Facilitators of Adolescent Girls’ Access to Sexual and Reproductive Health Services in Iran: A Qualitative Study

Abstract Background People living a trans-life require access to equitable healthcare services, policies and research that address their needs. However, trans people have experienced different forms of violence, discrimination, stigma, and unfair access barriers when dealing with healthcare providers. Therefore, adapting sexual and reproductive health services with the purpose of providing more equitable, inclusive and discrimination-free healthcare services is an urgent need. The article presents an example of how operative research can be used in order to adjust sexual and reproductive healthcare services to trans people’s needs, identities and circumstances. Methods This is a qualitative study written from a constructivist perspective, and it is based on the voices and experiences of trans people in four major cities in Colombia. The research used a combination of focus groups of discussion (n = 6) and in-depth interviews with trans people (n = 13) in Barranquilla, Bogota, Cali and Medellin. This research had two specific objectives: i) identifying the main sexual and reproductive health needs of people living a trans-life; and ii) generating new evidence in order to guide the adaptation of sexual and reproductive health services centered to trans people’s needs, identities, and circumstances. Qualitative data codification and analysis was using NVivo. Results Once access barriers to sexual and reproductive health services, unmet sexual and reproductive health needs were identified, the research helped define strategies to adapt sexual and reproductive health services to the needs, identities, and circumstances of people living a trans-life in Colombia. Amongst the main barriers found were healthcare costs, lack of insurance, stigmatization, discrimination and abuse by health care providers. Perhaps among the most notable sexual and reproductive health needs presented were trans-specific services such as sensitive assistance for the transition process, endocrinology appointments, and sex reaffirmation surgeries. Conclusions The evidence obtained from this research allowed Profamilia, a Colombian healthcare provider, to adapt the sexual and reproductive health services it provides to people living a trans-life in Colombia. Furthermore, it was possible for Profamilia to design and implement an inclusive sexual and reproductive health program that specifically addresses trans people’s needs, identities, and circumstances.

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Women and substance use: a qualitative study on sexual and reproductive health of women who use drugs in Delhi, India

BMJ Open ◽

10.1136/bmjopen-2017-018530 ◽

2017 ◽

Vol 7 (11) ◽

pp. e018530 ◽

Cited By ~ 13

Author(s):

Vartika Sharma ◽

Avina Sarna ◽

Waimar Tun ◽

Lopamudra Ray Saraswati ◽

Ibou Thior ◽

...

Keyword(s):

Reproductive Health ◽

Qualitative Study ◽

Health Services ◽

Sexual And Reproductive Health ◽

Accurate Information ◽

Unsafe Sex ◽

Reproductive Health Services ◽

Community Based ◽

The Past ◽

Women Who Use Drugs

ObjectivesTo explore contextual factors that increase vulnerabilities to negative sexual and reproductive health (SRH) outcomes and possible differences in SRH-related behaviours and the needs of women who use drugs (WUD) through non-injecting and injecting routes.DesignQualitative study design using semi-structured in-depth interviews.ParticipantsTwenty women who injected drugs in the past 3 months and 28 women who reported using drugs through non-injecting routes in the past 1 month.SettingInterviews were conducted at community-based, drop-in centres in Delhi, India.ResultsStudy findings illustrate that WUD were sexually active and had multiple sex partners including clients of sex work. Transient relationships were reported and many participants engaged in unsafe sex. Factors which affected safe sex behaviours included: gender power imbalance, limited agency for decision-making, lack of accurate information for correct self-risk assessment, and being under the influence of drugs. Despite high awareness, low and inconsistent contraceptive use was reported. Some participants were coerced to conceive while a few others reported their inability to conceive. Violence was a key determinant for SRH outcomes. Perception of certain adverse health outcomes (such as infertility) to be ‘common and expected among WUD’ influenced access to healthcare. Further, healthcare providers’ stigmatising attitudes and lack of women-centric services deterred women from uptake of healthcare services.ConclusionFindings highlight that SRH-related behaviours and needs of this group are a complex interplay of multiple determinants which need to be addressed at all levels: individual, family, community and institutional. It is imperative to roll out a ‘one-stop-shop’ for a comprehensive package of health services. Expansion of existing drop-in-centres could be considered for setting-up community-based women-centric services with appropriate linkage to drug dependence treatment and reproductive health services.

