Adolescents' accessibility and use of sexual and reproductive health services in Kaolack and Gossas, Senegal.

In Senegal, the needs for care related to sexual and reproductive health and rights (SRHR) among adolescents are significant. This study evaluates the accessibility and use of gender-related SRHR services by adolescents in the municipalities of Kaolack and Gossas. It is based on quantitative and qualitative data from 2,263 adolescents in the 2 sites, 84 in-depth individual interviews, 12 focus groups with adolescents and sexual reproductive Health actors, and 4 interviews with key informants. Quantitative analysis consisted of the interpretation of univariate statistics and bivariate analyses, while qualitative analysis relied on the coding and thematic analysis of verbatim statements. The results show low use of health structures (3% and 0.4% in Gossas and Kaolack respectively). This was attributed to the perceptions that services are not suitable to the needs of adolescents, and also because of socio-cultural constraints in the two sites. Additionally, the distribution of access to reproductive health services by sex shows gaps between boys and girls. We conclude that efforts should be made to tailor the sexual and reproductive health services offered to adolescents to their needs and social circumstances.

Au Sénégal, les besoins en soins de Santé Sexuelle et Reproductive des Adolescent(e)s (SSRA) sont importants. Cette étude évalue l'accessibilité et l'utilisation des services de SSRA, en rapport avec le genre dans les communes de Kaolack et de Gossas. Elle est basée sur les données quantitatives et qualitatives provenant de 2263 adolescents, de 84 entretiens individuels approfondis, de 12 focus groupes avec des adolescents/tes et des acteurs de la SSRA et de 4 entretiens avec les informateurs clés. L'analyse quantitative concerne les statistiques univariées et bivariées, alors que l'analyse qualitative s'appuie sur le codage et l'extraction des verbatim. L'étude révèle une faible utilisation des structures de santé, liée à leur inadaptation aux besoins des adolescent(e)s et aux contraintes socio-culturelles. Le recours des adolescent(e)s aux services de SSRA (3% et 0,4% à Gossas et Kaolack respectivement) est très faible et on note des écarts entre les garçons et les filles.

New evidence on adolescent sexual and reproductive health and rights from the West and Central African region.

The African Journal of Reproductive Health is pleased to publish these compendiums of original research in this special edition that document new findings in adolescent sexual and reproductive health and rights from the West and Central African region (WCA). While sub-Saharan Africa has some of the worst indicators of sexual and reproductive health and rights (SRHR) in the world, the indicators are more daunting in the WCA region. To date, the WCA is recognized to have the highest rates of unwanted pregnancy, unsafe abortion, and human immunodeficiency virus (HIV) and other sexually transmissible infections, as well as the lowest contraceptive prevalence rates among adolescents worldwide.1 Despite the high rate of adverse adolescent reproductive health outcomes in WCA, there has been limited documentations of the socio-cultural and economic circumstances that perpetuate these adverse consequences. There have also been no purposefully designed interventions that provide strong scientific evidence for developing strategies to reverse the trend.

Le Journal africain de la santé reproductive est heureux de publier ces recueils de recherches originales dans cette édition spéciale qui documentent les nouvelles découvertes sur la santé et les droits sexuels et reproductifs des adolescents de la région de l'Afrique de l'Ouest et du Centre (WCA). Alors que l'Afrique subsaharienne possède certains des pires indicateurs au monde en matière de santé et de droits sexuels et reproductifs (SDSR), les indicateurs sont plus intimidants dans la région AOC. À ce jour, l'AOC est reconnue pour avoir les taux les plus élevés de grossesses non désirées, d'avortements à risque, de virus de l'immunodéficience humaine (VIH) et d'autres infections sexuellement transmissibles, ainsi que les taux de prévalence contraceptive les plus faibles parmi les adolescents dans le monde.1 Malgré le taux élevé de En dépit des résultats négatifs en matière de santé reproductive des adolescents en AOC, il existe peu de documentation sur les circonstances socioculturelles et économiques qui perpétuent ces conséquences néfastes. Il n'y a pas non plus d'interventions spécialement conçues qui fournissent des preuves scientifiques solides pour élaborer des stratégies visant à inverser la tendance.

Gender and adolescent sexual and reproductive health and rights in West and Central Africa: New evidence and emerging gaps.

