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1.
BMJ Open ; 15(1): e086351, 2025 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-39880419

RESUMEN

OBJECTIVES: To explore the experiences and perspectives of female patients with autoimmune rheumatic diseases (ARDs) regarding sexual and reproductive health, including contraception, family planning, and pregnancy. DESIGN: Qualitative descriptive study using semi-structured interviews. SETTING: Specialised rheumatology clinic in a tertiary hospital in Monterrey, Mexico. PARTICIPANTS: 21 female patients aged 18-49 with a confirmed ARD diagnosis who were receiving care at the clinic. Participants were selected using convenience sampling, ensuring diversity in age, disease type and stage, socio-economic and cultural background, sexuality and disability status. All participants completed the study. RESULTS: Four main themes emerged from the analysis. First, participants expressed confusion and concern about the safety and effectiveness of contraceptive methods in the context of their disease and treatment. Second, many participants shared anxiety about infertility, heredity and the risks of pregnancy associated with their ARDs, leading to uncertainty in pregnancy planning. Third, there was concern about the safety of medications during pregnancy and breastfeeding, indicating a lack of guidance and information from healthcare providers. Lastly, patients often deferred decision-making about contraception and medication to their rheumatologists but recognised the importance of a multidisciplinary care approach for comprehensive sexual and reproductive health management. CONCLUSIONS: The study revealed that women with ARDs experience significant challenges and unmet needs related to sexual and reproductive health, particularly in understanding safe contraception, pregnancy planning and medication use during pregnancy and lactation. These findings emphasise the need for rheumatologists to provide clearer guidance on these issues and collaborate closely with gynaecologists and other specialists to ensure comprehensive, patient-centred care. Enhancing communication and education strategies in rheumatology consultations could address these gaps and improve the sexual and reproductive health outcomes and decision-making processes of women with ARDs.


Asunto(s)
Enfermedades Autoinmunes , Anticoncepción , Investigación Cualitativa , Salud Reproductiva , Enfermedades Reumáticas , Salud Sexual , Humanos , Femenino , México , Adulto , Enfermedades Reumáticas/psicología , Persona de Mediana Edad , Embarazo , Adulto Joven , Anticoncepción/métodos , Adolescente , Servicios de Planificación Familiar/métodos , Entrevistas como Asunto
2.
Glob Public Health ; 20(1): 2456476, 2025 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-39874080

RESUMEN

This article presents the results of a mapping and analysis of key stakeholders operating in the field of Sexual, Reproductive, and Maternal Health and Rights (SRMHR) who are involved in the entitlement of health rights and access to health services for women, adolescents, LGBTQI+ individuals, migrants, indigenous people, Afro-descendants, and people with disabilities in Latin America and the Caribbean. Our study focuses on Argentina, Colombia, Guatemala, Guyana, Jamaica, Mexico, and Peru. The primary objective was to identify and comprehensively categorise the activities undertaken by them, since their actions shape, and promote or hinder the SRMHR political agenda in the region. The findings of this mapping can be useful in contributing to the development of public policy strategies.


Asunto(s)
Accesibilidad a los Servicios de Salud , Humanos , América Latina , Región del Caribe , Femenino , Salud Materna , Salud Reproductiva , Derechos Humanos , Participación de los Interesados , Salud Sexual , Adolescente , Masculino
3.
PLoS One ; 19(12): e0309317, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39642192

RESUMEN

CONTEXT: Women and girls form a substantial proportion of the population of internally displaced people (IDP) in Nigeria, these vulnerable populations are at risk of sexual and reproductive health (SRH) rights violations and greater risk of unsafe abortion and high maternal deaths. IDP women's living conditions are often precarious, exposing them to health risks, challenges are often faced due to lack of finance and other related factors to access health care services leading to them improvising health care services which is considered dangerous to their health. There is a gap in the study regarding the SRH needs of the IDP women and the alternative they opt for in meeting their sexual needs. OBJECTIVE: This study explores the SRH needs, barriers and coping strategies of women of reproductive age in North Central IDP camps. DATA AND METHODS: A qualitative study was conducted between January 8th and February 28th, 2024, in 4 internally displaced camps in Abuja and Benue among women of reproductive age. Using a well-structured interview guide for an in-depth interview, 14 respondents were purposively selected for the study. The women were interviewed to provide insight into the SRH needs, coping strategies and barriers to utilizing SRH services in the selected camps. Data analysis was conducted using Nvivo version 11. RESULTS: The study revealed the SRH needs for specific family planning methods, free SRH services and antenatal facilities in the camp and the need for toilets. Without the SRH services women cope using herbs and concoctions, they also patronize traditional birth attendants and some of the barriers include finance, husbands' approval and distance to health facilities. CONCLUSION: In conclusion, women in the IDP camp have SRH needs that need to be met as their coping strategies are not adequate but could complicate their sexual health. It therefore recommended the government should provide adequate medical personnel in the camp for easy access to SRH services.


