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1.
Pan Afr Med J ; 32: 172, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31303941

RESUMO

Introduction: Postpartum family planning is still little known and little practised by most couples in Cameroon. However, just after childbirth, many couples wish to postpone their second birth. This study aims to determine the level of competence and the education need of couples in immediate postpartum family planning in the Biyem-Assi health district, Cameroon. Methods: We performed a KAP survey (knowledge, attitudes and practices) in the Biyem-Assi health district. Data were collected using two questionnaires with 40 questions, written in french, one addressed to women in couples and during the post-partum period and the other addressed to men in couples and having at least one child. Collected data were entered in the software CSPro version 6.2 and then analyzed using the software SPSS version 20.0. Results: A total of 300 subjects with a sex ratio of 1 were surveyed. More than half (56.7%) had an approximate knowledge of family planning in the immediate postpartum period. Thirty six percent of the respondents believed that the immediate postpartum period was not an appropriate time to use a modern method of contraception. The interaction between contraceptives and breast milk (65.4%) and female infertility (26.3%) were the main reasons reported. Immediate postpartum contraception of 60.5% of couples living in the Biyem-Assi health district was inadequate. Therefore, the level of competence in the immediate postpartum family planning was insufficient (32.6%) and low (23.3%) in most of the respondents. Conclusion: Some prejudices and misconceptions about modern contraceptive methods persist in the Biyem-Assi health district population and these are an obstacle to contraceptive practice in general and during the immediate postpartum period in particular. Awareness and education efforts of couples to improve their competence in contraception during the immediate postpartum period are necessary.


Assuntos
Anticoncepção/estatística & dados numéricos , Anticoncepcionais/administração & dosagem , Serviços de Planejamento Familiar , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Camarões , Feminino , Humanos , Masculino , Período Pós-Parto , Gravidez , Educação Sexual/métodos , Inquéritos e Questionários
2.
Pan Afr Med J ; 33: 17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31312333

RESUMO

Introduction: family planning programmes have helped in increasing the prevalence of contraceptive use and reducing total fertility rate in developing countries from six to three births per woman. However, its uptake is lower in the rural areas compared to urban areas. This study seeks to elucidate the effect of community mobilisation on awareness, approval and use of family planning among women of reproductive age in the rural areas of Ebonyi state, Nigeria. Methods: we conducted a quasi-experimental study among women aged 15 to 49 years in two rural communities in Ebonyi state. Using simple random method, we recruited 484 women for the study. We used pre-tested interviewer-administered questionnaire to collect information from the participants. Community awareness and distribution of information, education and communication materials were carried out within one month. We estimated the effect of the intervention on the level of awareness, approval and uptake of family planning methods. Results: level of awareness increased by 19% (p<0.001) while uptake of family planning increased by 16.7% (p<0.001) in the intervention group. The approval rate was higher in the intervention group compared to the control group (p=0.008). The most commonly used method of family planning was the natural method in intervention and control arms. Conclusion: although uptake of family planning increased significantly in the study population, the rate is generally low. Given the critical role of the community in family planning programmes, community mobilisation may be deployed to increase uptake of family planning in similar rural communities.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Serviços de Planejamento Familiar/métodos , Conhecimentos, Atitudes e Prática em Saúde , População Rural/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Nigéria , Educação Sexual/métodos , Inquéritos e Questionários , Adulto Jovem
3.
BMC Public Health ; 19(1): 681, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31159767

RESUMO

BACKGROUND: Positive youth development (PYD) models are effective in improving adolescent sexual health. Adolescent programs including peer educators, parents and the wider community also demonstrate effectiveness in improving sexual health outcomes. An innovative Positive Adolescent Sexual Health (PASH) Conference model has been introduced in Northern NSW, Australia. It is run by the North Coast PASH Consortium, which is based on a health promotion framework. It takes a positive and holistic approach to sexual health education, and incorporates peer educators, parents, community workers and teachers. This study provides an introductory evaluation of the PASH Conference and identifies areas for increased effectiveness. It is intended as an early piece of research to inform future evaluations and to provide introductory information for public health educators. METHODS: Data collection included semi-structured interviews with 13 key stakeholders of the PASH Conference. Interviews were recorded, transcribed verbatim and analysed using deductive thematic analysis. RESULTS: Subjects included 2 teachers, 2 parents, 2 youth conference workers, 2 organisers, 2 presenters and 3 Peer Educators engaging Peers (PEEPs). Stakeholders perceived that young people were engaged to strengthen their sexual health and wellbeing due to many factors. These followed 3 themes: a safe and open learning environment, empowerment of young people and involvement of the support system and broader community. Multiple recommendations were identified across 2 themes: changes to conference format and planning, and enhancing stakeholder engagement. DISCUSSION: The PASH Conference is a promising new youth development design promoting positive adolescent sexual health, which may provide a feasible model for public health educators to trial. Elements of the conference identified as engaging to youth align well with those in PYD research literature. This study provides an early piece of research to inform the design of future research on the PASH Conference including evaluation of behavioural outcomes. It provides introductory information to inform PASH Conference development to further increase its effectiveness.