The West and Central Africa (WCA) region is a natural resource-rich, 24-country, contiguous area with a population of nearly 500 million people. The median age for the region is currently 18 years and approximately one-third of its population is aged between 10 and 24 years. If current demographic trends in the region persist, its population will reach 1.5 billion by 2050. At that time, WCA will not only have the largest number of young people globally, but it will also be the only part of the world whose population of young people will continue to increase1. Many countries in the region are also or have recently been involved in armed conflicts, which have devastated infrastructure, displaced people, stifled development, and more importantly, resulted in myriad deaths and morbidities.

La région de l'Afrique de l'Ouest et du Centre (AOC) est une zone contiguë de 24 pays riches en ressources naturelles et comptant près de 500 millions d'habitants. L'âge médian de la région est actuellement de 18 ans et environ un tiers de sa population est âgée de 10 à 24 ans. Si les tendances démographiques actuelles de la région persistent, la population de la région atteindra 1,5 milliard d'habitants d'ici 2050. À cette époque, l'AOC comptera non seulement le plus grand nombre de jeunes au monde, mais elle sera également la seule partie du monde dont la population de le nombre de jeunes va continuer à augmenter1. De nombreux pays de la région sont également ou ont été récemment impliqués dans des conflits armés, qui ont dévasté les infrastructures, déplacé les populations, étouffé le développement et, plus important encore, entraîné une myriade de morts et de morbidités.

Positive masculinity programmes and attitudes towards nonconforming gender identities among young males in urban Democratic Republic of Congo, Nigeria, and Rwanda.

Implementing programmes on sexual and reproductive health and rights (SRHR) in sub-Saharan Africa often involves promoting inclusive sexual identity/orientation. However, whether and how the programmes are changing gender norms in the target populations have not been established. This study was designed to determine whether participation in Positive Masculinity (PM) programmes can change attitudes associated with prevailing gender norms. We explored attitudes towards nonconforming sexual identity/orientation among young males in selected informal settlements in Democratic Republic of the Congo (DRC), Nigeria and Rwanda. The key variables we tested included "country of participation" and other socio-demographics such as "education", "marital status" and "prior residential location" (rural or urban). We found no significant association between participation in PM programmes with attitudes towards nonconforming sexual identities/orientations across our target populations irrespective of educational qualification, marital status, and previous location of residence. By contrast, religious teachings showed up in the qualitative responses as a significant factor influencing young people's resistance to PM programmes' advocating for inclusive sexuality. Additionally, negative masculinity attributes had significant negative association with attitudes towards nonconforming sexual identity, while respondents with violent tendencies showed significant positive attitudes. We conclude that current PM interventions do not significantly contribute to positive attitudes towards inclusive sexuality in DRC, Nigeria, and Rwanda.

La mise en œuvre de programmes sur la santé et les droits sexuels et reproductifs (SDSR) en Afrique subsaharienne implique souvent la promotion d'une identité/orientation sexuelle inclusive. Cependant, il n'a pas été établi si et comment les programmes modifient les normes de genre dans les populations cibles. Cette étude a été conçue pour déterminer si la participation à des programmes de masculinité positive (PM) peut changer les attitudes associées aux normes de genre dominantes. Nous avons exploré les attitudes à l'égard de l'identité/orientation sexuelle non conforme chez les jeunes hommes dans des quartiers informels sélectionnés en République démocratique du Congo (RDC), au Nigeria et au Rwanda. Les variables clés que nous avons testées comprenaient le « pays de participation ¼ et d'autres données sociodémographiques telles que « l'éducation ¼, « l'état civil ¼ et « le lieu de résidence antérieur ¼ (rural ou urbain). Nous n'avons trouvé aucune association significative entre la participation à des programmes de PM et les attitudes à l'égard des identités/orientations sexuelles non conformes au sein de nos populations cibles, indépendamment du diplôme, de l'état civil et du lieu de résidence précédent. En revanche, les enseignements religieux sont apparus dans les réponses qualitatives comme un facteur important influençant la résistance des jeunes aux programmes PM prônant une sexualité inclusive. De plus, les attributs négatifs de la masculinité présentaient une association négative significative avec les attitudes à l'égard d'une identité sexuelle non conforme, tandis que les répondants ayant des tendances violentes montraient des attitudes positives significatives. Nous concluons que les interventions actuelles de PM ne contribuent pas de manière significative à des attitudes positives envers une sexualité inclusive en RDC, au Nigeria et au Rwanda.