Asunto(s)
Adaptación Psicológica , Accesibilidad a los Servicios de Salud , Investigación Cualitativa , Refugiados , Salud Reproductiva , Humanos , Femenino , Nigeria , Adulto , Refugiados/psicología , Salud Sexual , Adulto Joven , Adolescente , Necesidades y Demandas de Servicios de Salud , Servicios de Salud Reproductiva , Persona de Mediana Edad , Habilidades de Afrontamiento
4.
Reprod Health ; 21(1): 187, 2024 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-39696444

RESUMEN

BACKGROUND: The effective attainment of sexual, reproductive, and maternal health and rights (SRMHR) requires a holistic life-course approach. This approach should address disparities in healthcare access and rights, guarantee the delivery of high-quality care devoid of discrimination, and underscore rigorous accountability mechanisms throughout the implementation process. Latin American and Caribbean (LAC) countries face significant disparities in SRMHR within and between nations. Vulnerable populations, such as indigenous communities, Afro-descendants, LGBTQI + population, persons with disabilities, older adults, and migrants, often endure discrimination and stigmatization, severely impacting their access to healthcare and health rights. This paper presents the findings from the qualitative component of a broader mixed-methods scoping study aimed at establishing a priority research agenda to address healthcare gaps affecting the SRMHR of vulnerable populations. The qualitative component focused on identifying key challenges hindering progress in SRMHR and access to health services for these populations in the LAC region, drawing on the perspectives of key informants at both regional and national levels. METHODS: Qualitative research approach employing semi-structured interviews with key informants. A purposive sample comprised of stakeholders from relevant regional organizations and local stakeholders in selected countries (Argentina, Colombia, Peru, Mexico, Guatemala, Jamaica, and Guyana), encompassing government representatives, civil organizations, and academia. A rapid content thematic analysis was conducted to analyze the data obtained from the interviews. RESULTS: We interviewed 27 key informants in SRMHR, six at a regional level and 21 at a country level. The region faces barriers around establishing and sustaining agency agendas, such as a lack of political will, political instability, and opposition from civil society groups regarding SRMHR agendas. Policy implementation presents difficulties due to insufficient and unstable funding, weaknesses in sexual and reproductive health programs, unequal policy implementation in federal countries, and the absence of evidence-based policies. The lack of high-quality data and quality indicators poses obstacles, leading to limitations in evidence generation. Access to SRMHR services faces barriers such as the low-quality provision of services, discrepancies between legislation and effective access, insufficient healthcare resources, and resistance from certain healthcare providers. CONCLUSION: Addressing these multifaceted challenges will be crucial in advancing the agenda of sexual, reproductive, and maternal health rights and ensuring effective access to health services for the most vulnerable populations in the LAC region.


Asunto(s)
Accesibilidad a los Servicios de Salud , Investigación Cualitativa , Salud Reproductiva , Salud Sexual , Humanos , América Latina , Femenino , Disparidades en Atención de Salud , Servicios de Salud Reproductiva/organización & administración , Servicios de Salud Reproductiva/normas , Masculino , Poblaciones Vulnerables
5.
Rev Esc Enferm USP ; 58: e20240162, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39625238

RESUMEN

OBJECTIVE: To analyze nursing mothers' social representations of sexuality in the breastfeeding context and their repercussions in sexual and reproductive health. METHOD: An exploratory study grounded on the Theory of Social Representations and conducted in a Human Milk Bank from northern Brazil with 110 nursing mothers, following the Free Word Association Technique. Data were analyzed by means of Correspondence Factor Analysis in the software Tri- Deux-Mots 5.1. RESULTS: Sexual intercourse was the significant expression of sexualities, reflected in the representation of this phenomenon in breastfeeding, anchored in cultural gender relations; meanwhile, the search for sexual desire and pleasure connected to the ideal of romantic love arises. The bodily and daily changes inherent to this period take on an unfavorable connotation and become naturalized over time, negatively influencing nursing mothers' sexual and reproductive health. CONCLUSION: Understanding sexuality/sexualities in the breastfeeding context can support Nursing and Health care models in line with the social experiences and thoughts of the different groups of nursing mothers.


Asunto(s)
Lactancia Materna , Madres , Humanos , Lactancia Materna/psicología , Femenino , Adulto , Madres/psicología , Brasil , Sexualidad/psicología , Adulto Joven , Análisis Factorial , Salud Reproductiva , Conducta Sexual/psicología
6.
Artículo en Español | LILACS, BNUY, UY-BNMED | ID: biblio-1581636

RESUMEN

En mujeres privadas de libertad de Uruguay existe un déficit asistencial en Salud Sexual y Reproductiva. El objetivo del estudio es mejorar el ejercicio de los Derechos Sexuales y Reproductivos en mujeres privadas de libertad, brindando acceso a servicios ginecológicos integrales dentro de las cárceles. Estudio descriptivo retrospectivo, se incluyeron todas las mujeres privadas de libertad en cárceles uruguayas. La intervención consistió en una consulta clínica ginecológica integral, se abordaron aspectos de salud sexual y reproductiva con diagnóstico y tratamiento. Las consultas se realizaron en cárceles de Montevideo e interior. Se realizó la consulta clínica a 513 mujeres privadas de libertad (83% del total) en 800hs de atención médica y 640hs de gestión, con participación de 52 profesionales médicos. Se realizaron 401 colpocitologías oncológicas, 74 patológicas (18%). Se realizaron 108 Test Virus Papiloma Humano, 16 positivos para Alto Riesgo oncogénico (14%). Se realizaron 103 colposcopías y detectando 11 lesiones escamosas de alto grado, realizándose tratamiento quirúrgico. En anticoncepción se realizaron acciones específicas en 166 pacientes: 55 implantes subdérmicos; 27 Dispositivos Intrauterinos, 62 anticonceptivos orales y 23 inyectables. En 61 mujeres se brindaron preservativos masculinos y femeninos. Se desarrolló una intervención en salud sexual y reproductiva al 83% de las mujeres privadas de libertad de Uruguay con especial abordaje en prevención del cancer genitomamario y anticoncepción. Puede ser un insumo para el desarrollo de políticas públicas en esta población.


