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Uhawenimana TC, Muganwa K, Uwimana MC, Musabwasoni MGS, Tengera O, Bahumura J, Mukashyaka J, Mukakamanzi J, Habyarimana E, Ngerageze I, Chinwe HN, Uwingabire E, Mujawamariya F, Nsengiyumva R, Bazirete O. Factors affecting the prevention of unwanted pregnancies among young adolescents in secondary schools in the Eastern Province of Rwanda: An explorative qualitative study. PLoS One 2024; 19:e0301248. [PMID: 39058739 PMCID: PMC11280217 DOI: 10.1371/journal.pone.0301248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION The escalating number of teenage pregnancies, especially in the Eastern province of Rwanda, continues to raise concerns regarding the sexual and reproductive health of adolescents in the country. Recent statistics indicate that 5% of adolescent girls between the ages of 15 and 19 have given birth and 4% are currently pregnant with their first child. This highlights the critical need for comprehensive sexual and reproductive health education tailored for adolescents. However, there is limited evidence on factors affecting adolescents' efforts to prevent unwanted pregnancies and sexually transmitted infections in the Eastern Province of Rwanda, and the support systems available to adolescents in secondary schools, including the role of parents in promoting their sexual and reproductive health to minimize the risky sexual practices. METHODS An explorative qualitative study utilizing focus group discussions was conducted to garner the perspectives of 118 adolescents enrolled in six twelve-year-basic-education schools from three districts of the Eastern Province of Rwanda. Thematic analysis was employed to identify themes related to the impact of various factors on adolescents' sexual and reproductive health as they navigate through the physical and emotional changes from puberty to adolescence. RESULTS Adolescents are aware of the potential consequences of engaging in unprotected sexual intercourse which include the risk of unplanned pregnancy, sexually transmitted infections, HIV/AIDS, and emotional distress. Female participants emphasized that young girls who do not receive adequate support upon becoming pregnant prematurely may encounter depression, discontinue their education, face the harsh reality of extreme poverty, and struggle significantly in assuming the responsibilities of parenthood as young single mothers. Adolescents highlighted the lack of parental guidance concerning sexual and reproductive matters as a significant obstacle in their pursuit of a healthy and safe sexual and reproductive health during adolescence. CONCLUSION Inadequate parental engagement still hinders adolescents in navigating the physical bodily, mental, and emotional changes during adolescence. This affects their capacity to make well-informed decisions to prevent adverse consequences such as unintended pregnancies, substance misuse, sexually transmitted infections, and HIV/AIDS resulting from unsafe sexual practices. Since this study was qualitative, quantitative data necessary for a precise evaluation of the extent of the problem related to the absence of parental involvement in educating adolescents on sexual and reproductive health needs further research.
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Affiliation(s)
| | - Kellen Muganwa
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Marie Chantal Uwimana
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Olive Tengera
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Joy Bahumura
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Joella Mukashyaka
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jackline Mukakamanzi
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Emmanuel Habyarimana
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Innocent Ngerageze
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Hellen Nwanko Chinwe
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Emmerance Uwingabire
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Francoise Mujawamariya
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Richard Nsengiyumva
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Oliva Bazirete
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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Aliyu TK. Situational context of home-based sexual education in urban slums of Ibadan, Nigeria-evidence from a qualitative study. PLoS One 2024; 19:e0304200. [PMID: 38885279 PMCID: PMC11182513 DOI: 10.1371/journal.pone.0304200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 05/07/2024] [Indexed: 06/20/2024] Open
Abstract
This study explores the influence of situational context on parent-adolescent communication about sexual and reproductive health (SRH) issues in the urban slums of Ibadan, Nigeria. A qualitative exploratory study was conducted in the Southeast and Northeast LGAs of Ibadan. Eight (8) vignette-based focus group discussions (FGDs) with parents and adolescents of both sexes were conducted in addition to four (4) key informant interviews (KIIs) with community and women's leaders. Interviews were tape-recorded, transcribed, and translated into English. Thematic analysis was adopted using ATLAS Ti 9 software. Findings portray SRH meanings and experiences, intergenerational cultural norms, and expectations for SRH, gender double standards in SRH discussion, streetwise SRH knowledge, and social media exposure as contexts that interfere with parent-adolescent communication on SRH issues. The findings show that despite understanding the need for SRH discussion, parents and adolescents lack effective communication on SRH issues due to the interference of unfiltered streetwise SRH knowledge and social media exposure. Also, SRH conversation between parents and adolescents promotes gender inequalities as different information is passed to adolescent girls and boys. Interventions that take into account situational occurrences must be geared towards enabling parents to give their adolescents early exposure to relevant, context-specific SRH knowledge.
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Affiliation(s)
- Taofeek Kolawole Aliyu
- Department of Sociology and Anthropology, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Sociology, Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
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Nabunya P, Byansi W, Muwanga J, Bahar OS, Namuwonge F, Ssentumbwe V, Ssewamala FM. Family Factors and Gender Norms as Protective Factors Against Sexual Risk-Taking Behaviors Among Adolescent Girls in Southern Uganda. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2024; 11:111-121. [PMID: 38859819 PMCID: PMC11164544 DOI: 10.1007/s40609-022-00237-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/05/2022] [Indexed: 06/11/2024]
Abstract
Adolescent girls and young women are at a higher risk for HIV infection stemming from barriers to accessing comprehensive sexual health education, unequal cultural, social, and economic statuses, limited access to education and health care services, and gender-based violence. This makes adolescent girls susceptible to high-risk sexual behaviors. This study examines the protective role of family, social support factors and gender norms against sexual risk-taking behaviors among secondary school adolescent girls in Uganda. Baseline data from the National Institute of Mental Health-funded Suubi4Her study were analyzed. A total of 1260 girls aged 14-17 years and enrolled in the first or second year of secondary school were recruited across 47 secondary schools. Hierarchical linear regression models were conducted to determine the role of family, social support factors and gender norms on sexual risk-taking behaviors. Results indicate that traditional gender norms, family care and relationships, and social support were all associated with lower levels of sexual risk-taking intentions-a proxy for engaging in sexual risk behaviors. Findings point to the need to develop family level support interventions to equip adolescent girls with adequate sexual health-related knowledge and skills to facilitate safer sexual practices and reduce high-risk sexual-taking behaviors, as they develop and transition into young adulthood.
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Affiliation(s)
- Proscovia Nabunya
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis, Brown School, 1 Brookings Drive, St. Louis, MO 63130, USA
| | - William Byansi
- Boston College School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA
| | - Joelynn Muwanga
- Department of Health and Human Services, New Hampshire, Division of Public Health, Littleton, USA
| | - Ozge Sensoy Bahar
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis, Brown School, 1 Brookings Drive, St. Louis, MO 63130, USA
| | - Flavia Namuwonge
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis, Brown School, 1 Brookings Drive, St. Louis, MO 63130, USA
| | - Vicent Ssentumbwe
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis, Brown School, 1 Brookings Drive, St. Louis, MO 63130, USA
| | - Fred M. Ssewamala
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis, Brown School, 1 Brookings Drive, St. Louis, MO 63130, USA
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Kyei-Arthur F, Agyekum MW, Kyei-Gyamfi S. "You cannot stay with one person once you begin having sex at a young age": the prevalence, correlates and effects of early sexual debut among children in Ghana. Reprod Health 2024; 21:38. [PMID: 38521936 PMCID: PMC10960462 DOI: 10.1186/s12978-024-01775-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/16/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Children's initiation of early sex has several negative implications on their sexual and reproductive health, growth and development. In Ghana, few studies on early sexual debut have focused on adolescents. Therefore, this study examined the prevalence, causes, correlates and effects of early sexual debut among children aged 8 to 17 in Ghana using secondary data from the Department of Children of the Ministry of Gender, Children, and Social Protection. METHODS A convergent parallel mixed-method approach guided the study. Descriptive statistics and multivariable binary logistic regression were used to analyse the quantitative data, while thematic analysis was used to analyse the qualitative data. RESULTS The study found that the prevalence of early sexual debut among children was 13.2%, which is more predominant among female children. The main causes of early sexual debut include engaging in sex after watching pornography, self-desire to have sex, and being influenced by alcohol consumption. Also, age, sex, education, marital status, religion, ecological zone, living arrangements, and access to the Internet were significant correlates of early sexual debut. Early sexual debut increases children's risk of unwanted pregnancy, which leads to the termination of children's education or induced abortion. Also, early sexual debut had adverse impacts on the wellbeing of pregnant children and increased children's risk of multiple lifetime sexual partners. CONCLUSIONS This study demonstrated that socio-demographic characteristics of children (e.g., age, sex, education, and marital status) were significant correlates of early sexual debut. Policymakers need to design appropriate interventions, considering the socio-demographic characteristics of children, to curb its occurrence in Ghana.
