Sexual and Reproductive Health Matters最新文献

{"title":"Immigrant women's perspectives on contraceptive counselling provided by midwives in Sweden - a qualitative study.","authors":"Mia Kolak, Charlotta Löfgren, Stefan R Hansson, Christine Rubertsson, Anette Agardh","doi":"10.1080/26410397.2022.2111796","DOIUrl":"10.1080/26410397.2022.2111796","url":null,"abstract":"<p><p>Immigrant women in Sweden often have unmet sexual and reproductive health (SRH) needs. Successful contraceptive counselling may improve their sexual and reproductive health and rights. The unique Swedish model, with midwives as the main providers of contraceptive counselling, is important for immigrant women's health at both individual and societal levels. This study explored immigrant women's perspectives on receiving contraceptive counselling from midwives in Sweden, in order to obtain deeper knowledge about the factors they perceive as important in the counselling situation. Nineteen in-depth individual interviews were conducted from December 2018 to February 2019, followed by qualitative manifest and latent content analysis. Trust emerged as the overall important factor in the contraceptive counselling meeting. Knowledge was lacking about the midwife's professional role as a contraceptive counsellor. Contraceptive counselling was seen as a private matter not easily shared with unfamiliar midwives or interpreters. Previous experiences of contraceptives and preconceptions were important considerations for contraceptive choice, but communicating these needs required trust. Women also wanted more knowledge about contraceptives and SRH care and rights. Cultural and social norms concerning when and why to use contraceptives needed to be acknowledged in the midwife encounter. Although immigrant women want more knowledge about contraception, a trustful relationship with the midwife is needed to be able to make informed contraceptive choices. Midwives may need increased awareness of the many factors influencing immigrant women's choices to ensure their contraceptive autonomy. Policy changes that promote new ways of counselling and ability to provide continuous care are needed.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/33/ZRHM_30_2111796.PMC9518243.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40374437","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 COVID-19 among Chinese-speaking lesbian, gay and bisexual people in Hong Kong: an inductive thematic analysis of survey response data.","authors":"Yiu Tung Suen, Eliz Miu Yin Wong, Randolph C H Chan","doi":"10.1080/26410397.2022.2102537","DOIUrl":"10.1080/26410397.2022.2102537","url":null,"abstract":"<p><p>As social inequalities during the COVID-19 pandemic have been recognised, emerging research showed that lesbian, gay and bisexual (LGB) people may be additionally affected during the pandemic. This paper adds to the understanding of the experiences of LGB people during the pandemic with a focus on Hong Kong, where issues of space significantly influence LGB people's lives in this city with high population density. As part of a larger community study of LGB lives in Hong Kong, COVID-19-related impact on 434 Chinese-speaking LGB people was explored. Data collection was conducted from 20 May to 30 June 2020. Inductive thematic analysis of the open-text response survey data found that the LGB participants described both negative and positive impacts brought by COVID-19. Such impacts could be dimensionalised into those related to personal space and privacy, romantic and sexual space, and community space. It was also found that the experiences of COVID-19 among LGB people in Hong Kong were intersectional, along the lines of living arrangement and relationship status. Such findings make unique contributions to the emerging literature. First, there needs to be a more nuanced understanding of sexual minority individuals' experiences during COVID-19 across cultural contexts. Second, COVID-19 was described as having brought positive impact in addition to its widely known negative impact.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/8f/ZRHM_30_2102537.PMC9423823.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33438211","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":"Title, Table of Contents and Acknowledgements.","authors":"","doi":"10.1080/26410397.2022.2166739","DOIUrl":"https://doi.org/10.1080/26410397.2022.2166739","url":null,"abstract":"","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ad/7e/ZRHM_30_2166739.PMC9946321.