University students' point of views to facilitators and barriers to sexual and reproductive health services

Utilization of reproductive health services among undergraduate regular class students in Assosa University, BGRS: a comparison among three varieties of multilevel binary logistic regression models

INTRODUCTION

Reproductive health service (RHS) helps for people to have a delighted and safe sex through their life journey. It enables especially for women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant. Therefore, this study aimed to identify the significant determinants of RHS utilization among undergraduate regular class students in Assosa University by using advanced methodology.

METHODS

We used cross-sectional study design to collect RHS data from 362 students in Assosa University from 5 to 16, may 2021. These students were selected using stratified random sampling technique. We also used cross-tabulation to summarize the extents of RHS utilization across all predictors in terms of percentage and three varieties of multilevel binary logistic regression model to model the determinants of RHS.

RESULTS

42.27% of undergraduate regular class students in Assosa University utilize at least one type of RHS during their time at Assosa University whereas, 57.73% of undergraduate regular class students in this University are not utilized it. Among three varieties of multilevel binary logistic regression models, the random slopes two-level model was selected as a best fitted model for the datasets. At 5% level of significance, awareness about RHS, gender, preference of service fees and student's monthly average income were significant predictor variables in this model. In addition, the covariates; age, gender and preference of service fees have a significant random effects on utilization of RHS across all colleges/school.

CONCLUSION

Students who; preferred service fee as usual rate, have awareness about RHS, are females and have high monthly average income were more likely to utilize RHS. RHS utilization among undergraduate regular students in Assosa University is likely to increase more effectively with interventions that address these factors.

Examining the correlation between sexual and reproductive health stigmatization level and gender perception: a case of a university in Turkey - a descriptive cross-sectional study

BACKGROUND

Stigmatization, which emerges depending on the sexual behavior of young individuals, leads to negative health and social outcomes, such as shame, social marginalization, violence, and mental health morbidity.

OBJECTIVE

This study aimed to examine the correlation between the level of sexual and reproductive health stigma and gender perception in female university students.

DESIGN AND SETTING

This descriptive cross-sectional study was conducted at the Faculty of Health Sciences of a university in Turkey.

METHODS

The data of this study were collected from digital media between July and October 2020 from a study population of 385 students. The data were collected using the Personal Information Form, including the socio-demographic characteristics of students, the Sexual and Reproductive Health Stigmatization Scale in Young Women and the Perception of Gender Scale. Descriptive statistics, independent samples t-test, analysis of variance, and Pearson's correlation test were used to assess the data.

RESULTS

It was determined that there was a negative correlation between the Sexual and Reproductive Health Stigmatization Scale in Young Women and the Perception of Gender Scale (r = -0.173, P = 0.001).

CONCLUSION

It was determined that as the gender perception in the young women who participated in the study increased, the sexual and reproductive health stigmatization level decreased. The sexual and reproductive health stigmatization levels of the participants were at an above average level, and gender perception was at a medium level.

Living with singleness: needs and concerns of never-married women over 35

BACKGROUND

Cultural and religious norms and expectations may influence the needs and behavior of single women. This is particularly true in those countries where religion and cultural expectations are salient in everyday life. In this context, the present study investigated the needs and concerns of Iranian never-married women aged 35 and older.

METHODS

This qualitative study involved a conventional content analysis. Interviews were done with 23 never-married women aged 36-64 years in Iran.

RESULTS

A total of 773 codes, 22 subcategories, 8 categories, and 3 themes were extracted from the interviews. The 3 themes were: (1) mental-spiritual lack; categories were lack of emotional support, uncertain future, mental rumination, and sexual worries; (2) reform of culture and society; categories were an adverse effect of culture and being overlooked in society; (3) loneliness arising from disability; categories were aging and loneliness and sickness and loneliness.

CONCLUSIONS

The results of the analysis indicate that the needs and concerns of never-married women over the age of 35 years in Iran remain unmet. This suggests that policymakers and health planners should take into consideration the growing number of never-married women as a societal reality deserving of attention.

Factors influencing sexual and reproductive health of Muslim women: a systematic review

BACKGROUND

In Islamic societies, issues related to sexual and reproductive health (SRH) are rarely discussed and considered sensitive subjects. This review aimed to identify any personal, religious, cultural, or structural barriers to SRH service and education among Muslim women worldwide.

METHODS

A search for qualitative and quantitative studies was conducted on seven electronic databases. A narrative synthesis using thematic analysis was conducted.

RESULTS

Fifty-nine studies were included from 22 countries: 19 qualitative, 38 quantitative and two mixed methods. Many Muslim women have poor SRH knowledge, and negative attitudes which influence their access to, and use of SRH services. Barriers to contraception use among Muslim women included a lack of basic reproductive knowledge, insufficient knowledge about contraception, misconceptions, and negative attitudes. Women had negative attitudes towards family planning for limiting the number of children but not for child spacing, which reflected religious views towards family planning. Religious and cultural beliefs were barriers to contraception use and access to SRH services and information. Family and the community have a significant impact on women's contraceptive use and access to SRH services. Husband and family opposition played a significant role in contraception access and use. Fear of stigmatization and being labelled as having pre-marital sexual relations among unmarried women acted as the main barrier to accessing contraception and seeking SRH information and services.

