Dissertations / Theses on the topic 'Sexual and Reproductive Health Policy'
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Oronje, Rose Ndakala. "Understanding the drivers of change in sexual and reproductive health policy and legislation in Kenya." Thesis, University of Sussex, 2013. http://sro.sussex.ac.uk/id/eprint/46469/.
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The thesis explored the drivers and inhibitors of change in sexual and reproductive health (SRH) policy and legislation in Kenya. The overall purpose was to contribute to the limited knowledge on national-level debates that shape how developing countries adapt the SRH agenda, which originated from international processes. The thesis explains how and why some SRH reforms have been realised in Kenya amid contention, while others have been blocked. Guided by a synthesis conceptual framework that emphasised the central role of discursive power in decision-making, the thesis adopted a qualitative case-study design enriched with various anthropological concepts. Three case-studies (two bureaucratic, i.e. adolescent RH policy and national RH policy, and one legislative, i.e. sexual offences law) were deconstructed. Data collection involved semi-structured in-depth interviews with policy actors, observations and note-taking in meetings, and document review. Findings revealed that four influential narratives of SRH – the moral narrative, cultural narrative, medical narrative (with two variations i.e. ‘moralised' versus ‘comprehensive' medical narratives), and human rights narrative – underpinned by conflicting actor interests, mediated the interplay of actor networks, knowledge, context and institutions to determine reforms. The findings revealed that the strong entrenchment of the moral and cultural narratives in the Kenyan context (mainly public structures and institutions) was a major barrier to reforms on contested SRH issues. Even then, the hegemonic narratives were in some cases unsettled to make reforms possible. The most important factors in unsettling the hegemonic narratives to facilitate reforms included: a change in the political context that brought in new political actors supportive of reforms, the presence of knowledgeable and charismatic issue champions within political and bureaucratic institutions, the availability of compelling knowledge (scientific or lay) on an issue, sustained evidence-informed advocacy by civil society/non-governmental organisations, donor pressure, and reduced political costs (for politicians and bureaucrats) for supporting reforms. The main contribution of the thesis is three-fold. First, the thesis captures the disconnect between international SRH agreements and national-level realities, showing the need for international actors to consider national-level realities that shape decision-making. Second, its findings provide lessons for informing future SRH reform efforts in Kenya and in other sub-Saharan African countries. Third, its analysis of discursive power contributes to a major theoretical gap in health systems research in developing countries identified as lack of critical analysis of power in decision-making.
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Moore, Sarah-Ann. "Policy responses to the sexual and reproductive health of queer youth in the global south: a systematic review." Thesis, Rhodes University, 2018. http://hdl.handle.net/10962/63021.
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Concerns surrounding youth sexual and reproduction health (SRH) are deeply embedded within systems of heteronormativity and ciscentrism. Resultantly, youth SRH is filtered through a lens of heterosexual and cisgender experience, rendering invisible the SRH needs of queer youth. Importantly, a failure to recognise queer experiences of SRH has implications for normative subject positions, which enjoy stronger institutional support and constitute legitimate ways of being. As such, the failure to recognise queer youth as health care subjects within policy has far reaching consequences for their sexual and reproductive health. Within this research, a sexual and reproductive justice (SRJ) framework is adopted as a backdrop for exploring policy documents related to youth SRH within selected global South countries in Africa, Asia, and the Caribbean. The final data set comprises of 1035 policy excerpts extracted from 152 policies across these three regions. Research takes the form of a systematic review utilising a deductive framing and positioning thematic analysis. Analysis identifies framings of youth SRH and explores the subject positions assigned to queer youth in relation to these identified framings, with the understanding that the manner in which youth SRH concerns are framed and queer youth are positioned within policies provides an important foundation for the implementation of SRH-related policy. Findings demonstrate that policy responses to youth SRH are most often framed in terms of a public health approach. As a result, dominant understandings of youth SRH serve to reduce youth sexuality to notions of infections and impact, which may speak to an overreliance on biomedical and population-level health models. Themes emerging within human rights framings demonstrate a presumption that rights are equally afforded to, and freely exercised by, all individuals once legally secured, failing to engage with the creation of enabling conditions to realise these rights. Although context and culture framings were by no means exhaustive examples of SRJ, they provide an interesting insight into how such SRJ concerns might be integrated into policy. Importantly, policy responses demonstrate a general pattern hypervisibility of men who have sex with men (MSM) standing in marked contrast to the invisibility of queer youth and other adult queer populations. Within policy extracts, both youth and „MSM‟ are positioned as particularly prone to poor SRH outcomes. By virtue of their inclusion within both populations, queer youth may be considered as especially at risk for, or vulnerable to, such outcomes. Relatedly, these populations (and by extension queer youth) are positioned as in need of correction, containment, and/or protection by those occupying „gatekeeping‟ positions (e.g. health care providers). The positioning of „MSM‟ solely within the context of HIV/AIDS serves to link same-sex sexualities (and at times gender non-conformity) with harmful consequences, suggesting that the positioning of queer youth could similarly serve to conflate their SRH needs with concerns around HIV/AIDS. Many of the subject positions deployed in policies serve to deny the potential for youth and „MSM‟ agency, strength, and resilience. Thus, queer youth subjects are unlikely to be positioned as empowered, autonomous, and agentic. Across both framing and positioning themes, a number of key shortcomings were observed. For the most part, policy responses fail to acknowledge the influence of social, economic, political, and cultural forces that may serve to hinder SRH outcomes according to particular contexts and the intersection of multiple and varied social identities. By obscuring these broader contextual factors and power relations, policy responses may serve to hold individual youth responsible for poor SRH outcomes. In failing to engage with the potential for diversity within youth populations, these populations are largely homogenised. Finally, the need for the creation of an enabling environment in order to secure sexual and reproductive health is largely unacknowledged within policy responses.
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Farahani, Farideh Khalaj Abadi. "Norms, attitude and sexual conduct among female college students in Tehran : implications for reproductive health policy and research." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2008. http://researchonline.lshtm.ac.uk/682381/.
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Despite social, cultural and religious prohibitions on premarital sexual relationships in Iran, some evidence suggests that premarital heterosexual relationships and sex among young people may be increasing, but no study has been conducted which gives a comprehensive picture of perceived societal norms, attitudes, sexuality and the nature and process of heterosexual relationships among unmarried young females in Iran. This study aimed to investigate and compare the views and conduct of young female college students with perceived societal norms. The objectives included; exploring sexual norms and attitudes, assessing the social and individual factors responsible for variation in norms, attitude, and behaviour of female college students and finally exploring the process and circumstances of sexual behaviour. Complementary qualitative and survey methods were used. The qualitative research includes 4 Focus Group Discussions (FGDs) and 30 In-Depth Interviews (IDIs). FGDs explored societal norms on pre-marital sexuality, while IDIs explored more personal attitudes and behaviours in greater depth. The survey was conducted in 2005-6 on a sample of 1743 female undergraduate students in four multidisciplinary universities in Tehran. A self-administered questionnaire was applied. This study revealed an ambiguity with regard to social acceptability of premarital heterosexual relationships, while sexual contact before marriage was perceived as socially proscribed. Personal attitudes were considerably more tolerant of such premarital relationships and sex than societal norms. These findings suggest that traditional norms on heterosexual relationships are eroding among young people. Within this complex attitudinal context, nearly half of unmarried women reported premarital friendships with men and more than one-fifth reported any type of sex (23%). Low self-efficacy, peers' liberal norms on virginity, older age, parents' liberal attitude and poor family relationships were predictors of ever having sexual contact. Qualitative findings showed that gender double-standards dictate restrictions for women, but permit sexual licence for men and owing to men's preference for a virgin bride, most relationships which involve sex are unlikely to result in marriage. Therefore although young people have adopted some liberal values in their premarital relationships their marriage still follows traditional and cultural values. These results have implications for programmes designed to improve young people's reproductive health in Iran.
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Lindeborg, Alicia. "Representation and its importance for women's sexual and reproductive health and rights : Does the proportion of women in national parliaments matter for the extent to which legislation and policy guarantee women's sexual and reproductive health and rights?" Thesis, Uppsala universitet, Statsvetenskapliga institutionen, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-432522.
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This thesis sets out to investigate if the proportion of women in the national parliament correlates with the extent to which national laws and policies guarantee women's sexual and reproductive health and rights. By conducting a cross-national comparison, this thesis contributes to the existing literature by offering an analysis of the relationship, utilizing a comprehensive measurement of states national legal and regulatory framework relating to women's sexual and reproductive health and rights. Further, it aims to offer an analysis of how the relationship appears in different regime-types, including both democratic and non- and partial democratic states. The results did not provide any support for a correlation between the proportion of women in the national parliament and the extent to which national laws and policies guarantee women's sexual and reproductive health and rights, regardless of the regime-type. While the results are inconsistent with the predictions of a correlation, this thesis is able to conclude that the concept of women's representation and how it may be connected to substantial changes in national legislation and policy is a complex relationship, worthy of further research.
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Hadi, Manizha. "An analysis of policy and social factors impacting the uptake of sexual and reproductive health services in Kabul, Afghanistan." Thesis, Durham University, 2016. http://etheses.dur.ac.uk/11862/.
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Research Question: What factors at individual, health service provision and system levels are influencing sexual and reproductive health (SRH) service uptake? Rationale: In many Afghan ethnic groups, girls and women face heavier risks of disease and infection than men. Their diminished economic and social status compromises their ability to select healthier life strategies and access to sexual reproductive health (SRH) services. The Afghan government estimates a high maternal mortality ratio (327/100,000 live births) in Afghanistan. However, due to inadequate reliability of data, the true maternal mortality and morbidity ratio remain unknown. A deeper understanding of the policy and social factors that impact on poor SRH service uptake would help the development of applicable and successful SRH Policy and frame applicable and appropriate approaches for sustainable SRH service uptake in Afghanistan. Method: It is a qualitative policy analysis using the ‘Broader Framework of Thinking’ by Walt and Gilson (1994) and a variety of data collection methods. Data was collected from 450 participants (Patients 223, Family members 72, Health service providers 63, Governmental staff 31, Coordinating organisation staff 17, Religious leaders 11, Health-promoters 13, Psychosocial counsellors 20) by conducting interviews, focus group discussions, participant observation, life narratives, document reviews and an audit of medical records. Findings: My results show the key factors underlying women’s poor health were a lack of knowledge about SRH, poor communication, and a lack of honour and trust both between individuals and within the health system. In addition, research findings highlighted that depression, multi-pregnancies, childbirth complications, anemia, malnutrition, sexually transmitted infections and interpersonal violence were routine for women. It clearly shows gaps within SRH Policy design and implementation and health service provision. These gaps are associated with social factors, which negatively impact on access and utilisation of proper SRH services Conclusions and Recommendations: This research analysed national reproductive health Policy (NRHP) and explored the impact of multifaceted social factors on SRH service uptake. In complex health systems recommending solutions require distinguishing between types of problems and a specific time-scale to improve SRH service uptake.
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Leiva, Rioja Zoila. "Public policies of sexual and reproductive health in Peru: the introduction of therapeutic abortion regulation into the government’s political agenda." Politai, 2016. http://repositorio.pucp.edu.pe/index/handle/123456789/91986.
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The objective of the present article is to analyze the process of introducing the regulation of therapeutic abortion into the peruvian governmental agenda, identifying the factors that came together to generate such event, the period of study being between the years 2005 to 2014. The investigation corroborates that said event was possible due to the confluence of certain political and institutional factors on the national stages, the strategy of groups in favor (pro-choice) and against (pro-life) the regulation, and international influence.El presente artículo tiene como objetivo analizar el proceso de ingreso de la reglamentación del aborto terapéutico en la agenda política gubernamental peruana, así como identificar los factores que confluyeron para generar dicho ingreso, siendo el periodo de estudio entre los años 2005 y 2014. La investigación corrobora que dicho ingreso fue posible gracias a la confluencia de ciertos factores políticos e institucionales del ámbito nacional, de las estrategias de los grupos a favor (pro-elección) y en contra (pro-vida) de la reglamentación, y de la influencia internacional.