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9444488","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":"\"Doulas shouldn't be considered visitors, we should be considered a part of [the] team\": doula care in Georgia, USA during the COVID-19 pandemic.","authors":"Daria Turner,&nbsp;Alyssa Lindsey,&nbsp;Priya Shah,&nbsp;Ayeesha Sayyad,&nbsp;Amber Mack,&nbsp;Whitney S Rice,&nbsp;Elizabeth A Mosley","doi":"10.1080/26410397.2022.2133351","DOIUrl":"https://doi.org/10.1080/26410397.2022.2133351","url":null,"abstract":"<p><p>Doula support improves maternal-child health outcomes. However, during the COVID-19 pandemic, hospitals restricted the number of support people allowed during childbirth. An academic-community research team conducted 17 in-depth interviews and structured surveys with doulas in metro-Atlanta, Georgia, USA from November 2020 to January 2021. Surveys were analysed for descriptive statistics in Stata v. 14, and interviews were analysed in Dedoose using a codebook and memo-ing for thematic analysis. All 17 doulas reported COVID-19 changed their practices: most were unable to accompany clients to delivery (14), started using personal protective equipment (13), used virtual services (12), and had to limit the number of in-person prenatal/postpartum visits (11). Several attended more home births (6) because birthing people were afraid to have their babies in the hospital. Some stopped seeing clients altogether due to safety concerns (2). Many lost clientele who could no longer afford doula services, and some offered <i>pro bono</i> services. Most doulas pointed to restrictive hospital policies that excluded doulas and disallowed virtual support as they felt doulas should be considered a part of the team and clients should not be forced to decide between having their doula or their partner in the room. COVID-19 has severely impacted access to and provision of doula care, mostly due to economic hardship for clients and restrictive hospital policies. At the same time, doulas and their clients have been resourceful - using virtual technology, innovative payment models, and home births.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/65/ef/ZRHM_30_2133351.PMC9718548.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10751634","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":"An investigation of the impact of the Global Gag Rule on women's sexual and reproductive health outcomes in Uganda: a difference-in-differences analysis.","authors":"Margaret Giorgio, Fredrick Makumbi, Simon P S Kibira, Suzanne O Bell, Doris W Chiu, Lauren Firestein, Elizabeth Sully","doi":"10.1080/26410397.2022.2122938","DOIUrl":"10.1080/26410397.2022.2122938","url":null,"abstract":"<p><p>In 2017, the Trump administration reinstated the Global Gag Rule (GGR), making non-U.S. non-governmental organisations ineligible for US government global health assistance if they provide access to or information about abortion. Little is known about the impact of the Trump administration's GGR on women's outcomes. Data for this analysis come from a panel of women surveyed in 2018 and 2019 in Uganda (<i>n</i> = 2755). We also used data from meetings with key stakeholders to create a detailed measure of exposure to the GGR within Uganda, classifying districts as more or less exposed to the GGR. Multivariable regression models were used to assess changes in contraceptive use, all births, unplanned births, and abortion from before to during implementation of the GGR. Difference-in-differences (DID) estimates were determined by calculating predicted probabilities from interaction terms for exposure/survey round. Descriptive analyses showed long-acting reversible contraceptive use increased more rapidly among women in less exposed districts after GGR implementation. DID estimates for contraceptive use were small. We observed a DID estimate of 3.5 (95% CI -0.9, 7.9) for all births and 2.9 (95% CI -0.2, 6.0) for unplanned births for women in more exposed districts during the period the policy was in effect. Our results suggest that the GGR may have attenuated Uganda's recent progress in improving SRHR outcomes, with women in less exposed districts continuing to benefit from this progress, while previously increasing trends for women in more exposed districts levelled off. Although the GGR was rescinded in January 2021, the impact of these disruptions may be felt for years to come.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/e0/ZRHM_30_2122938.PMC9586624.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40342090","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 experience of obstetric nursing students in an innovative maternal care programme in Chiapas, Mexico: a qualitative study.","authors":"M Montaño,&nbsp;V Macías,&nbsp;R L Molina,&nbsp;P Aristizabal,&nbsp;G Nigenda","doi":"10.1080/26410397.2022.2095708","DOIUrl":"10.1080/26410397.2022.2095708","url":null,"abstract":"<p><p>In Mexico, over the last decade, more non-physician medical professionals have been participating in birth care according to recent federal regulations. So far, very few sites have been able to implement birth care models where midwives and obstetric nurses participate. We describe the experience of a group of intern obstetric nurses participating in a model that provides respectful birth care to rural populations, managed by an international NGO in partnership with the Ministry of Health of Chiapas, Mexico. We conducted a case study including individual interviews and focus group discussions with obstetric nurse interns participating in the Compañeros En Salud programme over four years from 2016 to 2019. We applied targeted content analysis to the qualitative