International Perspectives on Sexual and Reproductive Health最新文献

{"title":"A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies.","authors":"S. Vargas, Miriam M Midoun, M. Guillen, Melissa L. Getz, K. Underhill, C. Kuo, K. Guthrie","doi":"10.1363/45e7619","DOIUrl":"https://doi.org/10.1363/45e7619","url":null,"abstract":"CONTEXT\u0000Vaginal rings are available for contraception and hormone replacement, and are being developed as HIV/STD or multipurpose prevention technologies. A comprehensive understanding of women's expectations of and experiences with rings is urgently needed to inform product development and to optimize ring use.\u0000\u0000\u0000METHODS\u0000Three databases (PubMed, Global Health and CINAHL) were searched for English-language, peer-reviewed articles published between January 1996 and November 2017 that reported qualitative data on barriers to and facilitators of use of female-controlled contraceptive methods. Data on study methods, findings and conclusions pertaining to contraceptive rings were extracted, organized and analyzed.\u0000\u0000\u0000RESULTS\u0000Twenty-six articles, all published since 2008, met the inclusion criteria. Seven studies focused largely or entirely on rings (and involved current, former or potential users), while the others focused on other contraceptive methods but included ring-specific data. Familiarity with the ring was low, and women commonly had initial concerns about the method-often related to insertion and removal, cleanliness and discomfort with touching their vagina-that were typically overcome over time. Other major themes were issues related to ring use and discontinuation, the importance of ring-related properties and characteristics, and considerations related to sexual partners and health care providers.\u0000\u0000\u0000CONCLUSIONS\u0000Qualitative data have the potential to inform ring design and promotion. Future research should further explore women's expectations and experiences with the ring, the value of involving male partners in ring evaluation, and evaluation of interventions to improve patient-provider communication concerning ring choice and use.","PeriodicalId":46940,"journal":{"name":"International Perspectives on Sexual and Reproductive Health","volume":"45 1","pages":"25-34"},"PeriodicalIF":4.4,"publicationDate":"2019-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42217087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closing the Poor-Rich Gap in Contraceptive Use in Rwanda: Understanding the Underlying Mechanisms.","authors":"Dieudonne Ndaruhuye Muhoza, C. Ruhara","doi":"10.1363/45e7519","DOIUrl":"https://doi.org/10.1363/45e7519","url":null,"abstract":"CONTEXT\u0000Evidence suggests that as Rwanda has strengthened its family planning program, disparities in contraceptive use by socioeconomic status have narrowed. However, the changes in these gaps, and the mechanisms that underlie them, are not well understood.\u0000\u0000\u0000METHODS\u0000Data from the 2005, 2010 and 2015 Rwanda Demographic and Health Surveys on 19,028 in-union women aged 15-49 were analyzed to examine trends in socioeconomic disparities in contraceptive use. Descriptive statistics and multivariate regression with interaction terms were used to identify changes in these disparities, as well as to describe trends in desired fertility, and in types and sources of contraceptives used.\u0000\u0000\u0000RESULTS\u0000Between 2005 and 2015, the prevalence of modern contraceptive use rose from 11% to 48%. In the regression analysis, interaction terms indicated that prevalence increased to a lesser extent among women who were wealthy, had a least a secondary education or lived in urban areas than among those who were poor, were uneducated or lived in rural areas (odds ratios, 0.5-0.7). In parallel, declines in desired fertility were greater among women with no education than among those with at least a secondary education (by 0.7 vs. 0.5 children); among the poorest than the richest women (by 1.0 vs. 0.5 children); and among rural than urban residents (by 0.9 vs. 0.4 children).