Assuntos
Saúde do Adolescente , Promoção da Saúde/métodos , Educação Sexual , Saúde Sexual , Adolescente , Desenvolvimento do Adolescente , Austrália , Feminino , Educação em Saúde , Humanos , Masculino , Pais , Grupo Associado , Percepção , Poder (Psicologia) , Pesquisa Qualitativa , Comportamento Sexual
4.
BMC Public Health ; 19(1): 689, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31159803

RESUMO

BACKGROUND: Reproductive health is a part of a comprehensive definition of complete physical, mental and social well-being. Sex education is an important aspect of public health. Ignorance, due to the lack of sex education leads to risky sexual behaviors. METHODS: Our cross-sectional study was aimed at investigating a representative group of Polish women's knowledge about the physiology of the menstrual cycle, contraceptive methods, infertility and cervical cancer prevention. The data were collected by face-to-face interviews and an anonymous electronic questionnaire. RESULTS: The study group involved 20,002 respondents. Most of the women were of reproductive age (mean 27.7), parous (60.8%), of higher education (71%) and living in large cities (> 500 k citizens, 36.8%). 62.2% of the women gave correct answers to at least 5 of 7 questions concerning the physiology of the menstrual cycle. Three factors had a significant influence on the number of correct answers: higher education (p = 0.0001), more frequent gynecological appointments (p = 0.0001) and living in a larger city (p = 0.002). Women of higher education level had more often used some form of contraceptive method previously (87% vs. 78.4%, p = 0.001), recommended natural family planning methods to their peers (18.4% vs. 15%, p = 0.001) and regularly attended gynecological appointments (85.7% vs. 78.8%, p = 0.001) when compared with those women with lower educational levels. The three most effective contraceptive methods identified by respondents were: oral contraceptives (71.1% answers), intrauterine devices (50.2%) and parenteral hormonal contraceptives (30.4%). The effectiveness of natural family planning was more often emphasized by women who had never used any contraceptives before (20.1% vs 6.7%). Most of the participants (80.8%) believed that in-vitro fertilization is an effective infertility treatment and should be reimbursed in Poland. Also, 95.2% of the respondents reported that they had undergone a Papanicolaou test within the past 3 years, but only 3% of these women were aware of all the risk factors for cervical cancer mentioned in our survey. CONCLUSIONS: It is very important to improve comprehensive reproductive health education in Poland, especially among women of lower educational levels and living in small centers. In future, educational programs and gynecologists should focus on implementing and improving these aforementioned issues.


Assuntos
Anticoncepção , Conhecimentos, Atitudes e Prática em Saúde , Saúde Reprodutiva , Assunção de Riscos , Educação Sexual , Comportamento Sexual , Adulto , Cidades , Anticoncepção/estatística & dados numéricos , Anticoncepcionais Orais , Estudos Transversais , Escolaridade , Serviços de Planejamento Familiar , Feminino , Humanos , Infertilidade , Dispositivos Intrauterinos , Aceitação pelo Paciente de Cuidados de Saúde , Polônia , História Reprodutiva , Neoplasias do Colo do Útero/prevenção & controle , Adulto Jovem
5.
Medicine (Baltimore) ; 98(19): e15576, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083234

