Developing application software to quickly detect the adolescent's risky behaviour to prevent teen pregnancy.

Objective: To develop a software application for early detection of adolescent's risky behaviour, and promotion of safe reproductive health. METHODS: The multi-stage study was conducted from September 20, 2018, to April 3, 2019, at Rumbai District Pekanbaru, Riau-Indonesia. The planned software application was developed using the waterfall design model which is a sequential process. Every progress was acknowledged to be flowing downwards, like a waterfall, by going through the phases of requirements, design, implementation, verification and maintenance. The application software was pilot-tested on a group of adolescents after it was first tested for validity. The adolescents were given a questionnaire at baseline and 2 weeks after the intervention to assess the application's effectiveness. The data was analyzed using SPSS version 21. RESULTS: Validation of the tool was confirmed by Aiken's V values >0.85, with sensitivity 84.8% and specificity 75%. Of the 45 adolescents tested, majority respondens were girls 38(84,4%), early adolescent 18(40%), middle adolescent 16(35,5%) and late adolescent 11(24,4%). About 5(11.1%) were found to be positive, and 28(62.2%)were truly positive, while 3(6.7%) were found negative and 9(20%) were truly negative. There was a significant difference between the pre-test and post-test assessments (p=0.0001). Conclusion: The application proved to be effective for the early detection of risky behaviour, and for the promotion of safe reproductive health.

Mental health outcomes across the reproductive life course among women with disabilities: a systematic review.

PURPOSE: This systematic review examined literature on mental health outcomes among women with disabilities living in high-income countries within the context of reproductive health, spanning menstruation through menopause. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE, CINAHL, and PsycINFO databases for studies published through June 2023. Eligible studies were observational, quantitative, and included a comparison group without disabilities. RESULTS: A total of 2,520 studies were evaluated and 27 studies met inclusion criteria. These studies assessed mental health during prepregnancy, pregnancy, postpartum, and parenting among women with and without disabilities. None of the studies examined reproductive health time periods related to menstruation, fertility, or menopause. Women of reproductive age with disabilities were more likely to have poor mental health outcomes compared to women without disabilities. During pregnancy and the postpartum, women with disabilities were at greater risk of diagnosed perinatal mental disorders and psychiatric-related healthcare visits. Findings also suggested mental distress and inadequate emotional and social support related to parenting among women with disabilities. The greatest risks of poor mental health outcomes were often observed among women with intellectual and developmental disabilities and among women with multiple types of disabilities, compared to women without disabilities. CONCLUSIONS: Routine reproductive healthcare visits provide significant prevention and treatment opportunities for poor mental health among women with disabilities. Further research examining mental health outcomes within the context of reproductive health, especially understudied areas of menstruation, fertility, parenting, and menopause, among women with disabilities is needed.

Reproductive healthcare utilization for women in the sex trade: a qualitative study.

BACKGROUND: Women in the sex trade encounter significant challenges in obtaining reproductive healthcare. Reports of reproductive healthcare for women in the sex trade center on the prevention and termination of pregnancies, yet most women in the sex trade globally experience full term pregnancies and bear children. This study aimed to explore barriers and enabling factors to providing reproductive healthcare for women in the sex trade in Israel. METHODS: We conducted a qualitative study utilizing a grounded theory method. Data were collected through semi-structured interviews, conducted between June 2021 and July 2022. Interviews were conducted with practitioners in healthcare settings (n = 20), practitioners in social services settings (n = 15), and women in the sex trade who received reproductive health care-related medical services (n = 13) in Israel. The interviews were audiotaped, transcribed, and thematically analyzed. RESULTS: The findings indicated a multilayered structure of healthcare system-related factors and women-related factors. Stigma was noted as a multidimensional barrier, reflected in service providers' attitude towards women in the sex trade, impairing the patient-provider relationship and impeding women's help-seeking. However, the creation of a relationship of trust between the women and healthcare providers enabled better health outcomes. CONCLUSIONS: Based on the findings, we propose recommendations for designing and implementing reproductive healthcare services for women in the sex trade. The recommendations offer to (a) include women with lived experiences in planning and providing reproductive healthcare services, (b) adopt a trauma-informed approach, (c) emphasize nonjudgmental care, (d) train healthcare providers to reduce stigma and bias, and (e) enhance the affordability of health services for women experiencing marginalization.