data. There were 28 participants from 4 groups of interns. Informants expressed their opinions in four areas: (a) training as a LEO, (b) training experience at CES, (c) LEO role in health care delivery; and (d) LEOs' perspectives about respectful maternity care. Interns identified gaps in their training including a higher load of theoretical content vs practical experience, as well as little supervision of clinical care in public hospitals. Their adaptation to the health services model has increased over time, and recent classes acknowledge the difficulties that earlier ones had to confront, including the challenging interactions with hospital staff. Interns have incorporated the value of respectful birth care and their role to protect this right in rural populations. Findings could be useful to call for the expansion of the model in public birth centres.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/0c/ZRHM_30_2095708.PMC9341332.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10247548","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":"Mental health, economic well-being and health care access amid the COVID-19 pandemic: a mixed methods study among urban men who have sex with men in India.","authors":"Venkatesan Chakrapani,&nbsp;Peter A Newman,&nbsp;Aleena Sebastian,&nbsp;Shruta Rawat,&nbsp;Sandeep Mittal,&nbsp;Vanita Gupta,&nbsp;Manmeet Kaur","doi":"10.1080/26410397.2022.2144087","DOIUrl":"https://doi.org/10.1080/26410397.2022.2144087","url":null,"abstract":"<p><p>Scant empirical research from Asia has addressed the impact of COVID-19 on sexual minority health. We aimed to explore and understand the impact of COVID-19 on income security, mental health, HIV risk and access to health services among men who have sex with men (MSM) in India. We conducted a concurrent mixed methods study from April to June 2020, including a cross-sectional survey and in-depth semi-structured interviews with MSM recruited from three non-governmental organisations providing HIV prevention services in Chandigarh, India. We examined the associations of sexual minority stressors (sexual stigma, internalised homonegativity), economic stressors, and stress due to social distancing, with depression and anxiety, HIV risk, and access to health services. Survey findings (<i>n</i> = 132) indicated that internalised homonegativity and stress related to social distancing were significantly associated with depressive and anxiety symptoms. Results also showed reduced access to condoms, HIV testing and counselling services. Qualitative findings (<i>n</i> = 10) highlighted adverse economic impacts of COVID-19, including loss of employment/wages and engaging in survival sex work, which contributed to psychological distress and HIV risk. The COVID-19 pandemic has resulted in considerable psychological and financial distress among low socioeconomic status MSM in India, including those involved in sex work - communities already marginalised in economic, family and healthcare sectors. Structural interventions to improve access to mental health and HIV services and decrease financial burden are critical to mitigate the impact of COVID-19.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10345016","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 impact of COVID-19 lockdown on abortion care: a time series analysis of data from Marie Stopes Nepal.","authors":"Corrina Horan, Melissa Palmer, Raman Shrestha, Chelsey Porter Erlank, Kathryn Church","doi":"10.1080/26410397.2022.2079185","DOIUrl":"10.1080/26410397.2022.2079185","url":null,"abstract":"<p><p>The COVID-19 pandemic significantly impacted sexual and reproductive health and rights. Nepal implemented a nationwide lockdown in March 2020, limiting population movement and service access. The 36 clinics run by Marie Stopes Nepal (MSN) closed for varying periods at the beginning of lockdown. This study assesses the impact of lockdown and associated clinic closures on abortion services within MSN's network. An interrupted time-series analysis of clinic-level MSN data compared abortion service use in the pre-closure and post-reopening periods, focusing on the following outcomes: number of abortion care visits, proportion of abortion-related visits, gestational age at time of abortion care and demographics of patients accessing abortion care. Subsequent meta-analyses combined clinic-level results to generate outcome-specific pooled effect estimates. As MSN clinics reopened, during ongoing wider lockdown, weekly visits for abortion care decreased by 37% on average, but abortion increased as a proportion of services post-reopening (OR: 1.53) compared with pre-closure, with no evidence of a change in the proportion of higher gestation abortions. The demographic profile of abortion care clients was altered, with post-reopening clients more likely to have completed primary education (OR: 1.54) and be aged 25 years or older (OR: 1.31) compared with pre-closure clients. COVID-19 lockdown and associated clinic closures reduced the absolute number of abortion services provided within MSN's network, impacting the composition of service provision. Reductions in safe abortion and wider SRH access will have wide-ranging consequences, curtailing crucial reproductive rights. Policy-makers must ensure ongoing abortion access to protect rights and ensure access.