Positive masculinity programmes and sexual and reproductive health behaviours among boys and men in poor urban settlements in Democratic Republic of Congo, Nigeria, and Rwanda.

As Positive Masculinity (PM) Programmes continue to develop globally, it is important to examine their role in Sexual and Reproductive Health and Rights (SRHR) outcomes. This multi-country qualitative study was conducted using in-depth interviews (IDI) and focus group discussions (FGDs) with community members, beneficiaries and implementers of PM programmes. The findings show that PM programmes are designed using a gender lens to make boys and men more aware and conscious of harmful masculinity traits and their effect on SRHR. The beneficiaries of the interventions report imbibing positive SRHR behaviours by being sexually responsible - upholding sexual rights, taking precautions against sexually transmitted Infections (STIs) and learning proper communication with their partners. They also report acting as vanguards of positive gender norms to their families and peers. Although there are challenges in implementing PM programmes, the results of the study suggest that interventions targeting boys and men hold promise for improving boys' and men's health behaviours and promoting gender equality in poor urban settings.

Alors que les programmes de masculinité positive (PM) continuent de se développer à l'échelle mondiale, il est important d'examiner leur rôle dans les résultats en matière de santé et de droits sexuels et reproductifs (SDSR). Cette étude qualitative multi pays a été menée à l'aide d'entretiens approfondis (IDI) et de discussions de groupe (FGD) avec des membres de la communauté, des bénéficiaires et des responsables de la mise en œuvre des programmes PM. Les résultats montrent que les programmes PM sont conçus en utilisant une optique de genre pour rendre les garçons et les hommes plus conscients des traits de masculinité néfastes et de leurs effets sur la SDSR. Les bénéficiaires des interventions déclarent avoir adopté des comportements positifs en matière de SDSR en étant sexuellement responsables ­ en respectant leurs droits sexuels, en prenant des précautions contre les infections sexuellement transmissibles (IST) et en apprenant une bonne communication avec leurs partenaires. Ils déclarent également agir en tant qu'avant-gardes des normes de genre positives auprès de leurs familles et de leurs pairs. Bien que la mise en œuvre des programmes PM présente des difficultés, les résultats de l'étude suggèrent que les interventions ciblant les garçons et les hommes sont prometteuses pour améliorer les comportements de santé des garçons et des hommes et promouvoir l'égalité des sexes dans les milieux urbains pauvres.

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.

The Effect of Nutrient Supplementation on Female Fertility: A Systematic Review.

Assisted reproductive technologies (ART) have improved infertility treatment but reproductive outcomes remain challenging. Nutrient supplementation is being explored to enhance pregnancy rates, increase live birth rates, and reduce miscarriage rates in females undergoing ART. Nutrients like folic acid, omega-3 fatty acids, and antioxidants have shown potential benefits, yet conflicting results exist. Live birth rates may also be influenced by nutrient supplementation, with coenzyme Q10 and vitamin D showing promise. Miscarriage rates may be reduced with nutrients such as vitamin D, omega-3 fatty acids, and antioxidants, although more research is needed for definitive conclusions. Scientific and medical literature databases such as Cochrane Library, PubMed, and Web of Science were queried to identify relevant English publications adhering to predetermined inclusion and exclusion criteria. Various reproductive metrics, encompassing biochemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, implantation rate, live birth rates, and miscarriage rates, were assessed as clinical endpoints. The study population included 996 female subjects receiving ART. Two studies performed investigations on subjects diagnosed with unexplained infertility, two studies specifically included polycystic ovary syndrome patients, and five studies did not provide any specific information on the type of infertility or subfertility. All studies reported on the clinical/ongoing pregnancy rate, among which four included studies observed a significantly higher rate. Out of the four studies that reported on implantation rates, three found significantly higher rates in treatment groups. Out of the three studies that reported on biochemical pregnancy rates, two studies found significantly higher rates in treatment groups. With respect to the clinical outcomes that were studied in this analysis, variable effects of nutritional supplementation on reproductive parameters were observed. Some studies reported significantly higher rates of clinical/ongoing pregnancy, implantation, biochemical pregnancy, and live birth, while no significant difference was found in miscarriage rates.

Navigating the Microbial Landscape: Understanding Dysbiosis in Human Genital Tracts and Its Impact on Fertility.