The dawn of a sexual assault relief center: A 12-year fact-finding survey of victims of sexual assault conducted since 2010 by SACHICO, Japan's first rape crisis center.

OBJECTIVE: In Japan, amidst insufficient legal provisions and governmental support, in 2010, the first rape crisis center, the Sexual Assault Crisis Healing Intervention Center Osaka (SACHICO) was established. We compared SACHICO visitor data from 2010 to 2021 with National Police Agency statistics to clarify the current situation of sexual assault victims in Japan and considered future issues for Japan to address. METHODS: This study was a cross-sectional study that analyzed the data described below. All visitations to SACHICO between April 2010 and December 2021 were considered targets for data totaling. Data on crime statistics were gathered from the official governmental statistics portal site. RESULTS: A total of 12 036 visitations occurred, of which 3189 were first-time consultations; 3100 initial medical examinations were conducted, and no medical examination was conducted in the remaining 89 cases (2.7%). The number of initial medical examinations increased 3.7 times from 2010 to 2021. Victims under the age of 19 comprised 60% of the total number of initial medical examinations (1863/3100). The reporting rate for all 3100 initial medical examinations was only 31.3% (969/3100) of the cases. The proportion of forcible sexual intercourse versus forcible indecency were the converse of those observed among acknowledged cases nationwide and in Osaka Prefecture. For several years, the number of initial medical consultations at SACHICO has exceeded that of acknowledged cases in Osaka Prefecture. CONCLUSION: Support for victims of sexual assault in Japan is still insufficient. It is necessary to strengthen the system of rape crisis centers system to realize an unbroken chain of support for victims.

Digital health utilization during pregnancy and the likelihood of preterm birth.

Objective: Given the complex nature of preterm birth, interventions to reduce rates of preterm birth should be multifaceted. This analysis aimed to explore the association between the duration of using Maven, a digital health platform for women's and family health, and the odds of preterm birth. Methods: Data came from 3326 pregnant, nulliparous Maven users who enrolled in Maven during their pregnancy between January 2020 and September 2022. Chi-square and Fisher's exact tests compared characteristics between users who developed gestational conditions and users who did not. This retrospective cohort study used logistic regression models to estimate the association between the duration of Maven use and odds of preterm birth, stratified by the presence of gestational conditions. Results: Compared to those without gestational conditions, individuals who developed gestational conditions were more likely to have a preterm birth (8.7% vs. 3.4%; p < 0.001). For every 1 h of Maven use, users experienced a 2% reduction in their odds of experiencing a preterm birth [adjusted odds ratio (AOR) (95% confidence interval (CI)) = 0.98 (0.95, 0.998), p = 0.04]. Among individuals who developed gestational conditions, every 1 h increase in Maven use was associated with a 5% reduction in the odds of experiencing a preterm birth [AOR (95% CI) = 0.95 (0.91, 0.99), p = 0.037]. There was no statistically significant association between Maven use and preterm birth in individuals without gestational conditions. Conclusion: Among those who developed gestational conditions, use of a digital health platform was associated with a decreased likelihood of preterm birth.

Longitudinal trends and correlation between autism spectrum disorder prevalence and sperm quality parameters (2000-2024): a comprehensive statistical analysis.

