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International Perspectives on Sexual and Reproductive Health

Eric Y Tenkorang
CONTEXT: Previous studies have established women's autonomy as an important determinant of several demographic outcomes in Sub-Saharan Africa, yet very few have considered intimate partner violence as one of these outcomes. METHODS: Data collected in 2017 from 2,289 women residing in 40 communities in Ghana were used to examine associations between three types of autonomy-economic decision making, family planning decision making and sexual autonomy-and women's experiences with physical, sexual, emotional and economic violence...
June 1, 2018: International Perspectives on Sexual and Reproductive Health
Anrudh K Jain
CONTEXT: Despite efforts to use facility surveys to measure the quality of family planning programs, routine, reliable measurement and monitoring of national-level quality has not been possible. METHODS: A new composite index to measure national-level quality, the National Quality Composite Index (NQCI), is proposed and used to compare program quality in 30 developing countries. Index scores represent the unweighted average of scores from indicators of three different dimensions of quality-structure, process and outcome...
June 1, 2018: International Perspectives on Sexual and Reproductive Health
Akinrinola Bankole, Patrick Kayembe, Sophia Chae, Onikepe Owolabi, Jesse Philbin, Crispin Mabika
CONTEXT: Unsafe abortion is common in Kinshasa, which contributes to high rates of maternal morbidity and mortality. Little is known about the complications and treatment experienced by women seeking postabortion care at health facilities in the city. METHODS: Data from 867 women admitted to a sample of health facilities providing postabortion care in Kinshasa in 2016 were drawn from a Prospective Morbidity Survey. A measure of severity of postabortion complications was developed on the basis of information from these women and their primary care provider...
March 1, 2018: International Perspectives on Sexual and Reproductive Health
Maia Sieverding, Eric Schatzkin, Jennifer Shen, Jenny Liu
CONTEXT: Health care providers' biases regarding the provision of contraceptives to adolescent and young adult women may restrict women's access to contraceptive methods. METHODS: Two mystery client visits were made to each of 52 private-sector health care facilities and individual providers in South West Nigeria in June 2016. In one visit, the mystery client portrayed an unmarried, nulliparous adolescent, and in the other, the client portrayed a married adult woman with two children...
March 1, 2018: International Perspectives on Sexual and Reproductive Health
Deborah Mindry, Mahlet A Woldetsadik, Rhoda K Wanyenze, Jolly Beyeza-Kashesya, Sarah Finocchario-Kessler, Kathy Goggin, Glenn Wagner
CONTEXT: Safer-conception counseling may help people living with HIV to reduce the risk of transmission to partners and children. However, such counseling is rarely offered or evaluated in low-income countries. METHODS: In 2014-2015, in-depth qualitative interviews were conducted at a Ugandan HIV clinic with 42 HIV-positive clients and 16 uninfected partners who had participated in a safer-conception counseling intervention for serodiscordant couples seeking to have a child...
March 1, 2018: International Perspectives on Sexual and Reproductive Health
Holly McClain Burke, Leila Dal Santo, Alissa Bernholc, Angela Akol, Mario Chen
CONTEXT: Short pregnancy intervals can contribute to maternal and child morbidity and mortality. No previous research has explored factors associated with short pregnancy intervals among young women in Uganda, where adolescent pregnancy and short birth intervals are common. METHODS: Data on 626 married or cohabiting women aged 15-22 with one or two previous pregnancies were drawn from the 2011 Uganda Demographic and Health Survey. Bivariate and multivariable logistic regression analyses were used to examine characteristics associated with rapid repeat pregnancy, defined in two ways: a pregnancy occurring within 24 months or 12 months of a prior pregnancy outcome...
March 1, 2018: International Perspectives on Sexual and Reproductive Health
Chelsey E Brack, Roger W Rochat, Oscar A Bernal
CONTEXT: In 2006, the Colombian Constitutional Court issued a decision largely decriminalizing abortion; however, illegal abortion persists. Understanding the barriers that cause women to resort to unsafe, illegal abortions could help improve access to legal services. METHODS: In-depth interviews were conducted in 2014 with 17 women aged 18 or older who had had legal abortions in the past year in Bogotá, Colombia, to identify barriers to abortion access and elucidate the ways in which these barriers affect women's decision making regarding abortion...