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A qualitative study to explore the barriers and enablers for young people with disabilities to access sexual and reproductive health services in Senegal

Reproductive Health Matters ◽

10.1080/09688080.2017.1329607 ◽

2017 ◽

Vol 25 (50) ◽

pp. 43-54 ◽

Cited By ~ 12

Author(s):

Eva Burke ◽

Fatou Kébé ◽

Ilse Flink ◽

Miranda van Reeuwijk ◽

Alex le May

Keyword(s):

Young People ◽

Reproductive Health ◽

Qualitative Study ◽

Health Services ◽

Sexual And Reproductive Health ◽

People With Disabilities ◽

Reproductive Health Services ◽

Barriers And Enablers

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How Iranian men perceive sexual and reproductive health? A qualitative study

10.21203/rs.2.19398/v1 ◽

2019 ◽

Author(s):

Razieh Lotfi ◽

Seyed Ali Azin ◽

Effat Hatefnia ◽

Mina Amiri ◽

Masoumeh Simbar ◽

...

Keyword(s):

Content Analysis ◽

Reproductive Health ◽

Qualitative Study ◽

Health Services ◽

Social Norms ◽

Sexual And Reproductive Health ◽

Social Issues ◽

Reproductive Health Services ◽

Sexual Reproductive Health ◽

Conventional Content Analysis

Abstract Background Despite the effective role of men in promoting their sexual and reproductive health, they have been often been overlooked for cultural and social issues and limited data are available in this context. In developing countries, the majority of men have limited knowledge and ability in terms of reproductive and sexual health. Hence, this study aimed to investigate male perceptions of sexual and reproductive health concepts.Materials and methods Using the conventional content analysis approach, a qualitative study was conducted on data retrieved through semi-structured interviews with 19 adult males aged 18 to 59 years, purposefully selected from among populations of health centers in the province of Alborz, Iran.Results Three main concepts and 9 categories emerged from the conventional content analysis: 1) Needs including “access to sexual and reproductive health services”, “awareness”, and “high-quality and safe sex”; 2) Responsibilities including “health- seeking behaviors”, “sexual skills”, “childbearing responsibilities” and “ethical commitment”; and 3) Social norms including “gender role attitudes”, and “changing marriage rules”.Conclusion This study showed that structural factors along with cultural and social norms affect sexual and reproductive health in men, who are men not adequately taken care and many of their sexual and reproductive health needs have not yet been addressed. Participants believed that men are responsible for their sexual reproductive health, although they have often difficulties fulfilling their responsibilities because of inadequate knowledge on the subject and the lack of access to sexual/ reproductive health services. Hence, along with socioeconomic changes, the health care system should be prepared to meet these needs and responsibilities using preventive strategies and programs.

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Transition into the sexual and reproductive role: a qualitative exploration of Iranian married adolescent girls’ needs and experiences

Reproductive Health ◽

10.1186/s12978-021-01208-6 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Shahnaz Kohan ◽

Shirin Allahverdizadeh ◽

Ziba Farajzadegan ◽

Morteza Ghojazadeh ◽

Zahra Boroumandfar

Keyword(s):

