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Like many areas of public health, sexual and reproductive health is concerned with politically contentious matters such as abortion and LGBT+ rights. Global setbacks at the hands of the far right highlight the extent to which the rights and practices underpinning sexual and reproductive health are politically mediated. Yet the political is often occluded in mainstream sexual and reproductive health responses. In this paper, I consider the recent travails of sexual and reproductive health in order to critique technocratic knowledge forms that dominate both sexual and reproductive health and public health responses. Exploring sexual and reproductive health responses across time and space, I identify alternative knowledge forms and approaches relevant to public health. [ABSTRACT FROM AUTHOR]

This paper describes a study that examined the challenges faced by Vietnamese ethnic minority girls regarding their sexual and reproductive health. The study employed photovoice, a research method which treats photographs and the accompanying stories provided by participants as qualitative data. Twenty-six (26) minority ethnic girls took photographs of aspects of their lives as a way of documenting the challenges, difficulties and barriers that they faced in looking after their sexual and reproductive health. Findings indicated limited access to sexual health knowledge, the exclusion of young people from mainly adult-focused sexual and reproductive health services in minority ethnic communities and the prevalence of cultural beliefs and practices that negatively affected young people's sexual and reproductive health. The intersection of ethnicity, age and gender places Vietnamese ethnic minority girls at risk, as everyday practices informed by culture and tradition curtail their access to the limited sexual and reproductive health information and services available in their communities. Understanding these challenges is needed in developing appropriate policies, programmes and services aimed at enhancing the sexual and reproductive health of this segment of the population. [ABSTRACT FROM AUTHOR]

Comprehensive sexuality education (CSE) seeks to improve young people's knowledge, attitudes and practices in relation to sexual and reproductive health, sexual and social relationships, and dignity and rights. In Ethiopia, young people with disabilities and young women involved in sex work are particularly vulnerable to sexual violence and poor sexual health, yet face stigma and accessibility challenges that continue to exclude them from information, support and services. Because they are often out of school, these groups are also often excluded from programmes that are largely delivered in school settings. This paper explores the challenges faced by these groups of young people in accessing inclusive and age-appropriate sexual and reproductive health knowledge and services in the Ethiopian context and the implications for delivering CSE. The research included literature review, mapping analysis and interviews with young people from those two groups and with service providers and programme implementers. Our findings indicate that young people with disabilities and young women involved in sex work face myriad barriers to accessing information and services that support positive and healthy sexuality, relationships and rights. However, changes over the past decade to national and regional governance structures and a political environment in which CSE has become increasingly contested have generated siloed approaches to the provision of sexual and reproductive health information and services, and poor linkages to complementary services including violence prevention and social protection. It is vital that efforts to implement comprehensive sexuality education are informed by these challenges in the wider policy environment. [ABSTRACT FROM AUTHOR]

The prevalence of pregnancy and sexually transmitted infections among adolescents in low and middle-income countries leads us to believe that sexual and reproductive health (SRH) information needs are still unmet. This paper investigates current sources and their limitations and then explores the role technology could play. Methods: In an exploratory qualitative study themes identified; (1) preferred sources of SRH information; (2) their limitations; (3) the role of technology in meeting their needs. Results: Mobile phone-based apps could improve awareness and provide information in a confidential way. Conclusions: Adolescents have an unmet need that vary by age and gender. Mobile phones could offer accessible, user-friendly platform. [ABSTRACT FROM AUTHOR]

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In the context of a growing adolescent population globally, it is imperative to understand which interventions will most effectively advance their sexual and reproductive health (SRH). In India and globally, peer education is often utilised as an intervention for promoting the SRH of young people. Globally, the evidence of its effectiveness is mixed. A systematic review of the literature from the Indian context gave insight into the knowledge, attitudinal, and behavioural (KAB) outcomes affected by peer education, as well as the inputs, coverage, content, and context of such interventions. Out of the over 1500 publications initially identified through the database and bibliographic searches, 13 were included in the review; no quality assessment was done, given the dearth of publications matching the inclusion criteria. Analysis of the included publications highlights the multiple ways that peer education is implemented in the Indian context, as part of multi-component programmes and as a stand-alone intervention. The KAB outcomes from these initiatives are mixed, with some multi-component and some stand-alone initiatives affecting statistically significant outcomes and others not–a finding consistent with global literature reviewed for this paper. Despite the mixed results and the limited effects of behaviour relative to knowledge, this paper proposes that peer education has a place in an overall response to improving the SRH of young people. It calls for better research on peer education in India, and for research in relation to the optimal conditions for peer education to succeed in affecting KAB and other outcomes. [ABSTRACT FROM AUTHOR]

Infertility affects one in eight couples in the US, yet many couples report feeling blindsided by the diagnosis. Lack of awareness about infertility can lead to missed opportunities for prevention, delays in diagnosis, and greater emotional distress when a diagnosis is made. This paper reports on the results of interviews with 54 American women experiencing infertility, conducted via phone between 2013 and 2015 with participants from across the country. The interviews explored whether differences in infertility awareness were related to patient trajectories for time to diagnosis and initiation of treatment. Interview data indicated a significant lack of informational resources for these women concerned about fertility. Older participants expressed regret that they were not educated about age-related fertility decline, while patients with infertility secondary to medical conditions often reported delays in diagnosis and lack of counseling about fertility implications. Participants' data also revealed that infertility was consistently absent from sex education curricula and that minorities may be more likely to experience delayed diagnosis of infertility and lack of appropriate fertility counseling. These findings suggest that the inequitable distribution of health information and education about reproduction is one mechanism by which experiences of infertility can become racially stratified. [ABSTRACT FROM AUTHOR]

