Communication and Information About "Safer Sex:" Intervention Issues Within Communities of African Migrants Living in Poorer Neighbourhoods in Portugal

A review of the literature on sexual and reproductive health of African migrant and refugee children

Background

Migration and involuntary displacement of children and young people have recently become common features of many African countries due to widespread poverty, rapid urbanization, joblessness, and instability that motivate them to seek livelihoods away from their places of origin. With limited education and skills, children become vulnerable socioeconomically, thereby exposing themselves to sexual and reproductive health (SRH) risks.

Methods

Against this background, the authors undertook a scoping review of the existing literature between January and June 2019 to highlight current knowledge on SRH of African migrant and refugee children. Twenty-two studies that met the inclusion criteria were reviewed.

Results

The results identified overcrowding and sexual exploitation of children within refugee camps where reproductive health services are often limited and underutilized. They also reveal language barriers as key obstacles towards young migrants’ access to SRH information and services because local languages used to deliver these services are alien to the migrants. Further, cultural practices like genital cutting, which survived migration could have serious reproductive health implications for young migrants. A major gap identified is about SRH risk factors of unaccompanied migrant minors, which have received limited study, and calls for more quantitative and qualitative SRH studies on unaccompanied child migrants. Studies should also focus on the different dimensions of SRH challenges among child migrants differentiated by gender, documented or undocumented, within or across national borders, and within or outside refugee camps to properly inform and situate policies, keeping in mind the economic motive and spatial displacement of children as major considerations.

Conclusion

The conditions that necessitate economic-driven migration of children will continue to exist in sub-Saharan Africa. This will provide fertile grounds for child migration to continue to thrive, with diverse sexual and reproductive health risks among the child migrants. There is need for further quantitative and qualitative research on child migrants’ sexual and reproductive health experiences paying special attention to their differentiation by gender, documented or undocumented, within or across national borders and within or outside refugee camps.

Child migration is increasingly becoming a common feature of many African countries as children migrate within and away from their countries of origin in search of better livelihoods due to widespread poverty, instability and rapid urbanisation. Many of the migrating children have little or no education and limited employable skills, thereby exposing themselves to sexual and reproductive health (SRH) risks. This paper is a scoping review of existing literature from 2000 to 2019 to document relevant findings on SRH of African migrant and refugee children.

The review identified migrant children within refugee camps to experience overcrowding and sexual exploitation amidst limited and underutilized reproductive health services. Language barriers are also key obstacles against young migrants’ access to SRH information and services as these services are delivered in local languages unfamiliar to them. Child migrants continue to suffer from cultural practices including genital cutting with serious reproductive health implications. SRH risk factors of unaccompanied migrant minors remain as a gap in the review and, therefore, more SRH studies on unaccompanied child migrants are needed. Attention should also be paid to the different dimensions of SRH challenges among child migrants to reflect gender differences, whether documented or undocumented, within or across national borders, and within or outside refugee camps for better understanding.

In conclusion, child migration in Africa will continue to be economic-driven and will expose the actors to diverse sexual and reproductive health risks. Further in-depth quantitative and qualitative research is required to inform relevant policies on child migrants’ SRH.

Teenage Pregnancies in Nepal - The Problem Status and Socio-Legal Concerns

INTRODUCTION

Teenage pregnancy is an issue that needs to be addressed for a better health of the women and the society. The present analysis is undertaken to find out the incidence of teenage mothers who have had hospital delivery and focuses upon the various reasons for teenage pregnancy with a brief discussion upon the associated medicolegal and social aspects.

METHODS

A cross sectional study was carried out in a tertiary hospital in western region of Nepal. The delivery case register were reviewed for teenage pregnancies and the relevant data was captured in a data sheet and analysed.

RESULTS

During the study period, a total of sixty-nine teenage pregnancies culminated into delivery/ childbirth. The mean age of teenage mother was 18.16±0.99 years. Majority of the teenage mothers had not completed their secondary education and were of low socioeconomic strata. Mode of delivery was caesarean section in thirty four cases, whereas vaginal delivery was conducted in thirty five cases. Live births accounted for 67 deliveries, a still birth case was of anencephalic foetus while the other one was a preterm which was spontaneously delivered at the 23rd weeks of gestation.