Dysbiosis, an imbalance in microbial communities, significantly impacts the health and functionality of the human genital tract, with profound implications for fertility and reproductive health. This review explores the intricate relationship between genital tract microbiota and reproductive outcomes, highlighting the composition and dynamics of these microbial communities in both females and males. In females, the vaginal microbiota, primarily dominated by Lactobacillus species, is essential for maintaining a healthy vaginal environment, preventing infections, and supporting reproductive functions. In males, the genital microbiota influences sperm quality and reproductive health. Dysbiosis in the genital tract, manifesting as bacterial vaginosis, yeast infections, urethritis, or prostatitis, disrupts these microbial communities, leading to adverse reproductive outcomes such as infertility, pregnancy, and increased susceptibility to sexually transmitted infections. This review delves into the mechanisms through which dysbiosis affects fertility, including alterations in vaginal pH, mucosal immunity, inflammation, sperm viability, and motility. It also evaluates diagnostic methods, clinical implications, and management strategies, including probiotics, prebiotics, antibiotics, antifungal treatments, lifestyle interventions, and emerging therapeutic approaches. By understanding the microbial landscape of the genital tract and its impact on fertility, this review aims to inform targeted interventions that restore microbial balance and enhance reproductive health, ultimately improving fertility outcomes and the potential for healthy pregnancies.

Fighting for menstrual equity through period product pantries.

BACKGROUND: Menstruators facing period poverty often struggle with menstrual hygiene and waste management, which can result in harmful short- and long-term health outcomes such as urinary tract infections, yeast infections, and vulvar contact dermatitis. Research indicates that 42% of menstruators in the United States have difficulty affording period products. Traditional methods of distributing period products through social services may unintentionally undermine menstruators' agency, leading to disempowerment and inefficient resource allocation. Period product pantries are a novel approach aimed at addressing period poverty, inequity, and inadequate menstrual health education in the United States. OBJECTIVES: This paper aims to examine the development, organization, and implementation of two distinct period product pantry networks in Ohio and New York. It seeks to compare the advantages and challenges of grassroots versus nonprofit-led models and to provide practical insights for future pantry operators. DESIGN: The study examines two models of period product pantries: a grassroots effort led by three local residents in Ohio and an initiative spearheaded by a nonprofit organization in New York. The design includes a comparative analysis of both models' organization, funding methods, and operational structures. METHODS: The authors gathered data on the construction, operation, and usage of two pantry networks, focusing on factors such as accessibility, community engagement, and sustainability. The study employed a combination of qualitative methods, including interviews with organizers, and a review of organizational documents to analyze the effectiveness and scalability of each model. RESULTS: Both pantry networks increased accessibility to period products in low socioeconomic neighborhoods, which are disproportionately affected by period poverty. The grassroots model, while resource-limited, fostered strong community ties and local engagement. The nonprofit-led model benefited from dedicated staff and a more stable funding structure but faced bureaucratic challenges. Despite their differences, both models demonstrated the potential to empower menstruators by preserving their dignity and autonomy. CONCLUSIONS: Period product pantries represent an innovative and equitable approach to addressing period poverty and inequity. The analysis of the two models offers valuable insights for organizations and individuals interested in establishing similar initiatives. While each model has its unique benefits and challenges, both are effective in empowering menstruators and providing accessible menstrual hygiene products to those in need. REGISTRATION: Not applicable.

Fighting for menstrual equity through period product pantriesPeriod product pantries are a new way to help people who can't afford period products and don't have enough education about menstrual health in the U.S. Many people who experience period poverty, or trouble getting products like pads and tampons, also face barriers to staying clean and managing period waste. This can cause health issues like infections. About 42% of people who get periods in the U.S. say they've had trouble paying for these products. Period product pantries are different from older methods of getting free products, like through social services, because they let people get what they need without feeling embarrassed or losing their sense of control. This paper looks at two types of period pantries: one started by three local people in Ohio and another run by a nonprofit group in New York. Both help people in neighborhoods where it's hard to afford period products. The paper talks about how these pantries were set up, how they are funded, and what worked well or didn't. The goal is to show how these pantries can be a good, fair way to help people while giving advice to others who might want to start their own pantries.

Parent-adolescent communication on sexual and reproductive health issues and associated factors among secondary public-school students in Gondar town, northwest Ethiopia: an institution based cross-sectional study.