Indigenous knowledge systems embody a holistic, inclusive view of the world and foreground interconnectedness for the promotion of life. Through reflective engagement with the author's positioning as an Indigenous researcher, this article explores Indigenous knowledges of sexual, reproductive health and motherhood shared by Basotho women. It draws on the life stories of twenty never-married women and uses decolonial African feminist approaches to challenge the assumed universality of conceptions of sexual and reproductive health that are both deeply embedded and produced within specific relations of power. It illuminates the Indigenous pitiki space as an Indigenous knowledge hub purposed to empower Basotho women's sexual and reproductive health. Within this space, Indigenous knowledges and skills are shared amongst women, with the elderly imparting knowledges to the young women. In the context of unsurmountable health disparities, the article shows how Indigenous knowledge-sharing outside the exclusive 'westernised' health systems enables communal support for the well-being of women and children in African contexts. It emphasises the need for inclusive and expansive knowledge production systems not only to better inform equitable health solutions for Indigenous communities but also for epistemic redress in the discipline of Sociology. [ABSTRACT FROM AUTHOR]

Background: Community participation can provide increased understanding and more effective implementation of strategies that seek to improve outcomes for women and newborns. There is limited knowledge on how participatory processes take place and how this affects the results of an intervention. Objective: This paper presents the results of two years of implementing (2013–2015) community groups for maternal health care in Magu District, Tanzania. Method: A total of 102 community groups were established, and 77 completed the four phases of the participatory learning and action cycle. The four phases included identification of problems during pregnancy and childbirth (phase 1), deciding on solutions and planning strategies (phase 2), implementation of strategies (phase 3) and evaluation of impact (phase 4). Community group meetings were facilitated by 15 trained facilitators and groups met monthly in their respective villages. Data was collected as an ongoing process from facilitator and meeting reports, through interviews with facilitators and local leaders and from focus group discussions with community group participants. Results: The majority of groups prioritized problems related to the availability of and accessibility to health services. The most commonly actioned solution was the provision of health education to the community. Almost all groups (95%) experienced a positive impact on the community as results of their actions, including increased maternal health knowledge and positive behaviour changes among health care workers. Facilitators were positive about the community groups, stating that they were grateful for the gained knowledge on maternal health, and positively regarded the involvement of men in community groups, which are traditionally women-only. Conclusion: The process of establishing and undertaking community groups in itself appeared to have a positive perceived impact on the community. However, sustained behaviour change, power dynamics and financial incentives need to be carefully considered during implementation and sustaining the community groups. [ABSTRACT FROM AUTHOR]

As part of Western European development aid policy, comprehensive sexuality education (CSE) is increasingly promoted in resource-poor countries. This paper engages with CSE promotion in Bangladesh funded by the Dutch Government. It unpacks the ‘collaboration’ by looking at how a paradox is played out between the universal ideals underlying a broader transnational rights-approach and the intended cultural sensitivity by adapting CSE to the targeted context. Feminist scholarship on the ideological, moral and affective underpinnings of CSE is used to question this model’s implied universality and neutrality. The various negotiations, concerns and strategies of NGO-representatives as co-producers of sexuality knowledge in Bangladesh are focused upon. Analysis focuses on how a ‘speakable’, middle-class-oriented ‘proper’ sexuality is invented and managed through affect; how cultural insensitivity and secular normativity with respect to CSE are challenged in discussions concerned a rights-versus-health approach; and how a confident and knowledgeable adolescent or young person is imagined through the emancipatory project attributed to sexuality education. Rather than via equal collaboration, it is argued, adolescent sexuality education in these development aid settings is shaped by powerful transnational and local processes of Othering. [ABSTRACT FROM PUBLISHER]

Internally displaced women are underserved by health schemes and policies, even as they may face greater risk of violence and unplanned pregnancies, among other burdens. There are an estimated 450,000 internally displaced persons in India, but they are not formally recognised as a group. Displacement has been a common feature in India's northeast region. This paper examines reproductive and maternal health (RMH) care-seeking among Bru displaced women in India. The study employed qualitative methodology: four focus group discussions (FGDs) were held with 49 displaced Bru women aged 18–45 between June and July 2018; three follow-up interviews with FGD participants and five in-depth interviews with community health workers (Accredited Social Health Activists – ASHAs) in camps for Bru displaced people in the Indian state of Tripura. All interviewees gave written or verbal informed consent; discussions were conducted in the local dialect, recorded, and transcribed. Data were indexed deductively from a dataset coded using grounded approaches. Most women were unaware of many of the RMH services provided by health facilities; very few accessed such care. ASHAs had helped increase institutional deliveries over the years. Women were aware of temporary contraceptive methods as well as medical abortion, but lacked awareness of the full range of contraceptive options. Challenges in accessing RMH services included distance of facilities from camps, and multiple costs (for transport, medicines, and informal payments to facility staff). The study highlighted a need for comprehensive intervention to improve RMH knowledge, attitudes, and practices among displaced women and to reduce access barriers. [ABSTRACT FROM AUTHOR]