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Dantas, Suellen Maria Vieira. "Sexualidade, reprodução e relações de gênero: reflexões a partir da análise da politica nacional de saúde do homem." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5137/tde-09082017-121622/.
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Estudos sobre a relação masculinidades-saúde tem apontando para a permanência de visões essencialistas sobre o sexo e desafios no que diz respeito aos direitos sexuais e reprodutivos, assim como para a dificuldade de se incluir homens nas práticas de cuidado em saúde devido às representações sociais do masculino e ao direcionamento dos serviços para mulheres e crianças. A implantação e implementação da \"Política Nacional de Atenção Integral à Saúde do Homem\" (PNAISH) no Brasil trouxe como desafio o reconhecimento das desigualdades de gênero vivenciadas pelos homens e de suas necessidades de saúde. Nesse sentido, compõe-se como justificativa para este trabalho a necessidade de se investigar como o homem tem sido contemplado institucionalmente em relação à sexualidade e reprodução. Assim, constitui-se como corpus da pesquisa o documento-base da política, documentos vinculados à construção da PNAISH e materiais desenvolvidos a partir desta, bem como publicações relacionadas à sexualidade e reprodução de homens nas páginas \"Saúde do Homem - Ministério da Saúde\" e \"Secretaria Municipal da Saúde de São Paulo\" em rede social. Por meio da análise de conteúdo, a discussão esteve amparada pelos pressupostos dos Estudos de Gênero e pelo pensamento foucaultiano. Buscou-se a compreensão de discursos que orientam a PNAISH: à que homens esta se dirige e como a política busca direcionar ações em saúde ao tratar da sexualidade e reprodução. Observou-se que a política reflete representações sociais, apresentando muitas das diferenças e desigualdades de gênero existentes. A sexualidade em seu sentido mais amplo é pouco abordada, observando-se ênfase dada à prática e potência sexual. Ainda, apesar de esforços, não houve plena incorporação de discursos de responsabilização igualitária nas questões reprodutivas e de parentalidade, estando ainda presentes visões sobre os homens como figuras de apoio. São necessárias ações que trabalhem as resistências a maiores liberdades e igualdades sexuais e reprodutivas? A PNAISH ainda precisa de maior aproximação das necessidades, diversidade de relações e desigualdades existentesStudies about the masculinity-health relationship have pointed to the persistence of essentialist visions about sex and challenges regarding sexual and reproductive rights, as well as the difficulty of including men in health care practices due to the social representations of the masculinity and the direction of the services for women and children. The implantation and implementation of the \"Brazilian Comprehensive Healthcare Policy for Men\" (PNAISH) in Brazil has brought as a challenge the recognition of the gender inequalities experienced by men and their health needs. In this sense, the justification for this study is the need to investigate how man has been contemplated in sexuality and reproduction institutionally. Thus, is constituted as corpus of the research, the official text of the policy, documents related to the construction of the PNAISH and materials developed from it, as well as publications related to sexuality and reproduction of men in the Facebook pages \"Health of Man - Ministry of Health\" and \"Municipal Health Department of São Paulo \". Through content analysis, the discussion was supported by the theories of Gender Studies and Foucaultian thinking. We sought the understanding of discourses that guide the PNAISH: to which men this is directed and how politics seeks to direct actions in health when dealing with sexuality and reproduction. It was observed that the policy reflects social representations, presenting many of the existing gender differences and inequalities. Sexuality in its broadest sense is not too much discussed in the documents, with an emphasis on sexual act and potency. Yet, despite efforts, there was no full incorporation of egalitarian accountability discourses on reproductive and parenting issues, and visions about men as support figures are still present. Still are needed actions that work the resistance for greater sexual and reproductive freedoms and for equality. The PNAISH still needs to approximate more to the needs, to the diversity of existing relationships and to the inequalities
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Santos, Carolina Orrico. "O processo de formulação da política pública em reprodução assistida: o Projeto de Lei Nº 517/2011, no Estado de São Paulo." Universidade Catolica de Salvador, 2013. http://hdl.handle.net/123456730/286.
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A pesquisa discute o processo de formulação da política pública em reprodução humana assistida, de modo especial o Projeto de Lei nº 517/2011 e sua entrada na agenda governamental do Estado de São Paulo, no intuito de investigar o porquê, como e para que se dá o processo de formulação do “Programa de Assistência Básica em Reprodução Humana” (Projeto de Lei n º 517/2011) na agenda governamental do Estado de São Paulo. Especificamente, buscou-se ainda: identificar o problema que justifica a formulação da política de assistência em reprodução humana assistida no sistema público de saúde do Estado de São Paulo à luz do modelo teórico de política pública de Kingdon; levantar e sistematizar os documentos existentes sobre as propostas/alternativas para a assistência em reprodução humana assistida no sistema público de saúde do Estado de São Paulo; mapear os atores/participantes do processo de formulação da política pública em reprodução humana assistida na agenda governamental do Estado de São Paulo. Assim, este estudo pretende ampliar a compreensão dos direitos sociais, quais sejam: o direito à saúde e o direito sexual e reprodutivo a luz da Lei do Planejamento Familiar, a fim de que as camadas menos favorecidas economicamente possam desfrutar desses direitos, por vezes tolhidos pelo sistema econômico neoliberal e capitalista. Tais direitos auxiliam na construção de um Estado do Bem Estar Social, no qual a cidadania pode ser exercida de maneira salutar à dignidade da pessoa humana. Nesse sentido, a metodologia adotada foi de uma pesquisa qualitativa com revisão bibliográfica, análise documental e o delineamento do estudo de caso, o qual utilizou como instrumento de coleta de dados a entrevista, para buscar a percepção dos atores envolvidos no processo de formulação da política supramencionada, tendo como referencial teórico o modelo de políticas públicas de Kingdon. O caso estudado foi o Projeto de Lei nº 517/2011, que institui o “Programa de Assistência Básica em Reprodução Humana”, da Assembleia Legislativa do Estado de São Paulo. Os dados obtidos evidenciaram que, no Brasil, a política pública ora abordada é escassa, refletindo, pois, no acesso a uma classe menos favorecida. Desse modo, fica evidenciada a necessidade da participação do Estado, através das ações formuladas pelo Sistema Único de Saúde (SUS) ou pelas Parcerias Público-Privadas (PPP). Ressalta-se, entretanto, que as questões orçamentárias para a consecução das políticas de reprodução humana assistida representam empecilhos para sua implementação, devido à limitação dos recursos governamentais, haja vista que a previsão orçamentária ainda é insuficiente. Outrossim, deve-se atentar para o discurso do benefício das privatizações nas prestações dos serviços garantidos constitucionalmente à população como um todo, uma vez que a ausência de regras bem definidas pode favorecer ao desvio dos objetivos reais da referida política, não atendendo, pois, ao público ao qual se destina.
The research discusses the process of public policy-making in assisted human reproduction, particularly the Bill of Law nº 517/2011 and its entry into the government agenda of the State of São Paulo, in order to investigate why, how and who gives the process of formulating the "Basic Assistance Program in Human Reproduction" (Bill nº 517/2011) on the government agenda of the State of São Paulo. Specifically, we sought also to identify the problem that justifies the policy formulation assistance in assisted human reproduction in the public health system of the State of São Paulo the light of the theoretical model of public policy Kingdon; lift and systematize existing documents on proposals / alternatives for assistance in assisted human reproduction in the public health system of the State of São Paulo; map the actors / participants in the formulation of public policy on assisted human reproduction in the government agenda of the State of São Paulo. Thus, this study aims to broaden the understanding of social rights, namely: the right to health and the right to sexual and reproductive Light Family Planning Law, in order that the economically less privileged can enjoy these rights sometimes hampered by neoliberal and capitalist economic system. Rights which help in building a State of Social Welfare, in which citizenship can be exercised so salutary to human dignity. In this sense, the methodology adopted was a qualitative study with literature review, documentary analysis and design of the case study, which used as a tool for data collection interview to seek the perception of the actors involved in the process of policy formulation above, with the theoretical model of public policies Kingdon. The case studied was the Draft Law nº 517/2011, establishing the "Basic Assistance Program in Human Reproduction," the Legislature of the State of São Paulo. The data showed that, in Brazil, the public policy discussed herein is scarce reflecting, as the access to a class less favored. Thus, it is clear the need for the participation of the state through the actions made by the Unified Health System (SUS) or the Public-Private Partnerships (PPP). It is noteworthy, however, that the budget issues for achieving policy assisted reproduction represent impediments to its implementation due to limited government resources, given that even the budget forecast is still insufficient. Furthermore, attention should be paid to the speech of the benefit of privatization in those services constitutionally guaranteed to the population as a whole, since the absence of well-defined rules may favor the deviation of the real objectives of the policy not serving as the public for which it is intended.
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Richiello, Isabella. "Women's experience of a sexual and reproductive health chatbot." Thesis, KTH, Medieteknik och interaktionsdesign, MID, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-231819.
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Chatbots are increasing in popularity and interacting with humans via written language. Previous research has looked at chatbots within several domains, but not towards women’s general sexual and reproductive health. This offers a need to extend the small body of current research. This report aimed to do so by describing women’s experiences of a sexual and reproductive health chatbot used as a decision support tool. The chatbot was designed based on a user-centered approach, allowing women to express desired personality traits in a person when discussing the topic. This resulted in the design creation of two chatbots with two different personalities. Exploratory Wizard of Oz studies were conducted with 6 users by simulating interaction with both chatbots operated by a human. Users were followed up with a survey and interview creating insights to their experiences with each chatbot. Findings resulted in contributing to research with proposed guidelines for how to design a sexual and reproductive health chatbot.Chatbots blir allt mer populära och interagerar med människor genom skriftligt språk. Tidigare forskning har utforskat olika användningsområden för chatbots, men kvinnors sexuella och reproduktiva hälsa har inte varit en av dessa områden. Detta skapar ett behov att expandera den nuvarande smala forskningen. Denna studie syftar till att göra det genom att beskriva kvinnors erfarenheter av en chatbot för sexuell och reproduktiv hälsa som används som ett beslutsstödsverktyg. Chatboten utformades utifrån ett användarcentrerat tillvägagångssätt, vilket tillät kvinnor att uttrycka önskade personlighetsdrag hos en person som man diskuterar ämnet med. Detta resulterade i ett design skapade av två chatbots med två olika personligheter. Wizard of Oz studier genomfördes med 6 användare genom att simulera interaktionen med båda chatbots drivna av en människa. Deltagarna följdes upp med en enkät, följt av en intervju för bättre insikt till deras erfarenhet med varje chatbot. Resultaten resulterade i att bidra till forskning med förslag på riktlinjer för hur man utformar en chatbot för sexuell och reproduktiv hälsa.
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Ellington, Renata Denise. "Sexual Health Education Policy: Influences on Implementation of Sexual Health Education Programs." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2971.
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High school youth in Grades 9-12 who are in public schools without comprehensive sexual health education (CSHED) are more likely to engage in high-risk sexual behaviors and have higher rates of HIV and sexually transmitted diseases than are their peers in schools with CSHED. The purpose of this correlational study was to explore the statistical relationship between the consistent implementation of CSHED, before and after the enactment of the Chicago Public Schools' (CPS) sexual health education policy, and the sexual risk behaviors of Chicago high school youth in Grades 9-12. The study was based on Antonovsky's salutogenic model of health and wellbeing. CPS students' sexual risk behaviors were analyzed using data obtained from the Youth Risk Behavior Surveillance System (YRBSS) for the years of 2007 and 2013. Logistic regression was used to estimate prevalence and odds ratios of each sexual risk behavior. The findings showed a complex pattern of and variances across the sexual risk behaviors analyzed. The prevalence of sexual behaviors among all students remained relatively stable. The prevalence estimates for students who drank alcohol or used drugs before the last sexual encounter and who were never taught about AIDS or HIV increased from 2007 to 2013. The likelihood of not using birth control pills before the last sexual intercourse encounter decreased among Black students; the likelihood that Hispanic/Latino students ever had sex, and had sex with 4 or more people in their life, decreased. The decrease of sexual risk behaviors indicates a positive influence by CSHED, while the increases indicate continuing challenges to the promotion of healthy sexual behaviors. These findings show the need for legislators and school administrators to increase support for the enactment of CSHED policy to help mitigate the sexual risk behaviors of high school youth.