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Affiliation(s)
- Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana.
| | - Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies, University of Education, Winneba, Ghana
| | - Sylvester Kyei-Gyamfi
- Department of Children, Ministry of Gender, Children and Social Protection, Accra, Ghana
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Kim Y, Lee J, Ross R. A study on the reliability and validity of the Korean version of the parenting outcome expectancy scale for parents of elementary school students. Front Psychol 2023; 14:1165783. [PMID: 37599723 PMCID: PMC10436294 DOI: 10.3389/fpsyg.2023.1165783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Many parents do not engage in active discussions with their children about sexuality. This can contribute to negative sexual and reproductive health outcomes among youth. To foster a healthy environment for sexual activity, it is crucial for parents to provide comprehensive sex education to their children at home. This study aims to cross-culturally adapt and evaluate the psychometric properties of a Korean version of the Parenting Outcome Expectancy Scale to measure the sexual communication abilities of parents of elementary school students in South Korea. Method The study participants were parents of elementary school students between 6 to 13 years old. We used exploratory and confirmatory factor analyses to examine the reliability and validity of the 23-item Korean version of the Parenting Outcome Expectancy Scale. Results The study confirms the reliability and validity of the scale, comprising five factors and 22 items, for the evaluation of the outcome expectancy of communication about sex between parents and their children. Results also demonstrate that talking about sex is still a challenge for many parents. Discussion This instrument can help parents prepare for sex communication with their children and for sexual education, potentially yielding a positive effect on children's sexual health and parental satisfaction.
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Affiliation(s)
- Yoonjung Kim
- College of Nursing, Konyang University, Daejeon, Republic of Korea
| | - Jungmin Lee
- School of Nursing, Hallym University, Chuncheon, Republic of Korea
| | - Ratchneewan Ross
- School of Nursing, University of Louisville, Louisville, KY, United States
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Yalew AZ, Olayemi OO, Yalew AW. Reasons and prevention strategies of unintended pregnancy in Addis Ababa, Ethiopia: a phenomenological qualitative study. BMJ Open 2023; 13:e072008. [PMID: 37491099 PMCID: PMC10373735 DOI: 10.1136/bmjopen-2023-072008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVES To explore the reasons for unintended pregnancy and effective prevention measures from the perspectives of women and healthcare providers in Addis Ababa, Ethiopia. DESIGN Phenomenological qualitative study. SETTING AND PARTICIPANTS This study was conducted at three public health facilities found in Addis Ababa, Ethiopia. Women with unintended pregnancies and healthcare providers currently working in maternal health services were purposively recruited for in-depth interviews. Twenty in-depth interviews were conducted until data saturation was achieved. Data were analysed using thematic analysis. RESULTS Seven themes emerged from the transcribed interview data. These include: Personal characteristics (negligence; lower pregnancy expectation), family influence (fear of family), sociocultural and economic influence (stigma and discrimination), healthcare provider influence (disrespectful and abusive approach; disregard for women's contraceptive choice), preconception thoughts and behaviours (unprotected early sexual practice; myths and misunderstanding), lack of access to quality family planning services (lack of trained contraceptive counsellor, inappropriate contraceptive use), and preventive strategies for unintended pregnancy (comprehensive sexual education; sexual and reproductive health and rights service integration) CONCLUSIONS: This study identified multilevel reasons for unintended pregnancy from the perspective of the participants. Participants shared their views on preventive measures for unintended pregnancy, including comprehensive sexual education, service integration and male-inclusive contraceptive counselling. This study highlights the need to improve sexual and reproductive health services by shedding light on the viewpoints and experiences of women and healthcare providers.
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Affiliation(s)
- Ayalnesh Zemene Yalew
- Department of Obstetrics and Gynecology, Pan African University, Institutes of Life and Earth Sciences (including Agriculture and Health), College of Medicine, University of Ibadan, Addis Ababa, Ethiopia
- School of Nursing, St Paul's Hospital Millennium Medical College, Ibadan, Nigeria
| | - Oladapo O Olayemi
- Department of Obstetrics and Gynecology, University of Ibadan, Ibadan, Nigeria
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Ndugga P, Kwagala B, Wandera SO, Kisaakye P, Mbonye MK, Ngabirano F. "If your mother does not teach you, the world will…": a qualitative study of parent-adolescent communication on sexual and reproductive health issues in Border districts of eastern Uganda. BMC Public Health 2023; 23:678. [PMID: 37041536 PMCID: PMC10088803 DOI: 10.1186/s12889-023-15562-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/29/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Adolescents experience a host of sexual and reproductive health (SRH) challenges, with detrimental SRH and socio-economic consequences. These include early sexual debut, sexually transmitted infections including HIV/AIDS, teenage pregnancy, and early childbearing. Parent-adolescent communication about SRH has significant potential to reduce adolescents' risky sexual behaviors. However, communication between parents and adolescents is limited. This study explored the facilitators and barriers to parent-adolescent communication about sexual and reproductive health. METHODS We conducted a qualitative study in the border districts of Busia and Tororo in Eastern Uganda. Data collection entailed 8 Focus Group Discussions comprising of parents, adolescents (10-17 years), and 25 key informants. Interviews were audio-recorded, transcribed, and translated into English. Thematic analysis was conducted with the aid of NVIVO 12 software. RESULTS Participants acknowledged the key role parents play in communicating SRH matters; however, only a few parents engage in such discussions. Facilitators of parent-adolescent communication were: having a good parent-child relationship which makes parents approachable and motivates children to discuss issues openly, a closer bond between mothers and children which is partly attributed to gender roles and expectations eases communication, and having parents with high education making them more knowledgeable and confident when discussing SRH issues with children. However, the discussions are limited by cultural norms that treat parent-child conversations on SRH as a taboo, parents' lack of knowledge, and parents busy work schedules made them unavailable to address pertinent SRH issues. CONCLUSION Parents' ability to communicate with their children is hindered by cultural barriers, busy work schedules, and a lack of knowledge. Engaging all stakeholders including parents to deconstruct sociocultural norms around adolescent SRH, developing the capacity of parents to confidently initiate and convey accurate SRH information, initiation of SRH discussions at early ages, and integrating parent-adolescent communication into parenting interventions, are potential strategies to improve SRH communication between parents and adolescents in high-risk settings such as borders.