Incarcerated women in Uruguay face a healthcare deficit in Sexual and Reproductive Health. The study's objective is to improve the exercise of Sexual and Reproductive Rights for incarcerated women by providing access to comprehensive gynecological services within prisons. This is a descriptive retrospective study. The target population was all incarcerated women in Uruguayan prisons. The intervention consisted of a comprehensive gynecological clinical consultation, addressing aspects of sexual and reproductive health with diagnosis and treatment. Consultations were conducted in prisons in Montevideo and other regions. Clinical consultations were conducted for 513 incarcerated women (83% of the total) over 800 hours of medical attention and 640 hours of management, with the participation of 52 medical professionals. A total of 401 oncological colpocytologies were performed, 74 of which were pathological (18%). Additionally, 108 Human Papillomavirus (HPV) tests were conducted, with 16 testing positive for high oncogenic risk (14%). 103 colposcopies were performed, detecting 11 high-grade squamous lesions, which were subsequently treated surgically. Specific contraception actions were taken for 166 patients: 55 subdermal implants, 27 intrauterine devices, 62 oral contraceptives, and 23 injectable contraceptives. Male and female condoms were provided to 61 women. A sexual and reproductive health intervention was developed for 83% of incarcerated women in Uruguay, with a special focus on the prevention of genital and breast cancer and contraception. This initiative can serve as a resource for the development of public policies targeting this population.


Mulheres privadas de liberdade no Uruguai enfrentam um déficit de assistência em Saúde Sexual e Reprodutiva. O objetivo do estudo é melhorar o exercício dos Direitos Sexuais e Reprodutivos em mulheres privadas de liberdade, proporcionando acesso a serviços ginecológicos integrales dentro das prisões. Estudo descritivo retrospectivo. A população-alvo foram todas as mulheres privadas de liberdade nas prisões uruguaias. A intervenção consistiu em uma consulta clínica ginecológica integral, abordando aspectos de saúde sexual e reprodutiva com diagnóstico e tratamento. As consultas foram realizadas em prisões de Montevidéu e do interior. Realizou-se a consulta clínica a 513 mulheres privadas de liberdade (83% do total) em 800 horas de atendimento médico e 640 horas de gestão, com a participação de 52 profissionais médicos. Foram realizadas 401 colpocitologias oncológicas, 74 patológicas (18%). Foram realizados 108 Testes de Vírus do Papiloma Humano, com 16 positivos para Alto Risco oncogênico (14%). Foram realizadas 103 colposcopias, detectando 11 lesões escamosas de alto grau, sendo realizado tratamento cirúrgico. Em anticoncepção, realizaram-se ações específicas em 166 pacientes: 55 implantes subdérmicos; 27 Dispositivos Intrauterinos, 62 anticoncepcionais orais e 23 injetáveis. Para 61 mulheres foram fornecidos preservativos masculinos e femininos. Foi desenvolvida uma intervenção em saúde sexual e reprodutiva para 83% das mulheres privadas de liberdade no Uruguai, com foco especial na prevenção do câncer genitomamário e na contracepção. Esta iniciativa pode servir como um recurso para o desenvolvimento de políticas públicas voltadas para essa população.


Asunto(s)
Humanos , Prisioneros , Neoplasias de la Mama/prevención & control , Anticoncepción , Neoplasias de los Genitales Femeninos/prevención & control , Uruguay , Salud Reproductiva/estadística & datos numéricos , Salud Sexual/estadística & datos numéricos
7.
Arch Med Res ; 55(8): 103102, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-39454469

RESUMEN

Prolactin (PRL) is a polypeptide hormone produced by the lactotrope cells of the anterior pituitary gland. Among its myriads of biological functions, PRL is the main regulator of mammary gland growth and development, as well as of the production and secretion of milk. Hyperprolactinemia represents a frequent consultation cause in medical practice. Nevertheless, elevations in serum PRL are not always pathological. Drug induced hyperprolactinemia is the most common cause, mainly by antipsychotics, followed by other causes such as pituitary neuroendocrine tumors, physiologic conditions, and systemic diseases such as chronic kidney disease and hypothyroidism. When evaluating a patient with hyperprolactinemia it is of utmost importance to consider the diverse etiologies of this condition in order to avoid unnecessary diagnostic workup and treatment. Regarding reproductive health, hyperprolactinemia is a well-documented cause of infertility, as approximately 15-20% of women undergoing infertility evaluation have hyperprolactinemia, which causes secondary amenorrhea, and other menstrual irregularities. Similarly, in men it is a cause of hypogonadism.