Globally, adolescent pregnancy is one of the key issues in women's reproductive health. Adolescent mothers face a higher risk of obstetrical concerns, and motherhood in adolescence is strongly influenced by lower education level and lower socioeconomic status. The present study was carried out across all Indian states and Union Territories using the National Family Health Survey, rounds 1 to 5 (1992–1993 to 2019–2021) in which various socioeconomic and cultural factors associated with adolescent pregnancies was examined in detail. The article uses univariate, bivariate with chi-square test, and multivariate logistic regression models to understand the extent of which socioeconomic factors and sexual behavior of the couple are related to early motherhood experiences. It was found that age at marriage, respondent education, employment, age gap between partners, and religion are some of the important variables that affect the likelihood of adolescent pregnancy among females in Indian states. Comprehensive institutional efforts like free contraceptives and counseling services should be provided to address the increasing risk of pregnancy among adolescents. [ABSTRACT FROM AUTHOR]

Roma health mediators are part of a government funded, community-led health intervention. One of the programme's central aims is to improve access to reproductive care for Roma women, often said to be one of the most disadvantaged population groups in Europe. This paper is a critical analysis of mediation in Romania, focusing on how social determinants shape access to family planning and how mediators are employed to address inequalities. It is based on ethnographic observations of mediators at work, as well as indepth interviews with community members, health professionals, and mediators. Health professionals tended to see Roma families as wanting and having an unreasonably large number of children and tried to curtail this through the promotion of contraception. This contrasted with the perspective of community members, who appeared not to choose having many children but who instead struggled to access contraception for financial reasons. Roma health mediators generally seemed aware of multiple and intersecting pressures that women were facing, but ultimately tended to frame family planning as a matter of choice, culture, and knowledge. I set these perspectives against the background of anti-Roma racism and eugenic sentiments, reflected in popular discourses about Roma reproduction. I explore how an intervention that nominally aims to promote the emancipation of Roma communities, in fact entrenches some of the racially fused assumptions that are connected to inequalities of access to reproductive health care in the first place. The discussion has implications for Roma reproductive health interventions across Europe, and for participatory interventions more globally. [ABSTRACT FROM AUTHOR]

Background: Teen pregnancy and childbearing are common in Nigeria, and understanding the complexities, such as sociodemographics and economic factors including sexual and reproductive health knowledge and awareness among adolescents over time can trigger innovative approaches and interventions. This study intends to capture the patterns and associated factors of teen motherhood among sexually active adolescents (15–19 years) between 2008 and 2018. Methods: The study data was extracted from 2008, 2013, and 2018 Nigeria Demographic and Health Surveys. Descriptive analysis was presented using frequencies and percentages; multivariable analysis was conducted using log-binomial logistic regression at a p-value <0.05. All analyses were performed using Stata 15.0, weighted and adjusted for the complex survey design and population size. Results: The prevalence of teen motherhood increased between the three successive survey waves (50.9% vs. 52.4% vs. 55.2%) from 2008, 2013, and 2018. Although, the pooled adjusted analysis revealed no significant change over the 10-year period. Knowledge of modern contraceptive methods, primary education, non-Catholic Christians, residing in the South-South region, and those currently or formerly married were associated with increased risk of teen motherhood. There was an inverse relationship between teen motherhood and wealth status; lower wealth status was associated with high adolescent pregnancy and childbearing. Conclusion: This study revealed an increase in the proportion of teen pregnancy and childbearing in Nigeria. Notably, there exist variations across age groups, geographic location, educational level, religious belief, marital and economic status. Interventions that ensure comprehensive sexuality education, girl child education, and economic empowerment especially for school dropouts are advocated to reduce teen motherhood. [ABSTRACT FROM AUTHOR]

Communication about menstrual health continues to be influenced by institutional and social practices which deem it to be unclean and impure. In a country such as India, several customs and traditions reinforce secrecy and shame about menstruation. As such, scholars advocate the need to generate knowledge that can open opportunities to converse on the topic of menstruation and understand issues related to bodily changes. Using a culture-centered approach, this study examined how college-going adult women from two cities in Northern India made sense of menstrual health. Data collection included 20 focus groups with 180 college-going women and interviews with 16 female family members. Participants discussed communication patterns surrounding menstrual health and how they uphold, challenge, and change social practices. Specifically, participants reflected on how they were communicated to about their menstrual health with underpinnings of secrecy and shame and how the influence of current opportunities for openness encourage them to anticipate positive change. Theoretical and practical implications for studying communication around menstruation in diverse cultural contexts are discussed. [ABSTRACT FROM AUTHOR]

Having a good knowledge of family planning methods is vital for reducing maternal morbidity and mortality resulting from unintended pregnancies and unsafe abortions. In this paper, we highlight deaf people’s ability to discern various misconceptions about pregnancy, with the aim of assessing their level of knowledge on pregnancy prevention methods. The article is derived from a sexual and reproductive health (SRH) needs assessment involving participants residing in two cities and a senior high school in Ghana. The needs assessment involved three focus groups with 26 participants, a survey with 152 respondents, and an interview with one health professional. Apart from the health professional, all the remaining participants were deaf people. Findings from the study indicated that more than half the participants lacked familiarity with pregnancy prevention methods. The findings of this study confirm other studies that there is a general lack of knowledge on SRH issues among deaf people in Ghana. Thus, although this study focused on prevention of unwanted pregnancy, which is just one component of SRH issues, the study provides insights into the broader SRH needs of the deaf community and calls for making these issues visible for policy-making. [ABSTRACT FROM PUBLISHER]