Reproductive Health ◽

Health Services ◽

Adolescent Girls ◽

Sexual And Reproductive Health ◽

Qualitative Content Analysis ◽

Healthcare Providers ◽

Early Marriage ◽

Reproductive Health Services ◽

Pregnancy And Childbirth ◽

Mental Preparedness

Abstract Background It is necessary to invest in married adolescent girls’ health because of their roles in promoting the community and health of the next generation. Meanwhile, there are many concerns about their sexual and reproductive health. The International Conference on Population and Development emphasized the importance of access to adolescent girls to reproductive health services and counseling. In Iran, about 24% of registered marriages are to girls under 19, while their sexual and reproductive health needs have neglected. Therefore, this study aimed to identify married adolescent girls’ reproductive and sexual needs. Methods/design Data were obtained through in-depth, semi-structured individual interviews with 36 participants, including 11 women who got married at 10 to 21 years of age, two mothers whose daughters were married in adolescence, and 23 healthcare providers and policymakers. The participants were selected through purposive sampling with maximum variation. Data collection continued until data saturation. The interviews were analyzed by qualitative content analysis. Similar codes were merged, and sub-categorization was performed, whereby similar categories were combined until the main categories that emerged. Results The results revealed five main categories: preparing for marriage, enhancing awareness and decision—making power on sexual and reproductive health issues, developing adolescent-friendly sexual and reproductive services, providing tailored pregnancy and childbirth services, and preparing adolescents for motherhood. Conclusion Adolescents step into marital life without the required life skills or physical and mental preparedness. They often become pregnant due to social pressures and lack of access to contraception. Therefore, in countries like Iran, where there is a high frequency of early marriage, families, education, and the health system should prepare the necessary foundation to support these adolescents and provide tailored and comprehensive sexual and reproductive health services.

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Understanding sexual and reproductive health needs of adolescents: Evidence formative study in three districts of lake regions in Tanzania

10.21203/rs.3.rs-1049780/v1 ◽

2021 ◽

Author(s):

mwifadhi mrisho ◽

Michaela Mantel ◽

Abdunoor M Kabanywanyi ◽

Bakar Fakih ◽

Manzi Fatuma ◽

...

Keyword(s):

Health Care ◽

Reproductive Health ◽

Health Services ◽

Adolescent Girls ◽

Health Care Services ◽

Sexual And Reproductive Health ◽

Health Facilities ◽

Reproductive Health Services ◽

Care Services ◽

To Receive

Abstract Background Teenage marriage and adolescent pregnancy present a significant health challenge in the Tanzania. About 36% of women aged 15-49 are married before the age of 18, and 32% of rural adolescents (10-19 years) gave birth, compared with 19% of urban. In Mwanza region, one third of currently married adolescent and women aged 15-49 experienced unmet need for family planning and had low use of modern contraceptives. Here we present a study that explored the gaps in accessing and utilization of quality adolescent sexual and reproductive health services (ASRH). Methods This was a descriptive and exploratory cross-sectional formative study utilizing multiple qualitative research methods. Purposive sampling was used to select an urban district (Nyamagana), rural district (Magu) and an island (Ukerewe). Sixty-seven IDI and 30 focus group discussions (FGDs) stratified by gender (12 out-of-school, 12 in-school), and (3 male, 3 female adults) were purposefully sampled. Vignettes were done with 15-19 years old in-school and out-of-schools boys and girls. An experienced moderator, along with a note-taker, led the discussions while taking notes. The FGDs were recorded using an MP3 voice recorder. Thematic analysis approach was undertaken and data was analysed using NVivo 12, a qualitative software. Results The identified the most important pressing needs of the adolescents in relation to SRH. Adolescent girls needed specific services such as counselling on menstrual health, sexual consent, HIV/AIDS, and prevention of pregnancies. Sanitary pads during menstrual period were very important pressing need of the adolescent girls. Adolescents both girls and boys preferred to receiving friendly health care services in a respectful manner. Girls mentioned that they would like to receive SRH support from nurses in health facilities, mothers, sisters, aunties and friends. With regards to boys, they preferred to receive the SRH from health care providers followed with their peer’s friends. Several obstacles were reported to hinder access to SRHS predominantly among the adolescent girls as compared to the boys. Poor infrastructure tended to impair the privacy at the health facilities, and rarely there were specific buildings to provide friendly adolescent sexual and reproductive health services. Conclusions The strategies to guide delivery of ASRH should involve the inclusion of duty bearers, promotion of friendly health care services where health workers provide services in friendly-manner, provision of ASRH education for awareness creation to adolescents and supportive parents/ care takers.

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