Current Issue : July - September Volume : 2014 Issue Number : 3 Articles : 5 Articles
Background: Sexual activity during adolescence is common in Vanuatu, however many adolescents lack access to\nsexual and reproductive health (SRH) services and subsequently suffer a disproportionate burden of poor SRH.\nThere is limited peer-reviewed research describing adolescentsââ?¬â?¢ SRH service delivery preferences in Vanuatu to\ninform policy and programs. The aim of this qualitative study was to explore the barriers preventing adolescents\nfrom accessing SRH services in Vanuatu and the features of a youth-friendly health service as defined by\nadolescents.\nMethods: Sixty-six focus group discussions were conducted with 341 male and female adolescents aged\n15ââ?¬â??19 years in rural and urban communities. Additionally, 12 semi-structured interviews were undertaken with\npolicymakers and service providers. Data were analysed using thematic analysis.\nResults: Socio-cultural norms and taboos regarding adolescent sexual behaviour were the most significant factors\npreventing adolescents from accessing services. These contributed to adolescentsââ?¬â?¢ own fear and shame, judgmental\nattitudes of service providers, and disapproval from parents and community gate-keepers. Lack of confidentiality\nand privacy, costs, and adolescentsââ?¬â?¢ lack of SRH knowledge were also important barriers. Adolescents and service\nproviders identified opportunities to make existing services more youth-friendly. The most important feature of a\nyouth-friendly health service described by adolescents was a friendly service provider. Free or affordable services,\nreliable commodity supply, confidentiality and privacy were also key features. The need to address socio-cultural\nnorms and community knowledge and attitudes was also highlighted.\nConclusions: There are significant demand and supply-side barriers contributing to low utilisation of SRH services\nby adolescents in Vanuatu. However, there are many opportunities to make existing SRH services more youthfriendly,\nsuch as improving service provider training. Investment is also required in strategies that aim to create a\nmore supportive environment for adolescent SRH....
Background: Communities in South Sudan have endured decades of conflict. Protracted conflict exacerbated\nreproductive health disparities and gender inequities. This study, conducted prior to the countryââ?¬â?¢s 2011\nindependence, aimed to assess attitudes toward gender inequitable norms related to sexual relationships and\nreproductive health and the effects of sex, age, and education on these attitudes.\nMethods: Applying a community-based participatory research approach and quota sampling, 680 adult male and\nfemale respondents were interviewed in seven sites within South Sudan in 2009ââ?¬â??2011. The verbally administered\nsurvey assessed attitudes using the Gender Equitable Men scale. Data were stratified by sex, age (=35 years and\n>35 years), and education.\nResults: Of 680 respondents, 352 were female, 326 were male, and 2 did not indicate their sex. The majority of\nwomen (77%) and men (74%) agreed ââ?¬Å?a man needs other women, even if things with his wife are fineââ?¬Â.\nRespondents who reported no education (60%) were more likely than those who reported any education (45%)\nto agree ââ?¬Å?if a woman is married, she should have sex with her husband whenever he wants to, even if she doesnââ?¬â?¢t\nwant toââ?¬Â (p = 0.002). The majority of women (74%) and men (73%) agreed ââ?¬Å?it is a womanââ?¬â?¢s responsibility to avoid\ngetting pregnantââ?¬Â. Respondents who reported no education (81%) were more likely than those who reported\nany education (72%) to agree with this statement (p = 0.04). When asked about condom use, the majority of\nrespondents, across both sexes and both age groups, agreed ââ?¬Å?it would be outrageous for a wife to ask her husband\nto use a condomââ?¬Â and ââ?¬Å?women who carry condoms are easyââ?¬Â. There were no statistically significant differences\nbetween the two age groups for any of the assessed gender inequitable norms.\nConclusion: The study reveals differences in attitudes toward gender inequitable sexual and reproductive health\nnorms among those surveyed in South Sudan when stratified by sex and education. As a new nation seeks to\nstrengthen its health system, these data can inform sexual and reproductive health policies and programming in\nSouth Sudan....
