Exploring Sexual and Reproductive Health Needs and Associated Barriers of Homeless Young Adults in Urban Ghana: A Qualitative Study.

Background: Homelessness has become a major global and public health challenge, especially in low- and middle-income countries. This phenomenon predisposes young adults to severe psychosocial and health challenges. Aim: To explore the sexual and reproductive health needs and behaviours of homeless young adults and challenges in accessing these services. Methods: A semi-structured interview guide was used for data collection from in-depth interviews, focus group discussions, and key informant interviews. Data were collected between 01 June and 31 July 2020 from 30 participants using in-depth interviews, two focus group discussions involving 12 participants, and one key informant interview. Thematic analysis was used to analyse transcripts from the interviews. Results: The findings show that certain behavioural patterns associated with homelessness impact the lives of homeless young adults in their sexual and reproductive health (SRH) choices, beliefs, and perspectives. This group faces several challenges in accessing sexual and reproductive health services (SRHS) such as modern contraceptives and abortion care. The high cost, and undesirable and unfriendly attitude of service providers in health facilities pose as barriers to accessing SRHS by homeless young adults. Conclusion: Sustainable and proactive measures must be put in place to address the identified barriers. Timely delivery of accurate information and educative materials, ensuring affordability, and setting up of accessible and friendly facilities could improve SRHS for this group. Social and Public Policy Implications: This study may inform and support policy guideline development to address homelessness and SRH needs of young adults in urban Ghana.

Armed conflict, a neglected determinant of childhood vaccination: some children are left behind.

Vaccination is an indisputable intervention that has tremendously mitigated the global burden of vaccine-preventable diseases (VPDs). The number of armed conflicts globally seems to be at an all-time high, with devastating effects on vaccination coverage. This paper will examine how armed conflicts affect childhood vaccination and lead to the reemergence and spread of VPDs. Unarguably, socioeconomic factors, population demographics, the apparent long vaccination timetable, multiple vaccine doses, lack of trust in vaccination processes and the rumor of the adverse effects of some vaccines unnerve some parents and create a puzzle. By bringing under the global floodlight, the impact of armed conflicts which contextually affect vaccination coverage, this article will help strengthen the advocacy for vaccination, and call for the fortification of existing treaties on the rule of engagement during conflicts. In order to eliminate or eradicate VPDs, strategies to reach children that are left behind during conflicts is paramount.

Underuse of modern contraception in sub-Saharan Africa: are there implications for sustainable development and climate change? A review of the literature.

Objectives: The aim of this study was to review the recent literature regarding the underuse of modern contraception in sub-Saharan Africa (SSA) and examine the link with poverty, conflict, sustainable development and climate change. Methods: Data were examined in the PubMed, Hindawi and Science Direct databases. Selected studies were primary research published in the last 10 years relating to modern contraceptive use in SSA. Results: Six common themes contributing to modern contraceptive underuse in SSA emerged: conflicts and security, religious and cultural restrictions, partner consent and support, misconceptions and lack of education, health system barriers and the socioeconomic benefits of having a larger family. Conclusions: The identified barriers to modern contraceptive use in SSA are preventable. It is imperative to ensure that adequate, sustainable measures are implemented to increase the uptake of modern contraception in SSA.