likely to engage in high risk sexual behaviors than their peers in schools with CSE. Fiji continues to have very poor adolescents SRH indicators. This study aimed to gauge the perceptions of students towards the delivery of SRH education in schools in Fiji. Methods: A qualitative study design was used to collect data from students in Year 11-13 in public secondary schools in Suva, Fiji in 2018. Schools with equal ethnic mix were selected. A semi-structured open–ended questionnaire was used to guide Focus Group Discussions (FGDs). A male research facilitator conducted FGD with males while a female research facilitator facilitated that amongst the females. Data collected was analyzed thematically. Results: Seven FGDs were conducted. A total of 46 students (29 males) participated with the age range from 17-19 years old. Eight themes emerged: current SRH education; students’ knowledge on adverse consequences of SRH; sources of SRH information; need for sex education; provision of SRH education in schools; characteristics of teachers of SRH education; age-appropriate incremental sex education; and ideal version of SRH. Conclusions: The study shows that Fijian students desired a lot more from sex education than what is currently offered for sexual decision-making. There is a need for mandatory and comprehensive sex education for young people.

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Factors Influencing Modern Contraceptive Use among Adolescents in Nepal

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v16i3.1258 ◽

2018 ◽

Vol 16 (3) ◽

pp. 251-256

Author(s):

Ranjeeta Subedi ◽

Israt Jahan ◽

Pam Baatsen

Keyword(s):

Reproductive Health ◽

Sex Education ◽

Sexual And Reproductive Health ◽

Contraceptive Use ◽

Health Workers ◽

Influential Factors ◽

Modern Contraceptive ◽

Factors Influencing ◽

Modern Contraceptive Use ◽

Health Rights

In Nepal, contraceptive use among married adolescents is low and has remained nearly stagnant since 2006, while little information is available about contraceptive use among unmarried adolescents. Nepal is committed to improve sexual and reproductive health rights among all the adolescents. Promoting modern contraceptive use especially among married adolescents is one of the key approaches in practice, to prevent HIV or sexual transmitted infections, avoid unintended pregnancy and sub-sequent unsafe abortion. In spite of these efforts, modern contraceptive use among married adolescents is not increasing. In this study, we aimed to review the prevalence and trends as well as factors influencing modern contraceptive use among both married and unmarried adolescents in Nepal. A review of existing published and unpublished articles, documents, and reports were conducted. An adapted and modified socio-ecological model was used to explore the factors influencing contraceptive use.Contraceptive use is persistently low among adolescents. Various interrelated factors like socio-cultural norms and traditions, lack of comprehensive knowledge on contraceptive methods among adolescents, inadequate adolescent friendly Services and health workers not having the competencies to work with adolescents, are the major influential factors that limit adolescents to seek and use contraceptive services and information.A multilevel approach is required to address the interrelated factors and to create an enabling environment in which adolescent are fully informed and equipped to make use of contraceptives and related services. For this to happen, Government and NGOs working on sexual and reproductive health rights have to work towards translating the existing policies into practice. Involving adolescents, their families and communities; equipping teachers to provide comprehensive sex education within school and sex education programme for out of school and enhancing the competencies of health workers to provide adolescent friendly services – all in line with the written policy - is urgently needed. Keywords: Adolescent; barriers; contraceptive; Nepal; SRHR.

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Sexual and reproductive health education and its association with ever use of contraception: a cross-sectional study among women in urban slums, Accra

Reproductive Health ◽

10.1186/s12978-021-01322-5 ◽

2022 ◽

Vol 19 (1) ◽

Author(s):

Abdul-Aziz Seidu ◽

Edward Kwabena Ameyaw ◽

Bright Opoku Ahinkorah ◽

Leonard Baatiema ◽

Samuel Dery ◽

...

