The Sexual and Reproductive Health Context of an Internally Displaced Persons' Camp in Northeastern Nigeria: Narratives of Girls and Young Women

In humanitarian settings, ~35 million girls and young women of reproductive age (15–24) are in urgent need of sexual and reproductive health (SRH) information and services. Young women and girls in humanitarian contexts are particularly vulnerable to unwanted pregnancies, unsafe abortion, gender-based violence, and early and forced marriage. We sought to understand girls' and young women's experiences with unwanted pregnancy, abortion, contraception, sexually transmitted infections (STIs), gender-based violence (GBV), and forced marriage in an IDP camp in Northeastern Nigeria. We conducted 25 in-depth interviews with girls aged 15–19 (N = 13; 8 single and 5 married) and young women aged 20–24 (N = 12; 3 single and 9 married). All interviews were audiotaped, transcribed, translated, computer recorded and coded for analysis. The participants in our study fled from and witnessed violence to arrive in the IDP camp with little material support. Lack of necessities, especially food, has driven many to sex in exchange for goods or into forced marriages. This, in turn, leads to increased unwanted pregnancies and unsafe abortions. Participants had limited knowledge about contraception, and some information about SRH services available in the camp, but overall, knowledge and utilization of SRH services was low.

Pendidikan Kontrasepsi Pada Wanita Pasangan Usia Subur Sebagai Upaya Antisipasi Baby Bomming Di Masa Adaptasi Kebiasaan Baru Pasca Pandemi Covid-19 Di Wilayah Kecamatan Kuta Utara

The results of family planning services during the COVID-19 pandemic in national scale has decreasedin the number of contraceptive uses reaching 40% in almost all regions in Indonesia (BKKBN, 2020). This couldbe caused by various problems, including an increase in the number of unwanted pregnancies and baby booms orincrease of birth rate. This is due to the obstruction of access to services, delaying access to health facilities dueto fears of contracting COVID-19 and increasing of husband and wife sexual intercourse without usingcontraceptives that inducing pregnancy. Based on the results of Widiastuti's research in 2020, where a survey wasconducted to find out the description of family planning use during the pandemic in the North Kuta District, it wasfound that half of them (53.2%) of respondents were using contraceptives and almost half of them (46.8%) ofrespondents did not use contraception. One of the efforts to suppress the surge in baby births is through the FamilyPlanning program for couples of childbearing age. The aim of this community service is to provide knowledgeabout contraceptive tools and methods in suppressing the surge in baby births. The targets are women ofchildbearing age aged 15-45 years who have not used contraception or who use and do not make repeat visits asmany as 30 people. The implementation of the activity was carried out by assessing the level of understanding ofthe respondents by pre-testing through google forms, implementing counseling, family planning counseling andintroduction of contraceptives and evaluating the material by post-testing via google forms. The results of theactivity show that there is an increase in mother's knowledge about family planning tools and methods, which isexpected to influence the behavior of woman in using contraceptives so that they are expected to anticipate theoccurrence of baby boom.

The Mother’s Role in Mother-Child Relationship Among Adolescents with Unwanted Pregnancies

The mother’s role is essential in an adolescent’s development due to the challenges of life and exposure to the outside world, which affect and constantly change the mother’s role. This study intends to explore the experiences of the mother’s roles in the mother-child relationship among adolescents with unwanted pregnancies. A phenomenological approach was employed to obtain the essence of the experiences. A total of 10 participants comprising of five pregnant adolescents and their mothers were interviewed to understand the role played by the adolescents’ mothers during the pregnancy. A diary was distributed among the adolescents to allow them to externalise and express the experiences that they had with their mothers while being pregnant. This study used thematic analysis because it is flexible in interpreting the data and allows to approach large data sets more easily by sorting them into broad themes. Five themes emerged as follows: (a) supervising and monitoring, (b) rules and regulations, (c) showing affection, (d) educating adolescents, and (e) giving encouragement and support. This study provided insights on the mothers’ struggles in raising their adolescents which were highlighted from two perspectives: adolescents and mothers. The findings revealed the challenges faced by the mothers with various types of family structure.

