Empowerment of Adolescent Girls for Sexual and Reproductive Health Care: A Qualitative Study

Explaining sexual self-care status and its predictor factors in women referring to healthcare centers of Sari, Iran, 2021

INTRODUCTION

With the increase in the prevalence of non-communicable diseases and chronic health problems along with population growth, one of the definitions that is expanding is the ability to adapt and self-manage against diseases and self-care. Although there are several studies to examine self-care in medical conditions, there are not enough concepts and data related to sexual self-care. Therefore, the present study was conducted with the aim of explaining the status of sexual self-care and its predictor factors in women of reproductive age referring to healthcare centers.

MATERIAL AND METHODS

This research was a cross-sectional study that was conducted on 400 women of reproductive age that referring to healthcare centers affiliated to Mazandaran University of Medical Sciences, Sari in 2021. Data were collected using personal-obstetric characteristics and sexual self-care questionnaires in women of reproductive age. Pearson correlation coefficients, independent t-test, one-way analysis of variance and multiple linear regression model were used to analyze the data.

RESULTS

The average total score of sexual self-care in reproductive age women participating in the research was 70.66% ± 12.52%. In addition, the prevention of women's cancers and the prevention of unintended pregnancies obtained the lowest and highest scores, respectively. Factors such as age, education, education related to medical sciences, history of HIV testing, history of HPV vaccination, source of sexual information, method of contraception and infection-related action in a person can affect the level of sexual self-care in women. Based on the final regression model, education related to medical sciences (B = 5.46, P = 0.035), family income (B = 5.58, P = 0.025), prevention method (B = 10.127, P = 0.000) and action related to infection in the person (B = 12.27, P = 0.047) were the final predictors of sexual self-care score in reproductive age women.

CONCLUSION

Based on the findings of the study, development of self-care promotion programs for reproductive aged women are necessary in all areas of reproductive health, with a priority for women's cancer prevention, and focusing on promoting education and related economic assistance. The results of this study can be available to experts and policy makers to design programs to promote sexual self-care in women.

Effectiveness of Digital Media-base on Smoking Cessation Program toward Empowerment among Adolescent in Indonesia

BACKGROUND: There is a critical need for effective health education techniques for smoking cessation in adolescents. The use of digital media is a promising strategy to address adolescent health. AIM: This study aimed to determine the effectiveness of digital media-base on smoking cessation programs toward empowerment among adolescents in Indonesia. METHODS: This was a quasi-experimental design with pre- and post-instruments employing the youth group member survey. Quantitative data were evaluated using the Mann–Whitney U-test to examine changes in participants’ degree of adolescent empowerment toward smoking cessation between the control and intervention groups. RESULTS: A total of 170 adolescent smokers agreed to join this study, with 85 participants in each group. There is a significant difference in adolescent empowerment between the control group and the intervention group, as shown by p < 0.05. CONCLUSION: Digital media-based smoking cessation programs are promising techniques (with potential benefits) for increasing adolescent empowerment. The future studies should employ more rigorous procedures and a larger sample size to support this finding.

Is empowerment in sexual health measurable? A scoping review of definitions and measurement indicators

The concept of empowerment in sexual health is widely used in health promotion. This scoping review aims to identify how it is defined and measured. PubMed, Sage Journals, PsycInfo and the Web of Science are data sources. The inclusion criteria for studies were as follows: (1) an analysis of empowerment in sexual health, (2) quantitative evaluation and (3) publication in a peer-reviewed journal in French or English since January 1996. Data were extracted using a summary table of the definitions and indicators of empowerment in sexual health. Of the 2181 articles found, 29 met the inclusion criteria. Only 4 studies on 29 clearly defined empowerment in sexual health. Five dimensions emerged from the indicators used in the 29 studies in relation to sexual empowerment (social participation, participation in decision making, power to act, sexual health knowledge and gender norms), with two types of indicators: indicators unspecific to sexual health, which can be viewed as empowerment basic skills, and indicators specific to sexual health. Most studies concerned women and focused on individual empowerment, with a lack of measure of collective and structural levels of empowerment. Despite great heterogeneity in the definitions and indicators used, a set of core indicators emerged: participation in decision making, sexual negotiation power and sexual communication skills, knowledge and use of contraceptive methods, and HIV and sexually transmitted infections risk perception. This set could be systematically used in each study based on sexual empowerment concept, completed by supplementary indicators considering the specific context.