Introduction: Over the past few decades, there has been growing concern about the concurrent trends of increasing Autism Spectrum Disorder (ASD) prevalence and declining sperm quality. These trends represent significant public health challenges that warrant thorough investigation of their underlying causes and implications. Objectives: The primary objectives of this study are to analyze trends in ASD prevalence and sperm quality parameters from 2000 to 2024, assess the statistical significance and effect size of these trends, explore potential correlations between ASD prevalence and sperm quality parameters, and identify significant predictors among sperm quality parameters that influence ASD prevalence. Methods: This study employed a longitudinal approach using multiple regression, time series analysis, ANOVA, Principal Component Analysis (PCA), hierarchical clustering, logistic regression, and cross-correlation analysis. Data on ASD prevalence were sourced from the CDC Autism and Developmental Disabilities Monitoring Network, while sperm quality data were collected from various published studies. Results: The findings reveal significant negative associations between ASD prevalence and sperm quality parameters such as sperm concentration and motility, suggesting that better sperm quality is linked to lower ASD rates. Conversely, parameters like sperm DNA fragmentation (SDF), volume of ejaculate, pH level, and semen viscosity show positive associations with ASD prevalence, indicating higher values in these parameters correlate with higher ASD rates. Conclusion: The study highlights the importance of maintaining reproductive health to potentially mitigate ASD risk and calls for further research to elucidate the underlying mechanisms driving these trends. These findings support the hypothesis that reproductive health factors play a crucial role in ASD etiology and suggest potential biological markers for assessing ASD risk.

Endometriosis: A Comprehensive Exploration of Inflammatory Mechanisms and Fertility Implications.

Endometriosis is a prevalent gynecological disorder characterized by the ectopic growth of endometrial-like tissue outside the uterus. This condition poses significant challenges due to its chronic nature, debilitating symptoms such as pelvic pain and infertility, and substantial impact on quality of life. Central to the pathogenesis of endometriosis are inflammatory mechanisms that perpetuate tissue proliferation, adhesion formation, and immune dysregulation within the pelvic cavity. Inflammation plays a pivotal role in the development and progression of endometriosis, influencing the severity of symptoms and complications associated with the disease. Dysregulated immune responses contribute to the persistence of ectopic endometrial implants, exacerbating pelvic pain and other symptoms experienced by affected individuals. Moreover, the inflammatory milieu created by endometriotic lesions disrupts normal ovarian function, impairs follicular development, and compromises reproductive outcomes, thereby posing challenges to fertility. This review comprehensively explores the inflammatory mechanisms underlying endometriosis and their implications for fertility. Synthesizing current research and clinical insights elucidates the intricate interplay between inflammation, disease progression, and reproductive health outcomes. Understanding these complex interactions is essential for developing targeted diagnostic strategies and optimizing therapeutic approaches tailored to alleviate symptoms and improve fertility outcomes in individuals with endometriosis. Ultimately, this review aims to enhance the understanding of endometriosis pathophysiology, inform clinical practice, and stimulate further research to advance personalized care and management strategies for this challenging condition.

Menstrual Changes in Women Who Undergo Sleeve Gastrectomy in Saudi Arabia.

Introduction Obesity affects over 650 million globally, with rising rates posing significant public health challenges, especially among Saudi Arabian women. Obesity correlates with menstrual irregularities and reproductive health issues such as polycystic ovary syndrome (PCOS). Bariatric surgery (BS), particularly laparoscopic sleeve gastrectomy (LSG), is increasingly used due to its safety and effectiveness in treating obesity-related conditions. This study explores LSG's impact on menstrual cycles and fertility in Saudi women, aiming to optimize patient care and understand surgical effects on hormonal dynamics and reproductive health. Methodology It is a cross-sectional design among Saudi women post-sleeve gastrectomy from December 2023 to May 2024. Variables included age, marital status, and region, with primary outcomes focusing on menstrual cycle changes post surgery. Results Our study includes 387 participants, and demographic characteristics showed a significant proportion aged 26-35 years (n=147, 38.0%) and 36-45 years (n=119, 30.7%), with the majority being married (n=230, 59.4%). Regional distribution highlighted the south as the most represented (n=139, 35.9%), followed by the central (n=74, 19.1%). About 30.2% (n=117) reported chronic conditions. Post surgery, 70.5% (n=273) experienced menstrual changes, with regular cycles being the most common (n=102, 26.3%). Logistic regression indicated younger age as a protective factor against menstrual changes (p=0.028), while pre-surgery menstrual irregularities significantly predicted post-surgery changes (p=0.002). Regional analysis showed no significant association between geographic location and post-surgery menstrual changes (p=0.140). Overall, quality of life post-surgery was rated highly by participants, with 70.8% (n=274) giving ratings of 4 or 5. Conclusion Our study highlights a high prevalence of post-sleeve gastrectomy menstrual changes, predominantly regular cycles. Younger age appears protective, while pre-existing menstrual irregularities strongly predict postoperative changes. Regional differences did not significantly influence outcomes. Overall, participants reported high satisfaction with their quality of life post surgery.