Asunto(s)
Hiperprolactinemia , Prolactina , Salud Reproductiva , Humanos , Hiperprolactinemia/etiología , Hiperprolactinemia/diagnóstico , Femenino , Prolactina/metabolismo , Prolactina/sangre , Masculino , Hipogonadismo/etiología , Antipsicóticos/efectos adversos , Antipsicóticos/uso terapéutico , Neoplasias Hipofisarias/complicaciones , Infertilidad/etiología
8.
PLoS One ; 19(8): e0305831, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39186754

RESUMEN

BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease with worldwide representation that impacts every domain of a patient´s life, extending to sexual and reproductive domains. The study characterized sexual health (SH) and reproductive health (RH) in Mexican RA outpatients and identified factors associated with impaired sexual function (ISF). METHODS: From September 1, 2020-January 31, 2022, consecutive RA participants had semi-structured interviews focusing on their SH and RH biographies, and self-administered questionnaires were applied to assess patient-reported outcomes, including fatigue with the Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F). ISF was defined based on published cut-offs of the International Index of Erectile Function (IIEF) in males and the Female Sexual Function Index (FSFI) in females (≥1 sexual intercourse in the last four weeks was required for index scoring). Multivariable logistic regression analysis was used to identify the factors associated with ISF. RESULTS: There were 268 participants, and 246 (91.8%) were females. Participants had 13 years of disease duration. Among females, 151 (61.4%) had FSFI applied, and the satisfaction domain was impaired in 111 (73.5%). Among males (N = 22), 17 (77.3%) had IIEF applied, and erectile dysfunction was present in 5 (29.4%). Almost half of the participants denied using a family planning method, were in their 50s, and receiving teratogenic drugs; 89.7% of the participants had children. ISF was detected in 94 (62.3%) females and 3 (17.6%) males. Male sex (aOR: 0.07, 95%CI: 0.01-0.36, p = 0.001), FACIT-F score (aOR: 0.96, 95%CI: 0.92-1.00, p = 0.03), and cohabitation with the couple (aOR: 0.32, 95%CI: 0.11-0.96, p = 0.04) were associated with ISF. CONCLUSIONS: We observed a disproportionate burden of ISF among women with RA compared to male participants. Male sex, lesser fatigue, and cohabitation with the couple were protective against ISF. Regardless of the prevalent use of teratogenic medications, contraceptive use was suboptimal among the participants.


Asunto(s)
Artritis Reumatoide , Disfunciones Sexuales Fisiológicas , Humanos , Artritis Reumatoide/psicología , Artritis Reumatoide/fisiopatología , Artritis Reumatoide/complicaciones , Masculino , Femenino , México/epidemiología , Persona de Mediana Edad , Adulto , Disfunciones Sexuales Fisiológicas/epidemiología , Salud Sexual , Encuestas y Cuestionarios , Salud Reproductiva , Fatiga/epidemiología , Fatiga/psicología , Anciano
9.
Lima; Perú. Ministerio de Salud. Dirección General de Intervenciones Estratégicas en Salud Pública. Dirección de Salud Sexual Y Reproductiva; 1 ed; Ago. 2024. 81 p. ilus.
Monografía en Español | MINSAPERÚ, LILACS, LIPECS | ID: biblio-1570436

RESUMEN

La presente publicación describe las pautas para formular, planear, dirigir, coordinar, ejecutar la política sectorial para la prevención y control del VIH-SIDA, enfermedades de transmisión sexual y hepatitis; detalla las normas y lineamientos técnicos para la adecuada ejecución y supervisión de las políticas nacionales y sectoriales, seguimiento y evaluación de las políticas planes y programas orientadas al cumplimiento de la atención integral de salud de las personas afectadas por VIH, Infecciones de Transmisión Sexual y hepatitis mediante las intervenciones de promoción, prevención, manejo clínico y soporte; con enfoque salubrista y basado en género e interculturalidad. Asimismo, en su contexto las pautas para su difusión y homogenización de criterios en la recopilación y codificación de diagnósticos CIE 10 y Catálogo de procedimientos médicos y estomatológicos del Ministerio de Salud


Asunto(s)
Humanos , Adolescente , Adulto , Persona de Mediana Edad , Servicios Preventivos de Salud , Sistema de Registros , Clasificación Internacional de Enfermedades , Sistemas de Registros Médicos Computarizados , Salud Reproductiva
11.
Lima; Perú. Instituto Nacional de Estadística e Informática; 1 ed; Jul. 2024. 379 p. ilus.
Monografía en Español | MINSAPERÚ, LIPECS | ID: biblio-1586042

RESUMEN

El presente documento contiene doce capítulos y tres apéndices. En cada capítulo se presentan gráficos de los indicadores principales con sus respectivos análisis descriptivos. Se trata así, de las características de las viviendas y de la población, el nivel de fecundidad, la situación de la salud reproductiva y preferencias de fecundidad, asimismo la atención durante el embarazo, parto y postparto. También, destacan aspectos relacionados con las inmunizaciones de niñas y niños, cuya metodología del cálculo- de los indicadores de vacunas- está actualizada según lo plasmado en el Esquema Nacional de Vacunación vigente (RM Nº719-2018/MINSA, que aprueba la NTS nº141-MINSA/2018/DGIESP). En el noveno capitulo, se analiza aspectos relacionados a la lactancia, nutrición de niñas, niños y nutrición de mujeres, así como el Desarrollo Infantil Temprano (DIT). Igualmente se analiza el conocimiento de las mujeres en edad fértil sobre el VIH/SIDA y de las Infecciones de Transmisión Sexual (ITS). El penúltimo capítulo aborda los episodios de violencia familiar contra las mujeres, niñas y niños. El último capítulo muestra los indicadores contemplados en los Objetivos de Desarrollo Sostenible (ODS). Los Apéndices A, B, y C, se refieren respectivamente al diseño y cobertura de la muestra; errores de muestreo y calidad de la información


Asunto(s)
Humanos , Desarrollo Infantil , Demografía , Estadísticas Vitales , Violencia Doméstica , Encuestas de Atención de la Salud , Salud Reproductiva , Desarrollo Sostenible
12.
Rev Gaucha Enferm ; 45: e20230121, 2024.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-38922231