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Affiliation(s)
- Patricia Ndugga
- College of Business and Management Sciences (CoBAMS), School of Statistics and Planning, Department of Population Studies, Makerere University, Kampala, Uganda.
| | - Betty Kwagala
- College of Business and Management Sciences (CoBAMS), School of Statistics and Planning, Department of Population Studies, Makerere University, Kampala, Uganda
| | - Stephen Ojiambo Wandera
- College of Business and Management Sciences (CoBAMS), School of Statistics and Planning, Department of Population Studies, Makerere University, Kampala, Uganda
| | - Peter Kisaakye
- College of Business and Management Sciences (CoBAMS), School of Statistics and Planning, Department of Population Studies, Makerere University, Kampala, Uganda
| | - Martin K Mbonye
- College of Business and Management Sciences (CoBAMS), School of Statistics and Planning, Department of Population Studies, Makerere University, Kampala, Uganda
| | - Fred Ngabirano
- Labor and Social Development (MGLSD), Ministry of Gender, Kampala, Uganda
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Yamashita T. A Case of Primary Epithelioid Sarcoma of the Pleura. AMERICAN JOURNAL OF CASE REPORTS 2023; 24:e938696. [PMID: 36597286 PMCID: PMC9827392 DOI: 10.12659/ajcr.938696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Epithelioid sarcoma is a rare tumor and that is extremely rare as a primary pleural neoplasm. On imaging, it may appear similar to malignant pleural mesothelioma; thus, it can be difficult to diagnose. CASE REPORT A 64-year-old Asian woman, who had a treatment history of cervix adenocarcinoma, was admitted with dyspnea and right massive pleural effusion. Chest drainage was performed, and malignant cells were found in the pleural effusion. The malignant cells were thought to be metastasized from previous cervical cancer. We continued pleural drainage; however, the volume of the pleural effusion did not decrease. On the 5th hospital day, the chest tube became occluded. Computed tomography showed structures similar to empyema. Pleural irrigation and fibrinolytic therapy did not improve her condition. Empyema curettage was performed on the 14th hospital day. The resected pleura was submitted for pathological examination and showed tumor lesion but not metastatic adenocarcinoma of the cervix. The intrathoracic tumor grew extremely rapidly, and the patient died of respiratory failure on postoperative day 8 (22nd hospital day) before a diagnosis could be made. The final pathological diagnosis obtained on the 34th hospital day was epithelioid sarcoma. CONCLUSIONS For patients who appear to have empyema complicated by neoplastic lesions, a histopathological examination should also be performed to ensure accurate diagnosis. In addition, if a tumorous lesion is detected and it is neither metastatic nor malignant pleural mesothelioma, pleural epithelioid sarcoma should be added to the differential diagnosis in the presence of a rapidly growing and histologically difficult-to-diagnose pleural tumor.
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Azie RAE, Bagrmwin L, Setordzi M, Ndanu TA, Aniteye P. Parents’ attitude towards sexual and reproductive health communication: The case of Wa West district of the Upper West Region, Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2023. [DOI: 10.1016/j.ijans.2023.100551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
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Mwamba B, Mayers P, Shea J. Sexual and reproductive health knowledge of postgraduate students at the University of Cape Town, in South Africa. Reprod Health 2022; 19:225. [PMID: 36522681 PMCID: PMC9756593 DOI: 10.1186/s12978-022-01507-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 09/14/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Globally and in South Africa, university students' knowledge of sexual and reproductive health (SRH) is low. This study was conducted in response to the dearth of information about the sexual and reproductive health knowledge of postgraduate students. Research conducted to explore the SRH knowledge of undergraduate students suggests that the level of SRH knowledge among undergraduate students is low. The aim of this study was to determine the SRH knowledge of postgraduate students with regards to contraceptives, sexually transmitted illnesses (STI), human immunodeficiency virus (HIV), Pap smear and clinical breast examination at University of Cape Town (UCT), in South Africa. METHOD A cross sectional survey design was utilized, using an adapted and pretested online questionnaire. The aim of this study was to determine the SRH knowledge of postgraduate students at the UCT. Minor adjustments were made to the questionnaire to suit the South African context. Selected aspects of SRH were included in the current study: knowledge and use of contraceptives, Pap smear, clinical breast examination, STIs and HIV. These variables were considered to be general enough to be answerable by male and female respondents and are the most important considerations in reproductive health care in South Africa, as there is a high prevalence of STIs, HIV and cervical and breast cancers. All postgraduate students enrolled in the first semester of 2017 (9444) were invited to anonymously complete the online survey. Data was exported to the Statistical Package for Social Sciences (SPSS) version 23.0 and analysed using descriptive statistics such as mean, standard deviation, frequencies and percentages. RESULTS Four hundred and six (406) students completed the online survey, of whom 293 were female and 107 males. The age range of respondents was between 18 and 57 years, with the median age for both male and female respondents being 24 years. Six survey responses were excluded from the statistical analysis because of incomplete data. Post graduate students from the African continent comprised 90.75% of the respondents. Most respondents were white (51.50%) from both Africa and abroad. The results indicated that respondents knew about sexually transmitted infections, and human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). Female respondents were more aware of breast examination, and the role of Papanicolaou smear (Pap smear) in SRH. Almost half of the respondents in this study (49%) stated that they had no need for more information about contraceptives. Lecturers were identified as one of the top five sources of information, which suggests that the university environment provides students with important SRH-related information. CONCLUSION Most postgraduate students had knowledge of sexual and reproductive health with regards to contraception, Pap smear, clinical breast examination, STIs, HIV and AIDS. Further research should focus on the relationship between SRH knowledge and usage among this population. As university lecturers were identified as an important source of information across faculties, the University should consider the incorporation of SRH education in the broader curriculum and as an integral component of student health services.
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Affiliation(s)
- Bupe Mwamba
- grid.7836.a0000 0004 1937 1151Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Pat Mayers
- grid.7836.a0000 0004 1937 1151Associate Professor Emeritus, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa ,grid.8974.20000 0001 2156 8226School of Nursing, University of the Western Cape, Cape Town, South Africa
| | - Jawaya Shea
- grid.7836.a0000 0004 1937 1151Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Silva M, Kassegne S, Nagbe RHY, Babogou L, Ezouatchi R, Ado AL, Moussa F, Dougherty L. Changing the Script: Intergenerational Communication about Sexual and Reproductive Health in Niamey, Niger. JOURNAL OF HEALTH COMMUNICATION 2022; 27:755-763. [PMID: 36567672 DOI: 10.1080/10810730.2022.2160527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Most strategies to reduce adolescent pregnancies have been designed to educate adolescents directly about family planning (FP), while adolescents often cite peers and parents as their primary sources of sexual health information. Yet parents' lack of knowledge about sexual and reproductive health (SRH), low self-efficacy to initiate conversations, and adverse social norms act as barriers to open intergenerational communication. To better understand the normative environment influencing communication between parents and youth about FP/SRH in francophone West Africa, the USAID supported Breakthrough RESEARCH project conducted a multi-stage qualitative study in Niger. During Stage 1, the research team developed a screening tool (based on a literature review) to categorize research participants into those who practiced open intergenerational communication about FP/SRH, and those who did not. Stage 2 consisted of 40 in-depth interviews with young people (ages 15-24) and adults (≥25 years old), stratified by whether they practiced open intergenerational communication. Results showed restrictive social norms related to youth SRH and access to information and services. However, particularly among participants classified as open-communicators, there is a hierarchy of norms and normative beliefs, with abstinence as the most virtuous decision for youth, but approving communication about and access to SRH services in order to minimize harm. Participants rely on values such as the protection of youth, protection of family honor and promotion of well-being as means to act in counter-normative ways and communicate about FP/SRH. Implications for the field include demystifying and destigmatizing SRH topics, increasing adults' communication skills, and changing the "script" to a more life-affirming view of SRH.
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Affiliation(s)
- Martha Silva
- Department of International Health and Sustainable Development, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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Solehati T, Pramukti I, Rahmat A, Kosasih CE. Determinants of Adolescent Reproductive Health in West Java Indonesia: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11927. [PMID: 36231228 PMCID: PMC9565119 DOI: 10.3390/ijerph191911927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
The problem of adolescent reproductive health (ARH) in Indonesia is worrying, especially regarding the Triad Adolescent Reproductive Health (Triad ARH) behavior. Many factors influence ARH behavior. This cross-sectional study explores the association factors between demographic factors, knowledge, and attitudes toward ARH behavior. Six hundred and sixty-eight junior high school and senior high school students were randomly selected from five public schools in Bandung Regency, West Java, Indonesia. The questionnaire used in this study consisted of four parts, namely: (1) demographic data of respondents; (2) knowledge including 20 questions used multiple choice questions; (3) attitude with 12 questions measured using the Likert scale; and (4) behaviors with seven questions measured using Likert scale. Results showed that gender (p = 0.006), age (p = 0.031), and level of education (p = 0.006) were associated with behavior toward ARH behavior, but knowledge (p = 0.582), religion (p = 0.628), ethnic (p = 0.276), and attitude (p = 0.094) were not associated with ARH behavior. Multivariate analysis showed that only gender (p < 0.010) significantly contributed to ARH behavior. Multivariate analysis showed that gender (OR: 2.168, 95% (CI: 1.204-3.904)) significantly contributed to ARH behavior. Based on the results, it can be concluded that the gender factor influences adolescent reproductive health behavior. This study provides further evidence that to promote positive ARH behavior's among youth in West Java, Indonesia, gender should be put in place and be sustainable, using the media and the Internet and involving the collaboration of parents, teachers, and peers to improve adolescent reproductive health.