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Chavez, Isabel. "Truth or Consequence?: Navigating Barriers to Sexual and Reproductive Health Resources for Sexual Minority Women." Scholarship @ Claremont, 2019. https://scholarship.claremont.edu/cmc_theses/2131.
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In the United States and abroad, the LGBTQ+ population has both historically and currently, suffered from a higher likelihood of poorer health outcomes than their heterosexual and cisgender counterparts due to stigma and discrimination (Alencar Albuquerque et al., 2016). While these health disparities have been well studied for the United States LGBTQ+ community as a whole, there is less understanding of what subgroups within this population may be disproportionately more susceptible to poorer health outcomes and risky behaviors, as well as, less understanding for the reasons behind such health outcomes and behaviors. One such subgroup is that of sexual minority women (SMW), or women who are sexually and/or romantically attracted to other women or who identify outside of heterosexual norms (Youatt, Harris, Harper, Janz, & Bauermeister, 2017). Preliminary studies have found that SMW are less likely than their sexual minority male and heterosexual female peers to have regular access to healthcare providers and are more likely to have negative experiences in healthcare settings, specifically in regards to sexual and reproductive healthcare (Riskind, Tornello, Younger, & Patterson, 2014). For these reasons, coupled with discrimination and risky sexual and health behaviors, SMW are a vulnerable population in need of social, political, and medical attention. This thesis aims to understand the causes and barriers SMW face when accessing sexual and reproductive health resources, as well as, provide direction for navigating such barriers on a multifactorial level. This research analyzes how hegemonic heteronormativity and sexism take root in (a) economic and political barriers in obtaining health insurance and health knowledge for SMW, (b) SMW patient ignorance of health risks and needs, (c) minimal to no medical provider training and understanding for SMW health risks, behaviors, and needs. Each barrier is addressed holistically; a novel approach necessary for the initial alleviation of such barriers to sexual and reproductive care and knowledge for SMW.
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Englund, Linnéa, and Evelina Persson. "Young women's sexual and reproductive health and rights in Ecuador." Thesis, Högskolan i Jönköping, Hälsohögskolan, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-34734.
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Rokicki, Slawa. "Improving Reproductive Health: Assessing Determinants and Measuring Policy Impacts." Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:33493534.
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In this thesis, I investigate policies and programs to improve reproductive health. My thesis makes a substantive contribution to reproductive health policy and a methodological contribution to quasi-experimental research.
In chapter 1, I evaluate the impact of a mobile phone intervention for adolescent girls. I design and implement a randomized controlled trial in Ghana to test whether sending information via mobile phones is an effective way to improve girls’ knowledge of sexual health and to ultimately reduce teenage pregnancy. I find that mobile phone programs are effective not only in increasing knowledge, but also in decreasing risk of pregnancy among sexually active adolescents. I discuss the results in the context of sexual education policy in Ghana.
In chapter 2, I explore the complex interactions between migration and reproductive health. I reconstruct the complete migration and reproductive health histories of women residing in the urban slums of Accra, Ghana. Using individual fixed effects to reduce selection bias, I find an increased risk of pregnancy, miscarriage, and abortion in the 48 months after migration, with no significant increase in the chance of live birth during this time period. With half of abortions in Ghana classified as unsafe, these results suggest that policies which target the rapidly growing number of urban migrants by providing access to contraception and public hospital services may reduce unsafe abortion and improve maternal health outcomes.
In chapter 3, I investigate the bias of standard errors in difference-in-difference estimation, which typically evaluates the effect of a group-level intervention on individual data. Common modeling adjustments for grouped data, such as cluster-robust standard errors, are biased when the number of clusters is small. I run Monte Carlo simulations to investigate both the coverage and power of a wide variety of modeling solutions from the econometric and biostatistics fields, while varying the balance of cluster sizes, the degree of error correlation, and the proportion of treated clusters. I then apply my results to re-evaluate a recently published study on the effect of emergency contraception on adolescent sexual behavior. I find that the study’s results claiming that emergency contraception increases risky sexual behavior may be spurious once proper adjustments for grouped data are applied.Health Policy
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ROCHA, LIANA DIAS MARTINS DA. "SEXUAL AND REPRODUCTIVE HEALTH: WHAT DO THE SEXUAL MASCULINE ADOSLESCENTS OF PAPO CABEÇA PROJECT THINK." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2012. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=21317@1.
Full textAbstract:
PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIROCONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO
O objetivo desse estudo é analisar a contribuição do projeto papo cabeça para o cuidado da saúde sexuale reprodutiva, na perspectiva dos adolescentes do sexo masculino atendidos pelo referido projeto. O estudo consiste em uma investigação documental que possui como instrumento de coleta de dados o formulário de pesquisa do projeto projeto papo cabeça, denominado perfil. No universo de 342 formulários, foi analisada uma amostra de 50 formulários respondidos por adolescentes do sexo masculino, estudantes da rede municipal de ensino da Sétima Coordenadoria Regional de Educação do Rio de Janeiro, compreendidos entre as faixas de 10 aos 19 anos e que participaram do projeto papo cabeça no período de 2008 a 2010. As categorias de análise envolvidas no processo de investigação foram: a caracterização dos adolescentes do sexo masculino; o relacionamento com os pais e/ou responsáveis no que se refere ao diálogo sobre o sexo e sexualidade; o cuidado com a saúde sexual e reprodutiva e o relacionamento dos adolescentes com o projeto papo cabeça. Os resultados da pesquisa apontaram que o projeto papo cabeça constitui uma ferramenta para a aproximação dos adolescentes do sexo masculino com a saúde sexual e reprodutiva. Através da participação no projeto, os adolescentes afirmaram que passaram a obter conhecimentos e a adotar cuidados relativos ás doenças sexualmente transmissíveis e métodos contraceptivos. Na perspectiva dos mesmos, o projeto papo cabeça representa uma alternativa para a conscientização do cuidado com a saúde sexual e reprodutiva na medida em que encontraram pouca abertura no ambiente familiar para o debate sobre a temática.
The purpose of this study is to analyze the contribution of the project papo cabeça for the care of sexual and reproductive health, from the perpective of male adolescent who were seved by this project. The study consists of a documentary investigation and a research form entitled perfil was used to collect data. From 342 forms, we analyzed 50 forms perfilfilled by male adolescents, municipal students of 7th regional education coordination of Rio de Janeiro, in the 10 to 19 age group and who participated in the papo cabeça. Project in the period of 2008 and 2010. These are the categories analyses involved inthe investigation process: characterization of male adolescents; the relationships with parentes and guardians about the sex and sexuality dialog; the sexual and reproductive health care and the adolescents relationship with the papo cabeça project. The survey results show that the papo cabeça project contitues a tool for approaching the males adolescents to the sexual and reproductive health. Through participation in the project, the adolescents said the came to gain konwlegde and take care related to sexually transmitted diseases and contraceptive methods. From the perspective of male adolescent, the papo cabeça project represents an alternative to the sexual and reproductive health care consciousness, the extent that they have little chancesin the family enviromnentto discussabout the subject.
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Dahlbäck, Elisabeth. "Between opportunities and risks : adolescent sexual and reproductive health in Zambia /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-978-5/.
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Kirkham, Jacqueline. "Sexual and reproductive health in Romania and Moldova : contexts, actors, challenges." Thesis, University of Glasgow, 2011. http://theses.gla.ac.uk/2586/.
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Over the past two decades sexuality and reproduction have proved potent and contested subjects. After the unexpected collapse of the state socialist systems, societies facing uncertainty and dislocation have turned both to the allure of ‘the west’ and to pre-socialist traditional values of family and gender. Along with this, aspirations of moving closer to Europe sits alongside a resurgent nationalist sentiment throughout the region, and it is sexuality and reproduction which has become a particularly contested battleground, as the female reproductive body has become a metaphor for the vitality and viability of the nation-state. Discourses of demographic crisis, calls to produce more (indigenous) children to increase the population and ensure the stability and viability of the state, and proscription of so-called ‘deviant’ (defined as non-heterosexual/non-reproductive) sexualities have all gained in currency as the nations of the region try to establish themselves as sustainable entities following the years of state-sponsored paternalism. At the same time, western nations and donor agencies offer support to redevelop and redesign out-of-date systems and bureaucracies and the opportunity to modernise and enjoy the benefits of capitalism and liberal democracy. A particular focus on developing civil society along with the reform of state institutions widens the social marketplace still further. It is against this backdrop that policy makers and service providers attempt to develop and provide health services. Public health is a useful barometer of what is happening in society, as it reflects the effects of wider socio-economic and political trends. Within this, the study of sexual and reproductive health is crucial as it also has the ability to illuminate the differential effects of societal change on different groups within society, such as women or those from minorities. It also powerfully illustrates the contestations going on in wider society around meanings of the moral and healthy, as sexuality and reproduction are issues pertinent to the continued reproduction of states and other ‘communities of power’. This thesis is a study of the experiences and perceptions of service providers in the field of sexual and reproductive health in Romania and the Republic of Moldova. Through interviews with service providers in both state and civil society sectors as well as regional and national authorities and international donor agencies, and an extensive media review of the portrayal of sexuality, reproduction and sexual and reproductive health, opportunities and barriers to providing accessible and responsive services within the contested arena of two postsocialist countries with much in common historically and culturally but following very different paths in the contemporary period are explored. The continuing importance of sexual and reproductive health as a category of study which can illuminate wider macro-level debates on national identity and vitality, as well as the importance of discursive battles over control of meanings, are amply illustrated in the thesis. In particular the relation between health and morality is extensively explored, and the relevance of an area studies approach to this wider topic is demonstrated. The thesis finds that it is vital to consider sexual and reproductive health services within their wider sociocultural context and that transnationally-funded initiatives do not take full account of the multiplicity of meanings and values underpinning the reactions of target populations to their services; indeed services are often framed as representing an unwelcome invasion of ‘alien’ morality. Ultimately providers and funders need to take the moral understandings of their target populations very seriously if they are to overcome the considerable opposition to their services.
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Hoque, A. M. Mozibul Santhat Sermsri. "Sexual behaviour, contraceptive practice and reproductive health among Thai school adolescents /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-MozibulH.pdf.
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Krugman, Allison. "Addressing the Sexual and Reproductive Health Rights of Low-Income Women in Argentina." Scholarship @ Claremont, 2015. http://scholarship.claremont.edu/cmc_theses/1115.
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Though Argentine women have made marked advancements in terms of equality since the Latin American country’s return to democracy in the 1980s, they still face barriers to the full exercise of their sexual and reproductive rights in a number of arenas. For low-income women, the added dimension of poverty further erodes the ability to seek necessary services to maintain sexual and reproductive health. As a result, high rates of maternal mortality and adolescent pregnancy persist. Given the broad socioeconomic inequality among Argentine provinces, the policies created by Argentina’s government to address sexual and reproductive health lack widespread implementation and oversight. Furthermore, a strong opposition to these policies is in place, promoted by the heavy presence of the Catholic Church in Argentine institutions and society as well as deeply entrenched perceptions of motherhood. This study identifies the social, economic, legal, cultural, and political challenges that face the sexual and reproductive autonomy of Argentine women, evaluates the current policies in place to address them, and projects potential solutions for Argentina’s government, women’s movement, and NGOs.
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Lui, Paraniala Silas Celebi. "Reproductive health problems faced by men in Solomon Islands." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/101163/1/Paraniala%20Silas%20Celebi_Lui_Thesis.pdf.
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This study is one of few to examine reproductive health problems affecting men in the Pacific region. Four hundred men in Honiara suburbs were interviewed about their reproductive and sexual problems and their general health. Disorders of sexual function were reported by many men in the Solomon islands, and were associated with common chronic diseases and poor mental health. However, levels of help-seeking, medical screening and treatment were low. The study recommends development of culturally sensitive reproductive health care for men in Pacific Island nations and territories.