RESUMO

The aim of this study was to explore the relationship between different models of sexual morality education and the mental health level of female college students, to provide a scientific basis for college conduct an effective sexual morality education program that can improve the psychologic health level of female college students.The experimental and control groups were comprised of female college students who received different models of sexual morality education. Total and factor scores derived from the Symptom Checklist 90 (SCL90) were compared between these groups.The total mental health SCL90 score for female college students in the control group was 1.48 ±â€Š0.39, and the scores of 3 factors including SCL90-3 (interpersonal sensitivity, P < .01), SCL90-4 (depression, P < .05), and SCL90-5 (anxiety, P < .05) were all significantly higher than the national norm. The total mental health scores for female students in the purely theoretical experimental group and the integrated practical training experimental group were 1.40 ±â€Š0.42 and 1.33 ±â€Š0.39, respectively, both of which were significantly different from the control group (P < .05), while the difference between the 2 groups was near the threshold of significance (P = .052). There were significant differences between the integrated practical training experimental group and the control group for scores of 5 factors including SCL90-2 (obsessive-compulsive symptoms), SCL90-3 (interpersonal sensitivity), SCL90-4 (depression), SCL90-5 (anxiety), and SCL90-6 (hostility) (Ps < .01). There were also significant differences between the purely theoretical experimental group and the control group for scores of 3 factors including SCL90-2 (obsessive-compulsive symptoms), SCL90-3 (interpersonal sensitivity), and SCL90-6 (hostility) (Ps < .05). And, there were also significant differences between the 2 experimental groups for scores for 3 factors including SCL90-3 (interpersonal sensitivity), SCL90-4 (depression), and SCL90-5 (anxiety) (Ps < .05).Different models of sexual morality education have significantly different impacts on the mental health level of female college students. The integrated practical education model can significantly and effectively improve the mental health of female college students, and as such colleges and universities should adopt this integrated model to better improve these students' mental health.


Assuntos
Saúde Mental , Princípios Morais , Educação Sexual , Comportamento Sexual/psicologia , Estudantes/psicologia , China , Feminino , Humanos , Educação Sexual/métodos , Universidades
7.
BMC Public Health ; 19(Suppl 1): 604, 2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31138182

RESUMO

BACKGROUND: With a human immunodeficiency virus (HIV) prevalence of 2.1% among 15-24 year olds, opportunities for further integration of sexual and reproductive health (SRH) and HIV prevention services for young people in Uganda exist. We examine a range of factors that contribute to variance in risky sexual behaviour among young Ugandans. METHODS: A cross-sectional, nationally representative household survey was conducted between February and March 2016. The questionnaire used assessed knowledge, attitudes and practices related to SRH among young people aged 10-24 years. A composite indicator was constructed to assess risky sexual behaviour, defined as being involved in sexual relations under the influence of alcohol or drugs, engaging in sexual activities without a condom, and having multiple sexual partners in the 6 months preceding the survey. Exploratory analysis was conducted to provide descriptive statistics. Logistic regression was conducted to determine the factors associated with risky sexual behaviour. This analysis focuses on the sub-category aged 15-24 years, comprised of 2725 respondents. RESULTS: Knowledge levels of family planning (FP), sexually transmitted infections (STIs) and HIV across all respondents were high (above 82%). Self-reported perceived risk of STIs and pregnancy was consistently higher among 20-24 year old respondents, with 61.5% feeling at risk of STIs compared to 46.2% of 15-19 year olds. A total of 22.7% of respondents reported having been involved in risky sexual behaviour. Factors associated with risky sexual behaviour among the 15-19 years group included gender, single orphanhood, casual work, schooling status, FP knowledge and self-perceived risk of STIs/HIV. For the 20-24 year old respondents, significantly associated factors included gender, educational level, relationship to head of household, place of residence, and self-perceived risk of pregnancy. CONCLUSIONS: Despite high general SRH/HIV knowledge and perceived risk of pregnancy and HIV, risky sexual behaviour among young Ugandans remains high. Effectiveness gaps in the integrated SRH/HIV response for young people should be addressed and targeted interventions focused on holistic prevention at individual level through information, risk awareness, and skill development should be combined with interventions targeting social structures affecting individual behaviour.


Assuntos
Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Saúde Reprodutiva/estatística & dados numéricos , Saúde Sexual/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/psicologia , Adolescente , Grupo com Ancestrais do Continente Africano , Criança , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , HIV , Infecções por HIV/prevenção & controle , Comportamentos de Risco à Saúde , Humanos , Modelos Logísticos , Masculino , Gravidez , Autorrelato , Educação Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Doenças Sexualmente Transmissíveis/virologia , Inquéritos e Questionários , Uganda , Adulto Jovem
8.
Nursing (Säo Paulo) ; 22(251): 2937-2942, abr.2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-998896