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Affiliation(s)
- Tetti Solehati
- Department of Maternity, Faculty of Nursing, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
| | - Iqbal Pramukti
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
| | - Agus Rahmat
- Faculty of Communication Science, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
| | - Cecep Eli Kosasih
- Department of Emergency and Critical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung 45363, West Java, Indonesia
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Pretorius D, Mlambo MG, Couper ID. "We Are Not Truly Friendly Faces": Primary Health Care Doctors' Reflections on Sexual History Taking in North West Province. Sex Med 2022; 10:100565. [PMID: 36122542 PMCID: PMC9780778 DOI: 10.1016/j.esxm.2022.100565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Doctors experience barriers in consultations that compromise engaging with patients on sensitive topics and impede history taking for sexual dysfunction. AIM The aim of the study was to identify barriers to and facilitators of sexual history taking that primary care doctors experience during consultations involving patients with chronic illnesses. METHODS This qualitative study formed part of a grounded theory study and represents individual interviews with 20 primary care doctors working in the rural North West Province, South Africa. The doctors were interviewed on the barriers and facilitators of sexual history taking they experienced during 151 recorded consultations with patients at risk of sexual dysfunction. Interviews were transcribed and line-by-line verbatim coding was done. A thematic analysis was performed using MaxQDA 2018 software for qualitative research. The study complied with COREQ requirements. OUTCOME Doctors' reflections on sexual history taking. RESULTS Three themes identifying barriers to sexual history taking emerged, namely personal and health system limitations, presuppositions and assumptions, and socio-cultural barriers. The fourth theme that emerged was the patient-doctor relationship as a facilitator of sexual history taking. Doctors experienced personal limitations such as a lack of training and not thinking about taking a history for sexual dysfunction. Consultations were compromised by too many competing priorities and socio-cultural differences between doctors and patients. The doctors believed that the patients had to take the responsibility to initiate the discussion on sexual challenges. Competencies mentioned that could improve the patient-doctor relationship to promote sexual history taking, include rapport building and cultural sensitivity. CLINICAL IMPLICATIONS Doctors do not provide holistic patient care at primary health care settings if they do not screen for sexual dysfunction. STRENGTH AND LIMITATIONS The strength in this study is that recall bias was limited as interviews took place in a real-world setting, which was the context of clinical care. As this is a qualitative study, results will apply to primary care in rural settings in South Africa. CONCLUSION Doctors need a socio-cognitive paradigm shift in terms of knowledge and awareness of sexual dysfunction in patients with chronic illness. Pretorius D, Mlambo MG, Couper ID. "We Are Not Truly Friendly Faces": Primary Health Care Doctors' Reflections on Sexual History Taking in North West Province. Sex Med 2022;10:100565.
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Affiliation(s)
- Deidré Pretorius
- Division Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa,Corresponding Author: Deidré Pretorius, Division Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, Room 412 4th Floor, The Phillip Tobias Health Sciences Building, 29 Princess of Wales Street (corner York Road), Parktown, 2193, South Africa. Tel: +27825553597
| | - Motlatso G. Mlambo
- Division Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa,Department of Institutional Intelligence, University of South Africa, Pretoria, South Africa
| | - Ian D. Couper
- Division Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa,Ukwanda Centre for Rural Health, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
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Iacoella F, Gassmann F, Tirivayi N. Which communication technology is effective for promoting reproductive health? Television, radio, and mobile phones in sub-Saharan Africa. PLoS One 2022; 17:e0272501. [PMID: 35976900 PMCID: PMC9384982 DOI: 10.1371/journal.pone.0272501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022] Open
Abstract
The use of radio and television as means to spread reproductive health awareness in Sub-Saharan Africa has been extensive, and its impacts significant. More recently, other means of communication, such as mobile phones, have received the attention of researchers and policy makers as health communication tools. However, evidence on which of the two types of communication (i.e. passive communication from TV/radio, or active communication through phones) is more effective in fostering better reproductive health choices is sparse. This study aims to identify the potential influence of TV or radio ownership as opposed to cell phone ownership on contraceptive use and access to maternal healthcare. Cross-sectional, individual analysis from eleven high-maternal mortality Sub-Saharan African countries is conducted. A total of 78,000 women in union are included in the analysis. Results indicate that ownership of TV or radio is more weakly correlated to better outcomes than mobile phone ownership is. Results are stronger for lower educated women and robust across all levels of wealth. Interestingly, the study also finds that decision-making power is a relevant mediator of cell phone ownership on contraceptive use, but not on maternal healthcare access. A key takeaway from the study is that, while the role of television and radio appears to have diminished in recent years, mobile phones have become a key tool for empowerment and behavioural change among Sub-Saharan African women. Health communication policies should be designed to take into account the now prominent role of mobile phones in affecting health behaviours.
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Klu D, Agordoh P, Azagba C, Acquah E, Doegah P, Ofosu A, Ansah EK, Gyapong M. Determinants of communication on sexual issues between adolescents and their parents in the Adaklu district of the Volta region, Ghana: a multinomial logistic regression analysis. Reprod Health 2022; 19:101. [PMID: 35477467 PMCID: PMC9044737 DOI: 10.1186/s12978-022-01402-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor communication on sexual issues between adolescents and their parents results in high rates of negative sexual practices such as teenage pregnancy. Contributing factors to this poor communication on sexual issues between adolescents and their parents in a high teenage pregnancy setting have not been adequately explored. We sought to fill this gap by examining the factors that predict communication on sexual issues between adolescents and their parents in the Adaklu district of the Volta region of Ghana. METHODS A baseline cross-sectional household survey of 221 adolescents aged 10-19 years in 30 randomly selected communities was used. A well-structured questionnaire was developed. A multinomial logistic regression analysis was used to examine factors that significantly influenced communication between adolescents and their parents regarding sex. RESULTS Only 11.3% of adolescents had discussions on sexual issues with both parents while 27.6% of communicated sexual issues with only one parent in Adaklu district. Adolescent males (AOR = 0.21, CI = 0.06-0.75), those aged 10-14 years (AOR = 0.41, CI = 0.04-0.57), non-members of adolescent health clubs (AOR = 0.46, CI = 0.21-1.00), and those living with only a father (AOR = 0.19, CI = 0.06-0.61) had lower odds of communicating with their parents on sexual issues. CONCLUSIONS Adolescent-parental communication on sexual issues in Adaklu district is very low. This situation requires more empowerment of adolescents to enable them to discuss sexual issues with their parents through increased engagement with adolescent health club activities and capacity building capacity of parents with the right information on sexual and reproductive health by health staff within the district. Additionally, parents need to be equipped with communication skills to enable them to communicate effectively with their children.