CONCLUSION

The findings reveal that there are multiple levels of factors that influence Muslim women's SRH. Poor SRH knowledge and practices among Muslim women is complex matter that is affected by personal, community, cultural, religious factors and existing policies and regulations. All these factors overlap and are affected by each other. There is an urgent need for interventions addressing modifiable barriers to SRH education and services to improve knowledge, informed choice and access to services to facilitate better sexual and reproductive wellbeing for Muslim women. It is important to note that while this review aimed to report findings on Muslim women, we acknowledge that significant variations exist within every culture and religion.

A qualitative study of sexual health education among Iranian engaged couples

BACKGROUND

Sexual health education for Iranian engaged couples is always ignored in the premarital education program.

OBJECTIVES

The aim of this study was to explore the necessity of sexual health education for Iranian engaged couples.

MATERIALS AND METHODS

This qualitative study was conducted in Rasht, Iran. The studied sample consisted of 38 engaged men and women; and also 9 health experts and policymakers. We used interview guides to collect data. The data was analyzed through content analysis method.

RESULTS

Analyzing participants' perspectives revealed six themes including: (1) socio-cultural changes, (2) emerging social pathologies, (3) inadequate sexual knowledge; (4) challenges in providing sexual health services, (5) individual consequences and (6) social consequences.

CONCLUSION

Most participants emphasized the necessity of sexual health education not only because of medical concerns, but also from the perspective of social issues. Providing these services should be considered a priority.

Multiple levels of social influence on adolescent sexual and reproductive health decision-making and behaviors in Ghana

Little is known about the multilevel social determinants of adolescent sexual and reproductive health (SRH) that shape the use of family planning (FP) among young women in Africa. We conducted in-depth, semi-structured, qualitative interviews with 63 women aged 15-24 years in Accra and Kumasi, Ghana. We used purposive, stratified sampling to recruit women from community-based sites. Interviews were conducted in English or local languages, recorded, and transcribed verbatim. Grounded theory-guided thematic analysis identified salient themes. Three primary levels of influence emerged as shaping young women's SRH experiences, decision-making, and behaviors. Interpersonal influences (peers, partners, and parents) were both supportive and unsupportive influences on sexual debut, contraceptive (non) use, and pregnancy resolution. Community influences included perceived norms about acceptability/unacceptability of adolescent sexual activity and its consequences (pregnancy, childbearing, abortion). Macro-social influences involved religion and abstinence and teachings about premarital sex, lack of comprehensive sex education, and limited access to confidential, quality SRH care. The willingness and ability of young women in our study to use FP methods and services were affected, often negatively, by factors operating within and across each level. These findings have implications for research, programs, and policies to address social determinants of adolescent SRH.

Stigma Reduction Training Improves Healthcare Provider Attitudes Toward, and Experiences of, Young Marginalized People in Bangladesh

PURPOSE

Working with health providers to reduce HIV stigma in the healthcare setting is an important strategy to improve service utilization and quality of care, especially for young people who are sexually active before marriage, are sexual minorities, or who sell sex. A stigma reduction training program for health providers in Bangladesh was evaluated.

METHODS

A cohort of 300 healthcare providers were given a self-administered questionnaire, then attended a 2-day HIV and sexual and reproductive health and rights training (including a 90-minute session on stigma issues). Six months later, the cohort repeated the survey and participated in a 1-day supplemental training on stigma, which included reflection on personal values and negative impacts of stigma. A third survey was administered 6 months later. A cross-sectional survey of clients age 15-24 years was implemented before and after the second stigma training to assess client satisfaction with services.

RESULTS

Provider agreement that people living with HIV should be ashamed of themselves decreased substantially (35.3%-19.7%-16.3%; p < .001), as did agreement that sexually active young people (50.3%-36.0%-21.7%; p < .001) and men who have sex with men (49.3%-38.0%-24.0%; p < .001) engage in "immoral behavior." Young clients reported improvement in overall satisfaction with services after the stigma trainings (63.5%-97.6%; p < .001).

CONCLUSIONS

This study indicates that a targeted stigma reduction intervention can rapidly improve provider attitudes and increase service satisfaction among young people. More funding to scale up these interventions is needed.

The Stigma of Reproductive Health Services Utilization by Unmarried Women

Background:

Fear of the stigma associated with reproductive health services has always been one of the reasons why youth and unmarried individuals avoid making use of such services. This stigma imposes a great deal of mental stress, fear, and depression on patients and causes delays in the diagnosis and treatment of their conditions.

Objectives:

This paper explores the concept of stigma in the context of the utilization of reproductive health services by unmarried women.

Patients and Methods:

This study is qualitative in nature. Purposive sampling was employed, and semi-structured interviews were conducted with 16 unmarried women, five midwives, and two physicians. The data were analyzed using the conventional content analysis method.

Results:

Four main categories constituted the general concept concerning the stigma suffered by unmarried women for using reproductive health services, i.e., prevalent stereotypical thinking patterns in society, the fear of being judged and labeled by others, discrimination, and feeling ashamed of seeking reproductive health services.

Conclusions:

The findings indicated that society associates reproductive health issues with sexual relations, which in turn shapes the stigma and places limitations on unmarried women for using reproductive health services. Thus, while reproductive health services are planned and provided to unmarried women, strategies are demanded for overcoming this stigma.