December 1, 2017: International Perspectives on Sexual and Reproductive Health
Lenka Benova, John Cleland, Marina A S Daniele, Moazzam Ali
The objective of this article is to review key components of LARC uptake in Sub-Saharan Africa with the aim of guiding policies and programs. We assess trends in access to the IUD and implant, including method knowledge and availability at facilities; examine trends in use, source of supply, discontinuation and characteristics of users; and discuss the prospects for expanding method choice by increasing the availability of LARCs in national programs and the policy implications of our results.
December 1, 2017: International Perspectives on Sexual and Reproductive Health
Jane Cover, Jeanette Lim, Allen Namagembe, Justine Tumusiime, Jennifer Kidwell Drake, Carie Muntifering Cox
CONTEXT: In Uganda, an estimated one in four adolescent women have begun childbearing. Many adolescent pregnancies are unintended because of substantial barriers to contraceptive access. The injectable contraceptive is the most commonly used method in Uganda, and a new subcutaneous version offers the possibility of reducing access barriers by offering a self-injection option. However, more information about adolescent attitudes toward and interest in self-injection is needed. METHODS: In 2015, in-depth interviews were conducted with a purposive sample of 46 adolescent women aged 15-19 from rural and urban areas of Gulu District...
December 1, 2017: International Perspectives on Sexual and Reproductive Health
Tamar Goldenberg, Rob Stephenson
CONTEXT: Use of maternal health care can reduce maternal morbidity and mortality in countries like Bangladesh, where rates of these outcomes are high. Community characteristics are associated with use of maternal care services, but it is unclear whether deviation from community norms is associated with service use. METHODS: Data from the 2014 Bangladesh Demographic and Health Survey on 4,106 ever-married women aged 15-49 were used to examine relationships between women's deviation from their communities on socioeconomic, fertility and other characteristics and use of maternal health care (antenatal care, delivery care, postpartum care and a composite measure)...
December 1, 2017: International Perspectives on Sexual and Reproductive Health
Nicholas Metheny, Rob Stephenson
CONTEXT: Intimate partner violence (IPV) is associated with negative physical and mental health outcomes. Antenatal care can act as a link to IPV services, but experiencing IPV may be associated with reduced uptake of antenatal care, an issue that has received little attention from researchers. METHODS: A scoping review was conducted to synthesize quantitative research on IPV and uptake of antenatal care in low-resource settings. Keyword searches of PubMed and other databases and snowball searches of reference lists were conducted to identify articles published in 2005-2015 that measured one or more types of IPV (physical, sexual or emotional) or controlling behavior and assessed the relationship of such abuse with use of antenatal care...
December 1, 2017: International Perspectives on Sexual and Reproductive Health
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September 1, 2017: International Perspectives on Sexual and Reproductive Health
Victoria Shelus, Nicki Ashcroft, Sarah Burgess, Monica Giuffrida, Victoria Jennings
CONTEXT: Given the proportion of Kenyan women not using hormonal contraceptives, the country appears to have a substantial need for a modern, natural family planning option. The CycleBeads® mobile phone application (app), a digital platform for the Standard Days Method® of family planning, could help address this issue. METHODS: After the CycleBeads app was promoted in Kenya in May-June 2015, a three-month pilot study was conducted to collect quantitative and qualitative data from 185 female app users...
September 1, 2017: International Perspectives on Sexual and Reproductive Health
Julie H Hernandez, Mbadu Muanda, Mélissa Garcia, Grace Matawa
CONTEXT: Despite the commitment of the Democratic Republic of the Congo (DRC) to expand the family planning method mix and increase access to services, awareness of emergency contraception is low among women, and the method remains underused and poorly integrated in family planning programming. METHODS: Data from 15 focus group discussions conducted in 2016 among women aged 15-35 were used to examine awareness and perceptions of, and attitudes toward, emergency contraceptives...
