Sexual and Reproductive Health Matters最新文献

{"title":"\"<i>I don't regret it at all. It's just I wish the process had a bit more humanity to it … a bit more holistic</i>\": a qualitative, community-led medication abortion study with Black and Latinx Women in Georgia, USA.","authors":"Elizabeth A Mosley,&nbsp;Sequoia Ayala,&nbsp;Zainab Jah,&nbsp;Tiffany Hailstorks,&nbsp;Indya Hairston,&nbsp;Whitney S Rice,&nbsp;Natalie Hernandez,&nbsp;Kwajelyn Jackson,&nbsp;Marieh Scales,&nbsp;Mariana Gutierrez,&nbsp;Bria Goode,&nbsp;Sofia Filippa,&nbsp;Shani Strader,&nbsp;Mariana Umbria,&nbsp;Autumn Watson,&nbsp;Joya Faruque,&nbsp;Adeola Raji,&nbsp;Janae Dunkley,&nbsp;Peyton Rogers,&nbsp;Celeste Ellison,&nbsp;Kheyanna Suarez,&nbsp;Dázon Dixon Diallo,&nbsp;Kelli S Hall","doi":"10.1080/26410397.2022.2129686","DOIUrl":"https://doi.org/10.1080/26410397.2022.2129686","url":null,"abstract":"<p><p>Traditional family planning research has excluded Black and Latinx leaders, and little is known about medication abortion (MA) among racial/ethnic minorities, although it is an increasingly vital reproductive health service, particularly after the fall of <i>Roe v. Wade</i>. Reproductive justice (RJ) community-based organisation (CBO) SisterLove led a study on Black and Latinx women's MA perceptions and experiences in Georgia. From April 2019 to December 2020, we conducted key informant interviews with 20 abortion providers and CBO leaders and 32 in-depth interviews and 6 focus groups (<i>n</i> = 30) with Black and Latinx women. We analysed data thematically using a team-based, iterative approach of coding, memo-ing, and discussion. Participants described multilevel barriers to and strategies for MA access, wishing that \"<i>the process had a bit more humanity</i> <i> … </i> <i>[it] should be more holistic.\"</i> Barriers included (1) sociocultural factors (intersectional oppression, intersectional stigma, and medical experimentation); (2) national and state policies; (3) clinic- and provider-related factors (lack of diverse clinic staff, long waiting times); and (4) individual-level factors (lack of knowledge and social support). Suggested solutions included (1) social media campaigns and story-sharing; (2) RJ-based policy advocacy; (3) diversifying clinic staff, offering flexible scheduling and fees, community integration of abortion, and RJ abortion funds; and (4) social support (including abortion doulas) and comprehensive sex education. Findings suggest that equitable MA access for Black and Latinx communities in the post-<i>Roe</i> era will require multi-level intervention, informed by community-led evidence production; holistic, de-medicalised, and human rights-based care models; and intersectional RJ policy advocacy.</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/0a/32/ZRHM_30_2129686.PMC9664998.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9309410","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":"Provider-client rapport in pre-exposure prophylaxis delivery: a qualitative analysis of provider and client experiences of an implementation science project in Kenya.","authors":"Victor Omollo, Stephanie D Roche, Felix Mogaka, Josephine Odoyo, Gena Barnabee, Elizabeth A Bukusi, Ariana W K Katz, Jennifer Morton, Rachel Johnson, Jared M Baeten, Connie Celum, Gabrielle O'Malley","doi":"10.1080/26410397.2022.2095707","DOIUrl":"10.1080/26410397.2022.2095707","url":null,"abstract":"<p><p>Daily oral pre-exposure prophylaxis (PrEP) is being incorporated into services frequented by adolescent girls and young women (AGYW) in sub-Saharan Africa who are at a significant risk of HIV. In non-PrEP studies, positive provider-client rapport has been shown to improve patient decision-making and use of medication in clinical care. We examined AGYW and healthcare provider (HCP) perspectives on the value of and strategies for building positive provider-client rapport. We conducted in-depth interviews from January 2018 to December 2019 with 38 AGYW and 15 HCPs from two family planning clinics in Kisumu, Kenya where PrEP was being delivered to AGYW as part of the Prevention Options for Women Evaluation Research (POWER) study. We used semi-structured interview guides and audio-recorded interviews with participant consent. Verbatim transcripts were analysed using thematic content analysis. HCPs and AGYW emphasised the importance of positive provider-client rapport to meet AGYW support needs in PrEP service delivery. HCPs described how they employed rapport-building strategies that strengthened AGYW PrEP uptake and continuation, including: (1) using friendly and non-judgmental tones; (2) maintaining client confidentiality (to build client trust); (3) adopting a conversational approach (to enable accurate risk assessment); (4) actively listening and tailoring counselling (to promote client knowledge, skills, and self-efficacy); and (5) supporting client agency. Positive provider-client relationships and negative experiences identified in this analysis have the potential to facilitate/deter AGYW from using PrEP while at risk. The strategies to enhance provider-client rapport identified in this study could be integrated into PrEP provider training and delivery practices.</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/bc/6d/ZRHM_30_2095707.PMC9542727.