RESUMO

A pesquisa objetivou analisar percepção dos enfermeiros da Estratégia Saúde da Família do Território de Manguinhos sobre a sexualidade infantil e a implicação desta percepção para o cuidado à saúde da criança. Trata-se de um estudo descritivo, exploratório e de natureza qualitativa. Realizado no Centro de Saúde Escola Germano Sinval Faria e Clínica da Família Victor Valla no Complexo de Manguinhos, no Município do Rio de Janeiro, onde está localizado e é campo de ensino e pesquisa para ENSP/FIOCRUZ, com 8 enfermeiros entrevistados atuantes na Estratégia Saúde da Família. Utilizou-se o método de interpretação de sentidos, baseando-se em princípios hermenêutico-dialéticos. Os depoimentos evidenciam que o despreparo do profissional sobre o assunto e a implicação desta percepção para o cuidado à saúde da criança, leva a um cuidado incompleto. Neste sentido, refletimos sobre a importância da atuação do enfermeiro como profissional de saúde nas consultas, onde pode colaborar de maneira positiva com a educação de pais e crianças a respeito da sexualidade.(AU)


The aim of the research was to analyze nurses' perceptions of the Family Health Strategy of the Manguinhos Territory on child sexuality and the implication of this perception for the health care of the child. It is a descriptive, exploratory and qualitative study. Held at the Germano Sinval Faria School of Health and Victor Valla Family Clinic in the Manguinhos Complex, in the city of Rio de Janeiro, where it is located and is a teaching and research field for ENSP/FIOCRUZ, with 8 nurses interviewed in the Health Strategy of the family. The method of interpretation of senses was used, based on hermeneutic-dialectical principles. The testimonies show that the professional's unpreparedness about the subject and the implication of this perception for the child's health care leads to incomplete care. In this sense, we reflect on the importance of nurses acting as health professionals in consultations, where they can collaborate in a positive way with the education of parents and children regarding sexuality.(AU)


La investigación objetivó analizar la percepción de los enfermeros de la Estrategia Salud de la Familia del Territorio de Manguinhos sobre la sexualidad infantil y la implicación de esta percepción para el cuidado de la salud del niño. Se trata de un estudio descriptivo, exploratorio y de naturaleza cualitativa. En el municipio de Río de Janeiro, donde está ubicado y es campo de enseñanza e investigación para ENSP / FIOCRUZ, con 8 enfermeros entrevistados actuantes en la Estrategia Salud, en el Centro de Salud Escuela Germano Sinval Faria y Clínica de la Familia Victor Valla en el Complejo de Manguinhos, en el Municipio de Río de Janeiro, donde está localizado y es campo de enseñanza e investigación para ENSP / FIOCRUZ, con 8 enfermeros entrevistados actuantes en la Estrategia Salud de la familia. Se utilizó el método de interpretación de sentidos, basándose en principios hermenéutico-dialécticos. Los testimonios evidencian que la despreparación del profesional sobre el tema y la implicación de esta percepción para el cuidado a la salud del niño, lleva a un cuidado incompleto. En este sentido, reflexionamos sobre la importancia de la actuación del enfermero como profesional de salud en las consultas, donde puede colaborar de manera positiva con la educación de padres y niños respecto a la sexualidad.(AU)


Assuntos
Humanos , Criança , Cuidado da Criança , Saúde da Criança , Sexualidade , Estratégia Saúde da Família , Enfermagem Pediátrica , Educação Sexual
10.
Rev Med Suisse ; 15(642): 579-582, 2019 Mar 13.
Artigo em Francês | MEDLINE | ID: mdl-30865390

RESUMO

In recent years, the number of smartphone users has exploded worldwide and downloads of applications for these phones have increased significantly. The purpose of this article is to present a review of the literature on the use of smartphone applications to improve sexual health, suggesting how they can be used in sex education, counselling and therapy ; the use of smartphone applications to provide sexual health information, particularly to younger populations, could increase awareness of risky sexual behaviours before first sexual intercourse. This article could help sexologists use smartphone applications to facilitate their work. It is very important that clinicians have specific knowledge of online sexual issues, otherwise they may be vulnerable to stereotypes and judgments.


Assuntos
Aconselhamento , Aplicativos Móveis , Educação Sexual , Comportamento Sexual , Conscientização , Humanos , Smartphone
11.
Reprod Health ; 16(1): 33, 2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30885215

