scholarly journals Interventions and Strategies to Improve Sexual and Reproductive Health Outcomes among Adolescents Living in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Adolescents ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 363-390
Author(s):  
Salima Meherali ◽  
Mehnaz Rehmani ◽  
Sonam Ali ◽  
Zohra S. Lassi
Keyword(s):  
Systematic Review ◽  
Reproductive Health ◽  
Financial Incentives ◽  
Sexual And Reproductive Health ◽  
Meta Analysis ◽  
Educational Interventions ◽  
Sexual Practices ◽  
Middle Income ◽  
Middle Income Countries ◽  
Post Abortion

Adolescent access to quality sexual and reproductive health and rights has been a major issue in most low- to middle-income countries (LMICs). This systematic review aims to identify the relevant community and school-based interventions that can be implemented in LMICs to promote adolescents’ sexual and reproductive health and rights. We identified 54 studies, and our review findings suggested that educational interventions, financial incentives, and comprehensive post-abortion family planning services were effective in increasing their knowledge and use of Adolescent Sexual and Reproductive Health and Rights (ASRHR) services, such as contraception, which led to a decrease in unwanted pregnancies. However, we found inconclusive and limited evidence on the effectiveness of interventions for improved violence prevention and adolescent behavior towards safe sexual practices. More rigorous studies with long-term follow-ups are needed to assess the effectiveness of such interventions.

scholarly journals Interventions and Strategies to Improve Sexual and Reproductive Health Outcomes among Adolescents Living in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Salima Meherali ◽  
Mehnaz Rehmani ◽  
Sonam Ali ◽  
Zohra S Lassi
Keyword(s):  
Systematic Review ◽  
Reproductive Health ◽  
Financial Incentives ◽  
Sexual And Reproductive Health ◽  
Meta Analysis ◽  
Unwanted Pregnancy ◽  
Educational Interventions ◽  
Sexual Practices ◽  
Middle Income ◽  
Middle Income Countries

Adolescent’s access to quality Sexual and Reproductive Health and Rights interventions has been a major issue in most of the low- to middle-income countries (LMICs) across the globe. This systematic review aims to identify the relevant community and school-based interventions that can be implemented in -LMICs to promote adolescent’s sexual and reproductive health and rights outcomes. We identified 54 studies and our review findings suggest that Adolescent’s Sexual and Reproductive Health and Rights (ASRHR) educational interventions, provision of financial incentives, and provision of comprehensive -post-abortion family planning services are effective in increasing adolescent’s knowledge on ASRHR, attitude towards ASRHR, uptake of ASRHR services, contraception and decreased unwanted pregnancy rates among young women. However, we found inconclusive and limited evidence on the effectiveness of the interventions to improve violence prevention and adolescent behaviors towards safe sexual practices. More rigorous studies with long-term follow-ups are needed to assess the effectiveness of such interventions.

scholarly journals Effective educational interventions for the promotion of sexual and reproductive health and rights for school-age children in low- and middle-income countries: a systematic review protocol

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Arone Wondwossen Fantaye ◽  
Amos Wung Buh ◽  
Dina Idriss-Wheeler ◽  
Karine Fournier ◽  
Sanni Yaya
Keyword(s):  
Systematic Review ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Educational Interventions ◽  
School Age Children ◽  
School Age ◽  
Middle Income ◽  
Middle Income Countries ◽  
School Aged Children ◽  
Low And Middle Income

Abstract Background Biological changes underlying the sexual and reproductive maturation of school-age children are linked with various sexual and reproductive health and rights risks. SRHR risks are predictors of poor SRHR outcomes, such as poor knowledge of sexually transmitted diseases and early sexual initiation occurring predominantly among school-age children. The aim of this proposed review, therefore, is to identify educational interventions that have proven to be effective in promoting or supporting the sexual and reproductive health and rights of school-aged children in low- and middle-income countries. Methods A systematic review of studies on the strategies promoting the SRHR of school-aged children shall be conducted. Electronic searches will be conducted from January 2000 onwards on the following databases: MEDLINE(R) ALL (Ovid), Embase (Ovid), CINAHL (EBSCOHost), APA PsycInfo (Ovid), ERIC (Ovid), Cochrane Central Register of Controlled Trials (Ovid), Education Source (EBSCOHost), Web of Science (Clarivate Analytics), SciELO Citation Index (Clarivate Analytics), Global Health (Ovid), and Sociological Abstract (Proquest). Studies eligible for inclusion will be randomized control trials (RCTs), non-randomized trials, quasi-experimental studies (e.g., pre-post tests), and observational studies (cross-sectional and cohort studies). Peer-reviewed studies published in English and/or French and involving school-aged children 5–10 years old will be included. The primary outcomes of interest will include knowledge, awareness, or attitudes about SRHR topics. The secondary outcomes of interest will include sexual and reproductive behaviors. Two reviewers will independently screen all citations, abstract data, and full-text articles, and the methodological quality of each study will be appraised using JBI critical appraisal tools. A narrative synthesis of extracted data will be conducted. Discussion The systematic review will synthesize the evidence on existing educational interventions targeting SRHR outcomes of school-aged children in low- and middle-income countries. It will identify which interventions have proven to be effective, and which interventions have not proven to be effective in promoting or supporting their SRHR. Review findings will provide a useful reference for policy-makers, program developers, global health leaders, and decision makers who wish to support the SRHR of school-age children. Systematic review registration The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO CRD42020173158).