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Affiliation(s)
- Desmond Klu
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana.
| | - Percival Agordoh
- School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Charles Azagba
- Adaklu District Health Directorate, Ghana Health Service, Accra, Ghana
| | - Evelyn Acquah
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Phidelia Doegah
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | | | - Evelyn Korkor Ansah
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Margaret Gyapong
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
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Arthur K, Christofides N, Nelson G. Effectiveness of a pre-adolescent inter-generational intervention to address HIV and obesity in South Africa, using a pretest-posttest design. BMC Public Health 2021; 21:2251. [PMID: 34895196 PMCID: PMC8665511 DOI: 10.1186/s12889-021-12228-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/13/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Strengthening pre-adolescents knowledge and skills through an age- and culturally-appropriate intervention could prevent health issues later in life. Early interventions could influence the trajectory of future risky behaviour, and may influence health behaviour amongst their parents. The CIrCLE of Life Initiative was developed to address HIV and obesity. We evaluated whether the combined intervention increased knowledge, enhanced skills, and/or promoted healthy behaviour among students (9-12 years old) and their parents. METHODS The study was conducted from May to December 2018. Trained educators delivered 30-min lessons over ten consecutive weeks with 537 Grade 6 students at five government-run schools, in a district, in South Africa. Schools were purposively selected based on socioeconomic status and urban-rural classification. Students communicated with parents through shared homework activities. A pretest-posttest study design was used, with a 3-month follow up. Both groups completed self-administered paper-based questionnaires. A score of subscales was used in analysis. The pretest and posttest scores were compared for students and parents using a dependent t-test. Differences in outcomes by school quintile were compared using one-way ANOVA. RESULTS Response rates were high for both students (80.6%) and their parents (83.4%). Statistically significant differences were observed in HIV knowledge in students pretest (mean 8.04, SD 3.10) and posttest scores (mean 10.1, SD 2.70; p < 0.01), and their parents (mean 10.32, SD 2.80 vs 11.0, SD 2.50; p < 0.01). For both students and parents, pre- and post-test obesity awareness mean scores were similar, 1.93, SD 0.92 and 2.78, SD 0.57; p < 0.01, for students; and 2.47, SD 0.82 and 2.81, SD 0.54; p < 0.01, for parents. In the posttest, statistically significant changes were also observed in both groups, enhancing skills in measuring body mass index and pulse rate, and interpreting food labels. Students had a high intention to share gained knowledge with parents who had a high intention to receive it (89.4 and 89.5%, respectively). CONCLUSION The intervention increased knowledge about HIV and obesity-related awareness, and it enhanced skills in selected outcomes among pre-adolescents and parents. Accurate messages and enhanced communication skills could support inter-generational knowledge transfer. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04307966 retrospectively registered on 12 March 2020.
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Affiliation(s)
- Keshni Arthur
- School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown, Johannesburg, 2193 South Africa
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown, Johannesburg, 2193 South Africa
| | - Gill Nelson
- School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown, Johannesburg, 2193 South Africa
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Envuladu EA, Massar K, de Wit JBF. Diversities of Sexual Activities and Correlates of Safe Sex Practices Among Adolescents in Plateau State, Nigeria. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:744622. [PMID: 36303998 PMCID: PMC9580655 DOI: 10.3389/frph.2021.744622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/20/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Unsafe sex, particularly, condomless sex exposes adolescents to sexual and reproductive health risks. This study aimed to assess the sexual experiences and to determine the most important covariates of sexual activity and consistent condom use among adolescents in Plateau State, Nigeria. Methods: A cross sectional survey was conducted among 428 adolescents selected from 6 LGAs through a multistage sampling technique. The data was analyzed using the IBM Statistical package for Social Sciences (SPSS) version 23, multiple logistic regression was conducted to determine the covariates of sexual activity and condom use. Results: About one third (38%) of the adolescents were sexually active, 5.7% had same sex partners, 70% had more than one sexual partner and majority (72.4%) were not consistently using condom during sex. Logistic regression results showed that older adolescents (OR = 5.73; CI = 3.72–8.12; p = 0.001) and out of school adolescents (OR = 2.68; CI = 1.79–4.00; p = 0.001) were more likely to be sexually active, while multivariable logistic regression analysis showed age (AOR = 0.33; CI = 0.12–0.90; p = 0.031) and gender as important covariates of being sexually active, (AOR = 6.29; CI = 3.18–12.44; p = 0.001). Inconsistent condom use was more likely among adolescents; with lower education, (OR = 2.14; CI = 1.19–3.85; p = 0.011), having sex with older partners (OR = 0.61; CI = 0.42–0.90; P = 0.013) and with low awareness of SRH issues (OR = 2.08; CI = 1.02–4.22; p = 0.044). The multivariable logistic regression however, showed gender, being male (AOR = 0.43; CI = 0.006–3.09; p = 0.023) as covariate of consistent condom use. Conclusion: Most sexually active adolescents had multiple sexual partners, some had same sex partners and majority were not consistently using condom. Older adolescents and those out of school were more likely to be sexually active. Awareness of SRH issues significantly influenced condom use while gender, specifically being male, was the independent covariate for being sexually active and for consistent condom use. We recommend sexual health intervention targeted at adolescents. In addition, gender should be mainstreamed into adolescent sexual and reproductive health programmes.
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Affiliation(s)
- Esther Awazzi Envuladu
- Department of Community Medicine, College of Health Sciences, University of Jos, Jos, Nigeria
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
- *Correspondence: Esther Awazzi Envuladu
| | - Karlijn Massar
- Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - John B. F. de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
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Usonwu I, Ahmad R, Curtis-Tyler K. Parent-adolescent communication on adolescent sexual and reproductive health in sub-Saharan Africa: a qualitative review and thematic synthesis. Reprod Health 2021; 18:202. [PMID: 34629082 PMCID: PMC8504018 DOI: 10.1186/s12978-021-01246-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Improving adolescent sexual and reproductive health continues to be a global public health need. Effective parent–adolescent communication on sexual health issues has been cited as a factor that could influence adolescents towards adopting safer sexual behaviour. The current review synthesises qualitative literature to understand the nature and relevance of parent–adolescent sexual and reproductive health communication and the barriers to effective communication in sub-Saharan Africa. Methods We systematically searched and synthesised qualitative literature published between 1st January 1990 to December 2019 and searched from CINAHL, PsycINFO, MEDLINE, Global Health, EMBASE, PubMed, and Google Scholar. We assessed the methodological quality of included studies using the Critical Appraisal Skills Programme (CASP) checklist. We thematically analysed qualitative data from the included primary studies. Results Fifteen studies were included. Social and physiological events act as triggers for initiating discussions. Fear of personal, social, and economic consequences of high-risk sexual behaviours act as drivers for communication but also carry a negative framing which hinders open discussion. Lack of parental self-efficacy and cultural and religious norms create an uncomfortable environment leaving peers, media, teachers, and siblings as important and sometimes preferred sources of sexual health information. Conclusions While mothers recognise their own role in adolescent sexual and reproductive health and school-based interventions can act as useful prompts for initiating discussion, fathers are mainly absent from home-based dialogue. Fear dominates the narrative, and the needs of adolescents remain unarticulated. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01246-0. Improving adolescent sexual and reproductive health remains an important public health need globally. Effective communication on sexual health issues between adolescents and their parents has been recognised to influence safer sexual behaviour among adolescents. This review combined qualitative evidence to understand the nature of, and barriers to communication about sex between parents and adolescents in sub-Saharan Africa. We searched academic databases for relevant articles published between January 1990 and December 2019 and found 15 studies of appropriate quality. Data on parents and adolescents’ experiences of sex communication in these studies was synthesised. Drivers for sex communication including fear of personal and economic consequences were highlighted. Results also identified barriers to communication such as cultural and religious norms and lack of parental knowledge and skills. Findings showed that adolescents sometimes prefer other sources of sexual health information like peers, media, and siblings. Mothers are recognised to be more involved with home-based interactions on sexual health with adolescents compared to fathers. The results of this review point to the necessity for adolescents’ needs to be understood and articulated towards influencing policy and programmes. Adolescents in sub-Saharan Africa remain at high risk for sexually transmitted infections, female genital mutilation, and early pregnancy. Adolescents mostly view sex-related discussions with parents as uncomfortable, and interactions are driven by fear of personal, social, and economic consequences of sexual risk-taking behaviour. Parents recognise their lack of capacity to engage with adolescents and are influenced by cultural norms and religious beliefs. Future research needs to address the current imbalance of adult versus adolescent voices in published work and also ensure a creation of space for conversations about sexuality with sexual and gender minority youth in the Lesbian, Gay, Bi-sexual, Transgender, Queer, Intersex, and Asexual communities.
