Practical justice as an innovative approach to addressing inequalities facing gender and sexually diverse people: a case example from Papua New Guinea

Local Pathways of "Serodiscordant Couples": Unpacking a Global HIV Population Category in Papua New Guinea

HIV prevention programs focus on global "key populations" and more localized "priority populations" to ensure effective targeting of interventions. These HIV population categories have been subject to considerable scholarly scrutiny, particularly key populations, with less attention given to critically unpacking priority populations at local levels, for example "serodiscordant couples" (one partner has HIV, but not the other). We examine this population in the context of Papua New Guinea to consider how local configurations, relational pathways, and lived realities of serodiscordant relationships strain the boundaries of this population category and raise intriguing questions about its intersection with contemporary biomedical agendas.

Barriers and enablers to young people accessing sexual and reproductive health services in Pacific Island Countries and Territories: A scoping review

BACKGROUND

The number of young people utilising sexual and reproductive health services in Pacific Island Countries and Territories remains poor despite the availability and the existence of the fundamental rights to access these services. Adolescents and youth need accurate information and timely access to contraceptives to prevent adverse consequences associated with unintended pregnancies, abortion, childbirth and untreated sexually transmitted infections. This scoping review identifies and analyses factors contributing to young people's low access to sexual and reproductive health information and services in this region.

METHODS

Guided by the PRISMA Scoping review guidelines, we searched three databases (Medline Ovid, Scopus and CINAHL Complete) for peer-reviewed articles published between 1st January 2000 and 31st August 2020 that reported on factors, including barriers and enablers, affecting access to sexual and reproductive health information and services by young people living in Pacific Island Countries and Territories. We assessed the quality of each study according to the study designs, methods of data collection, data analysis and ethical considerations. All information was sorted and organised using an Excel Spreadsheet. Text data from published articles were charted inductively using thematic analysis with no predetermined codes and themes.

FINDINGS

Five hundred eighty-nine articles were screened, and only eight met the inclusion criteria outlined in this scoping review protocol. These eight articles reported studies conducted in four Pacific Island Countries and Territories: Cook Islands, Fiji, Papua New Guinea, and Vanuatu. Factors such as lack of accurate sexual and reproductive health knowledge and social stigma were the leading causes of young people's limited access to sexual and reproductive health services. Cultural and religious beliefs also invoked stigmatising behaviours in some family and community members.

CONCLUSION

This scoping review revealed that social stigma and judgemental attitudes imposed by family and community members, including healthcare providers, hinder young unmarried individuals in Pacific Island Countries and Territories from accessing sexual and reproductive health information and contraceptives. Alternatively, a non-judgmental healthcare provider is perceived as an enabler in accessing sexual and reproductive health information and services. Moreover, given that only a few studies have actually focused on young people's sexual and reproductive health needs in the region, more research is required to fully understand the health-seeking behaviours of young people in their specific contexts.

A qualitative descriptive inquiry into factors influencing early weaning and breastfeeding duration among first-time mothers in Papua New Guinea's rural eastern highlands

BACKGROUND

Exclusive breastfeeding confers multiple maternal and child health benefits. Although breastfeeding initiation following birth is common in Papua New Guinea, many first-time mothers may not achieve optimal breastfeeding duration.

AIM

This study aims to explore and describe factors influencing early weaning and breastfeeding duration among first-time mothers in Papua New Guinea's rural eastern highlands.

METHODS

A qualitative descriptive approach was adopted in this study. Data were collected through semi-structured in-depth interviews with 20 first-time mothers. The interviews transcripts were then thematically analysed.

RESULTS

Three key themes identified were: source of breastfeeding information and support; social networks and breastfeeding communication; and balancing perceived gender and maternal roles. The study further identified a lack of fathers' involvement in supporting breastfeeding.

CONCLUSION

Social and relational networks, and maternal factors need to be considered to better understand breastfeeding practices. Efforts to achieve optimal breastfeeding outcomes entail targeted and culturally appropriate programs, including fathers' involvement as they play important roles in breastfeeding and infant feeding practices.