\u0000\u0000\u0000CONCLUSIONS\u0000The shrinking of gaps in contraceptive use by socioeconomic status coincided with narrowing of disparities in demand for children and with improvements in family planning services, suggesting that disadvantaged populations may have especially benefited from public programs to increase contraceptive access.","PeriodicalId":46940,"journal":{"name":"International Perspectives on Sexual and Reproductive Health","volume":"45 1","pages":"13-23"},"PeriodicalIF":4.4,"publicationDate":"2019-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42197776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive Autonomy and Modern Contraceptive Use at Last Sex Among Young Women in Ghana.","authors":"D. Loll, P. Fleming, A. Manu, E. Morhe, R. Stephenson, E. King, K. Hall","doi":"10.1363/45e7419","DOIUrl":"https://doi.org/10.1363/45e7419","url":null,"abstract":"CONTEXT\u0000Variability in the conceptualization and measurement of women's empowerment has resulted in inconsistent findings regarding the relationships between empowerment and sexual and reproductive health outcomes. Reproductive autonomy-a specific measure of empowerment-and its role in modern contraceptive use have rarely been assessed in Sub-Saharan contexts.\u0000\u0000\u0000METHODS\u0000Survey data were collected from a sample of 325 urban Ghanaian women aged 15-24 recruited from health facilities and schools in Kumasi and Accra in March 2015. Bivariate and multivariable logistic regression analyses were used to examine associations between two adapted reproductive autonomy subscales-decision making and communication-and women's use of modern contraceptives at last sex, controlling for demographic, reproductive and social context (i.e., approval of and stigma toward adolescent sexual and reproductive health) covariates.\u0000\u0000\u0000RESULTS\u0000In multivariable analyses, reproductive autonomy decision making-but not reproductive autonomy communication-was positively associated with women's modern contraceptive use at last sex (odds ratio, 1.1); age, having been employed in the last seven days and living in Kumasi were also positively associated with modern contraceptive use (1.1-9.8), whereas ever having had a previous pregnancy was negatively associated with the outcome (0.3). Reproductive autonomy decision making remained positively associated with contraceptive use in a subsequent model that included social approval of adolescent sexual and reproductive health (1.1), but not in models that included stigma toward adolescent sexual and reproductive health.\u0000\u0000\u0000CONCLUSIONS\u0000The reproductive autonomy construct, and the decision-making subscale in particular, demonstrated relevance for family planning outcomes among young women in Ghana and may have utility in global settings. Future research should explore reproductive autonomy communication and the potential confounding effects of social context.","PeriodicalId":46940,"journal":{"name":"International Perspectives on Sexual and Reproductive Health","volume":"45 1","pages":"1-12"},"PeriodicalIF":4.4,"publicationDate":"2019-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45348989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sterilization Regret Among Married Women in India: Trends, Patterns and Correlates.","authors":"Abhishek Singh","doi":"10.1363/44e7218","DOIUrl":"https://doi.org/10.1363/44e7218","url":null,"abstract":"CONTEXT\u0000Female sterilization has been the dominant contraceptive method in India since the late 1970s; however, evidence on sterilization regret-including on trends and on changes in correlates-is limited.\u0000\u0000\u0000METHODS\u0000Data from the 1992-1993, 2005-2006 and 2015-2016 rounds of the Indian National Family Health Survey were used to examine trends in sterilization regret among ever-married women aged 15-49. Multivariable binary logistic regression analyses were conducted to examine the correlates of sterilization regret in 2005-2006 and 2015-2016, and multivariate decomposition was used to estimate the contribution of correlates to the change in sterilization regret between surveys.\u0000\u0000\u0000RESULTS\u0000Sterilization regret in India increased by 2.3 percentage points, from 4.6% in 2005-2006 to 6.9% in 2015-2016. Most variables associated with regret in 2005-2006 remained so in 2015-2016: For example, women who lost a child after sterilization were more likely than those who had not experienced child loss to express regret (odds ratios, 2.8 in 2005-2006 and 1.9 in 2015-2016). Other associations were significant only in 2015-2016: For example, women informed that they would not be able to have children after sterilization had elevated odds of expressing regret (1.4). Changes in the composition of women by parity and by being informed of not being able to have children after sterilization each contributed 5-6% of the increase in sterilization regret between surveys.