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Affiliation(s)
- Ijeoma Usonwu
- Nursing, City University of London School of Health Sciences, London, UK.
| | - Raheelah Ahmad
- Division of Health Services Research and Management, City University of London School of Health Sciences, London, UK
| | - Katherine Curtis-Tyler
- Division of Health Services Research and Management, City University of London School of Health Sciences, London, UK
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Adekola AP, Mavhandu-Mudzusi AH. Addressing Learner-Centred Barriers to Sexuality Education in Rural Areas of South Africa: Learners' Perspectives on Promoting Sexual Health Outcomes. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2021; 20:1-17. [PMID: 34608403 PMCID: PMC8480970 DOI: 10.1007/s13178-021-00651-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The school-based sexuality education programmes in South Africa aim to improve the sexual and reproductive health of school-going adolescents. However, the high rate of unplanned pregnancy and sexually transmitted infections among learners in some schools in rural areas of King Cetshwayo district suggests that the programmes in these schools might not be effective due to certain learner-centred factors. METHOD This qualitative study explored lived experiences of 84 learners from nine public schools in 2020 through focus group interviews. Data was analysed using Interpretative Phenomenological Analysis. RESULTS Learner-centred barriers to effective school-based sexuality education identified in this study were attitudes, age disparity, psychological status, peer pressure, socio-economic status, the exploratory attitude of learners, media, lack of role models, previous experiences, socio-economic status, and lack of parental love. These factors could reduce good sexual health. Learner-targeted interventions such as campaigns, using guest professionals, condom distribution, videos, on-site family planning, formal demonstrations, and on-site counselling could address these barriers. CONCLUSIONS Addressing these barriers and implementing the proposed interventions will enhance school-based sexuality education and consequently improve adolescents' sexual health. POLICY IMPLICATIONS The findings could guide programming, implementation, and delivery of school-based sexuality education leading to improved adolescents' sexual and reproductive health.
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Affiliation(s)
- Ayobami Precious Adekola
- Department of Health Studies, College of Human Sciences, University of South Africa, Pretoria, South Africa
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Mushy SE, Rosser BRS, Ross MW, Lukumay GG, Mgopa LR, Bonilla Z, Massae AF, Mkonyi E, Mwakawanga DL, Mohammed I, Trent M, Wadley J, Leshabari S. The Management of Masturbation as a Sexual Health Issue in Dar es Salaam, Tanzania: A Qualitative Study of Health Professionals' and Medical Students' Perspectives. J Sex Med 2021; 18:1690-1697. [PMID: 37057493 DOI: 10.1016/j.jsxm.2021.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 07/05/2021] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Across Africa, there are strong cultural taboos against masturbation. AIM As part of a broader study investigating sexual health training needs of the health providers, researchers conducted a study to investigate how masturbation is addressed as a clinical issue in clinics in Dar es Salaam, Tanzania. METHODS An exploratory qualitative study design conducted in June 2019 involving 18 focus groups among health care providers and students in the health professions (midwives, nurses, medical doctors). A total of 61 health care students and 58 health providers were interviewed. The study participants were purposively selected and the design was purposively stratified to examine findings across the 3 main health care providers and by experience (clinicians vs students). A semistructured interview guide in Kiswahili language was used. The study participants were presented a case scenario of a 14-year-old boy who was found masturbating in his room by his father, and asked how this case would be handled in a clinical setting. Data were transcribed in Kiswahili and Translated to English. OUTCOMES Inductive-deductive thematic analysis was performed. Major themes and subthemes were identified. RESULTS Two main themes emerged: (i) knowledge about the management of masturbation and (ii) views about the effects of masturbation. Clinical interventions providers would try to include normalization of masturbation as a pubescent behavior combined with advice to stop the adolescent from masturbating, a recommendation to watch for negative effects immediately postmasturbation, and referral to a psychologist for treatment. Across providers and students, masturbation in adolescence was seen as clinically problematic, potentially leading to multiple issues in adulthood including sexual dissatisfaction with a spouse, psychological dependency, and erectile dysfunction, loss of sexual sensitivity in intercourse, premature ejaculation, and penis size reduction. Several participants mentioned they received no training about masturbation to guide their clinical practice. CLINICAL IMPLICATIONS These findings affirm the need for comprehensive sexual health training in Tanzanian universities. STRENGTHS AND LIMITATIONS Use of stratified design by profession and experience allowed to explore if there appear to be differences between students and experienced providers. The findings cannot be generalizable to all health professional students and providers across Tanzania. CONCLUSION When designing sexual health curricula for Tanzania, it is important to include accurate information about masturbation as a normal and healthy sexual practice to address widely held myths about its effects on health, and to train providers in how to counsel when concerns and inaccurate information are brought to the clinical encounter. Mushy SE, Rosser BRS, Ross MW, et al. The Management of Masturbation as a Sexual Health Issue in Dar es Salaam, Tanzania: A Qualitative Study of Health Professionals' and Medical Students' Perspectives. J Sex Med 2021;18:1690-1697.
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Affiliation(s)
- Stella E Mushy
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | | | | | - Lucy R Mgopa
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Agnes F Massae
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ever Mkonyi
- University of Minnesota, Minneapolis, MN, USA
| | | | | | - Maria Trent
- Johns Hopkins University, Baltimore, MD, USA
| | | | - Sebalda Leshabari
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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How perceived Australian sexual norms shape sexual practices of East Asian and sub-Saharan African international students in Sydney. BMC Public Health 2021; 21:395. [PMID: 33622290 PMCID: PMC7903731 DOI: 10.1186/s12889-021-10445-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/10/2021] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Sexual norms, real or perceived, shape young people's sexual behaviour and may constitute one of the greatest challenges in HIV/STIs prevention among this population. This study used sexual script theory to explore how international students in Sydney, Australia - from traditional cultures of East Asian and sub-Saharan African countries - construct home backgrounds and Australian sexual norms and how this may shape their sexual practices during their studies in Australia. METHODS The study involved face-to-face and telephone semi-structured in-depth interviews. Data were provided by 20 international students who are enrolled in various universities in Sydney. Interviews were audio-recorded, transcribed, coded into NVivo and analysed using reflexive thematic analysis. RESULTS Identified patterns in the data showed three themes through which participants perceive sexual norms in Australia as distinctly different from their home country norms. First, participants stated that unlike their home country norms, sexual norms in Australia are permissive. Second, participants hold the view that compared to their home country norms, sex in Australia is largely casual as it is not always attached to love. Some participants revealed that this could shape their own sexual practices during their studies in Australia. Finally, participants noted that compared to their home countries' norm of sex talk taboo, Australia has an open sexual communication norm; which they believe, enables young people in western societies to easily acquire sexual health information. CONCLUSIONS Findings provide evidence to support a need for contextualized and effective sexual health services for international students that take account of perceptions around sexual norms and how they can be modified to ensure that sexual practices which these students may engage in, will be managed in a safe and responsible manner.