Keyword(s):

Health Education ◽

Reproductive Health ◽

Sex Education ◽

Sexual And Reproductive Health ◽

Urban Slums ◽

P Value ◽

Odds Ratios ◽

Cross Sectional ◽

Contraception Use ◽

Reproductive Health Education

Abstract Background Sexual and reproductive health education among girls and women has several reproductive health benefits, including improved contraceptive knowledge, contraception use at first intercourse, increased chance of contraceptive use in a lifetime, and effective usage of contraceptives. It is however not clear whether women/girls in urban slums who have had sexual and reproductive health education would likely utilize contraception. This study sets out to test the hypothesis that Accra slum women who have had sex education have higher chances of ever using contraception. Methods A cross-sectional survey was conducted among reproductive aged women in two slums (i.e. Agbogbloshie and Old Fadama) in Accra, Ghana. A sample size of 691, made up of respondents who provided responses to the question on ever used contraception, sex education as well as those with complete information on all the other variables of interest was considered in this study. Binary logistic regression models were fitted to examine association between sexual and reproductive health education and ever use of contraception. Crude odds ratios (cOR) and adjusted odds ratios (aOR) at p-value less than 0.05 were used to assess the strength of the association between the outcome and independent variables. Results More than half (56.73%) of the women have never received sexual and reproductive health education. Most of the respondents (77.28%) had ever used contraceptives. Women who had no form of sexual and reproductive health education had lower odds of ever using contraception (OR = 0.641, 95% CI 0.443, 0.928) and this persisted after controlling for the effect of demographic factors (AOR = 0.652, 95% CI 0.436, 0.975] compared to those who have ever received any form of sex education. Non-married women as well as women who were exposed to media (newspapers/radio/television) were also more likely to use contraceptives in slums in Accra, Ghana. Conclusion The study revealed a relatively low prevalence of sex education among women in urban slums in Accra. However, sex education was found to increase the odds of ever use of contraception. These findings call for intensified sexual and reproductive health education among reproductive aged girls and women in urban slums in Accra using existing informal social networks and local media platforms.

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Sexual and reproductive health knowledge among young people: a bibliometric analysis (1900 – 2019)

10.21203/rs.3.rs-20762/v1 ◽

2020 ◽

Author(s):

waleed sweileh ◽

Ahmad Mansour

Keyword(s):

Young People ◽

Reproductive Health ◽

San Francisco ◽

Sex Education ◽

Sexual And Reproductive Health ◽

Health Knowledge ◽

Hpv Vaccination ◽

Well Being ◽

Research Activity ◽

Country Level

Abstract Background: Adolescents and youth (young people) are central to the success of the 2030 agenda. Sexual and reproductive health (SRH) knowledge among young people is critical for their well-being. The objective study was to assess and analyze publications on SHR knowledge among young people. Method: This study was a bibliometric descriptive one for publications retrieved from Scopus on SHR knowledge among young people. All relevant terms on young people, SHR, and knowledge were implemented to retrieve relevant publications for the study period from 1900 to 2019. Results: The search found 2544 publications. Publication started on 1951. The number of publications showed two steep phases: one in mid-1980s and one after 2005. Four research themes were identified: human immunodeficiency virus (HIV); human papillomavirus (HPV), condom, and contraception with documents on HPV vaccinations being the most recent. The retrieved publications received an average of 10.9 citations per document and an h -index of 61. The top cited documents published before 2010 focused mainly on HIV, HPV, and condom use while those after 2010 focused on HIV testing technology, HIV prophylaxis and HPV vaccination. The retrieved documents originated mainly from the region of the Americas (n=944). When data were normalized, the South-Eastern Asian region had the highest research activity. At the country level, the USA ranked first (n=701; 27.6%) but when data was normalized, India (91.5 publication per GDP per capita) ranked first followed by Nigeria (53.0) and South Africa (17.9). Journal of Adolescent Health (n=39; 1.5%) ranked first but documents published in AIDS Education and Prevention journal received the highest number of citations per document (34.1). The University of California, San Francisco ranked first (n=33; 1.3%) in this field. The average number of authors per publication was 3.8. Research networking in this field was poor. Conclusion: This was the first analysis of publications on SRH knowledge among a category of people who are most often neglected in their SRH needs. Research on knowledge and awareness on this subject need to be carried out in all world regions to tailor sex education and health policies to the sociocultural and religious situation in each country.