Sexual and reproductive health literacy is a key to attaining and maintaining sexual and reproductive health, especially among young people in low-income countries, such as sub-Saharan Africa. While the importance of sexual and reproductive health literacy is gaining wider recognition, studies on the topic have been mainly concentrated in high-income (developed) countries. The aim of this study was to provide a coherent summary and synthesis of the available evidence on sexual and reproductive health literacy among young people in sub-Saharan Africa, with implications for policy, interventions, and research. The review was conducted using the Joanna Briggs Institute's methodology for reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline to enhance the clarity and transparency of the reporting process. PubMed, CINAHL, AJOL, AIM, and Google Scholar were searched for evidence from 18 March to 20 May 2022. The search provided 2,682 articles in total, of which only 24 met the eligibility criteria and were included in this review. The findings revealed persistent sexual and reproductive health information/knowledge gaps, poor sexual and reproductive health-related knowledge and practices, lack of exercising sexual and reproductive health knowledge, and multiple determinants of sexual and reproductive health literacy among young people, ranging from personal to larger structural conditions. The review found that sexual and reproductive health literacy among young people in sub-Saharan Africa is concerning and has not been fully researched. A deeper understanding of the issue is essential for designing and implementing effective interventions to improve sexual and reproductive health literacy and health outcomes among young people. [ABSTRACT FROM AUTHOR]

In this article, we set out how menstrual activism is emerging as a novel strand in global feminist health demands that challenge the norms and practices which condone and institutionalise gender inequalities. Menstruation has moved from being understood principally as a biological function, invisible in the public sphere, to a vibrant form of global body politics with a flourishing set of diverse practices. We examine how menstruation has been brought to global attention in two ways: one through a global development discourse that promotes menstrual health by improving hygiene and the sanitary infrastructure in the Global South; and two through the upswell of feminist groups involved in menstrual activism around the world. The article is a contribution to moving closer towards productive alliances between these two strands as together they contribute to important changes in menstrual health and sexual rights. [ABSTRACT FROM AUTHOR]

There is no formal sexual and reproductive health (SRH) education currently offered in Saudi Arabia. Lack of knowledge and misconceptions are evident among Saudi women, which can lead to negative sexual and reproductive experiences. The aim of this study is to explore Saudi women's SRH knowledge, perceptions and experiences. Qualitative semi-structured interviews with Saudi women were conducted. Interviews took place in a public hospital in Riyadh, Saudi Arabia. Interviews were conducted in Arabic, recorded and transcribed verbatim, to allow for thematic analysis of the data. The following themes were identified: experience with menarche, deep-rooted negative views towards sex, difficulty discussing SRH topics, knowledge of sex and reproduction, generational gap, sources of SRH information and the role of the mother. A total of 28 women, both married and unmarried, aged 20–50 years were interviewed. A profound lack of SRH knowledge was observed among Saudi women which contributed greatly to negative experiences both in childhood and adulthood. Lack of knowledge about menstruation often caused emotional distress for young girls, and menarche was associated with bad memories and negative emotions. Lack of knowledge about sexual intercourse and the deep-rooted negative views towards sex were linked with physical and psychological issues for women. Women rarely received information from their parents or teachers and preferred the internet for their SRH information. There is a substantial unmet need for SRH education for women in Saudi Arabia. It is our recommendation that SRH education should be tailored to meet Saudi women's unique needs, while understanding specific socio-cultural barriers to SRH education and discussions. Research and policy efforts should be directed towards regulating and producing evidence-based health information on the internet, particularly Arabic language websites. [ABSTRACT FROM AUTHOR]

Empirical literature exploring the reproductive health experiences of middle-aged women is limited. Little is known about their experiences and decision-making processes related to reproductive health. The purpose of the Reproductive Health Seeking (RHS) study was to expand the understanding of reproductive health knowledge and influences impacting health decisions for middle-aged women. Thirty women aged 45–64 participated in semi-structured interviews and a focus group. Results highlighted a variety of experiences related to reproductive health including women's perceptions of reproductive health-related cancers, community resources for reproductive-related health education, and factors that influence reproductive health and healthcare seeking behavior. Results demonstrated that women are impacted by their conversations with family and friends, seek information through a variety of channels, and are calling for more information on a variety of reproductive health-related issues outside of breast cancer campaigns. [ABSTRACT FROM AUTHOR]