Introduction: Effective communication between adolescents and their parents is crucial for reducing sexual health problems. This open dialogue can help address misconceptions, provide accurate information, and foster a supportive environment where adolescents feel comfortable seeking guidance and discussing sensitive issues related to their sexual health. In Ethiopia, with its diverse ethnic and cultural background, effective communication between parents and adolescents about sexual and reproductive health (SRH) is crucial in reducing the likelihood of adolescents engaging in risky sexual behaviors. Despite the importance of such communications, there were no data showing the level of parent-adolescent communication (PAC) in secondary public schools in Gondar town. Therefore, this study aimed to determine the level of parent-adolescent communication on sexual and reproductive health issues along with its influencing factors, among secondary students in Gondar town, northwest Ethiopia. Methods: We employed an institution-based cross-sectional study design. A total of 424 students were recruited using a systematic random sampling technique, with a 100% response rate. We developed a structured questionnaire from the related literature to collect data from the participants of the study. The data were entered using EpiData version 4.6, and analyzed using SPSS version 25. A binary logistic regression model was fitted to identify associated factors. Results: The proportion of adolescents who had communicated with their parents was 37.7% (95% CI: 34.65-44.76). In a multivariable analysis at a 95% confidence interval (CI), variables such as being female (adjusted odds ratio (AOR) = 2.23; 95% CI: 1.09-7.45), belonging to grades 11-12 (AOR = 1.25; 95% CI: 1.19-6.98), living with parents/caregivers (AOR = 1.26; 95% CI: 1.07-5.66), having a positive attitude toward sexual health (AOR = 2.4; 95% CI: 1.34-7.82), having poor knowledge about SRH issues (AOR = 1.23; 95% CI: 1.04-7.81), and having good knowledge about the puberty period (AOR=1.23; 95% CI:1.04-7.89) were statistically associated with parent-adolescent communication. Conclusion and recommendations: This study found a low level of communication between parents and adolescents regarding sexual and reproductive health (SRH) issues. To address this challenge, it is crucial to implement evidence-based education on SRH topics, such as consent, healthy relationships, communication skills, STDs, contraception, and interpersonal dynamics. Enhancing parent-adolescent dialogue on SRH can be achieved by implementing peer education among senior students and training teachers in effective communication techniques. The study also recommended conducting qualitative research to explore the specific barriers affecting parent-adolescent communication.

Association between Serum Glycated Hemoglobin Levels and Female Infertility: A Cross-Sectional Survey and Genetic Approach.

Female infertility affects a significant portion of the population, and recent studies suggest a potential link between glycemic control and reproductive health. This study investigates the association between serum glycated hemoglobin (HbA1c) levels and female infertility, utilizing data from the NHANES 2017-2020 and Mendelian randomization (MR) analysis. A cross-sectional study was conducted with 1578 women aged 20-45 who attempted pregnancy for at least one year. Serum HbA1c levels were analyzed in relation to infertility status, with multivariable logistic regression models adjusting for covariates such as age, body mass index, race/ethnicity, education, marital status, hypertension, and hyperlipidemia. Higher HbA1c levels were significantly associated with increased infertility risk. Each 1% increase in HbA1c was linked to higher odds of infertility (adjusted OR: 1.40, 95% CI: 1.15-1.69, p = 0.003). HbA1c levels ≥ 6.5% showed the strongest association. MR analysis employed single-nucleotide polymorphisms as instrumental variables to assess the causal relationship between HbA1c and infertility, confirming a causal relationship between higher genetically predicted HbA1c levels and infertility (OR: 1.82, 95% CI: 1.33-2.49, p = 0.00018). Sensitivity analyses supported the robustness of these findings. Elevated HbA1c levels are associated with an increased risk of female infertility, suggesting the importance of glycemic control in reproductive health management.

Sexual and Reproductive Health Rights and Service Use among Undocumented Migrants in the EU: A Systematic Literature Review.

Most EU member states fail to provide essential sexual and reproductive health services to undocumented migrants, a vulnerable population facing limited access, utilization, and worse health-related outcomes. This study systematically reviewed the literature on access to and use of these services, as well as related health, economic, and migratory outcomes for undocumented migrants in the EU-EFTA region. The systematic review is reported based on the PRISMA 2020 checklist and includes 37 studies published between 2017 and 2024. Included studies were based upon original quantitative, qualitative, or mixed-methods data; conducted in one or more European countries; and published in one or more of the following languages: English, Spanish, French, Portuguese, or Romanian. A quality assessment was conducted using the CASP checklist for qualitative studies and the NHLBI Study Quality Assessment Tools for quantitative studies. The findings revealed numerous access barriers, including refusal of care, lack of knowledge about national healthcare schemes, bureaucratic hurdles, and affordability issues. Even when care was available, stigma, fear of deportation, socio-economic precarity, and abuse further hindered utilization. These barriers contributed to generally worse reproductive health outcomes for undocumented migrants in Europe, though the findings may not generalize to all EU-EFTA countries.

