Gender role beliefs and adolescent pregnancy in Colombia: findings from the 2015 DHS survey.

This study investigated the association between gender role beliefs and the prevalence and likelihood of experiencing pregnancy among 8525 young women and girls aged 13-19 years in Colombia. The primary outcome of interest was adolescent pregnancy. Retrospective cross-sectional analysis utilised data from the 2015 Demographic and Health Survey (DHS) in Colombia, which included an add-on questionnaire on gender relations. Our analysis measured both pregnancy prevalence and pregnancy likelihood in relation to gender role beliefs. With one exception, young women who disagreed with traditionally conforming gender roles had a lower prevalence of pregnancy and were less likely to experience pregnancy than those who agreed with them. The highest likelihood of pregnancy prevalence and likelihood was found among those who agreed with statements suggesting male dominance and those who agreed with women's homemaking responsibilities. The greater the adherence to traditionally conforming gender role beliefs, the higher the likelihood of experiencing pregnancy during adolescence. Girls' and young women's adherence to traditional gender role beliefs appeared to be a risk factor for adolescent pregnancy. Our findings support Colombia's current sex education policies and practices within the framework of gender equity, and evidence the link between gender equity and girls' and young women's reproductive health.

The Effect of Sexual Literacy on Adolescent Pregnancy in Colombia.

STUDY OBJECTIVE: In the present study we investigated the association between receiving information on sexual literacy topics and likelihood of experiencing adolescent pregnancy. DESIGN: Cross-sectional analysis. SETTING: Colombia. PARTICIPANTS: Female Adolescents, 13-19 years old (N = 8525). MAIN OUTCOME MEASURES: Our primary outcome of interest was adolescent pregnancy. RESULTS: We created a gradation of public health impact variable that ranged from grade 1 (least impactful) to grade 4 (most impactful) to determine which sexuality-related topics were most strongly associated with teenage pregnancy. We found that not receiving information on grade 4 topics had the strongest association with adolescent pregnancy. These topics were: changes related to puberty (prevalence ratio [PR], 2.15; 95% confidence interval [CI], 1.40-3.30), how sex organs work (PR, 1.90; 95% CI, 1.37-2.66), and sexual orientation (PR, 1.84; 95% CI, 1.38-2.44). In fact, teenagers who did not receive information on any sexuality-related topic were approximately 75% more likely (PR, 1.73; 95% CI, 1.09-2.74) to experience pregnancy during adolescence. CONCLUSION: The gradation levels of this study could guide sexual education programs in Colombia to prioritize sexuality-related themes, especially when resources are limited.

Phenotypes and markers of cesarean delivery among Colombian women.

OBJECTIVE: To investigate the association of socioeconomic status (SES) components (education, occupation, and household wealth) with number (1 or ≥2) and timing (planned/emergency) of cesarean delivery (CD) in Colombia, rates of which are well above the levels recommended by the World Health Organization. METHODS: A cross-sectional study using the 2015 Demographic and Health Survey (DHS) of Colombia was carried out; 38 718 women answered the woman only module. Binomial and multinomial logistic regression analyses were conducted to generate estimates of the association between markers of SES and likelihood of CD, timing of CD, and number of CDs. RESULTS: The analysis included 9977 women. Although education and wealth were strongly associated with CD (P<0.001), the association between occupation and CD suggested that women in agriculture were the least likely to experience CD (odds ratio [OR] 0.67, 95% confidence interval [CI] 0.44-1.03, P=0.061); and women in the "poorer" household wealth category were more likely to have emergency (OR 1.57, CI 1.29-1.90, P<0.001) and two or more (OR 1.64, CI 1.29-2.40, P<0.001) CDs. CONCLUSION: Markers of SES are associated with CD overuse in Colombia, as well as the number and timing of CD. More robust qualitative inquiry including additional questions to the DHS survey are needed to elucidate reasons driving the overutilization of CD in the country, particularly among vulnerable populations.

The power of culture and context on Hispanic/Latina teen pregnancy and birth in Oklahoma: provider and parental perspectives.

OBJECTIVE: To explore cultural-contextual factors that impact the high rate of Hispanic/Latina teen pregnancy in Oklahoma from the perspective of providers and parents. METHODS: Community Based Participatory Research at the Latino Community Development Agency in Oklahoma City; focus groups and in-depth interviews; 33 service providers and 14 Hispanic/Latino parents. RESULTS: (a) The value of respect among Hispanic/Latino families is a risk factor for unplanned teen pregnancy. (b) Contextual aspects (i.e. local ideology, Mexican media, underfunded schools, permissive law enforcement in bars, lack of bilingual providers) place Hispanic/Latina female adolescents at greater risk of unplanned pregnancy. (c) Gender roles perpetuate inequality and deepen Hispanic/Latina females' vulnerability to unplanned pregnancy. CONCLUSIONS: In addition to currently implemented communication tools and parenting skills to talk with adolescents about sexual health topics, interventions need to consider preferences that may be rooted in cultural aspects that could hinder the application of learned skills.

Adolescent Screening, Brief Intervention, and Referral to Treatment for Substance Use: An Application for School Social Workers.

Alcohol, tobacco, marijuana, and other substance use by adolescents can have a serious impact on their health and well-being according to the American Academy of Pediatrics (AAP, 2016). School social workers (SSW) are trained to conduct assessments and interventions with adolescents and families to improve their functioning and academic performance (National Association of Social Workers [NASW], 2003). Also, substance abuse prevention, identification, brief intervention, and referral to treatment are supported by the profession's standards for working with adolescents (NASW, 2003). For SSW interested in incorporating these services into their work, this practice highlights column describes the importance and principles of conducting adolescent screening, brief intervention, and referral to treatment (SBIRT) for substance use. Highlights are drawn from Substance Use Screening and Intervention Implementation Guide: No Amount of Substance Use Is Safe for Adolescents (hereinafter, AAP Guide), a guide developed through a cooperative agreement between AAP and Centers for Disease Control and Prevention (CDC) (AAP, 2016).

The influence of perceived health status on poor women's confidence in leaving welfare: implications for social work.

This article focuses on the realities poor women living in Georgia face in the pursuit of employment. The inquiry focuses on 107 women (84.1% African American, 15.9% white) who were respondents to a survey undertaken by the Welfare Reform Project in Georgia to predict the participants' self-reported confidence in leaving welfare. Predictors of confidence to leave welfare involved health, age, welfare dependency, educational attainment, race, and number of children at home. Health was the strongest predictor, followed by age. Based on Bandura's social cognitive theory, findings suggest that the confidence of female welfare recipients may be greater than can be justified by the realities of their lives and the society in which they live. The article identifies implications for social work including the delivery of social services and counseling for poor women who face complex health issues yet who want to enter the workforce.

The sexual and reproductive rights of internally displaced women: the embodiment of Colombia's crisis.

As of 30 June 2006, more than 3.5 million Colombians are internally displaced persons (IDPs), the second largest IDP population in the world after that of Sudan. While most IDP studies treat the plight of internally displaced women (IDW) as an isolated phenomenon, this paper demonstrates that their situation reflects Colombia's chronic cultural, political and socio-economic crisis. This paper uses a sexual and reproductive rights framework to establish a connection between IDW and Colombia's culture of violence, discrimination and inequality. The effects of this culture of violence, discrimination and inequality are highlighted during a discussion of the rights to health, reproduction, privacy, physical integrity, education, and freedom from violence and sexual exploitation. This paper argues that a holistic understanding of Colombia's humanitarian emergency is essential to improving the lives of IDPs. It ends with some concrete, short-term recommendations to meet some of the needs of IDPs and other vulnerable populations.