RESUMO

BACKGROUND: Husbands play an influential role in women's access to health care, such as family planning services. However, there is little evidence of the level of husbands' involvement in family planning services among pastoralist communities, who possess a distinct lifestyle. This study was aimed to assess husbands' involvement in family planning use and factors associated in pastoralist communities of Afar, Ethiopia. METHODS: Community-based cross-sectional survey was conducted among randomly selected 418 married women in Afambo district, Afar pastoralist community in 2017. Data were collected using semi-structured questionnaire. Data were entered to EPI-Info version 7 statistical software programs and exported to SPSS. Descriptive and multivariable logistic regression analyses were applied to identify factors associated with husband involvement. Odds ratio at 95% confidence interval were reported and significant association of factors was declared at the p-value of less than 0.05. RESULT: Four hundred eighteen married women were included in the study, making a response rate of 98%. The magnitude of husbands' involvement in family planning was found to be 42.2%. Women who ever used family planning (AOR: 7.21; 95%CI: 3.58-14.67), those who participated in community networks, those who reported health center as their source of information for family planning (AOR: 5.56; 95%CI: 1.92-16. o7) were higher likely to report husband involvement compare to their counterparts. Participants' increased knowledge was also significantly associated with higher odds of husband involvement in family knowledge (AOR = 1.31; 95% CI: 1.16-1.58). . CONCLUSION: Husbands' involvement in the district is low. Women's engagement in community networks aimed at increasing the knowledge of the women may involve in family planning. In addition, due focus among health care providers in lower health care units to provide information for both women and men might have a promising power to improve husbands involvement.


Assuntos
Comportamento Contraceptivo , Serviços de Planejamento Familiar , Conhecimentos, Atitudes e Prática em Saúde , Casamento , Cônjuges , Adulto , Estudos Transversais , Etiópia , Feminino , Acesso aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Educação Sexual
12.
J Pregnancy ; 2019: 2920491, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30834145

RESUMO

Background: Unintended pregnancy is seen as the key concept for better understanding the fertility and the unmet need for family planning of populations. It is seen as a major challenge among women in many developing countries including Ghana. However, there is scarcely nationally representative information on its prevalence and predictors in Ghana. Methods: In a cross-sectional study design, data for this study were extracted from the 2014 Ghana Demographic and Health Survey. The prevalence of unintended pregnancies was computed, and logit regression models were fitted to predict the factors influencing unintended pregnancies in the country. Results: The total prevalence of unintended pregnancies among pregnant women in Ghana was found to be 40%. Background characteristics such as age (OR=4.85, CI=1.48-15.84), level of education (OR=0.50, CI=0.26-1.01), marital status (OR=3.83, CI=1.67-8.75), parity (OR=0.13, CI=0.05-0.32), and region of residence (OR=0.11, CI=0.03-0.31) were the significant predictors of unintended pregnancy, net of unmet need for contraception. However, unmet need for contraception (OR=7.13, CI=1.57-8.91) serves as an independently significant predictor of unintended pregnancy regardless of the background characteristics of respondents. Conclusions: The study findings strongly underscore the need for significant improvement in the access to contraception methods and family planning information in the quest to considerably reduce unintended pregnancies in the entire country.


Assuntos
Gravidez não Planejada , Gravidez/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Anticoncepção/métodos , Anticoncepção/estatística & dados numéricos , Estudos Transversais , Escolaridade , Feminino , Previsões , Gana/epidemiologia , Humanos , Modelos Logísticos , Estado Civil , Pessoa de Meia-Idade , Prevalência , Educação Sexual , Adulto Jovem
13.
Res Nurs Health ; 42(1): 8-28, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30730043

RESUMO

Black youth account for the largest number of new HIV infections among heterosexual youth. Mental illness and difficulties in emotion regulation contribute to increased reports of HIV/sexually transmitted infection (STI) risk-related sexual behaviors in this group. Yet limited interventions exist to address this affective component of the sexual decision-making process. The purpose of this paper was to describe the trial design, research challenges, and baseline characteristics from a study designed to fill this gap. Project GOLD was a pilot randomized controlled trial of a psychoeducational HIV/STI prevention intervention designed to address the role of mental illness and emotion regulation in HIV/STI risk among heterosexually-active Black youth aged 14 to 17 (N = 108). Challenges encountered in the research process warrant further attention in future research (e.g., disagreement among the regulatory bodies on parental permission requirements). The most common mental health diagnoses were Recurrent Major Depressive Disorder (15.7%) and current substance abuse (7.4%). Participants reported higher levels of emotional suppression, and adaptive methods of emotion management, than culturally inappropriate expressions of anger or sadness. They also reported a mean age of 13.6 at first vaginal sex, used condoms 66% of the time for vaginal sex, and had an average of three sexual partners in the past 6 months. More than one-quarter (26.9%) had sex with more than one person in the same day. These findings indicate intervention is crucial for this population. The forthcoming trial evaluation will indicate the promise of such interventions in reducing HIV/STI infections in this key population.