Knowledge and practice of health workers on sexual and reproductive health and rights and gender-based violence: Evidence from three municipalities in Senegal.

Adolescents in low- and middle-income countries face numerous developmental, sexual and reproductive health (SRHR) challenges, including exposure to multidimensional violence. Dealing with gender-based violence (GBV) is of great importance and health personnel are key players. The objective of this work was to study the knowledge and practices of health personnel on SRHR and gender-based violence in Guédiawaye, Kaolack and Kolda communities in Senegal. A descriptive and analytical cross-sectional study was conducted, which consisted of health professionals (general practitioners and specialists, nurses, and midwives) and community health workers (community relays, bajenu gox, matrons). All health facilities in the three communities were included. Data analysis consisted of univariate analysis and logistic regression modeling to investigate the factors associated with the knowledge and practice of health personnels. An alpha risk of 5% was taken. A total of 78 health professionals and 128 community actors were included in the study. More than half of the health personnel (56.3%) had good knowledge of policies, standards and protocols relating to sexual and reproductive health services for women (adolescents) and about 60% on conventions and laws. The level of knowledge was good among 51% of respondents and good practices among 54.9%. The factors associated with good knowledge were the municipality in which the profession was practiced, and the effects of training received in the social construction of gender. The factors associated with the practices were knowledge of policies, standards and protocols through training, training received in the provision of family planning services, and in medico-psychosocial management of cases of sexual violence. We conclude that the knowledge of stakeholders (health professionals and community health workers) about sexual and reproductive health and gender-based violence is important for better service provision and good management of cases of gender based violence.

Les adolescents des pays à revenu faible et moyen (PRFM) sont confrontés à de nombreux défis en matière de développement, de santé sexuelle et reproductive (SSR), notamment l'exposition à une violence multidimensionnelle. La prise en charge des violences de genre est d'une grande importance et le personnel de santé en constituent des acteurs clés. L'objectif de ce travail était d'étudier les connaissances et les pratiques du personnel de santé sur la santé sexuelle et reproductive (SSR) et les violences basées sur le genre dans les communes de Guédiawaye, Kaolack et Kolda au Sénégal. Une étude transversale descriptive et analytique a été menée. La population était constituée des professionnels de santé (médecins généralistes et spécialistes, infirmiers, sages-femmes) et des agents de santé communautaires (relais communautaires, bajénu gox, matrones). L'ensemble des structures de santé des trois communes ont été inclus avec un choix raisonné des cibles. Une analyse univariée une modélisation par une régression logistique a été effectuée pour rechercher les facteurs associés à la connaissance et la pratique du personnel de santé. Un risque alpha de 5% a été pris. Au total 78 professionnels de santé et 128 acteurs communautaires ont été inclus dans cette étude. Plus de la moitié du personnel de santé (56,3%) avaient une bonne connaissance des politiques, normes et protocoles (PNP) des services de santé sexuelle et reproductive des femmes (adolescentes) et environ 60% sur les conventions et Lois. Le niveau de connaissance était bon chez 51% des enquêtés et les pratiques bonnes chez 54,9%. Les facteurs associés à la bonne connaissance étaient la commune d'exercice de la profession, le fait de bénéficier d'une formation en construction sociale du genre. Les facteurs associés aux pratiques étaient la connaissance des PNP à travers la formation, les formations reçues en offre de services PF et contraception d'urgence, en prise en charge médico-psychosociale des cas de violences sexuelles. En conclusion, la connaissance des acteurs (professionnels de santé, agents de sante communautaires) sur la santé sexuelle et reproductive et les violences basées sur le genre est importante pour une meilleure offre de service et une bonne prise en charge des cas de violences. (Afr J Reprod Health 2024; 28 [8s]: 163-175).

Gender-based violence and sexual and reproductive health and rights of adolescent girls in Senegal: an analysis of social control practices.