"I didn't support PrEP because I didn't know what it was": Inadequate information undermines male partner support for young women's pre-exposure prophylaxis use in western Kenya

The HIV infection rate is higher among adolescent girls and young women (AGYW) in Africa than men in the same age range. Pre-exposure prophylaxis (PrEP) can be used by women discreetly; however, for most AGYW, male partner approval is desired. We explored PrEP use in the context of relationship violence and power dynamics through focus group discussions and support club sessions with AGYW, in-depth interviews and male sensitisation sessions with male partners of AGYW, and joint sessions with AGYW and their male partners. Many male partners reported hesitancy in supporting partner's PrEP use without sufficient information; most of these became supportive following their engagement in study activities; and most preferred participation in decisions around PrEP use. For AGYW, male involvement minimised partner violence around their PrEP use. The findings support the need for correct PrEP information to be provided to male partners of AGYW and to involve them early on, in decision-making about PrEP use. This is likely to improve uptake of and adherence to PrEP.

Priorities for a gender-sensitive sexually transmitted infections and human immunodeficiency virus (STIs/HIV) services: An exploratory mixed methods study

Background and Aim

Providing gender‐sensitive health services is emphasized by the World Health Organization. This study aimed to assess and prioritize the needs for the gender‐sensitive sexually transmitted infections/human immunodeficiency viruses (STIs/HIV) prevention services by a valid and reliable questionnaire.

Methods

This was an exploratory mixed methods sequential study in Shiraz Iran 2019. The first phase was a qualitative study on 37 providers and managers of the services who were recruited using the purposive and then snowball sampling method. In the second phase, following the content analysis of the qualitative data and a review of related literature, a questionnaire was developed and its psychometric properties were evaluated. Then, in the third phase, the questionnaire was used to assess and prioritize the needs through a quantitative descriptive cross‐sectional study on all 290 providers of STI/HIV prevention services affiliated with Shiraz University of Medical Sciences.

Results

The finding of the qualitative phase showed gender‐sensitive STI/HIV prevention services should provide gender‐sensitive care and education by the trained personnel and manages with appropriate facilities and equipment. Providing these services also requires supportive policies, intersectoral cooperation, and community capacitation. In the second phase, a questionnaire was developed with 63 items. Assessment of psychometric properties of the questionnaire demonstrated the scale content validity index and ratio (S‐CVI = 0.98 and S‐CVR = 0.87, respectively), as well as the reliability of the questionnaire (internal consistency = 0.972 and intracluster correlation coefficient = 0.910). Results of the third descriptive phase of the study demonstrated the highest priorities for gender‐sensitive education (92.01 ± 11.76%) and care services (92.11 ± 12.04%), respectively.

Conclusions

To improve the quality of the services, a gender‐based education and care process, as well as a gender‐sensitive structure, including gender‐sensitive personnel, facilities, and management are necessary. Recognizing and meeting the needs for gender‐sensitive services will improve the quality of the services.

A qualitative study of the health information seeking behaviour of adolescent girls in Iran indicates that public libraries could help supply information required about puberty

INTRODUCTION

The present study aimed to identify the puberty related information seeking behaviour of adolescent female members of Zarrinshahr public libraries.

METHODOLOGY

Using a phenomenology approach, this study sought to identify the puberty related information seeking behaviours for a population of female adolescent public library patrons located in the Middle East. The data were collected via event based interviews and the samples were selected by purposeful sampling method. After converting the audio to text, the transcripts were imported into MAXQDA 10, they were coded and then, the relevant categories were extracted.

RESULTS

The information needs of girls experiencing puberty were identified and divided into four thematic categories: health issues, psychological issues, religious issues (religious precepts), and issues related to physical activity. Girls get this information from a variety of resources such as people, the Internet, social networks, documents, and libraries. The process of information seeking is so problematic for them because they are faced with content, family, social, and financial barriers and mainly lack Internet literacy and search skills.

CONCLUSION

Health information seeking constitutes the main part of adolescent girls' daily lives. Identification of adolescent girls' health information needs, the main channels of information seeking, and the barriers the girls face while information seeking can help public libraries adopt the right policies regarding the provision of health information services.

Sexual and reproductive health self-care: a theory-based intervention

Purpose

This study, a theory-based interventional study, aims to promote self-care behaviors regarding sexual and reproductive health in adolescents (female) in Karaj, Iran.

Design/methodology/approach

This study was conducted on 90 female students of the Alborz University of Medical Sciences in Iran. For selecting subjects, the researchers went to two girls' dormitories on working days and tried to observe the proportion of students with different fields. Initially, 200 eligible female students were identified in the dormitories of Alborz University of Medical Sciences. Based on the sample size estimation, 100 research units were divided into two groups of receiving counseling (intervention group) and not receiving counseling (control group) by four-digit block randomization. Sexual and reproductive health self-care questionnaire was used as a tool for data collection before, after and one month after intervention. Data were analyzed by using X2 and ANOVA tests using SPSS (16).