In 2010, following its approval by the Ministry of Health, the medical abortion combination pack Medabon (containing mifepristone and misoprostol) was made available at pharmacies and in a restricted number of health facilities in Cambodia. The qualitative study presented in this paper was conducted in 2012 as a follow-up to longer-term ethnographical research related to reproductive health and fertility regulation between 2008 and 2012. Observations were carried out at several clinic and pharmacy sites and in-depth interviews were conducted with a purposive sample of 20 women who attended two MSI Cambodia centres and 10 women identified through social networks; six men (women’s male partners); eight health care providers at the two MSI centres and four pill sellers at private or informal pharmacies (who also provided health care services in private clinics). Although the level of training among the drug sellers and providers varied, their knowledge about medical abortion regimens, correct usage and common side effects was good. Overall, women were satisfied with the services provided. Medical abortion was not always a women-only process in this study as some male partners were also involved in the care process. The study illustrates positive steps forward being taken in making abortion safe and preventing and reducing unsafe abortion practices in Cambodia. RésuméEn 2010, après son approbation par le Ministère de la Santé, le produit pour l’avortement médicamenteux Medabon, conditionnement qui associe la mifépristone et le misoprostol, a été commercialisé dans les pharmacies et dans un nombre restreint de centres de santé au Cambodge. L’étude qualitative présentée dans cet article s’est déroulée en 2012, comme prolongement d’une recherche ethnographique à plus long terme relative à la santé génésique et la régulation de la fécondité entre 2008 et 2012. Les observations ont été réalisées dans plusieurs dispensaires et pharmacies. Des entretiens approfondis ont été menés avec un échantillon raisonné de 20 femmes qui s’étaient rendues dans deux centres MSI Cambodge et dix femmes identifiées par les réseaux sociaux ; six hommes (des partenaires des femmes) ; huit prestataires de soins de santé dans les deux centres MSI et quatre vendeurs de comprimés dans des pharmacies privées ou informelles (qui assuraient également des soins de santé dans des dispensaires privés). Le niveau de formation des vendeurs de comprimés et des prestataires était divers, mais leur connaissance des schémas d’avortement médicamenteux, de leur utilisation correcte et des effets secondaires fréquents était bonne. Dans l’ensemble, les femmes étaient satisfaites des services fournis. L’avortement médicamenteux n’était pas toujours une « affaire de femmes » dans cette étude puisque certains partenaires masculins participaient également au processus. L’étude illustre les progrès accomplis pour rendre les avortements plus sûrs, tout en prévenant et réduisant les pratiques abortives à risque au Cambodge. ResumenEn el año 2010, después de ser aprobado por el Ministerio de Salud, el paquete combinación para el aborto con medicamentos Medabon (que contiene mifepristona y misoprostol) se hizo disponible en farmacias y en un número limitado de unidades de salud en Camboya. El estudio cualitativo presentado en este artículo fue realizado en 2012 como seguimiento a investigaciones etnográficas más extensas relacionadas con la salud reproductiva y la regulación de la fertilidad del 2008 al 2012. Se realizaron observaciones en varias clínicas y farmacias, así como entrevistas a profundidad con una muestra intencional de 20 mujeres que asistieron a dos centros de MSI Camboya y 10 mujeres identificadas por medio de redes sociales; seis hombres (parejas de mujeres); ocho profesionales de la salud en los dos centros de MSI y cuatro vendedores de píldoras en farmacias privadas o informales (que también prestaban servicios de salud en clínicas privadas). Aunque el nivel de capacitación entre los vendedores de medicamentos y profesionales de la salud varió, tenían buenos conocimientos acerca de los regímenes de aborto con medicamentos, uso correcto y efectos secundarios comunes. En general, las mujeres estaban satisfechas con los servicios que recibieron. En este estudio, el aborto con medicamentos no siempre fue un proceso solo para mujeres, ya que algunas parejas de sexo masculino también participaron en el proceso de brindar cuidados. El estudio ilustra los pasos positivos hacia adelante que se están realizando para lograr que el aborto sea más seguro y para prevenir y reducir las prácticas de aborto inseguro en Camboya. [ABSTRACT FROM PUBLISHER]

Laptop use comes with potential reproductive health risks for men. This study assessed the knowledge of reproductive health hazards and factors associated with direct use of laptop on the lap among male undergraduates of the University of Ibadan, Nigeria. A cross-sectional study conducted among 444 male undergraduates using multi-stage sampling and data collected through a validated questionnaire. Mean age was 21.0 years ± 2.6. Knowledge and perception of reproductive health hazards associated with direct laptop use were fairly good but practice was high. The knowledge of reproductive health hazards associated with direct laptop use on the lap was not associated with use (p = 0.08) and factors influencing use include; influence by colleagues (67.6%), non-availability of laptop cooling pads (42.6%), high cost of cooling pads (39.9%), perception of convenience (41.7%). Interventions on laptop ergonomics awareness and provision of affordable laptop ergonomic products for university students are recommended. [ABSTRACT FROM AUTHOR]

The provision of comprehensive sexuality education (CSE) accords opportunities for scientifically accurate information about sexual and reproductive health (SRH). We used a mixed-methods study to characterise adolescent SRH knowledge, attitudes and service utilisation experiences in the context of CSE implementation in Zambia. In-school young people aged 12–24 years (N = 1,612) in the North-Western Province were randomly surveyed. A 29-item index was constructed to measure alignment of knowledge, attitudes and values (KAV) with the CSE curriculum. Logistic regression, stratifying by sexual debut status, modelled associations of past-year HIV counselling and testing and family planning service access, respectively, with CSE-KAV index scores. Focus group discussions further explored perceptions of and experiences accessing SRH services. Despite moderate SRH knowledge and acceptability of SRH services, fewer than half of sexually experienced young people reported accessing SRH services. Among sexually experienced youth, neither HIV testing nor family planning service utilisation in the previous year were associated with higher CSE-KAV index scores. Salient barriers to SRH service uptake included limited perceived benefits, unsupportive household and community environments, and negative interactions with health providers. To increase accessibility and uptake of youth SRH services, linking school-based CSE to SRH services is recommended. [ABSTRACT FROM AUTHOR]