This article problematizes gender-based violence (GBV) as a social practice and explains its role as a social mechanism for controlling bodies. Based on a mixed methodological approach (combining questionnaires, qualitative interviews, focus groups, and participant observation) targeting both adolescent girls and community actors, this study reveals forms of GBV that are little explored among the adolescent population. Social practices, such as "nëpp nëppël" or the culture of silence, frequently conceal GBV within families, hindering reporting and thus limiting adolescents' access to sexual and reproductive health and rights (SRHR) services and influencing their limited knowledge of SRHR. Shelter centres, such as Kullimaaroo, are crucially important in this context by providing holistic support to victims of GBV, but such structures are rare in Senegal. We conclude that it is necessary to adopt a holistic approach taking into account social practices to address the complex relationship between GBV and SRHR among adolescents in Senegal.

Cet article problématise les violences basées sur le genre (VBG) comme des pratiques sociales et explicite leur rôle de mécanisme social de contrôle des corps. Basé sur une approche méthodologique mixte (associant des questionnaires, des entretiens qualitatifs, des focus-group, de l'observation participante, etc.) ciblant à la fois les adolescentes et les acteurs communautaires, cette enquête révèle des formes de VBG peu explorées chez la population adolescente. Les pratiques sociales, comme le "nëpp nëppël" ou la culture du silence, dissimulent fréquemment ces VBG au sein des familles, entravant la dénonciation et limitant ainsi leur accès aux services de santé sexuelle et reproductive (SSR) et influençant leurs connaissances limitées en SSR. Les centres d'hébergement, tels que Kullimaaroo, revêtent une importance cruciale dans ce contexte en fournissant un soutien holistique aux victimes de VBG, mais ces structures restent rares au Sénégal. Il est nécessaire d'adopter une approche holistique prenant en compte les pratiques sociales pour traiter les enjeux complexes de l'articulation entre les VBG et la SSR chez les adolescentes, un domaine actuellement insuffisamment documenté.

Sexual and Reproductive Health Goals and the 2030 Global Agenda for Sustainable Development: Progress, Prospects, and Challenges.

Today it is globally recognized that sexual and reproductive health is a human rights issue critical to economic growth and stability, ending poverty, and fostering sustainable development. Calls for improving sexual and reproductive health, including a spotlight on adolescents and young women, are highlighted in the Sustainable Development Goals (SDGs) adopted by the United Nations in 2015. In this commentary, we aim to (1) briefly review the history and objectives of global development goals (2) review the adolescent health related SDG targets and indicators with focus on sexual and reproductive health (3) discuss global progress and challenges in achieving target measures and (4) examine action steps that clinicians can take to accelerate progress.

User experiences of selfcare interventions for sexual and reproductive health services in community pharmacies in Rwanda: A qualitative study.

Self-care interventions for sexual and reproductive health (SRH) empower individuals to autonomously access services, reducing their reliance on traditional healthcare settings. However, there is limited knowledge about community pharmacy-based SRH services in Rwanda. Therefore, this study aims to explore the experiences of community pharmacy-based SRH users and inform strategies to enhance service delivery effectiveness. This study employed a qualitative research approach employing a phenomenological design. Semi-structured in-depth interviews were conducted with 22 participants from 1st June 2023 to 20th March 2024, in 5 Districts of Rwanda. Participants were recruited using purposive sampling methods. The interviews were recorded, transcribed, and imported into NVivo 11 software for further analysis. Users of pharmacy-based SRH products intended for self-care interventions reported positive experiences. Three main themes emerged from the interviews: community pharmacies ensured the utmost confidentiality, provided fast service delivery with minimal procedures, and expressed user satisfaction with friendly communication. Users of community pharmacy-based SRH services intended for self-care use reported positive experiences with community pharmacies. They received the needed confidentiality, faster service delivery, and friendly communication with community pharmacists. There is a pressing need for close collaboration among the public, private, and stakeholders to empower citizens over their SRH.

Reproductive health needs of HIV serodiscordant couples: a systematic review.