Assuntos
Afro-Americanos/psicologia , Infecções por HIV/prevenção & controle , Heterossexualidade/psicologia , Comportamento de Redução do Risco , Educação Sexual/métodos , Adolescente , Infecções por HIV/psicologia , Educação em Saúde/métodos , Humanos , Masculino , Projetos Piloto , Assunção de Riscos , Comportamento Sexual/psicologia , Doenças Sexualmente Transmissíveis/prevenção & controle
14.
Reprod Health ; 16(1): 17, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30744697

RESUMO

BACKGROUND: Involving male partners in family planning (FP) education and counseling may improve FP utilization and help meet couples' reproductive health needs in the postpartum period. We aimed to explore Kenyan men's and women's perspectives on an interactive short message service (SMS) approach to support postpartum FP decision-making, and inform intervention content for a randomized controlled trial (RCT). METHODS: We conducted four focus group discussions (FGD) among men (n = 35) and two among pregnant/postpartum women (n = 15) in western Kenya. Female participants were recruited at antenatal clinics; male participants were referred by antenatal attendees. FGDs included participant critique of pilot theory-based SMS messages. FGD transcripts were coded by two investigators and analyzed using an iterative, modified grounded theory approach. These data informed the intervention and RCT design, in which women had the option to refer male partners for trial enrollment. RESULTS: Men strongly desired inclusion in FP programs, and frequently discussed negative relationship consequences of women's covert contraceptive use. Female and male participants voiced a variety of concerns about contraceptive side effects and potential harms, which were central to narratives of community influence on personal contraceptive choices. Most participants felt that receiving FP-focused SMS and including men would be beneficial. They perceived that SMS dialogue with a nurse about FP could reduce misperceptions and may stimulate communication within couples, thereby improving contraceptive access and continuation. Shared decision-making around FP within couple relationships, in consultation with clinicians, was highly valued. CONCLUSIONS: Health concerns about FP and limited couple communication are perceived contributors to postpartum unmet contraceptive need. With women's consent, the inclusion of male partners in FP services, and specifically in an mHealth SMS intervention, is acceptable and desired. Receiving SMS may trigger communication about postpartum FP within couples. SMS content should address contraceptive knowledge gaps, anticipated side effects and FP misperceptions, and allow for real-time method choice assistance.


Assuntos
Serviços de Planejamento Familiar/educação , Aplicativos Móveis , Período Pós-Parto , Telemedicina , Adulto , Comportamento Contraceptivo/psicologia , Aconselhamento , Tomada de Decisões , Serviços de Planejamento Familiar/métodos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Quênia , Masculino , Serviços de Saúde Materna , Homens/psicologia , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Educação Sexual , Mensagem de Texto , Mulheres/psicologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-30791604

RESUMO

As reported by the World Health Organization in 2017, there are 2 million+ young people living with HIV worldwide. The World Health Organization also reported that a third of all new HIV infections around the world are estimated to occur among youths (aged 15⁻25). and teen pregnancy rates are on the rise in many places. These worrying trends suggest that existing sexuality education programs and interventions may be inadequate and/or ineffective. Although the 1994 International Conference on Population and Development's (ICPD) Programme of Action highlighted the roles of Governments to offer sex education to young people to promote teenage reproductive health, yet inconsistency exists in the related initiatives in the global context. The present article aims to provide a comprehensive literature review of the existing sexuality programs in selected places in both English-speaking (i.e., the United States of America, the United Kingdom) and Chinese-speaking contexts (i.e., Hong Kong, Mainland China, and Taiwan). Based on the review, observations and implications for sexuality education policy and practice, as well as recommendations for future research for youths are outlined.


Assuntos
Características Culturais , Educação Sexual , Adolescente , Adulto , China , Feminino , Infecções por HIV/epidemiologia , Hong Kong , Humanos , Gravidez , Gravidez na Adolescência , Saúde Reprodutiva , Comportamento Sexual , Sexualidade , Taiwan , Reino Unido , Estados Unidos , Organização Mundial da Saúde , Adulto Jovem
16.
Artigo em Inglês | MEDLINE | ID: mdl-30736271