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Priego, Hernández Jacqueline. "Sexual and reproductive health among indigenous Mexican adolescents : a socio-representational perspective." Thesis, London School of Economics and Political Science (University of London), 2011. http://etheses.lse.ac.uk/364/.
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In this thesis I advance a socio–representational perspective on sexual and reproductive health as constructed by indigenous Mexican adolescents. The social and psychological literature on health among indigenous populations and on adolescent sexual health is reviewed. It is argued that a socio–psychological perspective is needed to understand the resources through which contemporary indigenous youth, a population overlooked by research, make sense of their sexual and reproductive health. In generating the theoretical tools to tackle this issue, I adopt a dialogical approach to social representations theory to sharpen Jovchelovitch’s (2007) model of knowledge encounters by proposing a typology of potential outcomes of these encounters. The empirical research involved female and male indigenous adolescents in two social contexts: rural and urban. In–depth individual interviews, focus group discussions and unstructured observations were employed for data elicitation. Results from the interpretative thematic analysis performed are presented through a ‘funnelling’ approach whereby the interdependent engagements of indigenous adolescents with their social context, their partners and specific health beliefs are discussed by highlighting nuanced differences in relation to social context and gender. Key findings are related to the understanding of romantic relationships in terms of stability and continuity, which impacts on the way that sex and contraception are perceived and experienced. Results also reveal that, in dialogue with others, adolescents come to identify alternative ways of positioning themselves with regards to customary discourses about sexual health. Focus group discussions are further examined through a dialogical analysis of interactions that aim to identify, in sociodialogue, the outcomes of knowledge encounters initially proposed. A further data–driven outcome is subsequently added to the typology and analytical categories are refined. Implications for health promotion in terms of the reflexion entailed in dialogue are offered in the conclusion chapter.
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Abed, Itaf. "Reproductive and sexual health needs of women with physical disabilities in Gaza." Thesis, University of Nottingham, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.446390.
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Oliveira, Mariana GonÃalves de. "Manual of validation sexual and reproductive health: behavior contraceptive methods for blind." Universidade Federal do CearÃ, 2016. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=16756.
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nÃo hÃMulheres cegas tem baixa oferta de material educativo em saÃde. Manual educativo acessÃvel à possibilidade de ensino-aprendizado fornecendo informaÃÃo sobre saÃde sexual e reprodutiva com enfoque nos mÃtodos anticoncepcionais comportamentais. Este estudo teve como objetivos: Validar Tecnologia Assistiva para cegas na modalidade de Manual sobre mÃtodos anticoncepcionais comportamentais para promoÃÃo da saÃde. Trata-se de pesquisa quase experimental, desenvolvida na cidade de Fortaleza no Estado do Cearà no perÃodo de fevereiro 2014 a setembro 2015. Utilizou amostra nÃo-probabilÃstica de conveniÃncia, especialistas em conteÃdo e mulheres cegas. A coleta de dados foi dividida em duas fases: ValidaÃÃo do Instrumento de AvaliaÃÃo de Aprendizagem com especialistas e ValidaÃÃo do Manual com mulheres cegas. Foi construÃdo pela autora e depois validado por especialistas um Instrumento de AvaliaÃÃo do Conhecimento (prà e pÃs teste). Na segunda etapa, aplicou-se o instrumento (prà teste) e entrega do Manual para leitura, em seguida agendado um outro encontro para aplicaÃÃo do mesmo instrumento (pÃs teste) e devoluÃÃo do Manual. Os dados foram organizados em tabelas e grÃficos com frequÃncias absolutas e relativas. Utilizou-se o coeficiente de Alfa Cronbach, o teste estatÃstico de McNemar, bem como a odds ratio de McNemar e o teste dos postos assinalados de Wilcoxon. Foram respeitando os preceitos Ãtico-legais. Participaram do estudo cinco especialistas e 48 mulheres cegas. Observa-se que todos os itens do instrumento foram considerados bem redigidos e de fÃcil compreensÃo; e relevantes pelas especialistas. Houve concordÃncia excelente entre as especialistas que apÃs anÃlise foi considerado extremamente significante (p<0,001), logo, adequado para coleta de dados. A maioria das participantes (52%) tinha cegueira congÃnita. A idade variou de 18 a 66 anos, com mÃdia de 35  14 anos, predominando a faixa de 18 a 29 anos (42%). Predominaram mulheres com nÃvel superior (40%) e o estado civil solteiro (56%). A mÃdia de acertos no prà teste e pÃs teste em mulheres cegas com relaÃÃo ao tipo de cegueira evidenciou significÃncia estatÃstica nas com cegueira adquirida (<0,001) e congÃnita (<0,001). Em relaÃÃo a faixa etÃria evidenciou-se significÃncia estatÃstica nas mÃdias de acertos do prà e pÃs teste nas mulheres cegas com 18 a 29 anos (p=0,002), 30 a 39 anos (p=0,001) e 40 ou mais anos (p=0,002). No tocante a escolaridade observou-se que as mÃdias de acertos no prà e pÃs teste apresentou significÃncia estatÃstica nas mulheres cegas com ensino mÃdio (p<0,001) e ensino superior (p<0,001). Ainda, verificou-se que as mÃdias entre as mulheres com ensino fundamental foi inferior aos valores da mediana do grupo (p=0,056). A mÃdia de acertos no prà e pÃs teste em mulheres cegas com relaÃÃo ao estado civil evidenciou significÃncia estatÃstica nas mulheres solteiras (p<0,001) e casadas/uniÃo estÃvel (p<0,001). Dessa forma, foi possÃvel mensurar o aprendizado e confirmaram-se boas mÃdias de acertos pÃs-leitura do Manual, reforÃando que o mesmo representa excelente estratÃgia de aprendizagem, assim o Manual foi validado.
Mulheres cegas tem baixa oferta de material educativo em saÃde. Manual educativo acessÃvel à possibilidade de ensino-aprendizado fornecendo informaÃÃo sobre saÃde sexual e reprodutiva com enfoque nos mÃtodos anticoncepcionais comportamentais. Este estudo teve como objetivos: Validar Tecnologia Assistiva para cegas na modalidade de Manual sobre mÃtodos anticoncepcionais comportamentais para promoÃÃo da saÃde. Trata-se de pesquisa quase experimental, desenvolvida na cidade de Fortaleza no Estado do Cearà no perÃodo de fevereiro 2014 a setembro 2015. Utilizou amostra nÃo-probabilÃstica de conveniÃncia, especialistas em conteÃdo e mulheres cegas. A coleta de dados foi dividida em duas fases: ValidaÃÃo do Instrumento de AvaliaÃÃo de Aprendizagem com especialistas e ValidaÃÃo do Manual com mulheres cegas. Foi construÃdo pela autora e depois validado por especialistas um Instrumento de AvaliaÃÃo do Conhecimento (prà e pÃs teste). Na segunda etapa, aplicou-se o instrumento (prà teste) e entrega do Manual para leitura, em seguida agendado um outro encontro para aplicaÃÃo do mesmo instrumento (pÃs teste) e devoluÃÃo do Manual. Os dados foram organizados em tabelas e grÃficos com frequÃncias absolutas e relativas. Utilizou-se o coeficiente de Alfa Cronbach, o teste estatÃstico de McNemar, bem como a odds ratio de McNemar e o teste dos postos assinalados de Wilcoxon. Foram respeitando os preceitos Ãtico-legais. Participaram do estudo cinco especialistas e 48 mulheres cegas. Observa-se que todos os itens do instrumento foram considerados bem redigidos e de fÃcil compreensÃo; e relevantes pelas especialistas. Houve concordÃncia excelente entre as especialistas que apÃs anÃlise foi considerado extremamente significante (p<0,001), logo, adequado para coleta de dados. A maioria das participantes (52%) tinha cegueira congÃnita. A idade variou de 18 a 66 anos, com mÃdia de 35  14 anos, predominando a faixa de 18 a 29 anos (42%). Predominaram mulheres com nÃvel superior (40%) e o estado civil solteiro (56%). A mÃdia de acertos no prà teste e pÃs teste em mulheres cegas com relaÃÃo ao tipo de cegueira evidenciou significÃncia estatÃstica nas com cegueira adquirida (<0,001) e congÃnita (<0,001). Em relaÃÃo a faixa etÃria evidenciou-se significÃncia estatÃstica nas mÃdias de acertos do prà e pÃs teste nas mulheres cegas com 18 a 29 anos (p=0,002), 30 a 39 anos (p=0,001) e 40 ou mais anos (p=0,002). No tocante a escolaridade observou-se que as mÃdias de acertos no prà e pÃs teste apresentou significÃncia estatÃstica nas mulheres cegas com ensino mÃdio (p<0,001) e ensino superior (p<0,001). Ainda, verificou-se que as mÃdias entre as mulheres com ensino fundamental foi inferior aos valores da mediana do grupo (p=0,056). A mÃdia de acertos no prà e pÃs teste em mulheres cegas com relaÃÃo ao estado civil evidenciou significÃncia estatÃstica nas mulheres solteiras (p<0,001) e casadas/uniÃo estÃvel (p<0,001). Dessa forma, foi possÃvel mensurar o aprendizado e confirmaram-se boas mÃdias de acertos pÃs-leitura do Manual, reforÃando que o mesmo representa excelente estratÃgia de aprendizagem, assim o Manual foi validado.
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Macleod, Catriona. "The management of risk: adolescent sexual and reproductive health in South Africa." International Journal of Critical Psychology, 2006. http://hdl.handle.net/10962/d1015958.
Full textAbstract:
Scientific discourse allows for the calculation of negative outcomes attendant on conception and birth during adolescence, thereby producing a discourse of risk. The management of risk allows for the deployment of governmental apparatuses of security. Security, as outlined by Foucault, is a specific principle of political method and practice aimed at defending and securing a national population. In this paper I analyse how techniques of security are deployed in the interactions between health service providers and young women seeking contraceptive and reproductive assistance at a regional hospital in South Africa, and how racialised and gendered politics are strategically deployed within these techniques. Security combines with various governmental techniques to produce its effects. The techniques used in this instance include pastoral care, liberal humanism, the incitement to governmental self-formation, and, in the last instance, sovereign power.
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Adams, Michael John. "Sexual and reproductive health problems among Aboriginal and Torres Strait Islander males." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16599/1/Michael_John_Adams_Thesis.pdf.
