Does girls' empowerment predict contraceptive intentions? Evidence from a survey of secondary school girls in Northwest Nigeria.

In sub-Saharan Africa, women's empowerment has been linked to contraceptive use, but little is known about whether girls' empowerment affects contraceptive intentions, particularly in more traditional societies where early marriage and childbearing are common. Drawing on a survey of 240 secondary school students in Kebbi State, Northwest Nigeria, in September-November 2018, we examined whether dimensions of girls' empowerment (academic self-mastery, perceived career feasibility, progressive gender norms, and marriage autonomy) and family planning indicators (knowledge, desired family size) were associated with future intentions to use family planning. We found that half of the girls had no intention to use contraception, and only one-fourth intended to use contraception for both delaying/spacing and stopping pregnancies. Multivariate analysis revealed that one dimension of empowerment (perceived career feasibility) and family planning knowledge were significantly associated with intentions. These results suggest that girls perceive contraceptive use as risky, and require contraceptive knowledge and an anticipated career to overcome their trepidation. To increase girls' intentions to use contraceptives, it is vital that they receive comprehensive sexuality education and career counselling.

A Qualitative Study of Arab-American Perspectives on Intimate Partner Violence in Dearborn, Michigan.

Few studies explore how intimate partner violence (IPV) affects Arab Americans. Through focus groups with stakeholders from an Arab-centered health organization and semistructured interviews with Arab-American female clients (18-65 years), we explore how IPV affects Arab-American women and factors that impede and facilitate their access to support services. We find that IPV is a critical concern among Arab Americans and that generational status, educational attainment, and support from family, friends, or religious leaders were perceived to influence access to IPV support services. This study has implications for developing culturally sensitive IPV interventions for Arab-American women.

Reproductive justice in the time of COVID-19: a systematic review of the indirect impacts of COVID-19 on sexual and reproductive health.

OBJECTIVE: Despite gendered dimensions of COVID-19 becoming increasingly apparent, the impact of COVID-19 and other respiratory epidemics on women and girls' sexual and reproductive health (SRH) have yet to be synthesized. This review uses a reproductive justice framework to systematically review empirical evidence of the indirect impacts of respiratory epidemics on SRH. METHODS: We searched MEDLINE and CINAHL for original, peer-reviewed articles related to respiratory epidemics and women and girls' SRH through May 31, 2021. Studies focusing on various SRH outcomes were included, however those exclusively examining pregnancy, perinatal-related outcomes, and gender-based violence were excluded due to previously published systematic reviews on these topics. The review consisted of title and abstract screening, full-text screening, and data abstraction. RESULTS: Twenty-four studies met all eligibility criteria. These studies emphasized that COVID-19 resulted in service disruptions that effected access to abortion, contraceptives, HIV/STI testing, and changes in sexual behaviors, menstruation, and pregnancy intentions. CONCLUSIONS: These findings highlight the need to enact policies that ensure equitable, timely access to quality SRH services for women and girls, despite quarantine and distancing policies. Research gaps include understanding how COVID-19 disruptions in SRH service provision, access and/or utilization have impacted underserved populations and those with intersectional identities, who faced SRH inequities notwithstanding an epidemic. More robust research is also needed to understand the indirect impact of COVID-19 and epidemic control measures on a wider range of SRH outcomes (e.g., menstrual disorders, fertility services, gynecologic oncology) in the long-term.

The impact of respiratory epidemics, like COVID-19 on women and girls' sexual and reproductive health (SRH) is not yet known. This review applies a reproductive justice framework, to systematically review the impact of respiratory epidemics on SRH, in order to examine the impact of COVID-19 on equitable, sustained access to quality SRH services for all populations. This framework highlights the right to reproductive autonomy, including the right to have an abortion, conceive, bear and raise children; and is inclusive of the intersectionality of race, class and gender. This review includes original, peer-reviewed research related to COVID-19 and women and girls' SRH through May 31, 2021, and consisted of title and abstract screening, full-text screening, and data abstraction. Overall, twenty-four studies met eligibility criteria. Results emphasize that the COVID-19 pandemic resulted in service disruptions that effected access to abortion, contraceptives, HIV/STI testing, and changes in changes in sexual behaviors, menstruation, and pregnancy intentions. These findings highlight the urgent need to enact policies that ensure equitable, timely access to quality SRH services for women and girls, despite pandemic response policies. This review also highlights opportunities to better understand how COVID-19 related disruptions in SRH service provision, access and/or utilization have impacted underserved populations and those with intersectional identities, who faced SRH inequities prior to the COVID-19 pandemic. More research is needed to understand the indirect impact of COVID-19 and epidemic control measures on a wider range of SRH outcomes (e.g., menstrual disorders, fertility services, gynecologic oncology) in the long-term.

The Eco-Social Trauma Intervention Model.

OBJECTIVES: We describe a transdisciplinary theory of change for interventions to promote trauma recovery that utilizes an eco-social approach to enhance health status and well-being following trauma exposures. This four-level theory of change could be applied to other population health problems, as well. METHODS: This theory-development process included reviewing existing literature, identifying assumptions, defining core concepts, stating propositions, depicting concepts and propositions for clarity, and illustrating with case examples grounded in our focus on trauma. RESULTS: The resulting Eco-Social Trauma Intervention Model offers a framework for interventions that address the impact of trauma on the individual level through self-regulation, interpersonal level through relationships, community/organizational level through safety, and societal level through identities. Application of this model to intervention development for those affected by trauma is intended to promote resilience, recovery, posttraumatic growth, and positive adaptations to traumatic stress for populations, going beyond the current Western paradigm of treating individuals for psychopathology. CONCLUSIONS: The Eco-Social Trauma Intervention Model offers an adaptable transdisciplinary framework for developing and researching scalable trauma interventions for individuals, communities, and populations.