Andrea Whittaker, Trudie Gerrits, Karin Hammarberg, Lenore Manderson
{"title":"Access to assisted reproductive technologies in sub-Saharan Africa: fertility professionals' views.","authors":"Andrea Whittaker, Trudie Gerrits, Karin Hammarberg, Lenore Manderson","doi":"10.1080/26410397.2024.2355790","DOIUrl":"10.1080/26410397.2024.2355790","url":null,"abstract":"<p><p>Across sub-Saharan Africa, there remains disagreement among local expert providers over the best ways to improve access to assisted reproduction in low-income contexts. Semi-structured qualitative interviews were conducted between 2021 and 2023 with 19 fertility specialists and 11 embryologists and one clinic manager from South Africa, Zimbabwe, Namibia, Kenya, Ethiopia and Uganda to explore issues surrounding access and potential low-cost IVF options. Lack of access to ART was variously conceptualised as a problem of high cost of treatment; lack of public funding for medical services and medication; poor policy awareness and prioritisation of fertility problems; a shortage of ART clinics and well-trained expert staff; the need for patients to travel long distances; and over-servicing within the largely privatised sector. All fertility specialists agreed that government funding for public sector assisted reproduction services was necessary to address access in the region. Other suggestions included: reduced medication costs by using mild stimulation protocols and oocyte retrievals under sedation instead of general anaesthetics. Insufficient data on low-cost interventions was cited as a barrier to their implementation. The lack of skilled embryologists on the continent was considered a major limitation to expanding ART services and the success of low-cost IVF systems. Very few specialists suggested that profits of pharmaceutical companies or ART clinics might be reduced to lessen the costs of treatments.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11172248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed K Ali, Alka Barua, Rajesh Mehta, Venkatraman Chandra-Mouli
{"title":"Nimble adaptations to sexual and reproductive health service provision to adolescents and young people in the early phase of the COVID-19 pandemic.","authors":"Ahmed K Ali, Alka Barua, Rajesh Mehta, Venkatraman Chandra-Mouli","doi":"10.1080/26410397.2024.2372165","DOIUrl":"10.1080/26410397.2024.2372165","url":null,"abstract":"<p><p>Early in the COVID-19 pandemic, emerging evidence showed that the provision and use of a range of health services, including sexual and reproductive health (SRH) services, were affected. Otherwise, there was little evidence on whether and how they were adapted to maintain the access of different population groups, including adolescents. The study aims to provide an overview of adaptations to adolescent sexual and reproductive health (ASRH) services carried out during the early phases of the pandemic in low- and middle-income countries (LMICs). The Human Reproduction Program (HRP) at the World Health Organization (WHO) called upon WHO and United Nations Populations Fund (UNFPA) regional offices to reach out to organisations that provided ASRH services to submit analytic case studies using a short-form survey. The study team charted information from 36 case studies and performed a content analysis. Results show that the adaptations covered a wide array of SRH services that were provided to a diverse group of adolescents. Most adaptations focused on SRH education and access to contraception in comparison to other SRH services. Over half of the case studies included mental health services, most of which were not provided before the pandemic. The adaptations varied between being face-to-face, remote, digital, and non-digital. Most adaptations complemented a pre-existing service and were nimble, feasible, and acceptable to the targeted adolescents. Lessons learned from this study could be extrapolated into other humanitarian settings and rapid responses for future public health emergencies, provided that rigorous evaluation takes place.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What do oral contraceptive pills have to do with human rights abuses in sport?","authors":"Katrina Karkazis, Michele Krech","doi":"10.1080/26410397.2024.2342105","DOIUrl":"10.1080/26410397.2024.2342105","url":null,"abstract":"","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11134067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emma Halper, Blake Erhardt-Ohren, Melissa Cobb, Oscar Hidalgo-Mora, Sebastián Ospina-Henao, Amari O'Bannon, Roger Rochat, Subasri Narasimhan, Anna Newton-Levinson