Full textAbstract:
Compared to males in almost any social group in all affluent nations, Australia's Aboriginal and Torres Strait Islander men suffer from substantially more serious illnesses and early death. To date, research done by or in collaboration with Indigenous communities has revealed the extent of the problems that arise from diabetes, heart disease, hypertension, cancers, respiratory diseases, psychological disorders, accidental injuries, violence and other causes. Reproductive health, however, rarely has been studied among Indigenous men. To date, research in this field has been limited mainly to studies of sexually transmitted infections. No data has been published on Aboriginal men's symptoms of prostate disease or erectile dysfunction, nor has the clinical screening and treatment of these disorders among these men been assessed. In-depth search of the worldwide web demonstrated that little information on these issues was available from other Indigenous populations. It does appear that Indigenous men in Australia, New Zealand and North America are less likely than European-ancestry men to die from prostate cancer, or for living cases to be recorded on cancer registries. This may arise because Indigenous men genuinely have a lower risk, or because they are not captured by official statistics, or because they do not live long enough to develop severe prostate disease. We also know very little about other reproductive health problems such as sexual dysfunction and specifically erectile difficulties. One reason for our scant knowledge is that research mainly relies on self-report of sensitive information. The aim of the research study was to improve the understanding of sexual and reproductive health problems experienced by Indigenous men. This is best gathered by Aboriginal males who are inside the culture of middleaged and older Indigenous men, but until now this has not been attempted. In this study we adopted the World Health Organization (WHO) definitions for Reproductive and Sexual Health (WHO, 2001). Thus, we consider reproductive system disorders (prostate disease, erectile dysfunction) and related health care-seeking, and also men's perceptions about a "satisfying and safe sexual life". The methodology was framed within an Aboriginal and Torres Strait Islander research protocol that advocates respect for cultural, social and community customs. A mixed method design combined qualitative inquiry (4 focus groups and 18 in-depth interviews) and quantitative survey (n=301) involving men living in remote, rural and urban communities (Tiwi Islands, Darwin and north and south-east Queensland). Survey data were compared to recently published self-reports from 5990 randomly selected men aged over 40 years in Australia (Holden et al., 2005, The Lancet, 366, 218-224. The qualitative interviews revealed that most men were silent about reproductive health. They were unwilling to reveal their inner feelings to wives or partners, and they were unwilling to discuss such issues with doctors and other health care workers. Men's reaction to sexual difficulties included shame, denial, substance abuse and occasionally violence. On a positive note many men said they want to learn about it, so they understand how to cope with such problems. The Indigenous men reported symptoms of erectile dysfunction at least as much as non-Indigenous men in other Australian studies. Bivariate analysis showed that erectile dysfunction was correlated with many health and lifestyle variable. However multivariate analysis revealed that only three factors significantly predicted ED: presence of chronic disease, presence of pain when working, and living in a remote geographic location The quantitative survey data indicate that Indigenous men have more symptoms of prostate disease than non-Indigenous men. The syndrome appears to be poorly managed in clinical practice (e.g. rates of PSA testing and digital-rectal examination are only one-third the rate reported by non-Aboriginal men, despite equivalent likelihood of GP visits). The research study adds to the literature by providing better insight and depth into the issues impacting on Aboriginal and Torres Strait Islander males experiencing reproductive and sexual health difficulties. It also provides a platform to undertake comprehensive research with Aboriginal and Torres Strait Islander men to explore a wider spectrum of questions in this important but neglected area. Implications for education of primary healthcare workers and community-based awareness campaigns for Indigenous males are discussed. Most of all, this study revealed "layers" of silence around sexual and reproductive health of Indigenous men. This includes silence in the scientific establishments in health services, and in the community. It is hoped that this study puts the voices of the men forward to help to break down this silence.
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Adams, Michael John. "Sexual and reproductive health problems among Aboriginal and Torres Strait Islander males." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16599/.
Full textAbstract:
Compared to males in almost any social group in all affluent nations, Australia's Aboriginal and Torres Strait Islander men suffer from substantially more serious illnesses and early death. To date, research done by or in collaboration with Indigenous communities has revealed the extent of the problems that arise from diabetes, heart disease, hypertension, cancers, respiratory diseases, psychological disorders, accidental injuries, violence and other causes. Reproductive health, however, rarely has been studied among Indigenous men. To date, research in this field has been limited mainly to studies of sexually transmitted infections. No data has been published on Aboriginal men's symptoms of prostate disease or erectile dysfunction, nor has the clinical screening and treatment of these disorders among these men been assessed. In-depth search of the worldwide web demonstrated that little information on these issues was available from other Indigenous populations. It does appear that Indigenous men in Australia, New Zealand and North America are less likely than European-ancestry men to die from prostate cancer, or for living cases to be recorded on cancer registries. This may arise because Indigenous men genuinely have a lower risk, or because they are not captured by official statistics, or because they do not live long enough to develop severe prostate disease. We also know very little about other reproductive health problems such as sexual dysfunction and specifically erectile difficulties. One reason for our scant knowledge is that research mainly relies on self-report of sensitive information. The aim of the research study was to improve the understanding of sexual and reproductive health problems experienced by Indigenous men. This is best gathered by Aboriginal males who are inside the culture of middleaged and older Indigenous men, but until now this has not been attempted. In this study we adopted the World Health Organization (WHO) definitions for Reproductive and Sexual Health (WHO, 2001). Thus, we consider reproductive system disorders (prostate disease, erectile dysfunction) and related health care-seeking, and also men's perceptions about a "satisfying and safe sexual life". The methodology was framed within an Aboriginal and Torres Strait Islander research protocol that advocates respect for cultural, social and community customs. A mixed method design combined qualitative inquiry (4 focus groups and 18 in-depth interviews) and quantitative survey (n=301) involving men living in remote, rural and urban communities (Tiwi Islands, Darwin and north and south-east Queensland). Survey data were compared to recently published self-reports from 5990 randomly selected men aged over 40 years in Australia (Holden et al., 2005, The Lancet, 366, 218-224. The qualitative interviews revealed that most men were silent about reproductive health. They were unwilling to reveal their inner feelings to wives or partners, and they were unwilling to discuss such issues with doctors and other health care workers. Men's reaction to sexual difficulties included shame, denial, substance abuse and occasionally violence. On a positive note many men said they want to learn about it, so they understand how to cope with such problems. The Indigenous men reported symptoms of erectile dysfunction at least as much as non-Indigenous men in other Australian studies. Bivariate analysis showed that erectile dysfunction was correlated with many health and lifestyle variable. However multivariate analysis revealed that only three factors significantly predicted ED: presence of chronic disease, presence of pain when working, and living in a remote geographic location The quantitative survey data indicate that Indigenous men have more symptoms of prostate disease than non-Indigenous men. The syndrome appears to be poorly managed in clinical practice (e.g. rates of PSA testing and digital-rectal examination are only one-third the rate reported by non-Aboriginal men, despite equivalent likelihood of GP visits). The research study adds to the literature by providing better insight and depth into the issues impacting on Aboriginal and Torres Strait Islander males experiencing reproductive and sexual health difficulties. It also provides a platform to undertake comprehensive research with Aboriginal and Torres Strait Islander men to explore a wider spectrum of questions in this important but neglected area. Implications for education of primary healthcare workers and community-based awareness campaigns for Indigenous males are discussed. Most of all, this study revealed "layers" of silence around sexual and reproductive health of Indigenous men. This includes silence in the scientific establishments in health services, and in the community. It is hoped that this study puts the voices of the men forward to help to break down this silence.
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Pomonis, Hailey Sierra. "Adolescent Sexual and Reproductive Needs in Rural ND: A Needs Assessment." Diss., North Dakota State University, 2020. https://hdl.handle.net/10365/31757.
Full textAbstract:
In order to reduce sexual risk behaviors and related health problems, preventative and educational measures must be implemented to help adolescents adopt lifelong attitudes and behaviors that support their health and well-being. Given the period of adolescence is a time of increased risk, positive health practices are vital. The end goal of this quality improvement project is to help form positive health practices during the period of adolescence, this in turn will create a healthy and strong passageway into adulthood. A qualitative approach was used to elicit the perspectives of adolescents, health providers, educators, and parents regarding the sexual and reproductive health needs of adolescents in rural N.D. Individual, semi-structured interviews were conducted with five participants in each target group.
It was evident in the provider interviews that there was a range of approaches to addressing sexual and reproductive health with adolescents. Their approaches ranged from very comprehensive, to more limited in the discussion of sexual and reproductive health with the adolescents they saw in their clinic. The fact that the amount and quality of information adolescents received was entirely dependent upon which individual provider they happened to see means that both consistency and quality of information was compromised. The educators described little to no experience discussing sexually education with adolescents. The only educator participant who actively educated adolescents on sexual and reproductive health was a health educator within a rural school system. The parent participants stated that adolescents need more open and honest education regarding sexual and reproductive health. The adolescent participants gave one-worded responses; they did not expound on any questions they were asked. The interviewer asked for an expansion on their one-worded answers, but the adolescents would repeat what they had said initially. The adolescent participants were asked about sexual and reproductive health messages given to them by either health care providers, educators, or parents. Their responses consisted of abstinence is best, and the consequences of sexual experimentation. If this is the adolescent participants’ truthful answer, it is concerning on many levels.
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Milanes, Lilian. "Health care providers' perspectives on male involvement in their sexual and reproductive health care needs." Honors in the Major Thesis, University of Central Florida, 2012. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/590.
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Young men are at the greatest risk of contracting sexually transmitted infections (STIs) within the U.S. male populations, yet are the least likely to make a sexual and reproductive health (SRH) care visit. Clinical approaches in these areas that include the outreach to and the involvement of male partners of female patients can prove particularly useful in expanding SRH care to men and can also improve health outcomes for women who have sex with men. In this study I examined UCF's healthcare provider's approaches to educate and involve men (between the ages of 18 and 30) and male partners of female patients in their SRH needs. I conducted qualitative semi-structured interviews with 18 health care providers at the Student Health Center; including physicians, physician assistants, and registered nurses. This study found that there were significant differences in perception of men's SRH risk behaviors among the providers. In addition, this study revealed issues that might deter male students from accessing care, specifically how patients are required to state to the operator (who is also an undergraduate student) their name, PID and exactly why they are scheduling a visit to the clinic, thus many men say they have cold symptoms instead of issues with SRH. This study is significant because it can contribute to improvements in the delivery of SRH care to male students on campus.B.A.
Bachelors
Sciences
Anthropology
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Sheehy, Grace. "A Reproductive Health Needs Assessment in Peri-Urban Yangon, Myanmar." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32785.
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The 2010 elections in Myanmar installed the country’s first civilian-elected government in more than 50 years, and subsequent growth and change have been rapid. However, reproductive health indicators are generally poor and reflect significant regional and geographic disparities. Rural populations are increasingly migrating to urban centers, like Yangon, in search of better economic opportunities and in response to persistent conflict. Many are settling in peri-urban Yangon, a dynamic series of townships characterized by poor infrastructure, slums, and a highly mobile population. However, very little is known about the reproductive health needs of this population. This study was designed to identify the reproductive health needs of women in peri-urban Yangon, and to understand better current practices, available services, and potential avenues for improvement. My research focused on delivery care, contraception, abortion, and post-abortion care. Using a multi-methods approach, and standard qualitative analytic techniques, I identified significant unmet reproductive health needs in peri-urban Yangon. The findings suggest that reproductive health services are often available but inaccessible. Findings demonstrate considerable misinformation, common and unsafe practices surrounding abortion and delivery, and a dearth of comprehensive sexual and reproductive health services for adolescent and unmarried populations.
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Thor, Thorvardarson Haukur. "Fatique or Failure : An Investigation Into Youth-Centric Sexual and Reproductive Health Program." Thesis, Södertörn University College, School of Life Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-1278.
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Today there is increasing pressure on NGOs in Tanzania who are working with sexual and reproductive health programs (SRHP) from foreign donors because the HIV/AIDS epidemic has taken on emergency proportions. The risk of increasing interference into the policy shaping of domestic SRHP is that the programs lose their
local relevance as they get too involved in pleasing foreign donor agendas in order to ensure donor funding. The aim of this study is to analyze the cooperation of The Tanzanian Family Planning Association (UMATI) UMATI and The Swedish Association for Sexuality Education (RFSU), who have jointly worked together to form the project Young Men as Equal Partners (YMEP). I argue that the YMEP project has failed to meet the needs of the adolescents with the peer-to-peer
methodology as the needs of the adolescents are not being met. The reasons for this are twofold: the Eurocentric post-colonialist nature of the project planning and the local exclusion of adolescents in the project planning process as their sexual and reproductive rights are not being addressed in formal or informal education programs because of traditionalist values. This study is a qualitative study, which uses semi-structured interviews conducted in secondary schools in Manyara Region in Tanzania as a method of data collection. The theory used in this study is a literature review wherein empirical results from both individual and group interviews will be compared
to other theoretical views. The conclusion of this study is that adolescents must be incorporated into the NGO programs as well as other stakeholders as this will perhaps challenge their traditionalist values and produce a sustainable behavioral change that will improve the sexual and reproductive health of adolescents in The United
Republic of Tanzania.
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García, Micaela. "Female social workers perspectives on interventions in sexual and reproductive health in Argentina." Thesis, Ersta Sköndal högskola, Institutionen för socialvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-4733.