Objectives: HIV is closely linked to reproductive and sexual health. HIV Serodiscordant couples face significant social, reproductive, and sexual challenges. This systematic review aimed to identify their reproductive health needs. Methods: A comprehensive literature search was conducted across six databases: Scopus, PubMed, Web of Science, Google Scholar, Magiran, and Iranmedex. No date restrictions were applied, and only English-language articles published before February 21, 2023, were included. We also searched the grey literature and conducted forward/backward citation searches. Results: From an initial 758 articles, 18 met the inclusion criteria. Studies were qualitative (n = 10) and quantitative (n = 8). Key reproductive health needs included (1) childbearing intention, (2) HIV serodiscordance and sexuality, (3) psychological and social support, (4) training and consultation services, (5) access to reliable information, and (6) focused training for healthcare providers. Conclusion: HIV-discordant couples face various reproductive health challenges. Implementing comprehensive guidelines for reproductive and sexual health, rehabilitation, and fertility planning is crucial to improving their quality of life and health. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023393567.

Sexual and reproductive health focus group discussions with Syrian men and women living as refugees in the Bekaa Valley, Lebanon.

Background: Conflict in Syria since 2011 led to over one million Syrians fleeing to Lebanon, predominantly from economically disadvantaged areas with low literacy and high child marriage rates. Over 90% live in extreme poverty, in informal tented settlements with minimal access to education, healthcare or employment. Displacement and poverty have further increased early marriages and unplanned pregnancies, and curtailed access to sexual and reproductive healthcare (SRH) in the Bekaa valley. This is exacerbated by increasing rates of sexual and gender-based violence (SGBV), intimate partner violence and domestic violence. Study design: We aimed to explore SRH beliefs and practices and teach on key SRH topics through focus group discussions (FGD) and questionnaires, co-designed with Syrian practitioners, conducted with Syrian men and women. FGD were recorded, transcribed and thematically analysed. Questionnaires collected demographics and explored SRH beliefs and practices. Findings: 24 FGD with 203 participants, 72.4% female and 27.6% men. 90.1% participants were married with an average age-gap of 6.3 years between partners. Teenage marriage rates were 55.6% for women, and 47.4% delivered their first child before the age of 20. 43.6% participants were not using any contraception. Findings demonstrate the impacts of SRH cultural norms and changes due to displacement, financial crisis, and increased exposure to technology and NGOs. Conclusions: SRH is multifaceted and contested, requiring systemic improvements in access to care, employment and education. This small but important proof-of-concept study demonstrates the possibility of engaging men and women in SRH discussion; paramount to empowering communities and challenging intergenerational SGBV.

Self-care for maternal and reproductive health in conflict settings: qualitative case study in Nuba Mountains, Sudan.

Introduction: Self-care is a critical component of Reproductive, Maternal, and Neonatal Health (RMNH), offering women the knowledge, skills, and autonomy needed for well-being throughout the reproductive cycle. This paper explores the significance of self-care in conflict-affected regions, where access to formal healthcare is limited. Such areas place pregnant women at higher risk due to increased incidents of adverse events during pregnancy and childbirth. Self-care interventions have the potential to enhance access to quality healthcare services. Methods: Employing a qualitative approach, this study explores RMNH self-care practices among pregnant and post-natal women in the Nuba Mountains. The methods included in-depth semi-structured interviews with 24 participants, comprising pregnant women, recent mothers, and healthcare providers. Purposive sampling was used to capture the experiences of mothers, and thematic analysis identified key patterns and themes in self-care practices. The perspectives of healthcare professionals were included to understand the context of RMNH care in conflict settings. Results: The study revealed the crucial role of community cohesion in providing emotional and practical support in pregnancy, childbirth, and in the post-natal period. Limited healthcare infrastructure and ongoing conflict-related challenges provided important drivers for self-care practices. A spectrum of self-care interventions ranged from personal hygiene practices to community-supported childbirth and postnatal care. Significant reliance on elder women's wisdom and traditional midwifery was observed, particularly in the absence of formal healthcare facilities. Some women moved to live with family close to the hospital in the weeks before their due dates in order to mitigate the risks of early deliveries, complications, or general insecurity in their home areas. Discussion: The findings present a compelling narrative of communal self-care, challenging the conventional notion of self-care as solely individualistic. In this setting, the community's role is fundamental, with knowledge sharing and mutual support forming the bedrock of maternal health practices. Elder women, embodying repositories of perceived traditional wisdom, emerge as central figures, guiding pregnant and postpartum women through shared experiences and practices. This collective approach is not merely a cultural characteristic but a necessity born out of the region's limited healthcare infrastructure and ongoing conflict. The study underscores the need to recognize and integrate these communal self-care strategies into broader health interventions.