Perceived Sustainability and Reliability of Naturopathic Birth Control Methods; A Study in Ningo-Prampram, Ghana

Background: According to worldwide estimates, some 600,000 women die each year of pregnancy-related causes, and another 75,000 die following unsafe abortions. At least 200,000 of these maternal deaths are attributable to the failure or lack of contraceptive services. Naturopathic birth control methods have been proven to be a safe and effective way to prevent unwanted pregnancies Aim: this study aimed to examine the use of naturopathic birth control methods and to explore the perceived reliability and perceived sustainability of naturopathic birth control methods among adults. Methods: A cross-sectional descriptive survey design was used. Adults in the Ningo-Prampram Municipality were randomly sampled to select 100 respondents, who were then administered with the structured questionnaire. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 24. Results were presented using descriptive metrics. Results: Majority of the respondents (39.6%) strongly agree to the use of naturopathic birth control methods 12 months. 34.1% strongly agreed as against 2.2% who strongly disagreed to the reliability of naturopathic birth control methods. 38.5 showed agreement as against 19.8% showing disagreement on the reliability of naturopathic birth control methods. 49.5% agreeing strongly to its sustainability, as against 3.3% disagreeing strongly. Conclusion: It is indicative that given the benefits of naturopathic birth control methods, more adults are in strong agreement of its usage, reliability and sustainability, since it presents the user with no later life health issues such as infertility and complications in parturition. It is therefore important that, the issues of Sexually Transmitted infections (STIs) are addressed with abstinence and or fidelity with one sexual partner.

PENDAMPINGAN PADA PASANGAN USIA SUBUR DALAM PENGGUNAAN KONTRASEPSI SEBAGAI UPAYA MENEKAN UNMET NEED KB DI MASA ADAPTASI KEBIASAAN BARU

ABSTRAKTingginya angka unmet need bukan hanya menjadi permasalahan dalam program Keluarga Berencana di Indonesia, namun juga dihadapai oleh tiap belahan dunia. Kelompok unmet need merupakan sasaran yang perlu mendapatkan perhatian khusus dalam pelayanan KB. Pada masa awal pandemi Covid-19, angka unmet need KB cenderung mengalami peningkatan. Berdasarkan laporan dari BKKBN 2020 tercatat sebanyak 36 juta peserta KB aktif pada bulan Maret mengalami penurunan menjadi 26 juta peserta dibulan April, sehingga terdapat selisih 10 juta akseptor yang tidak menggunakan alat kontrasepsi dan 25% diantaranya merupakan Pasangan Usia Subur (PUS). Penurunan kepesertaan KB aktif ini dapat berdampak pada resiko terjadi Kehamilan Yang Tidak Diinginkan (KTD), maupun peningkatan “baby boom” pasca pandemi. Tujuan dari kegiatan ini adalah membantu PUS dalam memecahkan dan menemukan solusi terhadap permasalahan terkait KB serta memberikan layanan KB. Kegiatan ini dikemas dalam bentuk pendampingan konseling dan pelayanan KB gratis terutama bagi PUS yang tergolong unmet need. Dilakukan secara tatap muka dengan menerapkan protokol kesehatan yang ketat. Hasil kegiatan Pengabdian kepada Masyarakat ini yaitu dari 20 orang PUS yang melakukan konseling, sebanyak 15 orang (75%), bersedia menjadi akseptor KB aktif sedangkan 2 orang (10%) akan mendiskusikan kembali dengan pasangannya dan 3 orang lainnya (15%) belum siap untuk menggunakan kontrasepsi. Kata kunci: pendampingan; PUS; unmet Need KB; adaptasi kebiasaan baru ABSTRACTThe high number of unmet need is not only a family planning problem in Indonesia, but also in every part of the world. Unmet need target groups that need special attention. At the beginning of the Covid-19 pandemic, the number of unmet need for family planning tends to increase.Reports from the BKKBN in 2020, from March to April there was a decrease in active family planning acceptors by 10 million participants and 25% of them are couples of childbearing age. This decrease in participation has an impact on the risk of unwanted pregnancies and an increase in the post-pandemic "baby boom". The purpose of this activity is to assist couples in solving and finding solutions to family planning problems and providing family planning services. This activity is packaged in the form of counseling assistance and free family planning services, especially for couples of childbearing age with unmet need. The results of this Community Service activity are from 20 people who did counseling, as many as 15 people (75%), were willing to become active family planning acceptors while 2 people (10%) would discuss again with their partners and 3 other people (15%) were not ready to use contraception. Keywords: accompaniment; couples of childbearing age; unmet need KB; new habit adaptation

ATTACHMENT STYLES AND RISKY SEXUAL BEHAVIORS IN ADOLESCENTS

Infection with sexually transmitted diseases and unwanted pregnancies are risks associated with adolescents’ risky sexual behavior. Mental models of attachment relationships influence behavior and may influence adolescents’ involvement in sexual activities that are risky. This study explored whether attachment styles predicted adolescents’ involvement in risky sexual behavior. A correlational study design was adopted with 367 students from public secondary schools in Nairobi County taking part in the study. The Attachment Styles Questionnaire and Risky Sexual Behavior Scale were used to collect data. Multiple regression analysis was used to determine whether secure, preoccupied, dismissing or fearful attachment styles predicted students’ risky sexual behavior. The study found that preoccupied attachment style and secure attachment style had predictive effects on risky sexual behavior. Preoccupied attachment style was predictive of greater involvement in risky sexual behavior whereas secure attachment style was predictive of less risky sexual behavior. It was evident based on the findings that secure attachment style was protective against risky sexual behavior whereas preoccupied attachment style created vulnerability to risky sexual behavior. It was recommended that special attention should be paid to adolescents with insecure attachment styles in guidance and counseling programs aimed at discouraging adolescents’ risky sexual behavior and parents/guardians should be encouraged to be more nurturing towards their children in order to encourage formation of secure attachment which was protective against risky sexual behavior. Keywords: attachment styles, attachment avoidance, attachment anxiety, secure attachment, risky sexual behavior