RESUMEN

OBJECTIVE: To analyze the content published in the Proceedings of the 71st Brazilian Nursing Congress and the 20th National Research Seminar in the field of sexual and reproductive health. METHOD: Qualitative, descriptive study, whose data sources were the annalsof two 2019 events that were related to Sexual and Reproductive Health. Content analysis and lexical typology were carried out with the aid of the IRAMUTEq® software. RESULTS: In a universe of 3,433 abstracts, 603 were analyzed and showed a higher prevalence of qualitative studies and experience reports, focusing on the maternal-child area and on the pathologizing and medicalizing processes of women's health, with incipient use of software in the analysis. However, there were signs of health promotion and humanized care. CONCLUSION: The dissemination of studies in the field of sexual and Reproductive Health seems to be in a conflict between accommodation and resistance, at the same time that it maintains old imperatives of the hegemonic domain, seeking to overcome them with new methodologies and care based on integrality and equity.


Asunto(s)
Salud Reproductiva , Salud Sexual , Brasil , Humanos , Congresos como Asunto , Femenino , Investigación Cualitativa , Edición
13.
PLoS One ; 19(6): e0304659, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38923959

RESUMEN

INTRODUCTION: Peer-reviewed literature is commonly used to assess academic progress and research excellency. However, representation in authorship of global health publications is biased and unfair. In order to shed light on current gaps towards attaining gender equality in scientific production and shift power asymmetries in global health research, we conducted an assessment of authorship trends from 1972 to 2021 with a focus on gender and geographic representation in scientific articles authored or co-authored by researchers affiliated with UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP). METHODS: We searched PubMed, Web of Science, and HRP public reports for publications where at least one author was affiliated with HRP. Our main outcome measures were author gender and location of author affiliation, classified by region and country income group. We used descriptive statistics to characterize the publications under analysis as well as the total number of authors from the included papers. We applied a logistic regression model to explore associations between author gender and other characteristics of published articles and a time series analysis to assess how time can influence the inclusion of women as authors in a publication. Python and R were used for all analyses. RESULTS: A total of 1,484 publications with 14,424 listed authors representing 5,950 unique authors were included in our analysis: 42.5% were female, 35.1% male, and 22.4% unknown (p<0.0001). First authorship was more likely female (56.9%) and from a high-income country (74.6%, p<0.0001) while last authorship was mostly male (53.7%) also from a high-income country (82.5%, p<0.0001). Females more frequently published papers using qualitative data (61.4%) and reviews/estimates (59.4%) while men published more case control (70.7%) and randomised controlled studies (53.0%), p<0.0001. The adjusted odds of there being a female author increased 4% for every additional year that passed. CONCLUSION: While there are more females authoring articles as compared to the past, they are still lagging behind with regards to seniority and prestige. Likewise, female representation is closely tied to what institution they are affiliated with and where that institution is located. Global health research institutions need to actively promote change by ensuring women are included in research and research outputs, giving them opportunities to lead.


Asunto(s)
Autoria , Publicaciones , Salud Reproductiva , Humanos , Femenino , Masculino , Salud Reproductiva/estadística & datos numéricos , Publicaciones/estadística & datos numéricos , Salud Sexual , Salud Global
14.
Rev. Enferm. Cent.-Oeste Min. ; 14: 4886, jun. 2024.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1579552

RESUMEN

Objetivo: Identificar as ações de assistência à concepção na Atenção Primária à Saúde. Método: Estudo qualitativo, realizado com 30 médicos e 50 enfermeiros de equipes da estratégia de saúde da família. Os dados foram interpretados segundo a análise de conteúdo e à luz da literatura especializada. Resultados:Destacam-se entre as orientações oferecidas ao público: a identificação do período fértil, recomendações sobre a frequência de práticas sexuais, prescrição de ácido fólico preventivo e anamnese limitada à história de vida sexual da mulher. Em casos mais complexos, é realizado o encaminhamento para outro nível de atenção à saúde, por exemplo, a consulta especializada de ginecologia, por falta de serviço de referência para infertilidade. Conclusão:as ações incipientes realizadas pelos profissionais na abordagem clínica e na gestão dos serviços não vão ao encontro da recomendação de documentos ministeriais


Objective: Identify conception assistance actions in Primary Health Care. Method: Qualitative study, carried out with 30 doctors and 50 nurses from family health strategy teams. Data were interpreted according to content analysis and in the light of specialized literature. Results: Among the guidelines offered to the public, the following stand out: the identification of the fertile period, recommendations on the frequency of sexual practices, preventive folic acid prescription and anamnesis limited to the woman's sexual life history. In more complex cases, referrals are made to another level of health care, for example, a specialized gynecology consultation, due to the lack of a reference service for infertility. Final remarks: the incipient actions carried out by professionals in the clinical approach and in the management of services are not in accordance with the recommendation of ministerial documents.