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In this field study, female social workers perspectives have been collected, on interventions regarding sexual and reproductive health in the public sector in Argentina. The purpose was primary empirical and secondary to analyze empirical data using critical theory. The methodology was qualitative and the theoretical framework was created using an abductive approach. Thirteen female social workers were interviewed in the municipality of general Pueyrredón, in the province of Buenos Aires. Empirical data was categorized using the hermeneutic approach; described and analyzed using critical theory. Results presented challenges regarding lack of accessibility, continuity and accountability, from the nation, the province and the municipality. Moreover, results show challenges on how to target vulnerable groups, adolescents, people with low intellectual disability, people from neighboring countries, and from the north of Argentina. In addition, there were challenges on how to increase correct use and use of contraceptives. Suggestions were to make interventions more adaptable and creative. Stressed challenges were regarding male involvement in sexual and reproductive health decisions, gender violence, the patriarchal society, and the macho culture. Critical theory highlighted challenges created by Argentina’s societal structures, structures that contribute to oppression of service users, making them powerless and marginalized. By increasing the knowledge of critical social work theory in social work education, there would be more tools for social workers to use it in practice. When using critical social work theory all levels in a society shall be included. Specific policies and interventions are requested to battle female discrimination.
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Wexler, Adam. "Social franchising and the efficiency of sexual and reproductive health care in India." CONNECT TO ELECTRONIC THESIS, 2008. http://hdl.handle.net/1961/6998.
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Nyemba, Dorothy Chiwoniso. "Determinants of voluntary or coerced sexual debut among Black African female adolescents in Soweto, South Africa: Findings from The Birth to Twenty Plus cohort study." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/28068.
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Early sexual debut whether voluntary or coerced increases exposure to high risk sex which leads to unplanned pregnancy, sexually transmitted infections including HIV and reproductive heal th problems during adolescence. This study aim s to examine the risk factors for age of sexual debut, either voluntary or coerced among Black African female adolescents from the Birth to Twenty cohort study in Soweto, South Africa . Part A is the study protocol which outlines the rationale for conducting this study , study aim, research methodology, analysis plan and ethical considerations. Part B forms the literature review which gives a summary of the existing literature and provides context for the dissertation. The objectives of the literature review were to identify published literature on determinants of either voluntary or coerced sexual debut in adolescents and identify gaps for further research. Part C is the manuscript presenting the results and discussion on the implications of key findings. The results showed that there are many Black African female adolescents who are engaging in early sexual debut and there is prevalenc e of coerced sexual debut among adolescents of similar age. Socio-economic status and maternal education were found to be significantly associated with coerced sexual debut. There is a need for interventions to delay sexual debut among young female adolescents from low socio-economic backgrounds and lower maternal education.
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Jardim, Renata Teixeira. "O controle da reprodução : estudo etnográfico da prática contraceptiva de implantes subcutâneos na cidade de Porto Alegre/RS." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2009. http://hdl.handle.net/10183/17215.
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Este trabalho se inscreve no campo dos estudos sobre sexualidade e práticas reprodutivas e contraceptivas, no contexto do Município de Porto Alegre onde muito recentemente passou a ser disponibilizado, na rede pública de saúde, um novo método contraceptivo, o implante subcutâneo Implanon. Partindo de um caso específico de implementação de uma ação governamental na área de saúde reprodutiva, este estudo tem como objetivo compreender, a partir de uma perspectiva antropológica, os significados da prática contraceptiva de implantes subcutâneos para as jovens residentes na região geográfica da cidade, a Restinga e seu entorno, que foi alvo privilegiado desta intervenção pública. Como pano de fundo descreve-se e apresenta-se o processo de idealização, implementação e debate em torno desta política de saúde, assim como o conjunto de atores e agencia que participaram do mesmo. Com a finalidade de conhecer o universo cultural das mulheres que optaram pela tecnologia contraceptiva oferecida pela política municipal, analisam-se as práticas sexuais, reprodutivas e contraceptivas das mulheres entrevistadas, evidenciando algumas categorias e valores imputados a estas práticas e experiências. Discutem-se, a partir do contexto específico pesquisado, os significados e o universo de relações onde se dá a prática contraceptiva de implantes subcutâneos. Enfatiza-se, nesta parte final, como é que tal prática contraceptiva se conecta com as relações afetivo-sexuais, contraceptivas e reprodutivas. A partir desta contextualização foi possível perceber que os eventos envolvidos no processo de gestar e evitar gravidez pode significar e gerar diferentes consequências para os sujeitos neles envolvidos. Igualmente, a abordagem centrada nas especificidades do grupo social "alvo" da ação governamental, evidenciou as diferentes perspectivas e apropriações desta política municipal.Situated within the field of studies on sexuality and reproductive and contraceptive practices, this study takes as its context the municipality of Porto Alegre, where a new contraceptive method - the subcutaneous implant, Implanon - was recently made available through the public health system. Departing from a specific case of the implementation of a governmental action in reproductive health, the objective of this study is to understand, from an anthropological perspective, what the contraceptive implants mean for young female residents of a particular area of the city - Restinga and its surroundings - that was a target of this public intervention. As background, the process of the health policy's formulation and implementation, and the subsequent debates regarding it, is described, and the collection of participating actors and agencies is presented. With the aim of becoming familiar with the cultural universe of the women who opted for the contraceptive technology proffered by the municipal policy, the sexual, reproductive, and contraceptive practices of interviewed women are analyzed; these data bring to light some of the categories and values ascribed to aforesaid practices and experiences. The meanings and the universe of relationships in which the contraceptive practice of the implants takes place is discussed with specific reference to the research context. The last section emphasizes how such contraceptive practices connect with affective-sexual, contraceptive and reproductive relationships. Through contextualization, it is possible to perceive that the process of both becoming pregnant and avoiding becoming pregnant can mean different things and generate diverse consequences for the subjects involved. Likewise, an approach focused on the specificities of the target population of this governmental action makes plain the different perspectives on and appropriations of municipal policy.
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Mayhew, Susannah Harding. "Health care in context : policy into practice : a policy analysis of integrating STD/HIV and MCH/FP services in Ghana." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1999. http://researchonline.lshtm.ac.uk/682260/.
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This research is one contribution to understanding the nature of policy and of power. the interaction of the state and its machinery with individuals at all levels, the tensions between public and private choices and responsibilities, between public health and clinical health care. Adapting a policy analysis approach, this thesis provides a case study of the development and implementation of reproductive health policies in Ghana. The aim is to enhance understanding of why there are differences between policy and practice and what the potentials are for integrating STD/HIV management into MCH/FP services in Ghana to improve reproductive health. This thesis argues that all elements of policy and policy analysis are located within a 'contextual framework' and are influenced by a range of contextual factors (defined and illustrated through the thesis) which are seldom taken into account in policy process and analysis. It is argued that understanding the different levels of context is fundamental to understanding the processes of policy development and implementation, the actions of actors at all levels and the policy outcomes. Using a multi-level focus and a combination of approaches, this thesis identifies the contextual factors and their manifestations at each level of the policy process and illustrates how they impact on policy. The analysis synthesises macro and micro dimensions gaining a more comprehensive understanding of the influences on and gaps between policy development and implementation. At the implementation level, 27 clinics were visited and 94 clinic staff interviewed in one rural region of Ghana, to ascertain what STD/HIV management services are actually being provided and what factors influence service provision (policy implementation). Interviews with community leaders and focus groups with villagers were conducted in the same region to explore community perspectives of disease and health care services and understand the factors influencing service utilisation (policy outcome). The role of the regional health administration as an intermediary was considered and understanding sought of the concepts of power which influence administrative and management structures. The national level interviews with government and Ministry of Health officials and with donor, NGO and national group representatives, provide further insight into the concepts of power and status and who influences policy making. Finally, all elements are brought together and discussed, a reworked framework is presented and suggestions for future policy and research directions are made.
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Sobiech, Kathleen L. "Unmet Need for Sexual and Reproductive Health Services| Results from the 2013 Liberia Demographic and Health Survey." Thesis, Indiana University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10605446.
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Although the association between poor sexual and reproductive health (SRH) and sociodemographic indicators has been explored in many resource-poor settings, limited information exists specific to Liberia. The two studies in this document seek to describe unmet need for SRH services using three critical indicators of SRH services: knowledge of HIV status (sexual health); use of skilled provider for antenatal care and delivery (reproductive health); and use of modern contraception when there is a desire to limit or space reproduction (family planning). Data from Liberia’s 2013 Demographic and Health Survey (LDHS) was used to summarize individual-level profiles according to key sociodemographic and sexual health characteristics for sexually active women and men aged 15-49 (Nwomen=7,787; Nmen=3,426). Frequency distributions from log-binomial regressions show the prevalence of unmet need for sexual health services for women is 51.9% and 72.8% for men; 39.7% for reproductive services (women only); and prevalence of unmet need for family planning is 70.7% for women and 76.1% for men. Results show wide disparities in unmet need for sexual health services by wealth and educational attainment for both men and women. Differences in unmet need for reproductive services were disparate based on educational attainment, wealth, and urban/rural residence. Although the unmet need for family planning is high, the disparities among subgroups is not as dramatic as other unmet needs. Results indicate the need to evaluate the gaps between national policy and service utilization with special attention to subgroups with a high-burden of unmet need.
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Shaluhiyah, Zahroh. "Sexual lifestyles and interaction of university students in central Java, Indonesia and their implications for sexual and reproductive health." Thesis, University of Exeter, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.430571.
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Cabezas, Da Rosa Manuela. "Problematisations of youth, sex and risk in sexual health policy." Thesis, King's College London (University of London), 2017. https://kclpure.kcl.ac.uk/portal/en/theses/problematisations-of-youth-sex-and-risk-in-sexual-health-policy(041badad-9139-4b1f-9dc4-79edea63cd3d).html.
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This thesis tracks the process of how politics addresses the problem of youth sexual health by comparing policy texts from Sweden and England. The purpose is to seek new insights into how we are governed, following Foucault and his notion of ‘problematisation’. The analysis tracks the objectives and effects of power, revealing the kind of techniques, knowledges and mechanisms that make youth sexual health an intelligible and legitimate problem for policy. The research questions are: How is youth sexual health problematised in Swedish and English policy texts? And how do the English and Swedish problematisations of youth sexual health compare in terms of similarities and differences and how can these be understood? The analysis reveals a shared biopolitical problematisation in the Swedish and English texts, inspired by neoliberal aspirations of how to govern youth through freedom. Analytically, this can be described as a common governmentalised problem-space. However, the analysis also highlights the specificity of the effects of biopolitics, highlighting the contingent constellations of power emerging within each empirical context of youth sexual health, as biopolitics expands. Further, the frame of biopolitics proves particularly useful for comparative analysis as it bridges across empirical context revealing the systemic character of how biopower orders and administers the living, while also capturing local differences that allow meaningful theorisations on how youth sexual health is problematised in policy texts.
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Iwami, Michiyo. "Sexual and reproductive health care development and participation in Peru : the role of CLAS." Thesis, University of Warwick, 2008. http://wrap.warwick.ac.uk/1089/.
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This study aims to analyse policy and political processes at multiple levels, and examine the consequences for Sexual and Reproductive Health (SRH) care development arising from the engagement of a participatory movement in Peru. I used Associations of Local Community of Health Administration (CLAS) as a core organisation for Peru’s major participatory model at local level. With policy makers, NGOs, health workers and (potential) service users, I explored factors that facilitated/prevented women’s participation in decision-making mechanisms and health practices. I employed a case study and multi-disciplinary approach at national, regional and local levels, focused upon women from multiple aspects in Andean Peru. I studied rural, periurban CLAS and non-CLAS models to compare across the case studies. I conducted semi-structured in-depth interviews with 116 respondents, unstructured observation, and documentary analysis in 2004. My analytical frameworks focused upon: ‘policy content’, ‘context’, ‘actors’, ‘process’, ‘patterns of participation’, and ‘outcomes and impacts’. Political, economic, legal and technical were identified which reflected the stagnant state of the development of SRH and CLAS policies. The central policy focuses on a narrow sense of SRH care, and neglects Reproductive Tract Infections (RTIs). Central government’s weak political leadership and stewardship to CLAS policies reflected that personal leadership (e.g. regional health directors) can define the destiny of regional CLAS development. Facilitating factors were led by NGOs and mixed factors were led by donors. CLAS appeared to create favourable conditions/environment for women’s participation in the community. Local respondents in the CLAS system understood the importance of participation to solve local problems compared to their non-CLAS system counterparts. Nevertheless, women in CLAS model had no influence on changes of SRH agenda, despite difficulties in the acquisition of contraceptives and effective RTIs medicines. The following actors must be incorporated into the decision-making and evaluation/feedback mechanisms in CLAS model to achieve more gender, age-gentle, and ethnically-sensitive Local Health Programmes and strengthen a rights- and trust-based approach: women’s Grassroots organisations, Defence Committees of Women’s Rights, Community Health Agents, Committees of Communal Development or Health (CODECOS)/(COSACOS), and traditional health providers. Alternative relationships (e.g. rapprochement) between CLAS and government authorities must be sought.