Research indicates that parent-child communication about sexual and reproductive health can improve safe sex practices among adolescents, but barriers to such communication exist. In this systematic review, we thematically synthesised qualitative data in 37 articles on parent-child sexual and reproductive health communication barriers conducted on five continents and in 19 different countries. We identified both barriers to communication and barriers to effective communication reported by parents and/or children. Internationally, both parents and children experienced personal barriers, such as embarrassment, discomfort and fear; communal barriers, such as outside sources and responsibility shift; and cultural barriers, such as sex as taboo, focus on abstinence and age/generational differences. Implications for future family communication interventions and measurement that could help parents navigate this form of sexual education are discussed. [ABSTRACT FROM AUTHOR]

Our study aimed to assess the knowledge and awareness regarding pelvic floor disorders (PFDs) among pregnant women. We additionally evaluated whether the knowledge of PFDs was different in relation to gestational age, parity, the attendance to an antenatal education (ANE), and history of urinary incontinence (UI) and/or pelvic organ prolapse (POP). A cross-sectional descriptive study was conducted in pregnant women from all trimesters of pregnancy. The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) and three questions were used for knowledge and awareness. Two hundred and forty-one women participated in the study. Of them, 18.6% (n = 46) and 3.6% (n = 9) had UI and POP, respectively. The median of the PIKQ-UI and the PIKQ-POP scores were 6 (min-max: 0–11) and 5 (min-max: 0–12), respectively. The median PIKQ-UI and PIKQ-POP scores were higher in women who had attended ANE. There was no significant difference in terms of gestational age, parity, the attendance to ANE, and the history of pelvic floor disorder (p >.05). Knowledge and awareness were low among the women in all trimesters. Education programs involving pelvic floor training should be organized for pregnant women. [ABSTRACT FROM AUTHOR]

The aims of the study were to explore the contraceptive practices of married adolescent girls in rural Upper Egypt and identify the determinants of their ever use of modern contraception. The study was a household survey of 729 married adolescent girls in 23 villages of two governorates in Upper Egypt. Listing and enumeration of all households in the selected villages were performed prior to data collection, to recruit married adolescent girls below 20 years of age. The girls were interviewed using a structured questionnaire. Only 6% of married adolescent girls were using a modern contraceptive method; 10.6% had ever used a modern contraceptive method, mostly a short-acting method. Considerable proportions of participants believed that using contraception would reduce a woman's fertility and that women should not delay their first pregnancy (34% and 54.3%, respectively); only 50.2% believed that contraception could be used for birth spacing. Predictors of the ever use of a modern method of contraception among married adolescent girls were: accepting that contraception could be used for birth spacing (B = 1.82, p <.001), older age (B = 0.42, p <.01), better reproductive health knowledge (B = 0.23, p <.05) and sharing in contraceptive decision making (B = 0.55, p <.05). Married adolescent girls' current use and ever use of modern contraception were very low in rural Upper Egypt. Changing the social norms to create the desire to delay first childbirth, improving adolescent girls' reproductive health knowledge, correcting myths about contraception and building girls' agency to use contraception may increase their contraceptive use. [ABSTRACT FROM AUTHOR]

Women with severe mental illnesses are a vulnerable population and little is known about their reproductive planning needs. The aim of our study was to describe rates of unintended pregnancies, postpartum contraception, identify use and knowledge of prenatal/pregnancy vitamins and identify modifiable lifestyle risks. Mixed methods study incorporating a cross-sectional survey and prospective pregnancy data collection A multidisciplinary antenatal clinic in Australia Thirty-eight pregnant women with severe mental illnesses: schizophrenia, schizoaffective, bipolar and severe post-traumatic stress disorder Unintended pregnancy rates, immediate postpartum contraception, use of prenatal and pregnancy vitamins and knowledge sources, obesity, and use and cessation rates for smoking, and substances, and comorbid medical conditions Overall 42% of women had unintended pregnancy, with those with schizophrenia at most risk (56%). A long acting reversible contraception was inserted in 5 women (13%), with 45% having no immediate contraception prescribed prior to postnatal discharge. Women's main source of vitamin supplementation for pregnancy was from general practitioners. Prenatal folic acid use occurred in 37%, with rates differing for those with a diagnosis of bipolar disorder (52%) and schizophrenia (25%). Vitamin deficiencies occurred in pregnancy, with iron deficiency (ferritin <30 ng/mL) (n = 27, 73%) the most frequent. Overall 21% of women smoked cigarettes and 35% were obese. Addressing gaps in use of effective contraception, proactive reproductive planning and lifestyle management may improve outcomes for women with mental illnesses and their babies. Women with severe mental illnesses have complex health needs that require targeted reproductive counselling. This study adds to what is known by highlighting that: •Women with schizophrenia appear more likely to have unintended pregnancy. •Prenatal counselling for women with severe mental disorders should include recognition and optimisation of management for the high rates of pre-existing medical comorbidities, obesity and elevated nicotine and substance use. •Many women with severe mental illness need increased doses (5 mg) of prenatal folic acid due to psychotropic medication risk and obesity, as well as treatment for high rates of iron and vitamin D deficiency in pregnancy. [ABSTRACT FROM AUTHOR]