\u0000\u0000\u0000CONCLUSIONS\u0000Efforts to increase use of reversible contraceptive methods and to reduce infant and child mortality may help reduce rising sterilization regret in India.","PeriodicalId":46940,"journal":{"name":"International Perspectives on Sexual and Reproductive Health","volume":"44 4 1","pages":"167-176"},"PeriodicalIF":4.4,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45027411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive Method Attributes and Married Women's Intention to Use the Pill or the Injectable in Rural Bangladesh.","authors":"F. Huda, J. Casterline, F. Ahmmed, K. Machiyama, Hassan Rushekh Mahmood, Anisuddin Ahmed, J. Cleland","doi":"10.1363/44e7118","DOIUrl":"https://doi.org/10.1363/44e7118","url":null,"abstract":"CONTEXT\u0000The factors underlying contraceptive method choice are poorly understood in many countries, including Bangladesh. It is important to understand how Bangladeshi women's perceptions of a method's attributes are associated with their intention to use that method.\u0000\u0000\u0000METHODS\u0000Data on 2,605 married women aged 15-39 living in rural Matlab were taken from a baseline survey conducted in 2016. Conditional logit analysis was used to examine associations between 12 method attributes and intention to use the pill or the injectable among the 583 fecund women not currently using a method. Method attributes included those relating to ease of obtainment and use, efficacy, health effects, husband's approval, the experiences of the respondent and the experiences of women in the respondent's social network.\u0000\u0000\u0000RESULTS\u0000Women tended to perceive the pill more positively than the injectable. For example, greater proportions of women reported believing that the pill is easy to use (90% vs. 72%) and does not cause serious health problems (75% vs. 38%). The likelihood that a woman intended to use a method was positively associated with her perception that it is easy to use (odds ratio, 2.9) and does not cause serious health problems (1.7) or affect long-term fertility (2.9). Satisfied past users of a method were more likely than never users to report intending to use the method (5.2). Intention to use the pill rather than the injectable was positively associated with education (2.0-3.6) and having a migrant husband (1.7).\u0000\u0000\u0000CONCLUSIONS\u0000Negative beliefs not supported by evidence, particularly about the injectable, are associated with women's intention to use a contraceptive method. The results may be useful in improving contraceptive care, counseling and training.","PeriodicalId":46940,"journal":{"name":"International Perspectives on Sexual and Reproductive Health","volume":"44 4 1","pages":"157-165"},"PeriodicalIF":4.4,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44972557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnolinguistic Concordance and the Receipt of Postpartum IUD Counseling Services in Sri Lanka.","authors":"Mahesh Karra,&nbsp;Erin Pearson,&nbsp;David Canning,&nbsp;Iqbal Shah,&nbsp;Ranjith de Silva,&nbsp;Arnjali Samarasekera","doi":"10.1363/44e6918","DOIUrl":"https://doi.org/10.1363/44e6918","url":null,"abstract":"<p><strong>Context: </strong>Ethnic and linguistic concordance are important dimensions of the patient-physician relationship, and are linked to health care disparities. However, evidence on the associations between health behavior and outcomes and patient-provider concordance is limited, especially in low- and middle-income settings.</p><p><strong>Methods: </strong>To examine how concordance between women and their primary health midwife is associated with women's receipt of postpartum IUD counseling, observational data from a cluster-randomized trial assessing an intervention to increase postpartum IUD counseling were used. Data on 4,497 women who delivered at six hospitals in Sri Lanka between September 2015 and March 2017 were merged with data on 245 primary health midwives, and indicators of linguistic concordance, ethnic concordance and their interaction were generated. Multivariate logistic regression analyses were used to assess the associations between concordance and women's receipt of counseling.</p><p><strong>Results: </strong>Women from non-Sinhalese groups in Sri Lanka face disparities in the receipt of postpartum IUD counseling. Compared with the ethnolinguistic majority (Sinhalese women who speak only Sinhala), non-Sinhalese women have lower odds of having received postpartum IUD counseling, whether they speak both Sinhala and Tamil (odds ratio, 0.6) or only Tamil (0.5). Ethnic discordance- rather than linguistic discordance-is the primary driver of this disparity.