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Gubert, Fabiane do Amaral. "Report on dialogue of mothers about sexual and reproductive health with their adolescent daughters." Universidade Federal do CearÃ, 2008. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=2513.
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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel SuperiorAbstract: Qualitative study having as subject, the communication between mothers and adolescent daughters in the family context. Objectives 1. Know, based on experience with mothers of adolescents, their views and experiences on issues related to gender, sexuality and reproduction, the dialogue between mothers and daughters. 2. Identify the mothers difficulties/ potentialities, with support in their lived experiences.3. Discover the processes of communication between mothers and daughters, made collectively through dialogue, negotiation and argumentation.4. Propose the practice of Health Education as a mediator of communication between mothers and daughters in the family context. Methodology: The social agents of the research were seven mothers of female adolescents, participants from non-governmental organization Acartes, residents in the District of Pirambu in Fortaleza-CE. The theoretical framework used was the Theory of Diversity and Universality of the Care of Madeleine Leininger. Data collection followed the model Observation-Participation Reflection, proposed by Leininger; semi-structured interviews and eleven meetings with the group, addressing the stages of development of the daughters: birth, childhood, puberty and adolescence. The project was submitted and approved by the Ethics Committee of the UFC under Protocol No 17/08. Results: social and cultural factors in the community contribute to the vision of sexuality of women and make difficult the dialogue with their daughters. The early pregnancy is a factor in their story of life, and when they project this fact to their daughters, the pregnancy has already occurred, or report that their daughters are likely to become pregnant early. That experience, the fruit of social development, creates barriers, which, alone, women can not overcome, and what happens is the continuation of a cycle in which the relationship of non-dialogue between mother and daughter are reproduced over the generations. In this reality, many times women, placed in a particular cultural background, have little or no degree of motivation of the family or community. When they remember their experiences of adolescence, feelings such as fear and shame are reported in adulthood and relate these feelings as still present in their lives. In relation to dialogue with their daughters, the argument is used by the pregnancy issue, linking it to the future of these barriers in life. For STD, are little discussed as an argument for prevention, not on explaining signs and symptoms, making the vision of adolescents at the preventive issue. The TV is seen as an area that provides the reasoning and negotiation. Conclusions: The study may prompt a renewed vision in the field of sexual and reproductive health in the family, which considers the relational dimension of sexuality, sex and reproduction, aiming to contribute to the promotion of the dialogue between mother and daughter. The intervention of the nurse as part of the team of Health of the Family through the Health Education helps to improve self-esteem and perception of the womenÂs world, encouraging them to a greater degree of autonomy and power to decide about questions related to sexuality. The reflection of the experiences through the memories of the life cycle can encourage them to think about new projects for their lives and shows that even with difficulties, the dialogue between mothers and daughters can occur, whereas it is never too late to learn
IntroduÃÃo: A saÃde sexual e reprodutiva à fundamental na formaÃÃo de um adulto saudÃvel e, nesta trajetÃria, a famÃlia deve promover a comunicaÃÃo/diÃlogo entre seus integrantes sobre essa temÃtica; no entanto a responsabilidade à concentrada na mÃe que, somada Ãs especificidades do ciclo vital, pode desenvolver processos comunicativos fortalecidos ou conturbados. AlÃm das vulnerabilidades sociais vivenciadas pelas mulheres, as estatÃsticas na Ãrea da saÃde evidenciam a crescente feminizaÃÃo do HIV/aids e aumento dos casos de gravidez precoce, sobretudo nas mulheres mais pobres, jovens e com menor acesso a medidas assistenciais e de PromoÃÃo à SaÃde. A ambigÃidade das mÃes quanto ao seu papel na orientaÃÃo dos filhos, aliada Ãs caracterÃsticas da adolescÃncia, pode dificultar a comunicaÃÃo efetiva sobre sexo, sexualidade e contracepÃÃo. Objetivo: conhecer, com base na vivÃncia com mÃes de adolescentes, suas opiniÃes e experiÃncias acerca de temas ligados a sexo, sexualidade e reproduÃÃo, dialogados entre mÃes e filhas no contexto familiar. Metodologia: Estudo qualitativo, fundamentado na Teoria da Diversidade e Universalidade do Cuidado, de autoria de Madeleine Leininger. Realizou-se o estudo com um grupo de sete mulheres, moradoras do Bairro Pirambu em Fortaleza-CE. A populaÃÃo foi definida por mÃes com filhas adolescentes; integrantes da ONG ACARTES. A coleta de informaÃÃes seguiu o Modelo O-P-R (ObservaÃÃo-ParticipaÃÃo-ReflexÃo) proposto por Leininger, entrevista semi-estruturada e encontros com o grupo, abordando as fases de desenvolvimento das filhas: nascimento, infÃncia, puberdade e adolescÃncia. O projeto foi submetido e aprovado pelo Comità de Ãtica em Pesquisa da Universidade Federal do Cearà âUFC, sob protocolo n 17/08. Resultados: A faixa etÃria das mÃes variou entre 30 e 46 anos. Ao observar o contexto situacional das informantes, percebe-se que as questÃes ligadas aos fatores sociais e culturais contribuem para a visÃo da sexualidade que as mulheres possuem e dificultam o diÃlogo com suas filhas. Quando recordam as experiÃncias das mÃes na puberdade e adolescÃncia, sentimentos como medo e vergonha sÃo relatados. Sobre a argumentaÃÃo com suas filhas, utilizam o tema gravidez, relacionando a futuras barreiras no desenvolvimento social e profissional destas. Em relaÃÃo Ãs DST, essas sÃo pouco discutidas como argumento de prevenÃÃo, e apontadas numa perspectiva de risco à vida, porÃm nÃo esclarecendo muito sobre sinais e sintomas, o que dificulta a visÃo dos adolescentes ante a questÃo preventiva. A TV à vista como espaÃo que propicia a argumentaÃÃo e negociaÃÃo. Nas falas, percebe-se a reproduÃÃo das relaÃÃes de gÃnero: para trÃs informantes, as filhas irÃo aprender sobre sexo e sexualidade quando tiverem um companheiro, principalmente por meio do matrimÃnio. Dentre os discursos, a questÃo religiosa foi citada como um meio de influenciar no modo de viver a sexualidade e retardar o inicio da vida sexual. Outro fator à relativo à falta de motivaÃÃo da famÃlia ou da comunidade. ConclusÃo: Assim, a intervenÃÃo da enfermeira como integrante da equipe de saÃde da famÃlia pode contribuir para a melhoria da auto-estima e percepÃÃo do mundo de mulheres; ou seja, mediante a sistematizaÃÃo de um cuidado sensÃvel Ãs reais necessidades de mÃes e filhas, pode-se fomentar estratÃgias que contribuam para o âempoderamentoâ, incentivando as mulheres a um maior grau de autonomia e poder de decisÃo perante as questÃes sexuais e reprodutivas. Mesmo que muitas vezes todas as vulnerabilidades nÃo possam ser de todo eliminadas e as necessidades superadas na comunidade, as participantes reconhecem a necessidade de aprimorar ou iniciar o diÃlogo junto Ãs filhas adolescentes. Esse sentimento à importante, visto que o reconhecimento e a compreensÃo sobre o contexto no qual estÃo inseridas podem nortear e dar mais resolubilidade Ãs aÃÃes de promoÃÃo à saÃde neste contexto
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Louie, Karly Soohoo. "Sexual and reproductive health risk factors and risk of cervical cancer in developing countries." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2011. http://researchonline.lshtm.ac.uk/1386837/.
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Background: Invasive cervical cancer (ICC) is the second most common cancer among women in developing countries where early age at first sexual intercourse (AFSI) and first pregnancy (AFP) are prevalent events. The epidemiological evidence of how these sexual and reproductive health (SRH) factors impact the natural history of human papillomavirus (HPV) and ICC remain inconclusive. It has been debated that a woman's risk for ICC will depend more on the "high-risk" sexual behaviour of the male partner than of her own behaviour. Passive smoking in the context of couples is unclear. The aim is to study SRH factors in relation to ICC risk in developing countries. Methods: Study 1 evaluated the risk of ICC and its association with AFSI and AFP in a pooled analysis of IARC case-control studies of ICC from eight developing countries. Study 2 assessed these SRH factors and risk of HPV persistence in a population-based natural history cohort study in Guanacaste, Costa Rica. Study 3 characterised the male role in the aetiology of ICC among couples in a pooled analysis of five ICC case-control studies and two cervical carcinoma in situ (CIS) case-control studies. Results: The ICC risk was 2.4-fold among those who reported AFSI and AFP :~a6 years compared with AFSI and AFP ~21 years. Decreasing AFP, not AFSI, was associated with an increased risk of a-year persistence. Lifetime number of sexual partners of the husband was the strongest predictor of CIS and ICC risk. The absence of circumcision was significantly associated with an increased risk of CIS. A 2-fold increased risk of ICC was also found among couples with both ever smoking men and women. These data confirm AFSI and AFP as risk factors for ICC, but any independent effects could not be distinguished. The association of AFP with HPV persistence suggests that AFP may play a more relevant role in cervical carcinogenesis. The combined effects of exposure to active and passive smoking suggest its potential adverse role in cervical carcinogenesis.
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Chikovore, Jeremiah. "Gender power dynamics in sexual and reproductive health. A qualitative study in Chiredzi District, Zimbabwe." Doctoral thesis, Umeå universitet, Epidemiologi och folkhälsovetenskap, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-202.
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This thesis presents perspectives of men regarding abortion, contraceptive use and sexuality. Contrary to what we had expected, men expressed anxiety over abortion and contraceptive use, not because the issues concerned women’s health, but rather because men associated them with extramarital sexual activity they thought women were concealing. To understand the meanings of sexuality and factors shaping these meanings appeared to be a necessary step in promoting women’s health. We thus included in the study participants with different characteristics including men, women and adolescents, and used a variety of qualitative methods to explore in-depth these issues. Men’s anxiety over wives’ sexuality seemed to be exacerbated by their separation from the family through labour migration, and their inability to play the expected role of the family breadwinner. The men described using different strategies to ensure their wives did not use contraceptives. Men’s perspectives and the related dynamics seem therefore to be a manifestation of contradictory experiences of gender power within contexts of spousal separation. The thesis also illuminates the paradoxical situation of adolescents and adolescent sexual and reproductive health. As guardians, the men described how they are intolerant to premarital sex and pregnancy, which might threaten the expected bride wealth from the marriage of a daughter or sister. They therefore respond with violence. Ironically, information or service which would enable unmarried girls to prevent pregnancy is also denied. This is so in spite of the great concern by families over premarital pregnancy, and common knowledge that young girls are sexually abused by adult men. The men and boys described the pressure they exert on the girls for sex, but also how they then blame the girls for deliberately becoming pregnant in order to trap them into marriage. The boys are nevertheless anxious about pregnancy also for fear of family violence and the threat of being forced to terminate schooling. The girls expressed feeling trapped between the violence from guardians and partners, a situation which may lead to unsafe abortion. The silence, denial and violence imply the young people generally cannot discuss sexual abuse or abortion with parents, or seek health care when needed. Rather, sexually transmitted infections may be ndured or even self-treated, and abortion sought in silence. Preventive actions such as condom use are similarly difficult for the youth. The knowledge the youth may have about AIDS may also simply become a burden when room for applying it is limited. This thesis challenges public health promotion approaches that assume firstly a universal manifestation of gender power, and secondly ability of individuals to effect behaviour change once provided with information regardless of contextual factors. Whether in AIDS education or involvement of men in sexual and reproductive health, understanding social contexts and dynamics, and identities and experiences within these contexts is crucial.