Objetivo: Identificar acciones de asistencia a la concepción en la Atención Primaria de Salud. Método: Estudio cualitativo, realizado con 30 médicos y 50 enfermeros de equipos de estrategia de salud de la familia. Los datos fueron interpretados de acuerdo con el análisis de contenido ya la luz de la literatura especializada. Resultados: Entre las orientaciones ofrecidas al público, se destacan: la identificación del período fértil, recomendaciones sobre la frecuencia de las prácticas sexuales, prescripción preventiva de ácido fólico y anamnesis limitada a la historia de vida sexual de la mujer. En casos más complejos, se derivan a otro nivel de atención de la salud, por ejemplo, una consulta especializada de ginecología, debido a la falta de un servicio de referencia para la infertilidad. Conclusión: las incipientes actuaciones realizadas por los profesionales en el abordaje clínico y en la gestión de los servicios no se ajustan a las recomendaciones de los documentos ministeriales


Asunto(s)
Humanos , Atención Primaria de Salud , Reproducción , Atención a la Salud , Derechos Sexuales y Reproductivos , Salud Reproductiva
15.
Artículo en Inglés | PAHO-IRIS | ID: phr-60079

RESUMEN

[ABSTRACT]. Objective. To assess changes in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) in Haiti from August 2018 to September 2021, before and during the COVID-19 pandemic. Methods. A retrospective study using surveillance data from the Haitian Unique Health Information System, examining two periods: pre- and peri-COVID-19 pandemic. Health indicators at the national level in the two periods were compared using two-sample t-tests for proportions, and average absolute monthly changes were calculated using variance-weighted regression. Results. There was a statistically significant decline in the proportion of most of the indicators assessed from the pre- to the peri-COVID-19 pandemic period. However, the most affected indicators were the proportions of pregnant women with four antenatal care visits, with five antenatal care visits or more, and those who received a second dose of tetanus vaccine, which decreased by over 4 percentage points during the two periods. Likewise, the proportions of children who received diphtheria, tetanus, and pertussis (DTaP), BCG, polio, pentavalent, and rotavirus vaccines also all declined by over 8 percentage points. In contrast, pneu- mococcal conjugate vaccine increased by over 4 percentage points. A statistically significant decrease was also observed in the average absolute monthly changes of several reproductive and child health indicators assessed. Conclusions. The COVID-19 pandemic may have contributed to the decline observed in several RMNCAH indicators in Haiti. However, the role played by the sociopolitical crisis and control exercised by armed groups over the population in the last three years cannot be ruled out.


[RESUMEN]. Objetivo. Evaluar los cambios en materia de salud reproductiva, materna, neonatal, infantil y adolescente que se produjeron en Haití desde agosto del 2018 hasta septiembre del 2021, antes de la pandemia de COVID-19 y durante ella. Metodología. Estudio retrospectivo basado en datos de vigilancia del sistema único de información de salud de Haití para estudiar los periodos pre y peripandémico. La comparación de los indicadores de salud a nivel nacional de estos dos periodos se realizó mediante pruebas de t de dos muestras para comparar proporciones, y se calculó el promedio de la variación mensual absoluta mediante una regresión ponderada por la varianza. Resultados. Al comparar el periodo prepandémico con el peripandémico, se observó un descenso estadísticamente significativo de la mayoría de los indicadores porcentuales evaluados. Sin embargo, los indicadores porcentuales más afectados fueron los de mujeres embarazadas con cuatro visitas de atención prenatal, con cinco visitas de atención prenatal o más, o que recibieron una segunda dosis de la vacuna contra el tétanos; estos indicadores disminuyeron en más de cuatro puntos porcentuales en el segundo periodo en comparación con el primero. Asimismo, las proporciones de niños y niñas que recibieron las vacunas contra la difteria, el tétanos y la tosferina (DTPa), contra la poliomielitis, antirrotavírica, BCG, y pentavalente también disminuyeron en más de ocho puntos porcentuales. En cambio, la proporción de niños y niñas que recibieron la vacuna antineumocócica conjugada aumentó en más de cuatro puntos porcentuales. También se observó un descenso estadísticamente significativo en el promedio de la variación mensual absoluta de varios indicadores de salud reproductiva e infantil. Conclusiones. La pandemia de COVID-19 puede haber contribuido al descenso observado en varios indica- dores relacionados con la salud reproductiva, materna, neonatal, infantil y adolescente en Haití. Sin embargo, no se puede descartar el papel que ha desempeñado en dicho descenso la crisis sociopolítica y el control ejercido por los grupos armados sobre la población en los últimos tres años.


[RESUMO]. Objetivo. Avaliar mudanças na saúde reprodutiva, materna, neonatal, da criança e do adolescente no Haiti entre agosto de 2018 e setembro de 2021, antes e durante a pandemia de COVID-19. Métodos. Estudo retrospectivo usando dados de vigilância do Sistema Único de Informações de Saúde do Haiti, examinando dois períodos, antes e durante a pandemia de COVID-19. Os indicadores de saúde do país nos dois períodos foram comparados por meio de testes t de duas amostras para proporções, e as variações mensais absolutas médias foram calculadas por meio de regressão linear ponderada. Resultados. Entre o período anterior e o período durante a pandemia de COVID-19, houve uma queda estatisticamente significante na proporção da maioria dos indicadores avaliados. Os indicadores mais afetados, porém, foram as proporções de gestantes com quatro consultas de pré-natal, gestantes com cinco ou mais consultas de pré-natal e gestantes que receberam uma segunda dose de vacina antitetânica, que sofreram uma diminuição de mais de 4 pontos percentuais na comparação entre os dois períodos. Similarmente, as proporções de crianças que receberam vacinas contra difteria, tétano e pertússis (DTPa), BCG, poliomielite, pentavalente e rotavírus também diminuíram em mais de 8 pontos percentuais. Por outro lado, no caso da vacina pneumocócica conjugada houve um aumento de mais de 4 pontos percentuais. Além disso, foi observada uma redução estatisticamente significante nas variações mensais absolutas médias de vários indicadores de saúde reprodutiva e infantil avaliados. Conclusões. A pandemia de COVID-19 pode ter contribuído para a piora observada em vários indicadores de saúde reprodutiva, materna, neonatal, da criança e do adolescente no Haiti. No entanto, não se pode descartar o papel desempenhado pela crise sociopolítica e pelo controle exercido por grupos armados sobre a população nos últimos três anos.