scholarly journals Incidence of unintended pregnancy among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021779 ◽  
Author(s):  
Frances H Ampt ◽  
Lisa Willenberg ◽  
Paul A Agius ◽  
Matthew Chersich ◽  
Stanley Luchters ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Unintended Pregnancy ◽  
Low Income ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Sexual And Reproductive Health ◽  
Meta Analysis ◽  
Pregnancy Intention ◽  
Middle Income ◽  
Middle Income Countries

ObjectivesTo determine the incidence of unintended pregnancy among female sex workers (FSWs) in low-income and middle-income countries (LMICs).DesignWe searched MEDLINE, PsychInfo, Embase and Popline for papers published in English between January 2000 and January 2016, and Web of Science and Proquest for conference abstracts. Meta-analysis was performed on the primary outcomes using random effects models, with subgroup analysis used to explore heterogeneity.ParticipantsEligible studies targeted FSWs aged 15–49 years living or working in an LMIC.Outcome measuresStudies were eligible if they provided data on one of two primary outcomes: incidence of unintended pregnancy and incidence of pregnancy where intention is undefined. Secondary outcomes were also extracted when they were reported in included studies: incidence of induced abortion; incidence of birth; and correlates/predictors of pregnancy or unintended pregnancy.ResultsTwenty-five eligible studies were identified from 3866 articles. Methodological quality was low overall. Unintended pregnancy incidence showed high heterogeneity (I²>95%), ranging from 7.2 to 59.6 per 100 person-years across 10 studies. Study design and duration were found to account for heterogeneity. On subgroup analysis, the three cohort studies in which no intervention was introduced had a pooled incidence of 27.1 per 100 person-years (95% CI 24.4 to 29.8; I2=0%). Incidence of pregnancy (intention undefined) was also highly heterogeneous, ranging from 2.0 to 23.4 per 100 person-years (15 studies).ConclusionsOf the many studies examining FSWs’ sexual and reproductive health in LMICs, very few measured pregnancy and fewer assessed pregnancy intention. Incidence varied widely, likely due to differences in study design, duration and baseline population risk, but was high in most studies, representing a considerable concern for this key population. Evidence-based approaches that place greater importance on unintended pregnancy prevention need to be incorporated into existing sexual and reproductive health programmes for FSWs.PROSPERO registration numberCRD42016029185

scholarly journals From words to actions: systematic review of interventions to promote sexual and reproductive health of persons with disabilities in low- and middle-income countries

2020 ◽  
Vol 5 (10) ◽  
pp. e002903
Author(s):  
Shaffa Hameed ◽  
Alexander Maddams ◽  
Hattie Lowe ◽  
Lowri Davies ◽  
Rajat Khosla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Reproductive Health ◽  
Observational Studies ◽  
Sexual And Reproductive Health ◽  
Risk Of Bias ◽  
Safe Abortion ◽  
Middle Income ◽  
Persons With Disabilities ◽  
Middle Income Countries ◽  
Low And Middle Income

IntroductionPersons with disabilities have the same sexual and reproductive health and rights (SRHR) as non-disabled persons. Yet they face numerous barriers in their access to sexual and reproductive health services and their rights are often not met. Evidence on SRHR for persons with disabilities is sparse, particularly evaluations of interventions demonstrating ‘what works.’ This systematic review assessed interventions to promote SRHR for persons with disabilities in low- and middle-income countries.MethodsWe searched for qualitative, quantitative or mixed method observational studies representing primary research, published between 2010 and 2019, using MEDLINE, Embase, PubMed, Global Health and CINAHL Plus. Search strings were compiled for different elements of SRHR and for all forms of disability. 24,919 records were screened, leading to over 380 relevant papers, most of which were descriptive, focussing on needs and barriers to SRHR needs being fulfilled. Of the 33 full-text articles assessed for eligibility, 18 were included in the synthesis. All included studies were assessed for bias and quality of evidence, using STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) and RATS (relevance, appropriateness, transparency andsoundness) tools. Among the 16 interventions (from 18 articles), 25% had low risk of bias, 31% had moderate risk of bias and 44% had high risk of bias. Data analysis used narrative synthesis; a method suited for systematic reviews with heterogeneous studies. We used Levesque healthcare access model to analyse the focus of interventions.Results11 interventions were from upper middle-income settings; two from lower-income settings; only one operated in rural areas. Interventions addressed intellectual impairment (6), visual impairment (6), hearing impairment (4), mental health conditions (2) and physical impairments (2). Most interventions (15/16) focus on information provision and awareness raising. We could not identify any intervention promoting access to maternal health, family planning and contraception, or safe abortion for people with disabilities.ConclusionThis systematic review has highlighted stark gaps in evidence. More rigorous evaluations are needed.