RESUMO

A clear need exists for teen pregnancy prevention programs that are responsive to the specific needs and cultural contexts of Native American communities. Recent data indicates that the birth rate for Native teens is nearly two and a half times the rate for White teens (32.9 versus 13.2). To address this disparity, we conducted formative research with Northern Plains Native American community members, resulting in My Journey, a culturally attuned curriculum for 6⁻8th graders. My Journey is grounded in traditional values and teachings to promote self-efficacy in sexual health decision-making and engagement in prosocial behaviors. We conducted a pilot study with 6⁻8th grade students (n = 45), aged 11⁻14 years (22 females, 23 males). Pilot study findings confirm program feasibility and acceptability. The process evaluation revealed that teachers liked the curriculum, particularly its adaptability of cultural components and ease of student engagement. The outcome evaluation demonstrated that My Journey provided an avenue for NA youth to increase their sex refusal self-efficacy. Application of the culture cube framework revealed My Journey has made a meaningful practice-based evidence contribution as a community-defined, culturally integrated curriculum that is effective. Future directions include broader implementation of My Journey, including adaption for additional populations.


Assuntos
Comportamento do Adolescente/psicologia , Competência Cultural , Índios Norte-Americanos/educação , Índios Norte-Americanos/psicologia , Gravidez na Adolescência/prevenção & controle , Autoeficácia , Educação Sexual/métodos , Adolescente , Criança , Currículo , Tomada de Decisões , Feminino , Humanos , Masculino , Grupos Minoritários/educação , Grupos Minoritários/psicologia , Projetos Piloto , Gravidez , Gravidez na Adolescência/etnologia , Estados Unidos/etnologia
17.
Reprod Health ; 16(1): 13, 2019 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-30717804

RESUMO

BACKGROUND: World population is growing at about 80 million people each year. Ethiopia is the 12th most populous country in the world. Existing literatures showed that the role of proximate determinants in inhibiting the total fertility has not yet been determined from the DHS data in the country. This study may provide evidence based information regarding the observed changes in total fertility. The objective of this study was assessing proximate determinants of fertility and the role of selected socio-economic variables in influencing fertility in Ethiopia. METHODS: The EDHS data of 2011 and 2016 were used in our study. A total of 16,515 eligible women included in 2011 and 15,683 in 2016 surveys made up the sample for the study. The roles of each of the four proximate determinants in declining fertility have been determined. The background variables selected for the analysis include: region of residence, educational status, wealth index and place of residence. The Bongaart model is used to explain the observed socio-economic differentials in fertility during the two survey years. RESULTS: In 2011, index of marriage inhibited fertility by 37.8%, however in 2016 it inhibited fertility by 34.4%. In 2011, contraceptive use reduced fertility by 28.5% while in 2016 it reduced fertility by 30.7%. The index of postpartum infecundity decreased fertility by 34.7% in 2011 and by 34.5% in 2016. Foetal wastage inhibited fertility by 9.2% in both survey years. The total fertility rate in 2016 was 4.14 whereas the projected total fertility in 2020 will be 3.2 children per woman. CONCLUSION: Among the four proximate determinants of fertility, the contribution of index of marriage was the highest in inhibiting fertility in 2011. On the other hand, the contribution of postpartum infecundability was the highest in inhibiting fertility in 2016. The contribution of the index of contraceptive in inhibiting fertility increased from 28.5% in 2011 to 30.7% in 2016. The index of foetal wastage contributed the least in both 2011 and 2016 survey years. Therefore, strategies have to be designed to promote the contraceptive use and breast feeding practices among the reproductive women.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos , Fertilidade , Casamento/estatística & dados numéricos , Adulto , Coeficiente de Natalidade , Etiópia , Feminino , Humanos , Período Pós-Parto , Educação Sexual , Fatores Socioeconômicos
18.
Eur J Contracept Reprod Health Care ; 24(1): 45-53, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30730215

RESUMO

OBJECTIVES: We aimed to develop and pilot-implement an evidence-informed toolkit (SEXual health Identification Tool; SEXIT) for identifying young people exposed to or at risk of sexual ill health, at Swedish youth clinics, and to investigate SEXIT's potential to identify young people in need of special care and monitoring. METHODS: The SEXIT toolkit was developed, validated and pilot-implemented at three Swedish youth clinics. Pre-implementation staff readiness was assessed and youth clinic visitors' responses to SEXIT were analysed. RESULTS: All staff perceived a need for screening for sexual risk-taking and exposure. The response rate from 268 youth clinic visitors (aged 15-24 years) was 86%. Half of the visitors had one or no variable associated with sexual ill health, a third had two or three, and 15% reported between four and seven variables. The most common variables were alcohol use, three or more sexual partners in the past year and previous chlamydia. Visitors rated SEXIT as important and not uncomfortable or difficult to answer. CONCLUSIONS: The SEXIT toolkit was found to be feasible and highly acceptable in a clinical setting. The use of SEXIT may facilitate important questions on sexual risk-taking and sexual ill health to be raised with youth clinic visitors.