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40379948","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":"Ask me, listen to me, treat me well and I shall tell: a qualitative study of Swedish youths' experiences of systematic assessment of sexual health and risk-taking (SEXIT).","authors":"Sofia Hammarström,&nbsp;Susanne Bernhardsson,&nbsp;Per Nilsen,&nbsp;Jennie Elisson,&nbsp;Ellinor Frostholm,&nbsp;Malin Lindroth","doi":"10.1080/26410397.2022.2146032","DOIUrl":"https://doi.org/10.1080/26410397.2022.2146032","url":null,"abstract":"<p><p>Sexual ill health among young people, in terms of sexually transmitted infections (STIs), unintended pregnancy, transactional sex and sexual violence, is a global public health concern. To that end, the SEXual health Identification Tool (SEXIT) was developed. The purpose of this study was to explore the visitors' experiences of a youth clinic visit when SEXIT was used. A purposively selected sample of 20 participants (16-24 years of age) was recruited from three Swedish youth clinics using SEXIT. Participants were interviewed individually in March and April 2016, and data were analysed using inductive qualitative content analysis. The analysis resulted in four main categories describing the participants' experiences of using SEXIT: \"Issues of concern\" includes descriptions of the items in SEXIT as important; \"Enabling disclosure\" describes how SEXIT serves as an invitation to talk and facilitates disclosure of negative experiences; \"Road to change\" captures experiences of the conversation with the healthcare professional; and \"Managing power imbalance\" describes experiences regarding the response and attitudes of the healthcare professional as well as the participants' fears of being judged. The categories are connected by the overarching theme \"Ask me, listen to me, treat me well and I shall tell\". This study contributes knowledge on young people's experiences of a tool-supported dialogue on sexual health and risk-taking initiated by the healthcare professional. Structured questions in a written format, as a basis for dialogue, are appreciated and experienced as a functioning way of addressing sexual ill health and risk-taking at Swedish youth clinics.</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/ca/a6/ZRHM_30_2146032.PMC9733687.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9072328","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":"Women's perspectives on disrespect and abuse experiences during childbirth in a teaching hospital in Southwest Ethiopia: a qualitative study.","authors":"Hirut Megersa Werdofa,&nbsp;Anne Karin Lindahl,&nbsp;Belayneh Lulseged,&nbsp;Lisbeth Thoresen","doi":"10.1080/26410397.2022.2088058","DOIUrl":"https://doi.org/10.1080/26410397.2022.2088058","url":null,"abstract":"<p><p>There is evidence that women in Ethiopia often face disrespect and abuse in health care facilities during childbirth. Disrespect and abuse (D&A) violate women's right to dignified, respectful health care and decrease their trust in health care facilities. There is a need for more insight into women's perspectives on D&A during childbirth in different contexts. Therefore, this study aimed to explore women's perspectives on D&A during childbirth in a teaching hospital in South-West Ethiopia. A qualitative study was conducted from November 2017 to February 2018 using in-depth interviews and focus group discussions. Postnatal women were purposively chosen and scheduled for interviews six weeks postpartum. Data saturation occurred once 32 women were interviewed, and four focus group discussions were conducted. A thematic analysis method was used to analyse the data using MAXQDA qualitative analysis software. Three main themes emerged from the data: disrespect and abuse, its contributors, and perceived consequences. The subthemes of D&A include neglected care, non-consented care, physical abuse, lack of privacy, loss of autonomy, objectification, lack of companionship, and verbal abuse. The subthemes of contributors include health care provider-related, health care system-related, and women-related contributors. The subthemes of perceived consequences include the fear of using health care facilities. Women in Ethiopia experienced D&A. Health system factors, such as the teaching environment and scarcity of supplies, contribute the most to the identified D&A. Therefore, providers, administrators, training institutions, and researchers must collaborate to address these health system factors to reduce disrespect and abuse during childbirth in teaching hospitals.</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/7a/31/ZRHM_30_2088058.PMC9302010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40532942","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":"Men's involvement in women's abortion-related care: a scoping review of evidence from low- and middle-income countries.","authors":"Joe Strong","doi":"10.1080/26410397.2022.2040774","DOIUrl":"https://doi.org/10.1080/26410397.2022.2040774","url":null,"abstract":"<p><p>Men's involvement in abortion is significant, intersecting across the individual, community and macro factors that shape abortion-related care pathways. This scoping review maps the evidence from low- and middle-income countries relating to male involvement, including male abortion providers, in abortion trajectories. Five databases were searched, using search terms, to yield 7493 items published in English between 01.01.2010 and 20.12.2019. 37 items met the inclusion criteria for items relating to male involvement in women's abortion trajectories and were synthesised using an abortion-related care-seeking framework. The majority of studies were conducted in sub-Saharan Africa and were qualitative. Evidence indicated that male involvement was significant, shaping the ability for a woman or girl to disclose her pregnancy or abortion decision. Men as partners were particularly influential, controlling resources necessary for abortion access and providing or withdrawing support for abortions. Denial or rejection of paternity was a critical juncture in many women's abortion trajectories. Men's involvement in abortion trajectories can be both direct and indirect. Contextual realities can make involving men in abortions a necessity, rather than a choice. The impact of male (lack of) involvement undermines the autonomy of a woman or girl to seek an abortion and shapes the conditions under which abortion-seekers are able to access care. This scoping review demonstrates the need for better understanding of the mechanisms, causes and intensions behind male involvement, centring the abortion seeker within this.