Sexuality education in school is important for students' reproductive health; however, devising ways of tailoring it to the needs of a particular society can be challenging. We compared preferences for type of sexuality education in high schools and the level of knowledge of reproductive health among students, parents and teachers in Myanmar. A cross-sectional study was conducted in public high schools in Pyin Oo Lwin. Students, their parents and teachers were asked their preferences for sexuality education and their reproductive health knowledge. Focus group discussions were held to explore their insights on sexuality education for students. We found that 73% of students preferred comprehensive sex education whereas 62% and 56% of parents and teachers preferred an abstinence only approach, respectively. Reproductive health knowledge was low, particularly among students, and particularly with respect to knowledge of sexually transmitted infections. Cultural issues, training and manpower emerged as key themes from the focus groups. Over half of the students said that they were not receiving any form of sex education at school. Reproductive health knowledge was unsatisfactory among all participants reflecting the insufficiency of current sexuality education classes. Training and support for teachers should be provided. [ABSTRACT FROM AUTHOR]

Rates of unintended pregnancy among women receiving medication treatment for opioid use disorder (mOUD) are high, likely due in part to low rates of contraceptive use. Lack of knowledge about contraception may be contributing to inadequate contraceptive use. Objectives: To compare contraceptive knowledge among women and men receiving mOUD relative to a comparison group seeking primary care. Methods: We surveyed 332 reproductive-age women and men receiving mOUD or primary care with the recently validated 25-item Contraceptive Knowledge Assessment. We examined overall differences between patient groups and between females and males using two-way analyses of variance; individual item differences were tested using logistic regression. Results: The mean percent of total correct responses was lower among individuals receiving mOUD (n = 167) relative to the comparison group (n = 165), 47.7% vs. 53.8%, respectively (p <.001), and higher among females (n = 169) relative to males (n = 163), 56.1% vs. 45.2%, respectively (p <.001). Individual item analyses revealed patient group and sex differences primarily in the areas of contraceptive efficacy, attributes of contraceptive methods, and fertility awareness. Conclusion: While there were modest differences between patient groups and sexes, the results suggest a deficit in contraceptive knowledge across all groups. Substance use disorder treatment clinics could be an opportunistic setting in which to provide accurate information about contraception to patients with OUD and other substance use disorders. [ABSTRACT FROM AUTHOR]

Good quality sexuality education is crucial for promoting young people's sexual health and wellbeing. Teachers, as trusted resources of knowledge and skills, play a critical role in supporting young people's sexual wellbeing. This study set out to investigate Chinese novice teachers' perspectives on sexuality education. Interviews were conducted with 30 novice teachers who had graduated from a national pre-service teacher education programme in China. Results were analysed from a gender perspective. This study identified three specific capabilities teachers valued regarding delivering sexuality education in the classroom. A gender difference in teachers' perceptions of the three capabilities was found. Additionally, four main constraints limited teachers to deliver sexuality education, and the interplay between these constraints and gender and broader sociocultural factors, is discussed. Results suggest that policy steps need to be taken in the education sector to reorient the current examination-dominated culture. In addition, an eco-system which engaged parents, students and the wider community should be built at school level. Meanwhile, teacher education programs need to shift attention to building teachers' cross-curricular competences. Finally, a gender-sensitive approach is needed to address the influence of gender differences on teachers' classroom practices. [ABSTRACT FROM AUTHOR]

This study investigated the knowledge, practice and associated factors influencing preventive reproductive health among male civil servants in Ibadan, Nigeria. A descriptive cross-sectional study was conducted in 14 ministries of Oyo State Secretariat, Ibadan. A total of 272 male civil servants in service were selected using a multi-stage sampling technique. Data were collected using a pre-tested semi-structured self-administered questionnaire, which contained a 11–point knowledge scale and 5–point practice scale, and the data were analysed using descriptive statistics. The mean age was 38.0 years ± 9.4. The respondents' knowledge was poor (2.3 ± 1.9) resulting in inadequate preventive reproductive health behaviour practices (2.9 ± 1.4). Identified factors influencing preventive reproductive health behaviour include lack of adequate knowledge of reproductive health services (77.6%), religion/faith (76.5%), lack of trust in healthcare professionals (73.9%), influence of partner (64.7%), and attitude of health workers (69.5%). The male civil servants in the study did not exhibit preventive reproductive health behaviour, which could be due to inadequate knowledge. Hence, it is essential to increase knowledge among the male workers using workplace health promotion and education strategies. [ABSTRACT FROM AUTHOR]

Objective: To assess college students' sexual and reproductive health (SRH) literacy experiences, specific to contraception use and STI prevention. Participants: In Spring 2015, participants (n = 43) from a large institution participated in six focus groups (two male and four females groups). Methods: Focus groups were guided by the health literacy domains (access; understand; appraise; apply); data were analyzed in MaxQDA using the constant comparative method. Results: The Internet was the most commonly accessed source for SRH information. Participants discussed facilitators (eg, use of visuals) and barriers (eg, medical jargon) to understanding information; and personal lifestyle, advice from family/friends, symptoms, and sexual partners as appraisal factors. Participants applied information by communicating with friends/providers and seeking healthcare. However, findings were not linear nor mutually exclusive, representing the interaction of health literacy skills. Conclusion: Findings suggest that a patient-centered intervention capitalizing on technology and trusted individuals (providers/peer educators) may facilitate college students' SRH literacy. [ABSTRACT FROM AUTHOR]