Asunto(s)
Salud Infantil , Servicios de Planificación Familiar , Salud Materna , Salud Reproductiva , Servicios de Salud para Mujeres , COVID-19 , Haití , Salud Infantil , Servicios de Planificación Familiar , Salud Materna , Salud Reproductiva , Servicios de Salud para Mujeres , Haití , Salud Infantil , Servicios de Planificación Familiar , Salud Materna , Salud Reproductiva , Servicios de Salud para Mujeres
16.
Rev Esp Salud Publica ; 982024 May 14.
Artículo en Español | MEDLINE | ID: mdl-38742737

RESUMEN

OBJECTIVE: Limited Health Literacy implies an insufficient understanding of relevant health information, being associated with various variables. The objective of the study was to measure the prevalence of the level of Limited Sexual and Reproductive Health Literacy (AS-SR), its associated variables and the differences in scores between levels of AS-SR, universities and science of study in Chilean university students. METHODS: A multicenter and cross-sectional study, which applied a validated scale to measure levels of AS-SR, was carried out in a sample of 2,186 Chilean university students, categorizing it as high, medium high, medium low and low. The level of Limited AS-SR was obtained by adding the medium-low and low categories. Tests were carried out: descriptive, psychometric and reliability; association, logistic regression and differences between variables of interest. RESULTS: The prevalence of Limited AS-SR was 52.7%. The variables most associated with the level of Limited AS-SR were: low interest in information about health care (OR=2.819; 95% CI: 2.132-3.726), prevention (OR=2.564; 95% CI: 1.941-3.388), sexuality (OR=2.497; 95% CI: 1.807-3.452) and health promotion (OR=1.515; 95% CI: 1.239-1.853); certain sources of Information (OR=1.915; 95% CI:1.614-2.272); low economic income (OR=1.661; 95% CI: 1.361-2.026), among others. There were statistically significant differences in scores between categories of AS-SR levels, universities and study science. The scale had a reliability of 0.940. CONCLUSIONS: More than half of the students have Limited AS-SR, mainly associated with low interest in health information. The scale presents excellent psychometric indicators, being recommended for diagnoses of health situations.


OBJECTIVE: La Alfabetización en Salud Limitada implica una comprensión insuficiente de la información relevante en salud, asociándose con diversas variables. El objetivo del estudio fue medir la prevalencia del nivel de Alfabetización en Salud Sexual y Reproductiva (AS-SR) Limitada, sus variables asociadas y las diferencias de puntajes entre niveles de AS-SR, universidades y ciencia de estudio en universitarios chilenos. METHODS: Se realizó un estudio multicéntrico y transversal, que aplicó una escala validada para medir niveles de AS-SR, en una muestra de 2.186 estudiantes universitarios chilenos, categorizándola en alta, media-alta, media-baja y baja. El nivel de AS-SR Limitada se obtuvo mediante el sumatorio de categorías media-baja y baja. Se realizaron pruebas: descriptivas, psicométricas y fiabilidad; asociación, regresión logística y de diferencias entre variables de interés. RESULTS: La prevalencia de AS-SR Limitada fue del 52,7%. Las variables mayormente asociadas al nivel de AS-SR Limitada fueron: bajo interés en información sobre atención en salud (OR=2,819; IC 95%:2,132-3,726), prevención (OR=2,564; IC 95%: 1,941-3,388), sexualidad (OR=2,497; IC 95%: 1,807-3,452) y promoción de la salud (OR=1,515; IC 95%: 1,239-1,853); ciertas fuentes de Información (OR=1,915; IC 95%:1,614-2,272); bajo ingreso económico (OR=1,661; IC 95%: 1,361-2,026), entre otras. Existieron diferencias estadísticamente significativas de puntajes entre categorías de niveles de AS-SR, universidades y ciencia de estudio. La escala presentó fiabilidad de 0,940. CONCLUSIONS: Más de la mitad de los estudiantes poseen AS-SR Limitada, asociada principalmente al bajo interés en información en salud. La escala presenta excelentes indicadores psicométricos, siendo recomendable para diagnósticos de situación de salud.


Asunto(s)
Alfabetización en Salud , Salud Reproductiva , Salud Sexual , Humanos , Estudios Transversales , Femenino , Masculino , Chile/epidemiología , Salud Reproductiva/estadística & datos numéricos , Alfabetización en Salud/estadística & datos numéricos , Adulto Joven , Adulto , Adolescente , Estudiantes/estadística & datos numéricos , Estudiantes/psicología , Universidades
17.
JBRA Assist Reprod ; 28(3): 483-488, 2024 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-38712833

RESUMEN

OBJECTIVE: This systematic literature review aims to assess the impact of COVID-19 on male fertility. DATA SOURCES: The study draws upon data extracted from PubMed, SciELO, and LILACS databases. STUDY SELECTION: The review incorporates cross-sectional studies, cohort studies, and clinical trials, encompassing investigations related to the subject matter. The studies included were published between June 2020 and March 2023, and encompassed content in English, Portuguese, and Spanish. Exclusion criteria encompassed review articles, case reports, abstracts, studies involving animal models, duplicate articles, and letters to the editor. DATA COLLECTION: Data extracted included the author's name and publication year, the number of patients studied, patient age, the presence of COVID-19 in semen, observed hormonal changes, and alterations in seminal quality. CONCLUSIONS: While hormonal changes and a decline in seminal quality were observed in COVID-19 patients, the virus itself was not detected in semen in the analyzed articles, which contradicts certain findings in the existing literature. It is essential to note that methodologies in the studies were diverse, and, due to the novelty of this infection, it is premature to definitively ascertain its long-term effects on male fertility or whether fertility can recover after a period of convalescence. This underscores the necessity for further research, utilizing more robust methodologies such as cohort studies.