</p><p><strong>Conclusions: </strong>The findings highlight the need for interventions that aim to bridge the sociocultural gaps between providers and patients. Matching women and their providers on ethnolinguistic background may help to reduce disparities in care.</p>","PeriodicalId":46940,"journal":{"name":"International Perspectives on Sexual and Reproductive Health","volume":"44 4","pages":"133-145"},"PeriodicalIF":4.4,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37108250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Respondent-Interviewer Familiarity and Repeated Survey Participation on Abortion Reporting: Evidence from Rajasthan, India.","authors":"Suzanne O Bell,&nbsp;David Bishai","doi":"10.1363/44e7018","DOIUrl":"https://doi.org/10.1363/44e7018","url":null,"abstract":"<p><strong>Context: </strong>Researchers have long assumed that familiarity between an interviewer and a survey participant reduces the validity of responses, especially for such sensitive behaviors as abortion. However, little empirical evidence exists on this issue.</p><p><strong>Methods: </strong>Data on 6,041 women aged 15-49 and 133 interviewers who took part in the second (2017) round of the Performance Monitoring and Accountability 2020 survey in Rajasthan, India, were used to examine the effect of interviewer-respondent acquaintance and participation in the prior survey round on women's reporting of induced abortion. Associations were identified using multivariate, multilevel models that adjusted for respondent, interviewer and community characteristics, and that included interviewer random effects.</p><p><strong>Results: </strong>On average, interviewers completed interviews with 41 respondents from their assigned cluster; they reported that they were acquainted with 61% of respondents and that 13% of respondents had participated in the prior survey round. Four percent of women reported having had an abortion. Neither interviewer-respondent acquaintance nor participation in the previous survey round was associated with abortion reporting in any of the multivariate models or in additional sensitivity analyses.</p><p><strong>Conclusions: </strong>The findings do not support the hypothesis that respondent familiarity with the interviewer or the survey process is associated with lower reporting of sensitive behaviors, like abortion. Future studies should further explore these and other design features to identify those that provide statistically significant improvements in the reporting of abortion and other sensitive behaviors.</p>","PeriodicalId":46940,"journal":{"name":"International Perspectives on Sexual and Reproductive Health","volume":"44 4","pages":"147-156"},"PeriodicalIF":4.4,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37149875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Women's Social Position and the Medicalization of Female Genital Cutting in Egypt.","authors":"Nina Van Eekert,&nbsp;Els Leye,&nbsp;Sarah Van de Velde","doi":"10.1363/44e6618","DOIUrl":"https://doi.org/10.1363/44e6618","url":null,"abstract":"<p><strong>Context: </strong>Medicalization of female genital cutting (i.e., having the procedure done by a medical professional) has increased in Egypt in recent years. The relationship between a woman's social position and the decision to use a trained health professional to perform genital cutting is not well understood.</p><p><strong>Methods: </strong>Data from the 2005, 2008 and 2014 Egypt Demographic Health Surveys on 11,455 women whose daughter had undergone female genital cutting were used to examine relationships between mothers' social position and medicalization. Logistic regression models were used to identify associations between measures of social position and the decision to have genital cutting done by a trained provider.</p><p><strong>Results: </strong>Seventy-nine percent of women had had their daughter cut by a trained health professional. The odds of medicalization were greater among women who had a primary education (odds ratio, 1.2) or a secondary or higher education (1.8) rather than no education; who lived in wealthier households rather than in the poorest ones (1.4-2.6); and who shared decision making on large household purchases rather than had no say in such decisions (1.2). In addition, working for pay and the magnitude of the age difference between women and their husband were negatively associated with medicalization (0.99 and 0.9, respectively).