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Factors Influencing Modern Contraceptive Use among Adolescents in Nepal

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v16i3.21419 ◽

2018 ◽

Vol 16 (3) ◽

pp. 251-256 ◽

Cited By ~ 1

Author(s):

Ranjeeta Subedi ◽

Israt Jahan ◽

Pam Baatsen

Keyword(s):

Reproductive Health ◽

Sex Education ◽

Sexual And Reproductive Health ◽

Contraceptive Use ◽

Health Workers ◽

Influential Factors ◽

Modern Contraceptive ◽

Factors Influencing ◽

Modern Contraceptive Use ◽

Health Rights

In Nepal, contraceptive use among married adolescents is low and has remained nearly stagnant since 2006, while little information is available about contraceptive use among unmarried adolescents. Nepal is committed to improve sexual and reproductive health rights among all the adolescents. Promoting modern contraceptive use especially among married adolescents is one of the key approaches in practice, to prevent HIV or sexual transmitted infections, avoid unintended pregnancy and sub-sequent unsafe abortion. In spite of these efforts, modern contraceptive use among married adolescents is not increasing. In this study, we aimed to review the prevalence and trends as well as factors influencing modern contraceptive use among both married and unmarried adolescents in Nepal. A review of existing published and unpublished articles, documents, and reports were conducted. An adapted and modified socio-ecological model was used to explore the factors influencing contraceptive use. Contraceptive use is persistently low among adolescents. Various interrelated factors like socio-cultural norms and traditions, lack of comprehensive knowledge on contraceptive methods among adolescents, inadequate adolescent friendly Services and health workers not having the competencies to work with adolescents, are the major influential factors that limit adolescents to seek and use contraceptive services and information. A multilevel approach is required to address the interrelated factors and to create an enabling environment in which adolescent are fully informed and equipped to make use of contraceptives and related services. For this to happen, Government and NGOs working on sexual and reproductive health rights have to work towards translating the existing policies into practice. Involving adolescents, their families and communities; equipping teachers to provide comprehensive sex education within school and sex education programme for out of school and enhancing the competencies of health workers to provide adolescent friendly services – all in line with the written policy - is urgently needed.

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Sexual and reproductive health in schools in Fiji: a qualitative study of teachers' perceptions

Health Education ◽

10.1108/he-02-2019-0005 ◽

2020 ◽

Vol 120 (1) ◽

pp. 57-71

Author(s):

Sharan Ram ◽

Masoud Mohammadenzhad

Keyword(s):

Health Education ◽

Reproductive Health ◽

Qualitative Study ◽

Sex Education ◽

Sexual And Reproductive Health ◽

Structure Questionnaire ◽

Content Type ◽

Teachers Perceptions ◽

Education Delivery ◽

Context Specific

PurposeTeachers are a key to success for school-based sex health education programmes; however, they may not be able to consistently implement it due to a myriad of reasons. This study aimed to explore the perceptions of teachers regarding the delivery of sexual and reproductive health (SRH) education in secondary schools in Fiji.Design/methodology/approachA qualitative study design was used to collect the data from SRH education teachers in Suva, Fiji between July and August 2018. This study included teachers who taught sex education for at least two years. Five focus group discussions (FGDs) were run using a semi-structure questionnaire among groups stratified by gender. Data collected were transcribed verbatim and thematically analyzed.FindingsThe study findings reveal that implementation of SRH education is vague, not mandatory and not comprehensive. Teachers acknowledged that SRH was not adequately covered in homes and underscored its importance for young people. Teachers viewed schools as ideal place for delivering sex education, however, could not consistently implement due to a lack of adequate information and skills, feared negative parental reaction, felt uncomfortable delivering sensitive topics and in most cases felt apprehensive to discuss sexuality issues in light of lack of training and resources.Originality/valueTo improve SRH education delivery, there need to be a focus on strengthening capacity building of teachers through pre-service and in-service health education, improved monitoring, evaluation and context–specific resource development and allocation.

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