Association of blood isobutyronitrile with infertility among reproductive-aged women: Results from the NHANES cohort.

Isobutyronitrile finds extensive application in organic synthesis for the production of the insecticide diazinon. Apart from occupational exposure, cigarette smoking may also expose the general population to isobutyronitrile. However, to date, the association between isobutyronitrile and female infertility has not been explored in a population-based study. Hence, we analysed data from 1254 women, aged 18-44, with blood isobutyronitrile results and infertility questionnaires, from National Health and Nutrition Examination Survey (NHANES) 2015-2016 and NHANES 2017-March 2020. To compare differences, weighted chi-square tests were conducted for categorical variables and weighted regression models were performed for continuous variables. Logistic regression and generalized linear models were applied to examine the associations. Each standard deviation increment (SD=0.026) of isobutyronitrile increased the risk of infertility by 24 % after adjusting for potential confounders in logistic regression model (aOR=1.24; 95 % CI: 1.06-1.46). In women who had been pregnant and gave birth, the results exhibited a consistent linear relationship. The participants were classified into two groups, namely positive and negative, using an isobutyronitrile cut-off value that exceeded 0.040 ng/mL. The positive group did not demonstrate a statistically significant correlation (aOR=1.55; 95 % CI: 0.66-3.65). According to smooth curve fitting, isobutyronitrile and infertility was linearly related across the entire range, and no threshold effect was found. Particularly, non-Hispanic Black women had a significantly stronger association with isobutyronitrile exposure and infertility (aOR=4.27; 95 % CI: 1.32-13.83). In conclusion, our study was the first report of an independent association of isobutyronitrile with infertility, especially in non-Hispanic Black women. Additional fundamental research on nonhuman primates, along with comprehensive clinical studies, are necessary to fully elucidate the intricate mechanisms underlying isobutyronitrile activity.

Understanding the association between menstrual health and hygiene attitudes and personal agency among very young adolescents in Sao Paulo, Brazil: A cross-sectional study.

BACKGROUND: Although menstruation is a monthly biological phenomenon, it is shrouded in stigma and shame which directly impacts health, education, gender equality, decent work, and economic growth. However, there is scarce evidence on how personal agency, an individual's ability to access resources, may act as a protective factor to adequate menstrual health and hygiene practices. Therefore, we assess the association between attitudes toward menstruation and personal agency among very young adolescent girls. METHODS: We use cross-sectional data from the Global Early Adolescent Study in São Paulo, Brazil, among 10- to 14-year-old girls who have experienced menarche (n = 325) and completed a home-based self-administered questionnaire in 2021. "Attitudes toward menstruation" was created based on five indicators on a Likert scale, with a higher score indicating more positive attitudes. The main covariate was personal agency, comprised of three scales and modeled as three continuous variables: voice, decision-making power, and freedom of movement. Data were analyzed using multivariable linear regression. RESULTS: Attitudes toward menstruation mean score was 12.5 (range 5-19). Older adolescents (12-14 years-old) had higher mean scores (more positive) than younger adolescents (10-11 years-old) on attitudes toward menstruation, whereas no other sociodemographic or menstrual health indicator (knowledge or access to products) were associated with attitudes toward menstruation. In the multiple regression model, older age and higher freedom of movement remained positively associated with attitudes toward menstruation (ßadjust = 0.5; 95%CI 0.1 to 0.8). CONCLUSION: Positive attitudes toward menstruation are associated with higher freedom of movement among very young Brazilian adolescent girls. The promotion of personal agency should be recognized as key strategies to accelerate young girls' positive approaches to their own menstruation and, consequently, well-being.