Using mobile phones to improve young people sexual and reproductive health in low and middle income countries: A systematic review

2020 ◽  
Author(s):  
Anam Feroz ◽  
Naureen Akber Ali ◽  
Adeel Khoja ◽  
Armish Hussain ◽  
Sarah Saleem
Keyword(s):  
Systematic Review ◽  
Young People ◽  
Reproductive Health ◽  
Mobile Phones ◽  
Sexual And Reproductive Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Change Communication ◽  
Client Education ◽  
And Behavior

Abstract Background: Globally, reproductive health programs have used mHealth to provide sexual and reproductive health (SRH) education and services to young people, through diverse communication channels. However, few attempts have been made to systematically review the mHealth programs targeted to improve young people SRH in low-and-middle-income countries (LMICs). This review aims to identify a range of different mHealth solutions which can be used for improving young people SRH in LMICs and highlight facilitators and barriers for adopting mHealth interventions designed to target SRH of young people. Methods: Databases including PubMed, CINAHL Plus, Science Direct, Cochrane and grey literature were searched between January 01, 2005 and March 31, 2018 to identify various types of mHealth interventions that are used to improve SRH services for young people in LMICs. Of 2,181 titles screened after duplication, 207 potentially relevant abstracts were obtained. Out of 207 abstracts, 70 abstracts were shortlisted. Full text of 70 studies were reviewed using a pre-defined data extraction sheet. A total of 11 full text studies were included in the final analysis. Results: The final 11studies were categorized into three main mHealth applications including; client education and behavior change communication, data collection and reporting and financial transactions and incentives. The most reported use of mHealth was for client education and behavior change communication [n = 10, 91%]. This categorization provided the understanding that the potential of other mHealth applications has yet to be explored. Most studies showed, that mHealth interventions have proven to be effective in improving SRH services and outcomes through addressing barriers of provider prejudice, stigmatization, discrimination, fear of refusal, lack of privacy and confidentiality. Yet, the review also identified barriers to uptake of mHealth interventions for SRH including decreased technological literacy, inferior network coverage, and lower linguistic competency. Conclusion: The review provides detailed information about the implementation of mobile phones at different levels of healthcare system for improving young people SRH outcomes. This systematic review recommends that barriers to uptake mHealth interventions be adequately addressed to increase the potential use of mobile phones for improving access to SRH awareness and services.

scholarly journals Access to contraception and sexual and reproductive health information post-abortion: a systematic review of literature from low- and middle-income countries

2017 ◽  
Vol 43 (4) ◽  
pp. 309-318 ◽  
Author(s):  
Claire Rogers ◽  
Jaya A R Dantas
Keyword(s):  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Relevant Literature ◽  
Flow Diagram ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
Post Abortion ◽  
Access To Contraception ◽  
Low And Middle Income

AimThis systematic literature review documented, analysed and critiqued the accessibility of contraception and sexual and reproductive health (SRH) information for women living in low- and middle-income countries who have undergone medical or surgical abortion.MethodologyThis review systematically collated relevant and recent empirical evidence regarding women's access to contraception and SRH information post-abortion within low- and middle-income countries. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework Guidelines, Flow Diagram and Checklist were utilised to undertake the review. The Ovid (MEDLINE), ProQuest, Science Direct, Web of Science, PUBMED and CINAHL databases were searched and studies that met edibility criteria were assessed for validity and analysis. A narrative synthesis of characteristics and results of the included studies is presented.FindingsAfter detailed assessment of available and relevant literature, nine studies were selected for inclusion in the review. Studies highlighted barriers to contraception and SRH information including supply limitation, lack of comprehensive education and counselling, lack of skilled post-abortion care (PAC) providers and abortion stigma.ConclusionsThe review found that with access to a wide range of contraceptive methods combined with comprehensive SRH information and education, contraception uptake in women post-abortion does increase. The review also highlights the inconsistencies in clinic-reported ‘counselling’ and what this term actually involves within a PAC setting.

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