</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/PMC8956302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40318097","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":"Peer education interventions for HIV prevention and sexual health with young people in Mekong Region countries: a scoping review and conceptual framework.","authors":"Peter A Newman,&nbsp;Pakorn Akkakanjanasupar,&nbsp;Suchon Tepjan,&nbsp;Sharafdzhon Boborakhimov,&nbsp;Jan Willem de Lind van Wijngaarden,&nbsp;Nuttapon Chonwanarat","doi":"10.1080/26410397.2022.2129374","DOIUrl":"https://doi.org/10.1080/26410397.2022.2129374","url":null,"abstract":"<p><p>WHO-recommended rights-based approaches to sexual health emphasise participatory and youth-centred processes. Among these, peer education (PE) interventions are commonly used to promote HIV prevention and sexual health for young people, particularly in low-resource, high HIV prevalence contexts. We conducted a scoping review to identify key characteristics, implementation challenges, and knowledge gaps in the literature regarding PE interventions in Mekong Region countries. Out of 6521 publications identified through database searches, 17 peer-reviewed articles were included in the review (<i>n</i> = 21,469 participants). Studies from Thailand (<i>n</i> = 7), Vietnam (<i>n</i> = 5), Myanmar (<i>n</i> = 3), Cambodia (<i>n</i> = 1), and Lao PDR (<i>n</i> = 1) included adolescent and young key populations (<i>n</i> = 11) and general population youth (<i>n</i> = 6). Findings from quantitative (descriptive) and qualitative (thematic) analysis illustrate benefits and challenges of various elements of multicomponent PE interventions in reaching vulnerable young people and improving HIV prevention and sexual health outcomes. Focal knowledge gaps emerged in regard to peer educator outcomes (increased knowledge, skill-building, empowerment); interpersonal processes between peer educators and young people (role modelling, social dynamics); and social-structural contexts (sociocultural influences, gendered power relations), which may affect PE programme implementation and effectiveness. Future research should evaluate the potential benefits of complementing evidence-based intervention approaches - focused predominantly on assessing individual-level behavioural outcomes conceptualised as external to PE programmes - with evidence-making intervention approaches that support rights-based PE programmes: incorporating a focus on dialectical and relational processes between peer educators and young people; assessing salutary outcomes among peer educators themselves; and evaluating the situated implementation of youth-engaged PE interventions in complex sociocultural systems.</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/PMC9621210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40653330","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":"Examining access to sexual and reproductive health services and information for young women with disabilities in Senegal: a qualitative study.","authors":"Olivia Soule, Diatou Sonko","doi":"10.1080/26410397.2022.2105965","DOIUrl":"10.1080/26410397.2022.2105965","url":null,"abstract":"<p><p>This qualitative research aimed to examine Senegalese disabled women's access to sexual and reproductive health (SRH) services and information. Poor access to SRH services and information can lead to a range of negative consequences, including poor sexual, reproductive, and maternal health outcomes; rights violations; and impacts on mental health and livelihoods. Disabled women, who are marginalised and stigmatised both by their gender and their disability, may face significant barriers in access, but a full understanding of this access is lacking due to a dearth of research on this population. We used a snowball sampling method to identify 31 women with physical motor disabilities in the Dakar region, and we interviewed them from October to December 2019 using a semi-structured questionnaire. We analysed interviews using thematic analysis, which we complemented with frequency calculations and graphs where appropriate. Respondents reported having difficulties accessing SRH services and information because of structural inaccessibility within health care establishments, financial limitations, inaccessible transportation and far-away health establishments, long wait times in health care establishments, and prejudices and discrimination from health providers. Women had low knowledge of STIs, but were generally well-informed on different types of contraception, felt that accessing SRH information is easier than accessing services, and wished to see improvements in the Senegalese health care system specifically geared towards people with disabilities. Evidence from this research can inform policy and programmatic efforts to improve disabled women's access to SRH services and information.</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/3d/bf/ZRHM_30_2105965.PMC9415455.