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Yalew M, Adane B, Kefale B, Damtie Y, Arefaynie M, Wedajo S, Bitew A, Wasihun Y. Parent-young communication on sexual and reproductive health issues and its association with sex and perceptions of young people in Ethiopia, 2020: a systematic review and meta-analysis. Arch Public Health 2020; 78:133. [PMID: 33317624 PMCID: PMC7735417 DOI: 10.1186/s13690-020-00515-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/02/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND There is no national representative and conclusive data regarding parent-young communication. Therefore, this study aimed to estimate the pooled prevalence of parent-young communication on sexual and reproductive health issues and its association with sex and perceptions of young people about its importance in Ethiopia, 2020. METHODS The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) was used during systematic review and meta-analysis. The study included both published and gray literatures which were searched using appropriate key terms. The articles were searched from different databases: PubMed, Cochrane Library, PsycINFO, CINAHL, Global Health, HINARI and Google scholar. Data were extracted in a Microsoft Excel sheet and STATA/SE 14 was used for meta-analysis. I2 and Egger test statistics were used to test heterogeneity and publication bias respectively. RESULTS Twenty-nine articles were included in this systematic review and meta-analysis. The pooled prevalence of parent-young communication on sexual and reproductive health issues in Ethiopia was 42.96% [95% CI: (36.91, 49.02)]. Positive perception of young people towards parent-young communication [AOR = 3.72, 95% CI: (2.87, 4.86)] and female sex [AOR = 1.62, 95% CI: (1.12, 2.34)] were significantly associated with parent-young communication on sexual and reproductive health issues. CONCLUSIONS The prevalence of parent-young communication on sexual and reproductive health issues in Ethiopia was low as compared to other literatures conducted outside Ethiopia. Both perceptions of young people towards parent-young communication and sex were significantly associated with parent-young communication on sexual and reproductive health issues. Interventions targeting males and young who had negative perceptions regarding parent-young communication should be the primary focus of the government and their parents. REVIEW REGISTRATION The protocol of this systematic review and meta-analysis was registered in the PROSPERO International prospective of systematic reviews with a specific registration number: CRD42020161252 .
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Affiliation(s)
- Melaku Yalew
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Shambel Wedajo
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abebayehu Bitew
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yitbarek Wasihun
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Dziva Chikwari C, Bernays S, Dringus S, Simms V, Weiss HA, Sibanda E, Kranzer K, Ncube G, Chikodzore R, Webb K, Chirimambowa T, Sithole K, Ndondo N, Apollo T, Mutseta M, Ferrand RA. Addressing the challenges and relational aspects of index-linked HIV testing for children and adolescents: insights from the B-GAP study in Zimbabwe. Implement Sci Commun 2020; 1:99. [PMID: 33292817 PMCID: PMC7640428 DOI: 10.1186/s43058-020-00091-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/21/2020] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect uptake of index-linked HIV testing for children and adolescents. METHODS We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data. RESULTS Our findings showed there was inadequate emphasis on paediatric HIV in routine care which had a negative impact on subsequent uptake of testing for children. Once the decision to test had been made, access to facilities was sometimes challenging and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. CONCLUSION There is a need to improve messaging on the importance of HIV testing for children and adolescents and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family-centred approach can optimise index-linked testing.
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Affiliation(s)
- Chido Dziva Chikwari
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale, Harare, Zimbabwe.
| | - Sarah Bernays
- Global Health Department, London School of Hygiene and Tropical Medicine, London, UK
- School of Public Health, University of Sydney, Sydney, Australia
| | - Stefanie Dringus
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Victoria Simms
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale, Harare, Zimbabwe
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Helen A Weiss
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Katharina Kranzer
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale, Harare, Zimbabwe
| | | | | | - Karen Webb
- Organization for Public Health Interventions and Development, Harare, Zimbabwe
| | | | - Kenny Sithole
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale, Harare, Zimbabwe
| | - Nonhlanhla Ndondo
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale, Harare, Zimbabwe
| | | | | | - Rashida A Ferrand
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale, Harare, Zimbabwe
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Mekie M, Addisu D, Melkie A, Taklual W. Parent-adolescent communication on sexual and reproductive health issues and its associated factors in Ethiopia: a systematic review and meta-analysis. Ital J Pediatr 2020; 46:162. [PMID: 33126919 PMCID: PMC7596988 DOI: 10.1186/s13052-020-00921-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/05/2020] [Indexed: 01/22/2023] Open
Abstract
Background Every year, 1.3 million young people reported to die from preventable causes of death. Parent-adolescent communication on sexuality is critical in informing youth about risk and protective behaviors which in turn decrease the likelihood of involvement in risky sexual behaviors. This systematic review and meta-analysis was intended to assess the prevalence of parent-adolescent communication on sexual and reproductive health (SRH) issues and its associated factors in Ethiopia. Methods PubMed, EMBASE, HINARI, Google Scholar, and University repositories were used to search studies. Article search was conducted from May 20 to June 9, 2020. Critical appraisal of studies was conducted using Newcastle-Ottawa Quality Assessment Scale (NOS). Data analysis was conducted using Stata 11 software following the abstraction of data using a format prepared on Microsoft excel. The heterogeneity of studies was tested using Cochran (Q test) and I2 test statistics. Similarly, funnel plot and Egger’s regression asymmetry were used to assess publication bias. Subgroup analysis was conducted based on study Regions and sample size. Result Fourteen studies with sample of 8018 adolescents were included in this systematic review and meta-analysis. The pooled prevalence of parent-adolescent communication on SRH issues in Ethiopia was found to be 45.18% (95%, CI, 32.23, 58.13%). Adolescents’ knowledge of reproductive health matters (OR = 2.91, 95% CI:1.21, 7.01), believe on importance of discussion on SRH issues (OR = 4.18, 95% CI: 2.63, 6.65), had history of sexual exposure (OR = 1.95, 95% CI: 1.53, 2.50), parents openness to discuss SRH issues (OR = 3.39, 95% CI: (2.48, 4.62), and being female (OR = 1.60, 95% CI:1.07, 2.38) were the positive predictors of parent-adolescent communications on SRH issues. Conclusion The prevalence of parent-adolescent communication on SRH issues was found to be low. Knowledge of adolescents about reproductive health matters, believe on the importance of discussion on reproductive health issues, history of sexual exposure, parents’ openness to discuss SRH issues, and being female were found to be the positive predictors of parent-adolescent communication on SRH issues in Ethiopia. The finding our study indicated that evidence based education about reproductive health matters could significant to improve adolescent parent communication on SRH issues.
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Affiliation(s)
- Maru Mekie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Dagne Addisu
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Abenezer Melkie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wubet Taklual
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Wado YD, Bangha M, Kabiru CW, Feyissa GT. Nature of, and responses to key sexual and reproductive health challenges for adolescents in urban slums in sub-Saharan Africa: a scoping review. Reprod Health 2020; 17:149. [PMID: 32998741 PMCID: PMC7526107 DOI: 10.1186/s12978-020-00998-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Addressing adolescents' sexual and reproductive health and rights (SRHR) requires an understanding of the socio-cultural and spatial settings within which they live. One setting of particular importance is the informal settlements or 'slums' that are gradually dominating the urban space. We undertook a scoping review and synthesis of existing evidence on adolescent SRHR in slums in sub-Saharan Africa (SSA) focusing on the characteristics and nature of existing evidence. METHODS The scoping review was conducted based on Arksey and O'Malley framework and in accordance with the guidance on scoping reviews from the Joanna Briggs Institute (JBI) and using PRISMA reporting guidelines for scoping reviews. A comprehensive search was undertaken in PubMed, POPLINE, African Journals Online (AJOL), Bioline International and Google Scholar. The search was confined to studies published in peer reviewed journals and reports published online between January 2000 and May 2019. Studies were included in the review if they addressed SRHR issues among adolescents living in urban slums in SSA. RESULTS The review included a total of 54 studies. The majority (79.5%) of studies were quantitative. The bulk of studies (85.2%) were observational studies with only eight intervention studies. While half (27) of the studies focused exclusively on adolescents (10-19 years), 12 studies combined adolescents with other young people (10-24 years). The studies were skewed towards sexual behavior (44%) and HIV/AIDS (43%) with very few studies focusing on other SRHR issues such as contraception, abortion, gender-based violence and sexually transmitted infections (STIs) other than HIV. Most of the studies highlighted the significantly higher risks for poor SRHR outcomes among adolescents in slums as compared to their peers in other settlements. CONCLUSION Young people growing up in slums face tremendous challenges in relation to their SRHR needs resulting in poor outcomes such as early and unintended pregnancy, STIs, and sexual violence. The results of this review point to several potential target areas for programming, policy, and research aimed at improved adolescent SRHR in slums in SSA.