Menstrual Health and Hygiene Attitudes are associated with Personal AgencyOur results show that positive attitudes toward menstruation among very young adolescent girls are associated with personal agency, measured through freedom of movement. This information can inform strategies to accelerate young girls' positive approaches to their own menstruation and, consequently, well-being.

Knowledge and Attitudes Regarding Family Planning Options in Armenia.

Objective: In many Transcaucasian and Middle Eastern populations, research in women's sexual and reproductive health remains limited, especially in Armenia despite recent political and cultural changes. This study explores the current state of family planning in Armenia while both highlighting the recent progress and identifying current barriers to reproductive health. Study Design: We conducted a mixed-methods study using both a quantitative survey and qualitative interviews with women and key informants in the field of women's sexual and reproductive health. Results: Armenian women are familiar with many types of contraception. The use of modern methods has increased but remains low. Sexual education for women is uncommon and often sought through independent online searches or books. We found no significant access barriers, however, a prevailing distrust in hormonal contraceptive methods left many women to rely on condoms and withdrawal. Although the majority of surveyed women (72%) believed having access to safe abortions was an important right, only 42% would consider having an abortion in the case of an unintended pregnancy. Interviewees highlighted the lack of sexual education, discrepancies in sexual and reproductive services between rural provinces and the urban capital city of Yerevan, as well as the need for information and the government's responsibility in this field. Conclusions: The lack of comprehensive sexual education in Armenia fuels misinformation regarding family planning options. One option we recommend is a government-funded sexual education program which begins as culturally sensitive, sex-positive education in schools and continues with counseling and support for women within the health care system.

Nutritional Deficiencies and Subfertility: A Comprehensive Review of Current Evidence.

Subfertility, a condition marked by a reduced capacity to conceive naturally, affects a significant proportion of couples globally. Nutrition is a fundamental aspect of reproductive health, with various nutrients essential in maintaining optimal reproductive function. This comprehensive review explores the intricate relationship between nutritional deficiencies and subfertility. It examines key micronutrients such as vitamins D, E, C, and B12, as well as minerals such as zinc, iron, selenium, and magnesium, and their impacts on fertility. The review also considers macronutrients and the importance of a balanced diet in supporting reproductive health. Drawing on an extensive body of clinical evidence and studies, this review highlights how deficiencies in these nutrients can lead to hormonal imbalances, impaired gametogenesis, and suboptimal pregnancy outcomes. It discusses the efficacy of nutritional interventions, including dietary supplements and lifestyle modifications, in improving fertility. Furthermore, it addresses the emerging research on personalized nutrition and its potential to enhance reproductive outcomes. The review underscores the necessity for healthcare providers to assess and address the nutritional status of patients with subfertility. It provides practical recommendations for developing nutritional plans, counseling patients, and integrating nutritional interventions into fertility treatments. By offering a comprehensive synthesis of current evidence, this review aims to inform clinical practice and promote further research into the role of nutrition in enhancing fertility.

Access to and provision of sexual and reproductive health services in Ekurhuleni, South Africa: Experiences and coping strategies of migrant women and healthcare workers.