Asunto(s)
COVID-19 , Infertilidad Masculina , Salud Reproductiva , SARS-CoV-2 , Humanos , Masculino , COVID-19/complicaciones , COVID-19/epidemiología , COVID-19/virología , Fertilidad/fisiología , Infertilidad Masculina/fisiopatología , Infertilidad Masculina/virología , SARS-CoV-2/patogenicidad , Semen/virología , Análisis de Semen
18.
Cien Saude Colet ; 29(5): e09202023, 2024 May.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-38747771

RESUMEN

This review aims to disclose the gaps and needs for acknowledging the rights to experience motherhood of women with disabilities. To do so, we map how much is known about these women's experience with motherhood, shedding light on their sexual and reproductive rights. The present work followed the scoping review by the Joanna Briggs Institute (JBI). This research is structured by elaborating the question, identifying the relevant studies, selecting the studies, extracting the data, sorting, summarizing, and creating reports based on the results. Results: we found 1050 articles, of which 53 were selected for the analysis. considering the different themes, we generated three axes: (1) infantilization, dehumanization, and discredit in the experience of motherhood; (2) obstetric ableism - an expression of violence in obstetrics; (3) reproductive justice - politicize motherhood and care. The study showed the urgent need to regard women with disabilities as people having the right to make sexual and reproductive health choices. Health professionals need permanent education to acknowledge and guarantee such a need as interweaving relationships to reach decision-making and autonomy.


Nesta revisão, buscamos identificar lacunas e necessidades para o reconhecimento do direito das mulheres com deficiência ao exercício da maternidade. Objetivamos mapear o conhecimento referente às experiências com a maternidade dessas mulheres, ressaltando a produção de conhecimento relacionada aos direitos sexuais e reprodutivos. Realizamos uma revisão de escopo conforme o Joanna Briggs Institute (JBI). A pesquisa se sustentou na: formulação da questão; identificação dos estudos relevantes; seleção dos estudos; extração de dados; separação, sumarização e relatório dos resultados. Resultados: identificamos 1.050 artigos e selecionamos 53 para análise. A separação dos temas convergentes gerou três eixos: (1) infantilização, desumanização e descrédito na experiência da maternidade; (2) capacitismo obstétrico: uma expressão da violência obstétrica; (3) justiça reprodutiva: politizar a maternidade e o cuidado. Concluímos pela urgência de considerar as mulheres com deficiência com direitos de escolhas nas questões referentes à sua saúde sexual e reprodutiva. Os profissionais de saúde precisam de educação permanente para reconhecer e garantir as necessidades como relações de interdependência para decisões e autonomia.


Asunto(s)
Madres , Derechos Sexuales y Reproductivos , Humanos , Femenino , Madres/psicología , Embarazo , Derechos de la Mujer , Salud Reproductiva , Toma de Decisiones
19.
PLoS One ; 19(5): e0303974, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38781153

RESUMEN

Health literacy is generally low in marginalized groups, leading to delays in accessing care, poor health outcomes, and health disparities. Yet, some individuals in these groups demonstrate higher health literacy and better health outcomes. These exceptional cases exemplify 'positive deviance' because they have found ways to be successful where others have not. Identifying the methods, practices, and resources that these individuals have used to gain health literacy and healthcare access may have generalized application to improve health literacy, access to care, and health outcomes. Using the Integrated Model of Health Literacy, the main objectives of this study are to (1) identify facilitators, barriers, and strategies to gain sexual and reproductive health literacy and healthcare access and (2) to explore each of the core domains of health literacy as they relate to successful access of sexual and reproductive healthcare services among individuals identified as positive deviants. For the purposes of this mixed methods community engaged study, positive deviants are defined as Mexican American young women aged 18-29 years old living in Rural Western New York who have accessed sexual and reproductive healthcare within the past year. A community advisory committee will be formed to provide community-engaged guidance and support for the recruitment of participants. Positive deviants will participate in a survey and semi-structured interview. Data collection and analysis will be simultaneous and iterative. Results will provide evidence of positive deviant methods, practices, and strategies to gain health literacy and access to sexual and reproductive healthcare. Findings may reveal characteristics and patterns in the relationship of health literacy and healthcare access that can inform interventions to improve health literacy and make healthcare more accessible for this demographic group and context.


Asunto(s)
Alfabetización en Salud , Accesibilidad a los Servicios de Salud , Americanos Mexicanos , Salud Reproductiva , Salud Sexual , Adolescente , Adulto , Femenino , Humanos , Adulto Joven , Americanos Mexicanos/estadística & datos numéricos , New York , Servicios de Salud Reproductiva , Conducta Sexual , Población Rural
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