CONCLUSIONS

Education and awareness in the form of campaign, advertisements, road shows, television or radio programmes are suggested for a decline in the rate of teenage marriages and teenage pregnancies in Nepal in the days to come.

Sexual and reproductive health of Portuguese adolescents

BACKGROUND

As adolescent pregnancy and sexually transmitted infections (STIs) are major sources of morbidity, preventing them is an important health goal for Portuguese society.

OBJECTIVE

To review data on the knowledge, attitudes and statistics on sexual and reproductive health.

METHODS

A systematic review was conducted including peer-reviewed articles addressing issues influencing the sexuality of Portuguese adolescents (aged 13 to 19), published up to 2011 and conducted in any type of setting. After crossing-cleaning the reference list, 33 articles were included.

RESULTS

The rate of sexual activity by Portuguese adolescents is high (44%-95%), but there has been an increase in the age of intercourse debut (currently 15.6 years). Early commencement of sexual intercourse is associated with smoking and regular alcohol consumption. Condoms are the most frequently chosen contraceptive method for first (76%-96%) and subsequent (52%-69%) sexual encounters. The perception of a double standard in sex still exists in teenage culture for both genders and influence behavior. There are significant differences between migrant and native adolescents: African adolescents initiate sexual intercourse at earlier ages and are more likely to have unprotected sex. Only one-third of Portuguese teenagers have ever visited a health facility to seek counseling concerning contraception or STIs, and less than half have ever attended classes on reproductive health. Very few (12%) have knowledge about Chlamydia trachomatis infection. The prevalence of STIs in Portuguese youth is unknown. The adolescent fertility rate is still high (14.7 births per 1000 females aged 15-19 years), but it, as well as the rate of abortion, is steadily decreasing.

CONCLUSIONS

There is still a long way to go towards promoting a resourceful young population. Citizens and institutions must focus on increasing both the competence of youths and external supports. Information must be provided systematically and health services must have greater accessibility. Studies addressing cultural and environmental determinants that contribute to the molding of the sexual conduct of Portuguese adolescents must be held to produce new and effective culturally sensitive health interventions.

Parent-youth communication and concordance between parents and adolescents on reported engagement in social relationships and sexually intimate behaviors in Hanoi and Khanh Hoa Province, Vietnam

PURPOSE

Parent-child communication is associated with positive outcomes for youths' engagement in sexual behaviors. Limited data are available regarding parent-child communication in transitional countries. We present data from Vietnamese parent-youth dyads on parent reproductive health (RH) knowledge, comfort of communication, frequency of talk, and discordancy between youths' reported and parents' perceptions for engagement in relationships and sexually intimate behaviors.

METHODS

The cohort included 185 randomly selected parent-youth dyads in four communes in Hanoi and Khanh Hoa Province. Descriptive and comparative analysis included chi-squared tests, independent samples t-tests, and ANOVA. Linear regression analysis was used to assess relationships between parental knowledge, level of comfort, frequency of talk, and discordancy.

RESULTS

Seventy-six percent of parents and 44% of youth were female. The mean age of youth was 17.2 years. The mean score for parental "RH knowledge" was 24.74 (SD, 3.84; range, 15-34). Lower parental RH knowledge was positively associated with lower levels of education (F = 2.983; df, 184; p = .014). Data indicate a linear model in which knowledge is related to "comfort" (β = .17; p = .048), and "comfort" to frequency of "talk" (β = .6; p < .0001). Frequency of "talk" is not related to parents' discordant perceptions regarding their child's reported involvement in relationships (β = .002; p = .79) or sexual touching (β = .57; p = .60).

CONCLUSIONS

Parent and youth in Vietnam are engaged in limited communication about RH. There is a need for more data to assess the effect of these communication patterns on youths' engagement in sexual behaviors and for development of family-centered interventions to increase parental knowledge and skills for positive communication.