September 1, 2017: International Perspectives on Sexual and Reproductive Health
Cicely Marston, Alicia Renedo, Gertrude Nsorma Nyaaba, Kazuyo Machiyama, Placide Tapsoba, John Cleland
CONTEXT: According to Demographic and Health Survey (DHS) data, highly educated urban women in some West African countries simultaneously have low rates of both contraceptive use and fertility-suggesting that the DHS may not be capturing a complete picture of women's contraceptive practices. METHODS: Individual in-depth interviews and focus group discussions were conducted with a total of 48 women aged 18-49 in Accra, Ghana, who had at least a secondary education to explore their reproductive lives and relationships, and their views on and use of fertility regulation strategies...
September 1, 2017: International Perspectives on Sexual and Reproductive Health
Melanie Dawn Channon
CONTEXT: Son preference exerts a strong influence over contraceptive and fertility decisions in many South Asian countries. In Pakistan, where fertility remains high and contraceptive use low, research on son preference has been limited. METHODS: Data from Pakistan Demographic and Health Surveys conducted in 1990-1991, 2006-2007 and 2012-2013 were used to examine potential indicators and outcomes of son preference. Descriptive analyses looked at sex composition preferences of men and women, as well as the sex ratio at last birth...
September 1, 2017: International Perspectives on Sexual and Reproductive Health
Mohammad Karamouzian, Armita Shahesmaeili, Razieh Khajehkazemi, Samira Hosseini Hooshyar, Homeira Fallahi, Ali Akbar Haghdoost, Hamid Sharifi
CONTEXT: Evidence on STI knowledge among Iranian nonmedical university students is limited. Information is needed to inform research and policies to improve the sexual health of university students in Iran. METHODS: A convenience sample of 742 male and female undergraduate and graduate students was recruited from five nonmedical public and private universities in Iran in 2014. Respondents' awareness of and knowledge about STIs were assessed using a validated questionnaire...
July 7, 2017: International Perspectives on Sexual and Reproductive Health
Sarah Huber, Allahna Esber, Sarah Garver, Venson Banda, Alison Norris
CONTEXT: Pregnancy ambivalence and pregnancy indifference are thought to be associated with nonuse of contraceptives, but their conceptualization and measurement vary, and their relationship to contraceptive use in developing countries is poorly understood. METHODS: Data from the Umoyo wa Thanzi research program in rural Lilongwe, Malawi, were used to classify the pregnancy desires of 592 women aged 15-39 as antinatal, pronatal, ambivalent or indifferent, according to both the women's desire to conceive and their desire to avoid pregnancy...
July 5, 2017: International Perspectives on Sexual and Reproductive Health
Aimee Benson, Lisa M Calhoun, Meghan Corroon, Peter Lance, Rick O'Hara, John Otsola, Ilene S Speizer, Jennifer Winston
CONTEXT: Levels of fertility and contraceptive use have long fluctuated in Kenya. The multicomponent Tupange program, part of the Urban Reproductive Health Initiative, was initiated in 2011 to increase use of modern family planning methods. METHODS: Women aged 15-49 in the five Kenyan cities where Tupange was implemented were interviewed in 2010 and reinterviewed in 2014 to obtain information on their contraceptive use and exposure to components of the Tupange program...
June 1, 2017: International Perspectives on Sexual and Reproductive Health
Emily Freeman, Ernestina Coast, Susan F Murray
CONTEXT: Given that maternal morbidity and mortality from unsafe abortion persist, especially in Africa, there is a pressing need to understand the abortion decision-making process. However, little is known about men's influence on and involvement in women's abortion decision making and care seeking. METHODS: A qualitative study was conducted at the largest public provider of abortion-related care in Zambia. Thematic framework analysis was used to categorize and synthesize data from in-depth interviews conducted in 2013 with 71 women who received a safe abortion and 41 who received care following an incomplete (unsafe) abortion...
June 1, 2017: International Perspectives on Sexual and Reproductive Health
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