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Affiliation(s)
- Yohannes Dibaba Wado
- African Population and Health Research Center, APHRC Campus, Manga Close, P.O. Box 10787-00100, Nairobi, Kenya.
| | - Martin Bangha
- African Population and Health Research Center, APHRC Campus, Manga Close, P.O. Box 10787-00100, Nairobi, Kenya
| | - Caroline W Kabiru
- African Population and Health Research Center, APHRC Campus, Manga Close, P.O. Box 10787-00100, Nairobi, Kenya
| | - Garumma T Feyissa
- Dornsife School of Public Health, Drexel University, Philadelphia, USA
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Mbachu CO, Agu IC, Eze I, Agu C, Ezenwaka U, Ezumah N, Onwujekwe O. Exploring issues in caregivers and parent communication of sexual and reproductive health matters with adolescents in Ebonyi state, Nigeria. BMC Public Health 2020; 20:77. [PMID: 31952497 PMCID: PMC6969441 DOI: 10.1186/s12889-019-8058-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parent-child communication is an effective tool for fostering healthy sexual and reproductive behaviours among adolescents. However, the topic is underexplored in Nigeria. This study examines how parents and caregivers communicate sexual and reproductive health-related matters with adolescents aged 13-18 years in Nigeria. METHOD The study was undertaken in six communities in Ebonyi state, Nigeria using quantitative and qualitative research methods. Data were collected through, i) cluster randomized survey of 1057 adolescents aged 13-18 years, ii) twelve sex-disaggregated focus group discussions with adolescents aged 13 to 18 years, and iii) eight in-depth interviews with parents and caregivers. Univariate and bivariate analysis were performed for quantitative data, while qualitative data were analysed using thematic framework approach. RESULTS Less than half (47.9%) of adolescents in the survey reported ever discussing sex-related matters with anyone. Three-quarters of those who had this discussion did so with a friend/peer and this had significant correlation with sex/gender (p = 0.04). Out of 1057 adolescents who participated in the survey only 4.5% had ever discussed sex-related matters with a parent and this correlated significantly with wealth index (p = 0.003). Findings from qualitative interviews show that sex-related discussions between parents and adolescents are sporadic, mostly triggered by unpleasant occurrences, and consist of, i) information on pubertal changes, ii) warnings against intersex relationships and premarital sex, iii) promotion of abstinence, and iv) warnings against teenage pregnancy and unsafe abortion. Some parents were of the opinion that sex-related matters should not be discussed with adolescents because it could be interpreted as tolerance for sexual promiscuity. Overall, parents expressed that their capacity to discuss sex-related matters with adolescents is limited by lack of knowledge, and restrictive religious and cultural norms about adolescent sexuality. CONCLUSION Communication between parents and adolescents on sexual health and reproductive-related matters rarely occurs. However, when it does, it mostly consists of strict warnings that may not protect adolescents from making unhealthy sexual and reproductive health choices. Interventions to improve parent-adolescent communication of sexual and reproductive health (SRH) should aim at improving parents' capacity to communicate sexual and reproductive health matters, and deconstructing sociocultural norms around adolescent sexuality.
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Affiliation(s)
- Chinyere Ojiugo Mbachu
- Health Policy Research Group, University of Nigeria Enugu, Enugu, Nigeria.,Department of Community Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Ifunanya Clara Agu
- Health Policy Research Group, University of Nigeria Enugu, Enugu, Nigeria
| | - Irene Eze
- Health Policy Research Group, University of Nigeria Enugu, Enugu, Nigeria
| | - Chibuike Agu
- Health Policy Research Group, University of Nigeria Enugu, Enugu, Nigeria
| | - Uche Ezenwaka
- Health Policy Research Group, University of Nigeria Enugu, Enugu, Nigeria.,Department of Health Administration and Management, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Nkoli Ezumah
- Health Policy Research Group, University of Nigeria Enugu, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, University of Nigeria Enugu, Enugu, Nigeria.,Department of Health Administration and Management, University of Nigeria Enugu Campus, Enugu, Nigeria
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Mekie M, Taklual W, Melkie A, Addisu D. Parental communication on sexual and reproductive health issues and its associated factors among preparatory school students in Debre Tabor, Northcentral Ethiopia: institution based cross-sectional study. BMC Res Notes 2019; 12:598. [PMID: 31533808 PMCID: PMC6751799 DOI: 10.1186/s13104-019-4644-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 09/11/2019] [Indexed: 11/18/2022] Open
Abstract
Objective This study was aimed to assess parental communication on sexual and reproductive health (SRH) issues and its associated factors among preparatory school students in Debre Tabor, Northcentral Ethiopia. Institution based cross sectional study was employed among 394 preparatory school students through self-administered questionnaire. Result A total of 394 students were participated in the study with a response rate of 100%. The magnitude of parental communication on SRH issues was found to be 68.5%, (95% CI (63.7, 72.8)). Low grade (AOR = 0.31, 95% CI (0.17, 0.58)), feel embraced to discuss about SRH issues (AOR = 0.31, 95% CI (0.17, 0.56)), and living with mother/father (AOR = 0.15, 95% CI (0.06, 0.36)) were associated with reduced parental communication on SRH. While, family size < 5 (AOR = 2.46, 95% CI (1.25, 4.84)), and believe on the importance of discussion on SRH (AOR = 10.83, 95% CI (5.07, 23.17) were found to be associated with increased communication about SRH issues. Health education shall be given to preparatory school students on importance of discussion on SRH issues and related consequences of risky sexual behaviors.
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Affiliation(s)
- Maru Mekie
- Department of Midwifery, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
| | - Wubet Taklual
- Department of Population Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Abenezer Melkie
- Department of Midwifery, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Dagne Addisu
- Department of Midwifery, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
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Adolescent-parent communication on sexual and reproductive health issues and its factors among secondary and preparatory school students in Hadiya Zone, Southern Ethiopia: institution based cross sectional study. BMC Pediatr 2019; 19:9. [PMID: 30616650 PMCID: PMC6323653 DOI: 10.1186/s12887-018-1388-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 12/28/2018] [Indexed: 11/16/2022] Open
Abstract
Background Adolescent communication with parents is paramount to reduce sexual health problems. Currently, there is a shortage of information on adolescent-parent communication in Ethiopia in general and study area in particular. Thus, this study is intended to determine adolescent-parent communication on sexual and reproductive health issues and its factors among secondary and preparatory school adolescents in Hadiya Zone, Ethiopia. Methods We used institution based cross-sectional study design. We stratified schools into urban and semi-urban settings. Then, a total of 8 schools were randomly selected from the strata. The sample size was allocated for each stratum. Finally, participants were randomly selected from separate sampling frames prepared for each stratum. We developed structured questionnaire from related literatures to collect data on adolescent-parent communication and its factors. We cleaned and entered data using EPI info version 3.5.3 and exported to SPSS version 20 for descriptive and logistic regression analysis. Results The proportion of adolescents who had communicated with their parents was 144 (35.0%). Multivariate logistic regression analysis indicates that participants’ knowledge about availability of adolescent and youth friendly sexual and reproductive health services at health facilities [AOR: 0.40, 95% CI: (0.26, 0.62),P-value = 0.001], utilization of adolescent and youth friendly sexual and reproductive health services [AOR: 0.46, 95% CI: (0.29, 0.72),P-value = 0.001] and respondents’ educational status: being grade 9, [AOR: 3.21, (95% CI: ((1.16, 8.89), P-value = 0.025] and grade 11; [AOR: 2.96, (95% CI: (1.06, 8.30),P- value =0.039] were statistically associated factors affecting adolescents for not communicating with parents on sexual and reproductive health issues. Conclusion The findings of our study imply that adolescents were not communicating much with parents about sexual and reproductive health issues even though they were aware of adolescent and youth friendly sexual and reproductive health services. In addition, promotion of service availability may be important to motivate adolescents to communicate with parents. Contextual and age dependent communication barriers should be further identified. Further research is needed in the area to identify barriers particularly from parent side.
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