Sexual and Reproductive Health Matters最新文献

{"title":"Evaluating the effects of a multi-level intervention on young women's contraceptive use: sexual and reproductive health results of a cluster-randomised factorial-design study in Tshwane, South Africa.","authors":"Ilene S Speizer, Courtney P Bonner, Laura Nyblade, Jacqueline Ndirangu, Alexandra Minnis, Khatija Ahmed, Tracy L Kline, Felicia A Browne, Brittni Howard, Wendee M Wechsberg","doi":"10.1080/26410397.2026.2696689","DOIUrl":"10.1080/26410397.2026.2696689","url":null,"abstract":"<p><p>In South Africa, adolescent girls and young women (AGYW) are engaged in early, condomless, and unprotected (from pregnancy) sex, which puts them at risk of unintended pregnancies and sexually transmitted infections. At the individual, interpersonal, and structural levels, AGYW experience barriers to their access to and use of contraception and condoms. This study employed a cluster-randomised factorial design to examine the impact of a multi-level intervention on contraceptive use behaviours among 802 women ages 16-24 in Tshwane, South Africa. The two intervention components were the Young Women's Health CoOp (YWHC), an intervention to increase participants' knowledge and skills, and a stigma and discrimination (S&D) reduction training at the facility level. Study facilities were randomised into the four study arms: YWHC only; S&D only; both YWHC and S&D; and control (standard of care). The study demonstrated that AGYW in the YWHC arm (RRR: 2.45; 95% CI: 1.05-5.70, <i>p</i> = 0.038) and those in the YWHC and S&D arm (RRR: 3.65; 95% CI: 1.56-8.50, <i>p</i> = 0.003) were more likely to have started a contraceptive method than to remain a non-user compared to those in the control arm over the 9-month follow-up period. However, those in the S&D training-only arm had lower odds of adopting a method over the follow-up period (OR: 0.63; 95% CI: 0.41-0.97, <i>p</i> = 0.037). These results demonstrate the importance of supporting AGYW with tailored messaging in a safe environment as part of sexual and reproductive health services.<i>DOI: 10.1080/26410397.2026.2696689</i>.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2696689"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370219","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":"\"A beautiful chaos\": a qualitative study on exploring the role of international communities of practice in knowledge translation for sexual and reproductive health and rights.","authors":"Noa E M Kolpa, Nicole Moran, Joyce L Browne","doi":"10.1080/26410397.2026.2714691","DOIUrl":"10.1080/26410397.2026.2714691","url":null,"abstract":"<p><p>Persistent knowledge-to-action gaps in sexual and reproductive health and rights (SRHR) limit the translation of evidence into policy and practice. Knowledge platform Share-Net International (SNI) uses Communities of Practice (CoPs) to support knowledge exchange, yet little is known about how CoPs facilitate knowledge translation. This study examined how CoPs across SNI's networks translate SRHR knowledge into action and identified contextual factors shaping these processes. A transdisciplinary qualitative study (October 2024-January 2025) was conducted across eight SNI hubs. CoP members and facilitators with at least three months of involvement were purposely sampled. Data were transcribed verbatim and analysed inductively using thematic analysis in Atlas.ti guided by the knowledge-to-action framework and triangulated through member-checking. Outcomes included knowledge translation processes, CoP functioning, and contextual factors. CoPs create context-specific knowledge, facilitate learning spaces, and produce knowledge products. However, significant gaps were observed in dissemination planning and M&E, limiting the ability to assess impact. Political resistance, conservative norms, power dynamics, and crises were challenges to effective functioning, while supportive policies, activism, and cross-hub learning created opportunities. Strategies to strengthen CoP effectiveness were proposed. CoPs hold strong potential to advance knowledge translation for SRHR, but their effectiveness depends on structured dissemination, learning-oriented M&E, and approaches responsive to local contexts. As CoPs operate within power structures, their ability to contribute to equitable SRHR outcomes is shaped by the environments in which they function. Strengthening facilitation, resources, and cross-hub collaboration may enhance effectiveness, and longitudinal research is recommended to assess sustained policy and practice change. DOI: 10.1080/26410397.2026.2714691.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2714691"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763798","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":"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":"32 1","pages":"2355790"},"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}