The importance of universal access to health services including sexual and reproductive health and rights (SRHR) services by migrant populations and the fundamental role of healthcare workers in providing SRHR services, requires a balanced understanding of the experiences of both migrants and healthcare workers. This study explored the experiences of migrant women in accessing and utilising SRHR services and the experiences of healthcare workers in providing SRHR and HIV services in Ekurhuleni, South Africa. In-depth interviews were conducted with five internal migrants, eight international migrant women aged 18-49 years, and four healthcare workers. Migrant women were selected using snowball sampling while healthcare workers were purposively sampled. Migrant women face multifaceted challenges including but not limited to language barriers, discrimination based on migration status, cultural and religious hurdles when accessing and utilising SRHR and HIV services. Similarly, healthcare workers encounter challenges in providing SRHR and HIV services to migrant women which include language barriers and having migrants who seek services without referral documentation and legal migration documents. Training healthcare workers on cultural sensitivity and integration of migrant friendly services in the health policy may improve migrant women's experiences in accessing and utilising as well as healthcare workers' experiences in providing SRHR services.

L'importance de l'accès universel aux services de santé, y compris les services de santé et de droits sexuels et reproductifs (SDSR) pour les populations migrantes et le rôle fondamental des agents de santé dans la fourniture de services SDSR, nécessitent une compréhension équilibrée des expériences des migrants et des agents de santé. Cette étude a exploré les expériences des femmes migrantes en matière d'accès et d'utilisation des services SDSR et les expériences des agents de santé dans la fourniture de services SDSR et VIH à Ekurhuleni, Afrique du Sud. Des entretiens approfondis ont été menés avec cinq migrants internes, huit femmes migrantes internationales âgées de 18 à 49 ans et quatre agents de santé. Les femmes migrantes ont été sélectionnées à l'aide d'un échantillonnage boule de neige tandis que les travailleurs de la santé ont été échantillonnés à dessein. Les femmes migrantes sont confrontées à des défis multiformes, notamment les barrières linguistiques, la discrimination basée sur le statut migratoire, les obstacles culturels et religieux lors de l'accès et de l'utilisation des services SDSR et VIH. De même, les agents de santé rencontrent des difficultés pour fournir des services SDSR et VIH aux femmes migrantes, notamment des barrières linguistiques et le fait que les migrantes recherchent des services sans documents de référence ni documents de migration légaux. La formation des agents de santé à la sensibilité culturelle et à l'intégration de services adaptés aux migrants dans la politique de santé peut améliorer les expériences des femmes migrantes en matière d'accès et d'utilisation, ainsi que les expériences des agents de santé dans la fourniture de services SDSR.

Access of migrant women to sexual and reproductive health services: A systematic review.

BACKGROUND: The number of people living in a different place from their place of birth is increasing year by year. Although women have always been involved in migratory movements, today they are increasingly doing so independently. Women are migrating from the Global South to higher-income countries. One of the challenges they face is access to sexual and reproductive health (SRH) services. AIM: To identify the policy-level barriers that limit the access of migrant women to SRH services, their consequences, and strategies implemented to overcome these barriers. METHODS: A systematic review of the literature was undertaken in accordance with the PRISMA statement. A search was undertaken for articles published between 2018 and 2023 focusing on migrant women's experiences of SRH services. In total, 462 articles were retrieved from PubMed (n = 135), Scopus (n = 94) and Web of Science (n = 233); of these, 28 articles were included in this review. FINDINGS: The most common barrier to SRH services identified in the reviewed articles was lack of information (57 %), followed by language issues (43 %), cultural differences (39 %), economic status (25 %), administrative barriers (25 %) and discrimination (14 %). These barriers led to under-utilisation of maternity services and contraceptive methods. Strategies used by migrant women to overcome these barriers were primarily based on seeking help within their own community or family settings. CONCLUSION: Strategies at institutional level to improve the access of migrant women to SRH services need to reduce existing barriers, promote health literacy, and train health workers to be culturally sensitive and responsive to the needs of migrant women.

The role (and limits) of developmental neuroscience in determining adolescents' autonomy rights: The case for reproductive and voting rights.