Findings

Both groups were homogeneous in terms of demographic characteristics before the intervention. The results of the study indicated that after education, sexual and reproductive knowledge (p < 0.001), self-care of sexual health (p < 0.001), self-care of menstrual and genital health (p < 0.001) increased significantly. But, regarding parents' communications (p = 0.11), conversation barriers with parents (p = 0.83), interaction with (p = 0.79) and the perceptions of sexual risk behaviors relationships (p = 0.61) differences are not significant.

Research limitations/implications

Failure of parents to participate in this study and the implementation of this study only on the female sex were main limitations of the present study.

Practical implications

Theory-based education can improve sexual and reproductive health in adolescents' girls.

Originality/value

All Authors declare the manuscript entitled “Sexual and reproductive health self-care: a theory-based intervention” is original work of the author. All data, tables, figures, etc. used in the manuscript are prepared originally by authors; otherwise, the sources are cited and reprint permission is attached.

Living with Restrictions. The Perspective of Nursing Students with Primary Dysmenorrhea

Primary dysmenorrhea (PD) affects a large number of female university students, diminishing their quality of life and hindering academic performance, representing a significant cause of absenteeism. The purpose of our study was to determine how nursing students experienced restrictions as a result of primary dysmenorrhea. A qualitative exploratory study was conducted among 33 nursing students with primary dysmenorrhea. A purposeful sampling strategy was applied. Data were collected from five focus groups (two sessions each) and the field notes of 10 researchers. A video meeting platform was used to conduct the focus groups. A thematic inductive analysis was performed. Thirty-three female nursing students participated in the study with a mean age of 22.72 (SD 3.46) years. Three broad themes emerged: (a) restrictions on daily activities and sports; (b) academic restrictions, and (c) restrictions on social and sexual relationships. The students described restrictions in performing everyday activities, such as carrying weight, and shopping. Some students even gave up the practice of sports and were absent from classes at the university, and from clinical practices at the hospital. The pain affected their ability to maintain and create new social relationships. Primary dysmenorrhea caused restrictions in the personal, social and academic life of the nursing students.

Reproductive health outcomes: Insights from experts and verbal autopsies

BACKGROUND

Reproductive health outcomes are a measure of maternal and neonatal health. South Africa's state of maternal health is of particular concern because of the two Millennium Development Goals (MDGs) targets for monitoring maternal health, namely MDG 5a, to reduce the maternal mortality rate by three-quarters, and MDG 5b, to achieve universal access to reproductive health by 2015. Maternal mortality ratio and universal access to reproductive health receive unequal responsiveness from government. Monitoring the maternal mortality ratio has received favourable attention compared to ensuring universal access to reproductive health, hence the limited published research findings on the latter.

OBJECTIVES

The purpose of this article is to report on the insights from reproductive health experts and verbal autopsies on the determinants of poor reproductive health outcomes.

METHOD

Individual interviews with a purposively selected sample of six reproductive health experts were conducted, augmented by verbal autopsies of 12 next of kin of women and newborn babies who died within the previous 2 years period of the study. Burnard's (1995) approach of content analysis was used to analyse the data.

RESULTS

The findings revealed lack of empowerment, inaccessible reproductive health services and separation of patients living with human immune deficiency virus and those patients diagnosed with acquired immune deficiency syndrome.

CONCLUSION

To meet the reproductive health needs, especially of the rural population, urgent attention is needed to reduce their vulnerability to the risks of poor reproductive outcomes.

Development and psychometric properties of the female adolescents' sexual reproductive self-care scale

INTRODUCTION

The aim of this study was to design and evaluate the psychometric properties of an instrument for understanding female adolescents' reproductive and sexual self-care behaviors.

METHODS

A methodological study was conducted. In the qualitative phase, individual in-depth interviews were performed to develop the initial questionnaire. In the quantitative part, the psychometric properties of the questionnaire were evaluated.

FINDINGS

The initial questionnaire with 128 items was reviewed by the research team and taking into account the cut-off point 1.5 for the item impact and 0.62 for the content validity ratio (CVR), the number of questions fell to 82 items. S-CVR and S-content validity index (CVI) rations were 0.83 and 0.91, respectively. Exploratory factor analysis led to 74 items in seven dimensions. The alpha Cronbach's coefficient for the whole questionnaire was 0.895 and the intra-cluster correlation coefficient was 0.91.

CONCLUSION

The questionnaire developed in this study is reliable and valid for assessing female adolescents' sexual and reproductive self-care.