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40415091","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":"Ageing in obscurity: a critical literature review regarding older intersex people.","authors":"Adeline W Berry,&nbsp;Surya Monro","doi":"10.1080/26410397.2022.2136027","DOIUrl":"https://doi.org/10.1080/26410397.2022.2136027","url":null,"abstract":"<p><p>Intersex people experience a range of human rights abuses, including non-consensual, irreversible medical interventions on minors. These abuses have lifelong effects, yet little is known about older intersex people. People in this diverse group face multiple marginalisations and erasures across different policy and practice arenas. This article reviews literature about intersex issues, drawing out materials relevant to older intersex people using an historically grounded approach. It focuses on the key issues affecting older intersex people living in a range of countries in the global North, as harmful medical practices originated in this region. Based on existing evidence, we found a pressing need for medical reform including a cessation of harmful medical practices and the development of appropriate healthcare that centres the needs and wishes of each intersex person. As intersex issues are currently heavily erased in most countries, research, cross-sectoral policy and practice work, and awareness-raising are all needed.</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/1f/c3/ZRHM_30_2136027.PMC9704076.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40472661","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":"Understanding the role of race in abortion stigma in the United States: a systematic scoping review.","authors":"Katherine Brown,&nbsp;Ruth Laverde,&nbsp;Jill Barr-Walker,&nbsp;Jody Steinauer","doi":"10.1080/26410397.2022.2141972","DOIUrl":"https://doi.org/10.1080/26410397.2022.2141972","url":null,"abstract":"<p><p>The impact of abortion stigma is broad. Stigma impacts abortion providers, abortion patients and the broader community. Understanding how race and culture affect aspects of abortion stigma may be an important piece of expanding access to and support of abortion. We conducted a systematic search for studies involving abortion stigma and race in PubMed, PubMed Central, Embase, PsycINFO, Sociological Abstracts, Social Services Abstracts, GenderWatch and Ethnic NewsWatch on 7 January 2020. Articles were eligible for inclusion if they explored stigma and included participant race and/or ethnicity, were in English, and included original research. Thirty studies were included in the final review, including 11 quantitative studies, 9 qualitative studies, 4 mixed methods studies and 6 dissertations. Most studies provided basic racial and demographic data but did not provide racial differences in experiences of abortion stigma. Three quantitative studies found that women of colour had different experiences of abortion stigma compared to White women. Non-peer-reviewed studies of qualitative PhD-level dissertation research found that race, culture, religion and immigration had unique and complex effects on abortion stigma experienced by Latinx women. While abortion stigma is common, we found that there is a lack of research contextualising the racialisation of the United States. Quantitative studies found that women of colour experience abortion stigma at lower levels compared to White women. However, qualitative analyses of experiences suggest that quantitative measures of abortion stigma may not capture unique aspects of abortion stigma as experienced by women of colour.</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/5b/12/ZRHM_30_2141972.PMC9704102.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40702802","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":"Restrictions on contraceptive services for unmarried youth: a qualitative study of providers' beliefs and attitudes in India.","authors":"A Shukla,&nbsp;A Kumar,&nbsp;A Mozumdar,&nbsp;R Acharya,&nbsp;K Aruldas,&nbsp;N Saggurti","doi":"10.1080/26410397.2022.2141965","DOIUrl":"https://doi.org/10.1080/26410397.2022.2141965","url":null,"abstract":"<p><p>Sexual and reproductive health (SRH) of unmarried youth is an important issue, particularly in Indian society, where premarital sex is socially restricted. It is an uncomfortable subject for most people, including healthcare providers, who are responsible for catering to the reproductive health needs of youth. This is because of the prevailing social norms, where sex outside marriage is discouraged and stigmatised. These social norms give importance to virginity, and children outside marriage are not welcome. The present qualitative study was conducted in public health facilities (primary and secondary) to explore the attitudes of healthcare providers in providing contraceptive services to unmarried youth. In-depth interviews were conducted with family planning (FP) service providers (frontline healthcare workers [ASHAs] nurses and FP counsellors) between October 2017 and September 2018. Almost a quarter of the providers were either hesitant or against providing contraceptives to unmarried youth. Providers stated that they preferred emergency contraceptive pills for unmarried girls if they had already engaged in unprotected sex. Providers expressed strong personal views against premarital sex because they believed it was against existing social norms. Some providers were concerned about the possible negative reactions of the community if they recommended any contraceptive to unmarried youth. A few providers even considered it illegal to provide contraceptives to unmarried youth, though there is no such law in the country. Findings further indicated that though the country had launched programmes for improving adolescents and youth SRH, service providers were still conflicted between medical eligibility and social beliefs.</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/PMC9704070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40490748","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}