Neuroscientific evidence documenting continued neural development throughout adolescence has been leveraged in advocacy for more lenient treatment of adolescents in the criminal justice system. In recent years, developmental science, including neuroscience, has progressed and enabled more nuanced interpretations of what continuing neural development in adolescence likely means functionally for adolescents' capabilities. However, oversimplified interpretations equating continuing neural development to overall "immaturity" are frequently used to make the case that adolescents should have fewer legal rights to make decisions on their own behalf, including regarding reproductive and voting rights. Here we address ongoing debates about adolescents' autonomy rights and whether such rights should be expanded or restricted. We review extant neuroscientific and developmental research that can inform these debates. We call for: (1) a more nuanced application of developmental neuroscience to specific rights issues in specific contexts; (2) additional research designed to inform our understanding of the developmental benefits or harms of rights-based policies on young people over time; and (3) the grounding of developmental neuroscientific research on adolescents within a human rights framework. We offer suggestions to developmental and neuroscience scholars on how to discuss the science of adolescent development with those seeking guidance in their design of law and policy.

The Uterus Keeps the Score: Black Women Academics' Insights and Coping with Uterine Fibroids.

Few studies examine how high-achieving Black women navigate chronic reproductive health morbidities. Black women are disproportionately more likely to experience uterine fibroids, with earlier onset and more severe symptoms. This study leverages a national mixed-methods data set of Black women academics to examine how they describe symptomatic fibroids impacting their careers and lives. We find that participants (1) actively coped by engaging in superwoman schema, (2) postponed treatment due to the demands of their tenure-track position, and (3) normalized pain. Our findings suggest a potentially high prevalence of uterine fibroids among Black women faculty, that symptomatic fibroids were an impediment to some women's careers, and that women with symptomatic fibroids often identified expectations of their careers as an impediment to seeking timely treatment. We provide insights for how highly educated, successful Black women cope and navigate career stress coupled with challenges resulting from chronic reproductive health morbidities.

Adaptation and psychometric assessment of a sexual and reproductive empowerment scale in Arabic among refugee and non-refugee adolescent girls.

BACKGROUND: Sexual and reproductive empowerment (SRE) is an important determinant of women's and girls' health yet measuring it is complex due to cultural and domain-specific variations. This study describes the process of adapting an SRE scale consisting of four domains (self-efficacy; future orientation; social support; and safety) and testing its psychometric properties among Arabic speaking adolescent girls in Lebanon. METHODS: An SRE scale developed in a Western context was adapted in four steps: (1) reviewing the scale and selecting culturally appropriate domains for translation to standard Arabic; (2) conducting cognitive interviews with 30 11-17-year-old adolescent girls in Lebanon; (3) administering the scale to 339 refugee adolescent girls who participated in an early marriage intervention; and (4) conducting confirmatory factor analysis (CFA) on the data to assess the scale's psychometric properties. RESULTS: The original model for the 13-item, four-domain adapted scale demonstrated poor fit in CFA. After iteratively removing two items, scale properties were improved, albeit were not optimal. The validity and reliability results for the self-efficacy domain were acceptable. Cognitive interview data revealed that Arab adolescent girls understood self-efficacy in relational terms, recognizing that autonomous decision-making is not necessarily favored but is influenced by parents and family. CONCLUSIONS: This study presents an effort to customize an SRE scale for use in studies on the health of adolescent girls in an Arab cultural context. Findings from cognitive interviews highlight the importance of taking into consideration relationality in adolescent sexual and reproductive decision-making. The self-efficacy domain in the adapted scale demonstrates acceptable psychometric properties and is recommended for use in health studies to capture SRE.

Autonomy and freedom of choice: A mixed methods analysis of the endorsement of SRHR and its core principles by global agencies.