Early contraceptive implants removal and its associated factors among women using implants at a National Referral Hospital, Kampala Uganda

Background Early discontinuation of implant contraceptive methods and reasons for discontinuation remains a major concern for family planning programs. Early discontinuation is related to higher rates of the overall fertility rate, unwanted pregnancies leading to possibly induced abortion. There is paucity of data on the practice of discontinuation of contraceptives in developing countries. The objective of the study was to determine the magnitude of early implants discontinuation among women receiving implants services in the study area and the factors associated with it. Methods A cross-sectional study was conducted from 2nd January to 3rd March 2020. Data were collected from 207 women who had come to remove implants on socio-demographic characteristics, obstetric history, duration of implant, and reasons for wanting to remove the implant. We computed the proportion of those who removed the implant before 18 months (early discontinuation). To assess the factors associated with early discontinuation, we estimated the prevalence ratios with a generalized linear model of the poisson family with a log link and robust error variance. Results The proportion of early implant discontinuation was 87/207(42%). Factor associated with early implant discontinuation included; experience of side effects (PR = 1.1; 95% CI 1.03–1.24; P = 0.001), not having received pre-insertion counseling about the benefits and side effects of contraceptive implants (PR = 1.5; 95% CI 1.02–1.30; P = 0.019) and staying in rural areas (PR = 1.1; 95% CI 1.03–1.27; P = 0.014). Conclusion Nearly one in every two mothers have early discontinuation of contraceptive implants. Factors associated with early implant removal include; experience of side effects, lack of counseling services, and staying in rural areas. There is a need for intervention to address high prevalence of early contraceptive removal through improving on counselling services about possible side effects.

Determinants of Factors Causing Unwanted Pregnancy in Adolescents: A Literature Review

ABSTRACTBackground: The Phenomenon of unwanted pregnancy among adolescents is still rife in Indonesia. Results of interviews with the head of the National Population and Family Planning Agency (BKKBN), Hasto Wardoyo, explained in 2020 that there are not enough unwanted pregnancies in Indonesia which reach 17.5%.Objectives: Provide an overview of the determinants of unwanted pregnancy in adolescents in Indonesia.Methods: An article search was conducted using Google Scholar and Garuda Portal with the keywords "unwanted pregnancy", "unwanted pregnancy in adolescents aged 12-24 years", “unwanted” pregnancy factor in adolescents". Discussion: The total articles obtained were 157 articles, found 5 articles that met the inclusion criteria, namely articles with research conducted in Indonesia with publication years from 2015 to 2020, in the form of original articles, articles available in full text and free access, as well as factors causing pregnancy in adolescents. Lack of knowledge, permissive attitude of adolescents, easy access to pornographic media and parenting patterns are factors that cause pregnancy in adolescents.Conclusions: Lack of knowledge of adolescents about reproductive health and sexual health is the most dominant factor as a cause of unwanted pregnancy among adolescents, because knowledge can affect the attitudes and behavior. It is necessary to provide guidance and counseling related to knowledge andunderstanding to adolescents and parents regarding adolescent reproductive health.Keywords: Unwanted pregnancy, adolescents, unwanted pregnancy factors in Indonesia

Evaluation Of The Family Planning Program (Kb) During The Covid-19 Pandemic In 2020 In Puskesmas Kedungwuni I, Pekalongan Regency