{"title":"Socio-ecological influences on access to abortion care in Costa Rica: a qualitative analysis of key perspectives from clinical and policy stakeholders.","authors":"Emma Halper, Blake Erhardt-Ohren, Melissa Cobb, Oscar Hidalgo-Mora, Sebastián Ospina-Henao, Amari O'Bannon, Roger Rochat, Subasri Narasimhan, Anna Newton-Levinson","doi":"10.1080/26410397.2024.2374137","DOIUrl":"10.1080/26410397.2024.2374137","url":null,"abstract":"<p><p>Costa Rica prohibits abortion except under narrow circumstances to save the pregnant person's life. The country boasts historically strong support for social policy and human rights, while also presenting a complex and restrictive abortion access landscape. From September 2021 to March 2022, we conducted 23 interviews with obstetrician-gynecologist (OB/GYN) physicians, OB/GYN medical residents, and policy stakeholders to explore the socio-ecological influences on abortion access in Costa Rica. We sampled clinicians and policy stakeholders from the Universidad de Ciencias Médicas listserv through snowball sampling and conducted semi-structured in-depth interviews in Spanish. We identified limited access to comprehensive sexual health education, lack of support from interpersonal networks, inadequate provider knowledge and training, financial and migratory status, and both provider and community stigma as substantial barriers to abortion access. This study addresses a gap in published research around the social determinants of abortion in Costa Rica and sheds light on the attitudes and opinions of the medical and policy stakeholder communities about abortion access. The results highlight the need for expanded access to comprehensive sexual health education, abortion-related training for healthcare providers, and increased programming efforts, such as funding, outreach, and implementation, to ensure comprehensive reproductive health services are available and accessible, especially for vulnerable populations in Costa Rica.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11305048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Serah Gitome, Petina Musara, Miria Chitukuta, Felix Mhlanga, Bismark Mateveke, Thandiwe Chirenda, Nyaradzo Mgodi, Prisca Mutero, Allen Matubu, Gift Chareka, Charles Chasakara, Caroline Murombedzi, Tinei Makurumure, Carolyn Smith-Hughes, Elizabeth Bukusi, Craig R Cohen, Stephen Shiboski, Lynae Darbes, George W Rutherford, Z Michael Chirenje, Joelle M Brown
{"title":"\"<i>First was to sit down and bring our minds together</i>\". A qualitative study on safer conception decision-making among HIV sero-different couples in Zimbabwe.","authors":"Serah Gitome, Petina Musara, Miria Chitukuta, Felix Mhlanga, Bismark Mateveke, Thandiwe Chirenda, Nyaradzo Mgodi, Prisca Mutero, Allen Matubu, Gift Chareka, Charles Chasakara, Caroline Murombedzi, Tinei Makurumure, Carolyn Smith-Hughes, Elizabeth Bukusi, Craig R Cohen, Stephen Shiboski, Lynae Darbes, George W Rutherford, Z Michael Chirenje, Joelle M Brown","doi":"10.1080/26410397.2024.2366587","DOIUrl":"10.1080/26410397.2024.2366587","url":null,"abstract":"<p><p>Decision-making on childbearing and safer conception use in HIV sero-different couples involves an intricate balance of individual desires and perceived HIV acquisition risk. This paper addresses an important knowledge gap regarding HIV sero-different couples' considerations and the relationship and power dynamics involved when deciding to use a safer conception method. Between February and June 2019, we conducted semi-structured in-depth interviews among 14 men and 17 women, representing 17 couples, who exited the SAFER study - a pilot study assessing the feasibility, acceptability and cost-effectiveness of a safer conception programme for HIV sero-different couples in Zimbabwe. All couples in SAFER were provided with a choice of safer conception methods and were followed for up to 12 months of pregnancy attempts and 3 months following pregnancy. While couples generally perceived their safer conception discussions to be easy and consensus-driven, the decision-making process also involved complex gender dynamics and trade-offs in relationship power, which resulted in differing interpretations of what constituted a joint or shared couple decision. Participants regarded effective couple communication as an essential component of and precursor to good safer conception conversations and requested additional training in couple communication. Couples relied on information from healthcare providers to kickstart their safer conception discussions. Safer conception programmes should address relationship power imbalances, promote effective couple communication and offer healthcare provider support to enable HIV sero-different couples to make informed choices about conception in a manner that upholds their safety and reproductive autonomy.