{"title":"The continuing fight for abortion rights: taking stock of the evidence.","authors":"Eszter Kismödi, Emma Pitchforth, Tk Sundari Ravindran, Laura Ferguson, Mindy Jane Roseman, Jane Cottingham, Sapna Desai","doi":"10.1080/26410397.2024.2433822","DOIUrl":"10.1080/26410397.2024.2433822","url":null,"abstract":"","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2433822"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740874","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":"Approaches to a crisis in early pregnancy: an explorative qualitative study of medical students and doctors in training in Ireland, using a story completion model.","authors":"Mary Higgins, Sharon Cooley, Deirdre Hayes-Ryan, Brendan Dempsey","doi":"10.1080/26410397.2024.2419150","DOIUrl":"10.1080/26410397.2024.2419150","url":null,"abstract":"<p><p>A crisis in early pregnancy can be due to an unplanned pregnancy or a suspected abnormality. Pregnant people have the right to unbiased and comprehensive advice of all options from healthcare providers. Using story completion models (SCM), the aim of this qualitative study was to explore the attitudes of medical students and doctors in training towards crisis pregnancy, specifically two scenarios: early unplanned pregnancy and fatal fetal abnormality (anencephaly). Participants were invited from medical students attending University College Dublin (UCD) and trainees in Obstetrics and Gynaecology at the Royal College of Physicians of Ireland (RCPI) from July to December 2022. SCM involves giving the consenting participant an introduction to a hypothetical situation that acts as the beginning of a story and asking them to complete it. Stories were compiled and analysed using thematic analysis. Research Ethics Committee approval was given by both UCD and the RCPI. The standards for reporting qualitative research guidelines were followed. Eight doctors in training and six medical students consented to participate in the study; all but two medical students completed both stories to the required word count, giving 25 stories for analysis. For both situations, stories described a variety of approaches, all of which were based on the person's, or couple's, wishes, from continuing in pregnancy to deciding to end the pregnancy. SCM allowed detailed analysis of potentially sensitive subjects such as pregnancy options. This study showed that participating medical students and doctors in training recognise that pregnant people have the right to all choices in crisis pregnancy.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2419150"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476736","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":"Experiences of menstrual health in the Nordic countries: a scoping review of qualitative research, applying an intersectional lens.","authors":"Eva Åkerman, Anna Wängborg, Maria Persson, Marie Klingberg-Allvin","doi":"10.1080/26410397.2024.2446081","DOIUrl":"10.1080/26410397.2024.2446081","url":null,"abstract":"<p><p>Achieving menstrual health is fundamental to gender equality, human rights, and the well-being of all people who menstruate. We undertook a scoping review to map the extent and range of qualitative studies on menstrual health in the Nordic countries and applied an intersectional lens in reporting the findings. The specific research questions we aimed to answer were (1) what types of menstrual health experiences were researched, (2) whose experiences and voices were being researched, and (3) what gaps exist in understanding the experiences and challenges encountered by diverse groups. Four databases were searched for peer-reviewed articles published between 2011 and 2023. Searches yielded 2733, and 22 articles met our inclusion criteria. Included studies were undertaken in Denmark (<i>n</i> = 5), Iceland (<i>n</i> = 1), Norway (<i>n</i> = 3), and Sweden (<i>n</i> = 13). The samples included menstruating people, healthcare professionals, and/or other professionals. Most of the included studies reported on menstrual experiences related to menstrual pain and disorders such as endometriosis. Studies focusing on understanding menstrual health experiences among people in vulnerable situations in the Nordic countries are lacking. We found that menstrual health experiences of menstruating people with the following identities were under-researched: people with disabilities, non-Nordic ethnicities, refugees, gender-diverse people, people experiencing homelessness, and young adolescents. The findings suggest that we have little knowledge and understanding of the experiences and challenges that might be faced by these groups in the Nordic countries. Findings of this scoping review can be used to inform future research directions and policy programming.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":"32 1","pages":"2446081"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415606","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":" ","pages":"2342105"},"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}

