ABSTRACT
Background: Improving the design of family planning (FP) interventions is essential to advancing gender equality, maternal health outcomes, and reproductive autonomy for both men and women. While progress has been made towards applying a rights-based approach to FP interventions in sub-Saharan Africa, the ethical implications of FP interventions has been underreported and underexplored. Several ethical challenges persist related to measuring success, choice, and target population. Methods: We conducted a scoping review to understand if and how FP interventions published between 2000 and 2020 within sub-Saharan Africa address the ethical challenges raised within the literature. We identified a total of 1,652 papers, of which 40 were included in the review. Results: Our review demonstrated that the majority of family planning interventions in sub-Saharan Africa place a strong emphasis, on measuring success through quantitative indicators such as uptake of modern contraception methods among women, specifically those that are married and visiting healthcare centres. They also tend to bias the provision of family planning by promoting long-acting reversible contraception over other forms of contraception methods potentially undermining individuals' autonomy and choice. The interventions in our review also found most interventions exclusively target women, not recognising the importance of gender norms and social networks on women's choice in using contraception and the need for more equitable FP services. Conclusion: The results of this review highlight how FP interventions measured success through quantitative indicators that focus on uptake of modern contraception methods among women. Utilising these measures makes it difficult to break away from the legacy of FP as a tool for population control as they limit the ability to incorporate autonomy, choice, and rights. Our results are meant to encourage members of the global family planning community to think critically about the ethical implications of their existing interventions and how they may be improved. More public health and policy research is required to assess the effect of applying the new indicators with the FP community as well as explicitly outlining monitoring and evaluation strategies for new interventions to allow for programme improvement and the dissemination of lessons learned.
ABSTRACT
BACKGROUND: Health professional students are provided with a wealth of online learning resources recommended by curriculum developers or instructors, the majority of which focus on biological and clinical science. Our goal was to develop a database of learning resources to help students and faculty members understand chronic health conditions from a patient's perspective. Resources were recommended by patients and evaluated by students. Our goal was to develop a database of learning resources recommended by patients and evaluated by students METHODS: Patients and caregivers who recommend resources to their students in an interprofessional health mentors programme, and participants in a Disability Learning Resource planning session, provided 68 different resources, ranging from community organisation websites to personal biographies. Resources were organised into eight categories and rated by 10 senior health professional students. Patients provided 68 different resources, ranging from community organisation websites to personal biographies RESULTS: Patients recommended resources so that students could learn what it is like to live with a particular condition, and also learn about useful patient information resources and community-based advocacy organisations. Students identified 40% of the rated resources as useful or exceptionally useful, and identified the characteristics of useful and not useful resources. Students identified 40% of the rated resources as useful or exceptionally useful CONCLUSIONS: Students want resources that are easy to navigate and are well organised. They want a 'one-stop shop' to access information about a particular condition or disease, and value resources that they can recommend to their patients as well as use to expand their own knowledge. Students value information about local organisations for specific conditions that they can connect their patients to, and from which they may learn more about existing support initiatives in their communities. Clinical educators could better prepare students for practice by making available patient-recommended resources. Students value resources that they can recommend to their patients as well as use to expand their own knowledge Students value information about local organisations for specific conditions that they can connect their patients to Clinical educators could better prepare students for practice by making available patient-recommended resources.