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11251431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Finding the cosmos of intimacies: where pleasurable safe sex dances with liberation.","authors":"Anne Philpott, Paromita Vohra","doi":"10.1080/26410397.2024.2398939","DOIUrl":"https://doi.org/10.1080/26410397.2024.2398939","url":null,"abstract":"","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sexual and reproductive health and rights in Palestine - securing spaces to speak out.","authors":"Laura Ferguson, Sapna Desai","doi":"10.1080/26410397.2024.2397956","DOIUrl":"https://doi.org/10.1080/26410397.2024.2397956","url":null,"abstract":"","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laws governing access to sexual health services and information: contents, protections, and restrictions","authors":"Laura Ferguson, Sarah Emoto, Sofia Gruskin","doi":"10.1080/26410397.2024.2336770","DOIUrl":"https://doi.org/10.1080/26410397.2024.2336770","url":null,"abstract":"Abstract Access to sexual health services and information is critical to achieving the highest attainable standard of sexual health, and enabling legal environments are key to advancing progress in this area. In determining overall alignment with human rights standards to respect, protect, and fulfil sexual health-related rights without discrimination, there are many aspects of laws, including their specificity and content, which impact which sexual health services and information are availed, which are restricted, and for whom. To understand the nature of existing legal provisions surrounding access to sexual health services and information, we analysed the content of 40 laws in English, French, and Spanish from 18 countries for the specific sexual health services and information to which access is ensured or prohibited, and the non-discrimination provisions within these laws. Overall, there was wide variation across countries in the types of laws covering these services and the types and number of services and information ensured. Some countries covered different services through multiple laws, and most of the laws dedicated specifically to sexual health addressed only a narrow aspect of sexual health and covered a small range of services. The protected characteristics in non-discrimination provisions and the specificity of these provisions with regard to sexual health services also varied. Findings may inform national legal and policy dialogues around sexual health to identify opportunities for positive change, as well as to guide further investigation to understand the relationship between such legal provisions, the implementation of these laws within countries, and relevant sexual health outcomes.","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140677287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intimate strangers: commercial surrogacy in Russia and Ukraine and the making of truth","authors":"Jung Chen","doi":"10.1080/26410397.2024.2328474","DOIUrl":"https://doi.org/10.1080/26410397.2024.2328474","url":null,"abstract":"","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140731758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alis Bambara, Madeleine Wayack-Pambè, Idrissa Ouili, Georges Guiella, Alexandre Delamou
{"title":"Effets identitaires de la socialisation différentielle de genre sur les aspirations au premier enfant et au mariage des jeunes adolescent(e)s à Ouagadougou: une étude mixte.","authors":"Alis Bambara, Madeleine Wayack-Pambè, Idrissa Ouili, Georges Guiella, Alexandre Delamou","doi":"10.1080/26410397.2023.2294824","DOIUrl":"10.1080/26410397.2023.2294824","url":null,"abstract":"<p><p>Studies show that gender socialisation shapes differently the gendered identity, self-esteem, and sexual behaviours of girls and boys. While pre-adolescence is viewed as a pivotal period for gendered socialisation, few studies in francophone Africa investigate the role of gender identity effects on aspirations and sexual and reproductive behaviours at this life stage. This article explores how the internalisation of gender stereotypes during socialisation is linked to the aspirations of girls and boys for certain life events, such as having their first child or getting married. A survey was conducted in 10 primary schools in Ouagadougou, among pupils aged between 9 and 16 years, as well as seven focus group discussions with their parents. The findings indicate a gender-based variation in the effects of adherence to unequal gender norms among young adolescents. As a result, girls tend to have earlier aspirations towards marriage and later aspirations for childbearing, while boys show earlier aspirations for childbearing and later ones for marriage. These effects may expose both girls and boys to risks of poor sexual and reproductive health. Interventions promoting egalitarian gender norms could boost girls' self-esteem as well as mutual respect among young adolescents of both genders, aiming to improve their sexual and reproductive health during adolescence and into adulthood.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10833111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}