Background: Sexuality and reproductive health are among the most fundamental aspects of life. Poor parental\ninvolvement in preparing young people for safe sexual life and good reproductive health was part of the blame for\nthe lack of skills on sexual decision making. Despite the growing needs, there is no adequate health service or\ncounseling specifically suitable for this specific age group and research on the role of parents in this process has\nyielded inconsistent results.\nObjective: The objective of the study is to assess adolescentsââ?¬â?¢ communication on sexual and reproductive health\nissues with parents and associated factors among secondary and preparatory schools students in Debremarkos\ntown.\nMethods: School based study was conducted among secondary and preparatory schools students in Debremarkos\ntown, from April 8 to 21, 2012. Multistage sampling and self administered questionnaires were employed.\nResults: The proportion of the students who had discussion on sexual & reproductive health issues with their\nparent was found to be 254 (36.9%). Mother who able to read and write (AOR = 2; 95% CI 1.3 to 3.1), adolescents\naccepting discussion of sexual & reproductive health issues (AOR = 2.5 95% CI 1.3 to 4.5), adolescents who ever got\nSRH information (AOR = 2; 95% CI 1.4 to 2.9), adolescents who ever had sexual intercourse (AOR = 1.7; 95% CI 1.1 to\n2.6) were found to have significant positive associations, and being grade 12 students (AOR = 0.4; 95% CI 0.2 to 0.7)\nand having less than three family size (AOR = 0.5; 95% CI 0.2 to 0.9) showed significant negative associations.\nConclusion and recommendation: Study unveils that parent ââ?¬â??adolescent communications on sexual and\nreproductive health issues is low, only about one third of the students were communicating on SRH issues.\nTherefore; there is a need to equip and educate parents on different sexual & reproductive health issues.\nComprehensive family life education should also be initiated for the students and parents....
Background: The Integra Initiative designed, tested, and adapted protocols for peer mentorship in order to\nimprove service providers� skills, knowledge, and capacity to provide quality integrated HIV and sexual and\nreproductive health (SRH) services. This paper describes providers� experiences in mentoring as a method of\ncapacity building. Service providers who were skilled in the provision of FP or PNC services were selected to\nundergo a mentorship training program and to subsequently build the capacity of their peers in SRH-HIV\nintegration.\nMethods: A qualitative assessment was conducted to assess provider experiences and perceptions about peer\nmentoring. In-depth interviews were conducted with twelve mentors and twenty-three mentees who were\ntrained in SRH and HIV integration. Interviews were recorded, transcribed, and imported to NVivo 9 for analysis.\nThematic analysis methods were used to develop a coding framework from the research questions and other\nemerging themes.\nResults: Mentorship was perceived as a feasible and acceptable method of training among mentors and\nmentees. Both mentors and mentees agreed that the success of peer mentoring largely depended on cordial\nrelationship and consensus to work together to achieve a specific set of skills. Mentees reported improved\nknowledge, skills, self-confidence, and team work in delivering integrated SRH and HIV services as benefits associated\nwith mentoring. They also associated mentoring with an increase in the range of services available and the number of\nclients seeking those services. Successful mentorship was conditional upon facility management support, sufficient\nsupplies and commodities, a positive work environment, and mentors selection.\nConclusion: Mentoring was perceived by both mentors and mentees as a sustainable method for capacity\nbuilding, which increased providers� ability to offer a wide range of and improved access to integrated SRH and\nHIV services....
Background: Addressing the sexual and reproductive health (SRH) needs of young people remains a challenge for\nmost developing countries. This study explored the perceptions and experiences of Health Service Providers (HSP)\nin providing SRH services to young people in Kenya.\nMethods: Qualitative study conducted in eight health facilities; five from Nairobi and three rural district hospitals in\nLaikipia, Meru Central, and Kirinyaga. Nineteen in-depth interviews (IDI) and two focus group discussions (FGD) were\nconducted with HSPs. Interviews were tape recorded and transcribed. Data was coded and analysed using the\nthematic framework approach.\nResults: The majority of HSPs were aware of the youth friendly service (YFS) concept but not of the supporting\nnational policies and guidelines. HSP felt they lacked competency in providing SRH services to young people\nespecially regarding counselling and interpersonal communication. HSPs were conservative with regards to providing\nSRH services to young people particularly contraception. HSP reported being torn between personal feelings,\ncultural and religious values and beliefs and their wish to respect young people�s rights to accessing and\nobtaining SRH services.\nConclusion: Supporting youth friendly policies and competency based training of HSP are two common\napproaches used to improve SRH services for adolescents. However, these may not be sufficient to change HSPs�\nattitude to adolescents seeking help. There is need to address the cultural, religious and traditional value systems\nthat prevent HSPs from providing good quality and comprehensive SRH services to young people. Training\nupdates should include sessions that enable HSPs to evaluate how their personal and cultural values and beliefs\ninfluence practice....
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