Assuntos
Serviços de Planejamento Familiar/métodos , Medição de Risco/métodos , Educação Sexual/métodos , Adolescente , Comportamento do Adolescente , Estudos de Viabilidade , Feminino , Implementação de Plano de Saúde , Humanos , Masculino , Projetos Piloto , Assunção de Riscos , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Saúde Sexual , Parceiros Sexuais/psicologia , Suécia , Adulto Jovem
19.
Eur J Contracept Reprod Health Care ; 24(1): 18-23, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30747544

RESUMO

OBJECTIVES: While media campaigns are documented to be useful for increasing the uptake of family planning, very little is known about the population prevalence and correlates of exposure to mass media family planning messages among post-delivery women in Nigeria. We aimed to address this void by exploring the underlying factors that explain disparities in exposure to mass media family planning messages among post-delivery women in Nigeria. METHODS: Our study was a secondary analysis of the Nigeria Demographic and Health Survey, a nationally representative dataset of men and women. Using logistic regression techniques and drawing on the structural influence model of health communication, we explored post-delivery women's (N = 13,889) exposure to mass media family planning messages in Nigeria. RESULTS: We found that 32% of post-delivery women were exposed to family planning messages on mass media in Nigeria. At the bivariate level, Muslim women were less likely to be exposed to mass media family planning messages compared with Christian women (odds ratio [OR] 0.39; 95% confidence interval [CI] 0.36, 0.41); however, the OR became positive once we controlled for structural determinants such as household wealth and education (OR 1.22; 95% CI 1.07, 1.40). In the multivariate analysis, we found that traditionalist women (OR 0.29; 95% CI 0.14, 0.58) and women from rural areas (OR 0.69; 95% CI 0.62, 0.76) were less likely to be exposed to such messages. Moreover, richer, better educated, and employed women were more likely to be exposed to mass media family planning messages compared with their poorer, less educated and unemployed counterparts. Similarly, living in the South West region was positively associated with higher odds of being exposed to such messages. CONCLUSION: Findings were largely consistent with the structural influence model of health communication, as highlighted by inequalities in exposure to mass media messages. Based on these findings, we provide several policy recommendations.


Assuntos
Serviços de Planejamento Familiar/estatística & dados numéricos , Comunicação em Saúde , Meios de Comunicação de Massa/estatística & dados numéricos , Período Pós-Parto/psicologia , Educação Sexual/estatística & dados numéricos , Adolescente , Adulto , Cristianismo/psicologia , Demografia , Serviços de Planejamento Familiar/métodos , Feminino , Humanos , Islamismo/psicologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Nigéria , Gravidez , Educação Sexual/métodos , Adulto Jovem
20.
BMC Womens Health ; 19(1): 26, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30709344

RESUMO

BACKGROUND: The use of long-acting and permanent method (LAPM) for family planning (FP) is of importance to the FP movement. A better understanding of how fertility-related intentions shape the usage of LAPM is important for programming. This paper explored the interaction of fertility intentions with LAPM use in rural western Kenya. METHODS: We draw on monitoring data from 28,515 women aged 15-49 years who received FP services between 2013 and 2015 as part of a community-based FP project. We assessed the association between the use of LAPM and fertility intentions, adjusting for age, parity, education, service delivery model, FP counseling and year of data collection. RESULTS: Of the 28,515 women who accessed FP services during the period (2013-2015), about two-thirds (57%) reported using LAPM, much higher than the national rates, and around 46% wanted another child within or after two years. In a multivariable regression model, women who desired no more children tended to use LAPM more than those wanting a child within or after some years as well as those uncertain about their future intentions. CONCLUSION: The significant rates of utilization of LAPM between both women who desired no more children and the fair proportion of use among women spacing births underscore the benefits of sustained community level interventions that address both the demand and supply barriers of contraceptive adoption and use.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepcionais/uso terapêutico , Serviços de Planejamento Familiar/métodos , Contracepção Reversível de Longo Prazo/estatística & dados numéricos , Adolescente , Adulto , Anticoncepção/estatística & dados numéricos , Feminino , Humanos , Quênia , Pessoa de Meia-Idade , Paridade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Gravidez , População Rural/estatística & dados numéricos , Educação Sexual/organização & administração , Adulto Jovem
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