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42018048","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":"Pregnancy coercion, correlates, and associated modern contraceptive use within a nationally representative sample of Ethiopian women.","authors":"Shannon N Wood, Jessica L Dozier, Celia Karp, Selamawit Desta, Michele R Decker, Solomon Shiferaw, Assefa Seme, Robel Yirgu, Linnea A Zimmerman","doi":"10.1080/26410397.2022.2139891","DOIUrl":"10.1080/26410397.2022.2139891","url":null,"abstract":"<p><p>Partner-perpetrated pregnancy coercion inhibits women's reproductive autonomy. However, few studies have quantified pregnancy coercion and its effects on women's health within low- and middle-income countries. Among a national sample of Ethiopian women, this study aimed to: (1) assess the prevalence of past-year pregnancy coercion and explore regional differences; (2) identify correlates; (3) examine the relationship between pregnancy coercion and modern contraceptive use. Analyses utilise cross-sectional data from Performance Monitoring for Action (PMA)-Ethiopia, a nationally representative sample of females aged 15-49 conducted from October to November 2019. Past-year pregnancy coercion was assessed via five items and analysed dichotomously and categorically for severity. Among women in need of contraception, bivariate and multivariable logistic regression examined associations between variables of interest, per aim, accounting for sampling weights and clustering by enumeration area. Approximately 20% of Ethiopian women reported past-year pregnancy coercion (11.4% less severe; 8.6% more severe), ranging from 16% in Benishangul-Gumuz to 35% in Dire Dawa. Increasing parity was associated with decreased odds of pregnancy coercion. Among women in need of contraception, experience of pregnancy coercion was associated with a 32% decrease in odds of modern contraceptive use (aOR = 0.68; 95% CI: 0.53-0.89); when disaggregated by severity, odds decreased for most severe pregnancy coercion (aOR = 0.59; 95% CI = 0.41-0.83). Results indicate that partner-perpetrated pregnancy coercion is prevalent across diverse regions of Ethiopia, and most severe forms could interrupt recent gains in contraceptive coverage and progress to sexual and reproductive health and rights. Providers must be aware of potential contraceptive interference and address coercive influences during contraceptive counselling.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9728127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10374063","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":"Gender norms and family planning amongst pastoralists in Kenya: a qualitative study in Wajir and Mandera.","authors":"Leah Kenny, Michelle Lokot, Amiya Bhatia, Rahma Hassan, Shannon Pyror, Nana Apenem Dagadu, Abdullahi Aden, Abdalla Shariff, Loraine J Bacchus, Mazeda Hossain, Beniamino Cislaghi","doi":"10.1080/26410397.2022.2135736","DOIUrl":"10.1080/26410397.2022.2135736","url":null,"abstract":"<p><p>There is growing recognition among global health practitioners of the importance of rights-based family planning (FP) programming that addresses inequities. Despite Kenya achieving its national FP target, inequities in access and use of modern FP remain, especially amongst marginalised nomadic and semi-nomadic pastoralist communities. Few studies explore norms affecting FP practices amongst nomadic and semi-nomadic pastoralists and how these can influence social and behaviour change (SBC) interventions. We carried out 48 in-depth interviews and 16 focus group discussions with women and men from pastoralist communities in North Eastern Kenya in November 2018. Data were analysed thematically. Results from focus groups and interviews confirmed themes, while allowing differences between the qualitative approaches to emerge. We found that large family size was a descriptive and injunctive norm in both nomadic and semi-nomadic communities. The desire for around 10 children was sustained by religious beliefs and pastoralist ways of living. Despite a desire for large families, maintaining child spacing was encouraged and practised through breastfeeding and sexual abstinence. Most participants viewed modern FP negatively and as something used by \"others\". However, it was acceptable in order to prevent severe negative health outcomes. Future FP research to inform interventions should continue to consider community fertility preferences and the rationale for these, including norms, religion and power dynamics. Targeted qualitative social norms research could inform multi-component SBC interventions in this context.</p>","PeriodicalId":37074,"journal":{"name":"Sexual and Reproductive Health Matters","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9704065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40480365","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}