{"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":"32 1","pages":"2372165"},"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":"Impacts of the COVID-19 pandemic on access to sexual and reproductive health services for women and gender-diverse people with disabilities in Canada: a qualitative study.","authors":"Meredith Evans, Alexandra Rego, Nkem Ogbonna, Kate Welsh, Sidrah K Zafar, Lucy C Barker, Anne Berndl, Janice Du Mont, Yona Lunsky, Amy McPherson, Lesley A Tarasoff, Ashley Vandermorris, Hilary K Brown","doi":"10.1080/26410397.2024.2441027","DOIUrl":"10.1080/26410397.2024.2441027","url":null,"abstract":"<p><p>The COVID-19 pandemic has had a detrimental impact on sexual and reproductive health (SRH) and rights globally. However, little is known about the experiences of people with disabilities accessing SRH services during the COVID-19 pandemic. In this community-engaged qualitative study, we examined COVID-related impacts on access to SRH services for people with disabilities. We interviewed 61 women and gender-diverse people in Canada from May 2022 to March 2023. Informed by disability reproductive justice, we identified four major themes through constructivist analysis. First, COVID-related changes to SRH service delivery disrupted access to care and caused disability-related health implications. Second, pandemic response measures changed SRH service accessibility: in-person accessibility barriers were amplified, new in-person accessibility barriers were introduced, and the transition to telehealth exacerbated, as well as mitigated, accessibility barriers. Third, COVID-related social changes (e.g. lockdowns) had disability-related SRH and rights implications. Fourth, disabled people recommended improving SRH services by enhancing funding, provider training, information and communication, disability accommodations, representation, and comprehensive community engagement. Cutting across these themes were disproportionate negative impacts of the COVID-19 pandemic on access to SRH services for racialised women and gender-diverse people with disabilities. Failure to ensure SRH and rights for women and gender-diverse people with disabilities during the COVID-19 pandemic undermined disability reproductive justice. Comprehensive disability community engagement is necessary to inform accessible SRH services and policies, both during and beyond a pandemic.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2441027"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819657","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":"Attitudes toward sexual and reproductive health and rights and their associations with reproductive agency: a population-based cross-sectional study in Ethiopia, Kenya, and Zimbabwe.","authors":"Karin Båge, Anna Kågesten, Olalekan Uthman, Mariano Salazar, Bi Puranen, Signe Svallfors, Anna Mia Ekström, Helena Litorp","doi":"10.1080/26410397.2024.2444725","DOIUrl":"10.1080/26410397.2024.2444725","url":null,"abstract":"<p><p>We investigated the association between values and attitudes toward sexual and reproductive health and rights (SRHR) and gender equality, with reproductive agency in Ethiopia, Kenya, and Zimbabwe. Using 2020-21 World Values Survey (WVS) data (<i>n</i> = 3096), we utilised the SRHR Support Index including five subindices to gauge SRHR attitudes, the WVS Equality Index for gender equality values, and the perceived level of freedom of choice and control over whether, when, and how many children to have as a proxy for reproductive agency. Descriptive statistics, bivariate, and multivariable logistic regressions were used to analyse how values and attitudes differed between respondents of high vs low reproductive agency using the median as cut-off, stratified by country and sex. Country, education, subjective social class, and religion were associated with reproductive agency. Adjusted analyses indicated associations between supportive values and attitudes towards equitable masculinity norms, SRHR interventions and gender equality, with high reproductive agency. Associations varied more between countries than by sex. Findings suggest an association between SRHR and gender equality values and attitudes and the level of reproductive agency, and underscore the importance of addressing values and attitudes in context-specific interventions. Measures of SRHR progress should be critically reviewed and complemented with self-assessed - as opposed to researcher-ascribed - items to support the successful implementation of global SRHR agendas.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":" ","pages":"2444725"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972497","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}