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Borges, Ana Luiza Vilela. ""Adolescência e vida sexual: análise do início da vida sexual de adolescentes residentes na zona leste do município de São Paulo"." Universidade de São Paulo, 2005. http://www.teses.usp.br/teses/disponiveis/6/6136/tde-15042005-112703/.
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Homens e mulheres têm iniciado sua vida sexual, em grande parte, na adolescência e de formas um tanto diferenciadas. As práticas sexuais, nessa fase, têm sido descritas como dinâmicas e em constantes transformações, sendo que seus perfis podem acarretar impacto importante na vida reprodutiva dos adolescentes. Com o intuito de analisar o início da vida sexual de adolescentes, foram realizadas entrevistas domiciliárias com 383 homens e mulheres, não unidos, de 15 a 19 anos de idade, matriculados em uma unidade básica de saúde da família da zona leste do município de São Paulo, correspondendo a uma amostra representativa dos indivíduos deste grupo etário. A análise de regressão logística múltipla identificou como variáveis associadas ao início da vida sexual de adolescentes do sexo masculino a idade, a situação de estudo, a idade materna no primeiro filho, a concordância materna de que adolescentes tenham vida sexual, o fato de que o pai gostaria que seu filho iniciasse a vida sexual independentemente do casamento, o namoro anterior e o namoro atual. Por sua vez, as variáveis associadas ao início da vida sexual entre adolescentes do sexo feminino foram a idade, o tipo de domicílio, o namoro anterior, o namoro atual e a presença de irmão(ã) que tenha vivenciado uma gestação previamente à união. Entre os 164 adolescentes com experiência sexual, foi observada uma convergência na idade em que homens e mulheres tiveram a primeira relação sexual (mediana de 15 anos). No entanto, mesmo que a primeira relação sexual tenha ocorrido em idades similares e igualmente sem planejamento prévio, aspectos importantes do comportamento sexual diferiram entre os adolescentes e deveriam ser lembrados na assistência e promoção de sua saúde reprodutiva e sexual. Assim, as mulheres relataram ter iniciado a vida sexual, principalmente, porque estavam apaixonadas pelo parceiro, que foi, com maior freqüência, seu namorado. Por outro lado, os homens iniciaram sua vida sexual em relacionamentos ocasionais e justificaram como motivação a atração física. A prática contraceptiva foi deixada de lado por 41,5% dos homens e 31,7% das mulheres. Desta forma, os resultados indicaram que os diferenciais de gênero estiveram presentes em todo o processo de iniciação sexual e, ainda, os fatores individuais, tais como o namoro e a idade, e os fatores familiares, tais como os valores e atitudes dos pais e mães acerca da sexualidade, foram marcantes na iniciação sexual dos adolescentes.Women and men initiate their sexual life in different ways mainly during adolescence. Sexual practices in youth have been described as dynamic and in constant transformation, though its profile should be considered as having an impact in reproductive health. This study aimed to analyse associated factors to the onset of sexual life and to describe the first sexual relationship. Therefore, 383 fifteen to nineteen year-old single males and females enrolled in a family health unit from the east area of the city of São Paulo were interviewed at home. From multiple logistic regression analysis, data showed that associated variables to the onset of sexual life in males were age, schooling insertion, maternal age at first delivery, maternal acceptance that adolescents engage in sexual practices, paternal opinion that son should have the first intercourse independently from a marriage, previous and current dating. On the other hand, associated variables among females were age, house affording, previous and current dating and the presence of a single sibling who had already faced a pregnancy. Among the 164 adolescents who had sexual experience, a convergence in the age males and females initiated their sexual life (median at 15) was observed. Even though the first intercourse occurred at the same age and without planning, important aspects of the sexual behaviour differed between males and females and ought to be taken into consideration in their reproductive and sexual health promotion. Girls said they had the first intercourse because they were in love and it thus occurred majority with a boyfriend. Boys had their first intercourse mainly in occasional relationships and because of physical attraction. Contraceptive practice was observed in 58,5% of the boys and 68,3% of the girls. The results indicated that gender differences were present at the whole sexual initiation process and that individual factors, such as dating and age, and familial factors, such as parents attitudes towards sexuality, were determinants for the sexual initiation of these adolescents.
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Crich, Laura. "Exploring Syrian Refugee Women’s Sexual and Reproductive Health Experiences: A Multi-Methods Qualitative Study in Ottawa, Ontario." Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/42597.
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Since 2015 Canada has welcomed 44,620 Syrian refugees. The research on Syrian refugees in Canada has mainly focused on their immediate health needs, communicable diseases, and chronic illnesses. Aside from maternal health, the sexual and reproductive health (SRH) needs of Syrian refugee women is undocumented in Canada. To address this gap in the literature we conducted a qualitative study in Ottawa, Ontario that involved in-depth interviews with Syrian refugee women and individuals who provide health services to them.
When accessing SRH services Syrian women identified a preference for women providers, faced difficulty adjusting to societal norms during the perinatal period, felt that contraception counselling was not culturally informed, and struggled with their maternal mental health. Key informants mainly echoed these findings and expressed a need for more cultural competency/humility training, interpretation services, and trauma-informed counselling. The path to improving SRH services for Syrian women is complex, but highly warranted.
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Maness, Sarah Britney. "Associations between Social Determinants of Health and Adolescent Pregnancy: An Analysis of Data from the National Longitudinal Study of Adolescent to Adult Health." Scholar Commons, 2015. http://scholarcommons.usf.edu/etd/5848.
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This dissertation study utilized the National Longitudinal Study of Adolescent to Adult Health to analyze empirical relationships between social determinants of health and adolescent pregnancy. Although rates of adolescent pregnancy are at an all-time low in the United States, disparities persist. Examining relationships between the social determinants of health and adolescent pregnancy provides support for funding and interventions that expand on the current focus of individual and interpersonal level factors. Based on the Healthy People 2020 Social Determinants of Health Framework, proxy measures for social determinants of health were identified within the Add Health study and analyzed in relationship with adolescent pregnancy. Results indicated that six of 17 measures of social determinants of health had an empirical relationship with adolescent pregnancy. These measures included the following: feeling close to others at school, receipt of high school diploma, enrollment in higher education, participation in volunteering or community service, litter or trash in the neighborhood environment, and living in a two parent home. The results of this study can inform future research, allocation of funds and interventions based on social determinants of health that show an association with adolescent pregnancy.
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Keesbury, Jill E. "Evaluating the effectiveness of the international population regime the politics of post-Cairo policy change in South Asia /." Thesis, University of Hawaii at Manoa, 2003. http://proquest.umi.com/pqdweb?index=0&did=765882831&SrchMode=1&sid=9&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1209404689&clientId=23440.
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Jimmy-Gama, Dixon. "An assessment of the capacity of faculty-based youth friendly reproductive health services to promote sexual and reproductive health among unmarried adolescents : evidence from rural Malawi." Thesis, Queen Margaret University, 2009. https://eresearch.qmu.ac.uk/handle/20.500.12289/7456.
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Despite the recognition of the influence of cultural norms on adolescent sexual behaviours in most societies (Kaler 2004; Chege 2005), less attention has been paid to the link between social norms and effectiveness of health facilities to promote adolescent sexual and reproductive health (ASRH). This thesis therefore examines the capacity of facilitybased youth-friendly reproductive health services (YFRHS) to promote ASRH in rural Malawian societies where culture strongly influences adolescent sexual behaviours. The study employs a social constructionist epistemology and a social interactionism theory to understand the capacity of YFRHS in ASRH promotion in rural Malawi. Qualitative and quantitative data were collected using a sequential exploratory design. Semi-structured in-depth interviews, participant observations, client exit interviews, survey, focus group discussions and review of health strategic and service utilisation documents/records were conducted. The results were generated by triangulating both qualitative and quantitative data. The findings of the study illuminate how social norms related to social identities influence adolescent sexual behaviours and ASRH promotion. An exploration of the cultural context reveals a major disjuncture between an ideal norm - no premarital sex - and a modelled norm where unmarried adolescents are expected to engage in unsafe sex. It also shows the conflicts between the cultural and scientific models of ASRH promotion. Structural gender asymmetry that emphasises subservience in females and hegemonic masculinity also reduces adolescents’ rights and agency in SRH promotion. The health providers are cultural agents. They manage diverse roles both as ‘moral guardians’ and as ‘health promoters’ in a way that limits their effectiveness as health promoters. The thesis concludes that the way facility-based YFRHS is implemented has limited impact on SRH promotion among unmarried adolescents of rural Malawi. The study recommends that appropriate health promotion interventions based on conscientisationoriented empowerment theories directed at adolescents, community and health workers should be used in ASRH promotion in societies with strong cultural influence on sexual behaviours.
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Sharma, Richa. "Decision Making and Role Playing: Young Married Women's Sexual and Reproductive Health in Ahmedabad, India." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/20712.
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This MA thesis examines the decision-making capacity of young women married during adolescence within the context of their sexual and reproductive health in an urban ghetto in the city of Ahmedabad, India. Specifically, the development literature on married female adolescents (MFAs) is characterized by negative health indicators such as higher rates of unwanted pregnancies, reproductive tract infections, sexually transmitted diseases, high infant and maternal mortality and morbidity coupled with the phenomenon of early marriage, poverty and an overall lower social status. The result is a disempowering discourse that constructs and presents them as powerless victims who lack any decision-making capacity and are perpetually oppressed. This research is an effort to move the discussions of “Other third world women” outside the realm of victimization by challenging and destabilizing this disempowering, hegemonic discourse. We must ask what does decision making look like for these women, as exercised within the context of their sexual and reproductive health. This qualitative analysis is informed by primary research through focus groups and semi-structured interviews with young married women, and was conducted with the help of a local NGO, Mahila Patchwork Co-operative Society. The study provides insights on the young married women’s participation and role in determining their own health outcomes (negative and positive) to better inform programs and services offered by the community NGOs.
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Kemp, Julia Rachel. "A study of the sexual behaviour and reproductive health of adolescent girls in southeast Nigeria." Thesis, University of Liverpool, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.490844.
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Kemp, Julia Rachel. "A study of the sexual behaviour and reproductive health of adolescent girls on southeast Nigeria." Thesis, University of Liverpool, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367825.
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Ragúz, María. "Sexual and reproductive health and women development from a gender perspective: The role of men." Pontificia Universidad Católica del Perú, 2013. http://repositorio.pucp.edu.pe/index/handle/123456789/101096.
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Women's health, particularly, sexual and reproductive health, and development are here approached from a gender and human rights perspective, underlying the need to address these problems from a relational and comprehensive point of view. The issue of how sexual and reproductive health is approached and the "men's as partners" strategy is discussed. Adult women-centered, female-only family planning reproduction and contraception are criticized. Gender violence eradication is stressed as an entry to sexual and reproductive health programs. The case of Peruvian urban and rural women in poverty from Amazonian and Andean communities is taken as an example. Obstacles and achievements in working with men are reviewed but a gender transversal perspective is highlighted. Finally, women's sexual and reproductive health is related to development and seen as a standpoint for addressing health.Se discute como se tratan los problemas de la salud sexual y reproductiva y el desarrollo de la mujer desde una perspectiva transversal de género y de derechos, subrayando la necesidad de trabajarlos desde una perspectiva integral. Se critican los programas y servicios centrados en la mujer adulta, en la reproducción y en la planificación familiar femenina. Asimismo, se señala la necesidad de trabajar en la erradicación de la violencia de género como una entrada para el trabajo en este ámbito. Como ejemplo, se presenta el caso de la salud sexual y reproductiva en comunidades andinas y amazónicas rurales y en extrema pobreza del Perú. Las dificultades y logros en el trabajo con hombres son analizados, subrayándose la necesidad de una perspectiva transversal de género en el trabajo. Finalmente, se relaciona la salud de la mujer con desarrollo y se concluye en la necesidad de trabajar siempre en este sentido.