</p><p><strong>Conclusions: </strong>A woman's social position in Egypt is associated with medicalization of her daughter's genital cutting. Research is needed to explore the social meaning attributed to medicalized genital cutting, which may inform campaigns that could decrease the prevalence of the procedure.</p>","PeriodicalId":46940,"journal":{"name":"International Perspectives on Sexual and Reproductive Health","volume":"44 3","pages":"101-109"},"PeriodicalIF":4.4,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37161026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy Provision of Medication Abortion in Nepal: Pharmacy Owner and Worker Perspectives.","authors":"Goleen Samari,&nbsp;Mahesh Puri,&nbsp;Rebecca Cohen,&nbsp;Maya Blum,&nbsp;Corinne H Rocca","doi":"10.1363/44e6518","DOIUrl":"https://doi.org/10.1363/44e6518","url":null,"abstract":"<p><strong>Context: </strong>Medication abortion has the potential to transform the provision of safe abortion care in low- and middle-income countries, and can be provided with minimal clinical skills and equipment. In Nepal, first-trimester abortion using mifepristone and misoprostol is legally available at government-certified health facilities, but little is known about pharmacy workers' perspectives regarding pharmacy-based provision.</p><p><strong>Methods: </strong>In-depth interviews were conducted in 2015 with 19 pharmacy owners and auxiliary nurse-midwives in two districts of Nepal to examine respondents' views on medication abortion and on potential legal provision of medication abortion from pharmacies. Two coders independently reviewed interview transcripts, and coded and analyzed them using a thematic approach.</p><p><strong>Results: </strong>Participants were confident that they could provide safe medication abortion and felt that they filled an important niche by providing affordable, convenient and confidential services to women in their communities. They saw benefits of integrating pharmacies into legal abortion networks in Nepal, such as improved access to medication abortion and greater privacy. Participants also felt that the quality of the care they provided could be improved through ongoing training of pharmacy-based providers and formal incorporation of such providers into existing networks of abortion provision to streamline referrals.</p><p><strong>Conclusions: </strong>Integration of pharmacies into the legal abortion provision system could aid in regulation and training. Consideration of pharmacy workers' perspectives can help to ensure the sustainability and success of safe abortion programs.</p>","PeriodicalId":46940,"journal":{"name":"International Perspectives on Sexual and Reproductive Health","volume":"44 3","pages":"81-89"},"PeriodicalIF":4.4,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36910558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Middle-Aged Iranian Women's Accounts of Their Sexual Health Care Practices: A Conventional Content Analysis.","authors":"Sedigheh Moghasemi,&nbsp;Giti Ozgoli,&nbsp;Masomeh Simbar,&nbsp;Malihe Nasiri","doi":"10.1363/44e6718","DOIUrl":"https://doi.org/10.1363/44e6718","url":null,"abstract":"CONTEXT Little research has been done to examine sexual health care among middle-aged women, particularly in developing countries that are socioculturally conservative, such as Iran. METHODS In 2015, as part of a descriptive qualitative study, face-to-face interviews were conducted with 17 women aged 40-65 residing in Golestan Province, Iran. Graneheim and Lundman's approach to conventional content analysis was used to interpret the sexual health care narratives of the women. RESULTS Sexual health care for middle-aged Iranian women often took the form of self-care to preserve their privacy and confidentiality, and in general, any information on sexual health was appreciated. Data analysis identified three main categories of strategies for sexual self-care: sexual risk protection, prevention of sexual problems and undesirability, and sexual information seeking. Also, sexual self-care emerged as the central theme. CONCLUSIONS To meet the needs of middle-aged Iranian women, health care providers should become familiar with such women's sexual health care and self-care practices. Socioculturally sensitive policies and interventions should be developed to improve the sexual and reproductive health care conditions of middle-aged women.","PeriodicalId":46940,"journal":{"name":"International Perspectives on Sexual and Reproductive Health","volume":"44 3","pages":"91-99"},"PeriodicalIF":4.4,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37025271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}