Family planning can be interpreted as an action that helps married couples to avoiding unwanted pregnancies,planning the births, regulating he interval between pregnancies, controlling yhe time of the birth. This study used a descriptive survey design. The sampling technique used a total sample. The data collection tool used family planning achievement documentation. The result showed that there was an increase in active family palnning acceptors/participants during the Covid-19 pandemic (1.55%). There were also some increases in all types of (short and long-acting) contraception acceptor/participants. The increased of long-acting contraception acceptors were IUD (0.15%), MOP (0.26%), MOW (0.15%). The short-acting contraception was also increased, such as injections (0.2%) , Pills (0,28%), and Condom (0.09%). Meanwhile , the total number of the new family planning acceptor/participants was decreased (0.58%). The new participants also use various types of contraception. The total number of the new family who accepted long-acting contraception were in various levels, such as the IUD (decreased 1.03%), MOW (decreased 2.04%) , MOP ( increased 3.2%), and Impalnt (1.5%). The total number of the new family who accepted short-acting contraception was decreased, such as injections (3.36%), Pills (0.1%), and Condom (0.23%). Compared to the target, the total number of active family planning acceptor/participants was over the target, while the new family planning acceptor/participant were less than the target.Keywords : evaluation, achievement results, family planning, pandemic covid-19 AbstrakKeluarga Berencana dapat diartikan sebagai tindakan yang membantu pasangan suami istri untuk menghindari kehamilan yang tidak diinginkan, mendapatkan kelahiran yang memang sangat diinginkan, mengatur interval diantara kehamilan, mengontrol waktu saat kelahiran. Bertujuan untuk mengetahui evaluasi program keluarga berencana pada masa Pandemi Covid-19. Desain penelitian adalah survey deskriptif, Populasi dalam penelitian yang akan dilakukan ini adalah seluruh hasil dokumentasi data pencapaian KB pada masa pandemi Covid-19 Tahun 2020 di Puskesmas Kedungwuni I. Teknik pengambilan sampel menggunakan total sampel. Alat pengumpulan data menggunakan dokumentasi hasil pencapaian keluarga berencana. Hasil penelitian menunjukan akseptor KB Aktif ada masa Pandemi Covid-19 mengalami kenaikan pada Akseptor KB aktif sekitar (1,55%) ,mengalami kenaikan pada semua jenis kontra sepsi Akseptor/peserta KB aktif yaitu Akseptor KB Aktif (MKJP) untuk IUD naik (0,15%) MOP naik (0,26%) MOW naik (0,14%) dan Implan naik (0,15%). Untuk Akseptor KB Aktif (Non MKJP) yaitu Suntik naik (0,2%) Pil naik (0,28%) dan Kondom naik (0,09%). Sedangkan Akseptor/peserta KB Baru mengalami penurunan sekitar (0,58%) untuk hasil pencapaian penggunan macam-macam alat kontra sepsi pada KB Baru yang mengalami penurunan pada Akseptor/peserta KB Baru (MKJP) yaitu IUD turun (1,03%) dan MOW (2,04%) sedangkan yang mengalami kenaikan yaitu MOP (3,2%), Implan naik (1,5%) dan Akseptor/peserta KB Baru (Non MKJP) yang turunya itu Suntik turun (3,36%) Pil turun (0,1%) dan Kondom turun 0,23%. Sedangkan jika dibandingkan dengan Target melebihi target pada Akseptor/peserta KB Aktif dan Akseptor/peserta KB Baru kurang dari target Diharapkan masyarakat khususnya PUS tetap menggunakan KB di masa pandemi Covid-19 ini dengan datang ke Puskesmas terdekat dengan mematuhi protokol kesehatan dengan membuat janji bertemu dengan bidan terlebih dahulu.Kata kunci: evaluasi;hasilpencapaian;keluargaberencana;masapandemi, covid-19

Periods for Profit and the Rise of Menstrual Surveillance

Menstruation is being monetized and surveilled, with the voluntary participation of millions of women. Thousands of downloadable apps promise to help women monitor their periods and manage their fertility. These apps are part of the broader, multi-billion dollar, Femtech industry, which sells technology to help women understand and improve their health. Femtech is marketed with the language of female autonomy and feminist empowerment. Despite this rhetoric, Femtech is part of a broader business strategy of data extraction, in which companies are extracting people’s personal data for profit, typically without their knowledge or meaningful consent. Femtech can oppress menstruators in several ways. Menstruators lose control over their personal data and how it is used. Some of these uses can potentially disadvantage women in the workplace, insurance markets, and credit scoring. In addition, these apps can force users into a gendered binary that does not always comport with their identity. Further, period trackers are sometimes inaccurate, leading to unwanted pregnancies. Additionally, the data is nearly impossible to erase, leading some women to be tracked relentlessly across the web with assumptions about their childbearing and fertility. Despite these harms, there are few legal restraints on menstrual surveillance. American data privacy law largely hinges on the concept of notice and consent, which puts the onus on people to protect their own privacy rather than placing responsibility on the entities that gather and use data. Yet notice and consent is a myth because consumers do not read, cannot comprehend, and have no opportunities to negotiate the terms of privacy policies. Notice and consent is an individualistic approach to data privacy that envisions an atomized person pursing their own self-interest in a competitive marketplace. Menstruators’ needs do not fit this model. Accordingly, this Essay seeks to reconceptualize Femtech within an expanded menstrual justice framework that recognizes the tenets of data feminism. In this vision, Femtech would be an empowering and accurate health tool rather than a data extraction device.