Based on an adapted version of the conceptual framework used by the Guttmacher-Lancet Commission on Sexual and Reproductive Health and Rights (SRHR), this study sought to analyse to what extent seven global agencies, five of which belong to the UN family and the other two closely linked, incorporate women's autonomy and freedom of choice in accessing services into their SRHR policies, and how they operationalize these in their global SRHR programmes that target women and adolescent girls. Twenty-nine SRHR-related policy documents published in 2013-2020 and 17 independent evaluations of global SRHR programmes in the same period were analysed. They were found to fall short of considering women's individual autonomy and choice as the two core principles of SRHR. By ignoring autonomy and choice, global SRHR programmes missed the opportunity to incorporate activities that could enhance the emancipatory empowerment of women and girls to improve their sexual and reproductive wellbeing. The study identified concrete aspects on which global agencies, in view of their respective mandates, could have pronounced themselves more explicitly and might have been more effective in implementing SRHR programmes. In light of the international gender equality and women's empowerment discourse this suggests that donor countries could hold global agencies more accountable, bilaterally or jointly, for their SRHR performance, in particular their active endorsement and application of SRHR core principles.

Knowledge and attitude of adolescents towards sexual health and reproductive health technologies.

Reproductive health and reproductive health technologies are one of the challenging health studies in the developing world. The study focuses on the knowledge and attitude of adolescent students towards reproductive health technologies. It is the need and responsibility of all individuals especially adolescents (the future procreators) to know about Assisted Reproductive Technologies (ART) and the sexual health related to it. The objectives are to evaluate the level of knowledge among late adolescents (18-21 years) regarding sexual and reproductive health. To understand the attitudes of late adolescents towards sexual health and reproductive health technologies. To identify gaps in knowledge and misconceptions about sexual and reproductive health among late adolescents. To determine the awareness and perceptions of late adolescents regarding various reproductive health technologies. The study was a mixed method, 46 respondents of age groups between 18-21 years (late adolescents) were selected, using simple random sampling. A self-administered questionnaire was circulated through Google Forms. Data was collected and analysed using SPSS Statistics Data Editor version 22. The level of knowledge the late adolescents have towards sexual health and reproductive technologies is very low and the study should explore all, to know the merits and demerits of Assisted Reproductive Technologies (ART) and the alternative methods for childbirth. The dissemination of information and availability of educational resources on sexual and reproductive health may be resulting in comparable levels of knowledge among individuals of various age cohorts.

La santé reproductive et les technologies de santé reproductive constituent l'une des études de santé les plus difficiles dans les pays en développement. L'étude se concentre sur les connaissances et l'attitude des étudiants adolescents à l'égard des technologies de santé reproductive. Il est de la nécessité et de la responsabilité de tous les individus, en particulier des adolescents (les futurs procréateurs), de connaître les technologies de procréation assistée (TAR) et la santé sexuelle qui y est associée. Les objectifs sont d'évaluer le niveau de connaissances des adolescents tardifs (18-21 ans) en matière de santé sexuelle et reproductive. Comprendre les attitudes des adolescents tardifs à l'égard des technologies de santé sexuelle et de santé reproductive. Identifier les lacunes dans les connaissances et les idées fausses sur la santé sexuelle et reproductive chez les adolescents tardifs. Déterminer la sensibilisation et les perceptions des adolescents tardifs concernant diverses technologies de santé reproductive. L'étude était une méthode mixte, 46 répondants de tranches d'âge comprises entre 18 et 21 ans (adolescents tardifs) ont été sélectionnés, par échantillonnage aléatoire simple. Un questionnaire auto-administré a été diffusé via Google Forms. Les données ont été collectées et analysées à l'aide de SPSS Statistics Data Editor version 22. Le niveau de connaissances des adolescents tardifs en matière de santé sexuelle et de technologies de reproduction est très faible et l'étude devrait tout explorer pour connaître les avantages et les inconvénients des technologies de procréation assistée (ART). et les méthodes alternatives d'accouchement. La diffusion d'informations et la disponibilité de ressources éducatives sur la santé sexuelle et reproductive peuvent aboutir à des niveaux de connaissances comparables entre les individus de différentes cohortes d'âge.