Implementing effective health interventions in recent epidemics has been difficult due to the potentially global nature of their spread and sociocultural dynamics, raising questions concerning how to develop culturally-appropriate preventive measures, and how these health threats are understood locally. In Belize, health policy makers have only been marginally effective in managing infections and mosquito vectors, and Zika has been declared endemic in certain regions, particularly on the island of Caye Caulker. Based on ethnographic research conducted primarily in 2017, we examine how perspectives of Zika-related health consequences are shaped, and how state interventions to manage Zika are understood. We argue that despite its declared endemic status, Zika is not perceived as a true health concern for community members due to numerous neoliberal structural challenges. Moreover, the state’s restrictive form of reproductive governance which limits family planning services is forcing individuals to weigh conflicting conceptions of health consequences. This also contributes to an ambiguous healthcare environment for health practitioners, giving them an unclear picture of the scope of Zika as a public health concern. We also consider how critical medical anthropology and feminist analytical approaches are useful in exploring these questions and contributing to understandings of the health impacts of Zika. [ABSTRACT FROM AUTHOR]

The aim of this post-intervention assessment was to measure the effects of community intervention on the knowledge and attitudes of women regarding safe abortion in Ethiopia. In 2014, following implementation of an educational intervention on sexual and reproductive health from December 2012 to December 2013, 800 women were interviewed about their knowledge, attitudes, and practices regarding abortion. Multivariate regression analyses of respondents' demographics, sources of abortion information, knowledge, and attitudes about safe abortion were conducted. More women in the intervention community knew safe abortion was available in the community (76 percent vs. 57 percent; p < 0.001). Women in the intervention community had greater odds of feeling that women should have access to safe abortion services (adjusted odds ratio [aOR]: 1.55, 95 percent confidence interval [CI]: 1.06, 2.28) after adjusting for socio-demographic characteristics. They had significantly greater odds of feeling comfortable and confident talking to a healthcare provider (aOR: 2.44, 95 percent CI: 1.55, 3.84) and/or her partner (aOR: 2.47, 95 percent CI: 1.58, 3.85) about abortion. Increased mobilization of community networks in disseminating sexual health and abortion information was followed by increased knowledge of abortion services in the intervention community and improved reproductive choices for women. [ABSTRACT FROM AUTHOR]

The present study was designed to explore experiences and constructions of fertility and fertility control among new migrant and refugee women in Sydney, Australia and Vancouver, Canada. Seventy-eight individual interviews and 15 focus groups (n = 82) were conducted with women who had migrated from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and South America. Participants positioned having children as a cultural and religious mandate and as central to a woman’s identity. Many women had limited knowledge about contraception, positioned contraception as forbidden or dangerous, and described negative experiences with its use. These findings are interpreted in relation to the provision of culturally safe medical practice and sexual and reproductive health education. [ABSTRACT FROM AUTHOR]

Maternal mortality is one of the major challenges in reproductive health in Nigeria. Approximately two-thirds of the women (three quarters in rural Nigeria) deliver their babies outside of health facilities and without medically skilled birth attendants. Communication and education are vital since so many births take place outside formal health care environments, and the high mortality rate suggests there is potential for progress, which can supplement Nigerian government efforts. The purpose of the study was to elicit lay knowledge and interpretations about the major components of the problem as part of a wider mental models study aimed at improving risk communication. These knowledge and perceptions were elicited through semi-structured interviews with women of childbearing age (15–49 years). Interviews were analysed to evaluate common themes that will be used to model lay perceptions for comparison to the expert mental model as part of the wider method. The emergent themes will be presented and discussed in the context of the identification of important gaps in knowledge and misperceptions that have the potential for development of improved risk communication. [ABSTRACT FROM AUTHOR]

Social forces shape people's reproductive health in many ways. We examined people's knowledge about reproductive health using focus group data collected from 93 participants in rural districts of Malawi. Participants' perspectives were contextualized by explaining the socioeconomic, cultural, and gender factors that determine reproductive health for rural Malawians. Strategies to improve reproductive health care in environments lacking in health infrastructure, staff, and economic resources are then provided. We call for a reproductive health agenda to target preventive care by providing information about anatomy and biology, communicating information in culturally competent ways, and educating men and women over the life course. [ABSTRACT FROM AUTHOR]

All young people have the right to access comprehensive sexual and reproductive health information. However, most adolescent girls in developing countries face sexuality without adequate information. This is due to the unwritten but active traditional norm against the discussion of sex and sexuality issues with young people. This article reports a descriptive study that investigated the adolescent girls’ degree of access to reproductive health information and the barriers to accessing reproductive health information. Multistage sampling technique was used to select 18 schools, three from each of the six Local Education Districts (LEDs) in Lagos State. The study sample consisted of 1800 girls in the selected schools. Data were collected with a questionnaire. Descriptive and inferential statistics were used for data analysis. The result of the study revealed that in-school adolescent girls had limited access to reproductive health information. The findings also showed that lack of time to seek relevant information and unwillingness of parents to discuss reproductive health issues with the adolescents were major obstacles to reproductive health information access. The test of significance of relationship between access to reproductive health information and attitude towards reproductive health issues indicated significant positive relationship between access to reproductive health information and attitude towards reproductive health issues. The study concluded that access to reproductive health information exerts great influence on attitude towards reproductive health issues. The article recommends the adoption of multimedia approach for the dissemination of reproductive health information in public schools in Lagos State. [ABSTRACT FROM PUBLISHER]