Utilization of treated municipal effluent for irrigating agricultural land in Palestine: The driving factors and existing practices.

This article investigates the motivations and practices of using treated wastewater (TWW) to irrigate crop fields in Jenin, Palestine. Around 40 farmers were surveyed for data collection. The results showed that 66% of the farmers grew alfalfa crops while 30% grew fruit trees. The main obstacles the farmers faced before starting to use TWW were disgust (68.2%), worries about the quality of TWW (68.2%), health concerns (63.6%), and concerns about adverse effects on the soil (63.6%). All interviewed farmers considered the establishing and funding of an irrigation project to be the cornerstone for any reuse project. The second most important driving factor was the price of TWW that is 10-25% of the fresh water prices. After reusing TWW for irrigation, 59% of the farmers did not use any fertilizer, but they were not sufficiently aware of the crops' water needs, nor the nutrients in the TWW. All the fodder-growing farmers abstained from selling their crops before drying. The farmers used the TWW for five to nine months annually. After the TWW was reused, the main positive impacts of the TWW reuse were increased crop yields (77.3%), crops quality (50.0%), and crops marketing (47.7%). On the other hand, the main negative impacts were blocking of the irrigation systems (77.3%) and release of odors (54.5%). After practicing TWW use in crops irrigation, the key factors contributed to the "no difference" index were the effects on human health (100%), soil quality (56.8%), and insects spread (54.5%). Therefore, the results of the study support the decision makers to implement TWW reuse policies for crop irrigation in arid regions with scarce water resources. Monitoring TWW reuse and training farmers and helping them overcome obstacles is essential.

"An obedient wife never says "no" to her virtual god." High fertility conceptions and barriers to contraceptive use among mothers of Southern Pakistan: a qualitative study.

ISSUE: Biomedical approaches want to change locals' behaviors without understanding the sociocultural rationales and contextualizing the cultural and structural backdrop of women's agency. OBJECTIVES: This study explored the perceptions and practices of rural mothers about fertility and reproductive health and further examine the lack of preference for contraception and birth spacing in Southern Pakistan. METHODOLOGY: Using purposive sampling we recruited 15 healthcare providers and 20 mothers from Southern Punjab. Key informants and in-depth interviews were used for data collection. We extracted themes and sub themes to analyse qualitative data. FINDINGS: Five major themes identified preventing birth spacing and contraceptive use: (1) cultural barriers (2) economic difficulties and demographic factors; (3) gender-related hurdles; (4) spiritual and religious obstacles, and (5) medico-ethical complications. Nearly, ten sub-themes contributing to these major themes were: custom of girls' early marriages, in-laws' permission for contraception, women's concern for medical complications and preference for safer methods, misuse of contraceptive methods by the medical community, mothers' perception of contraception as sinful act and controlling birth is against faith, economic and rural-ethnic factors for high fertility, masculine disapproval of condom use, and wishing to give birth to male children. SUGGESTIONS: We advocate for understanding the sociocultural explanations for low contraceptive use and urge practice of more natural methods of birth spacing over commercial solutions. The study suggests socio-economic development of less developed communities and empowerment of poor, illiterate, and rural women along with behavior change communication strategies.

'I thought we would be nourished here': The complexity of nutrition/food and its relationship to mental health among Arab immigrants/refugees in Canada: The CAN-HEAL study.

Nutritional psychiatry suggests that diet quality impacts one's mental health (MH). The relationship between food/nutrition and MH may be particularly salient for immigrants/refugees who often experience high risk for household food insecurity and MH challenges. An innovative collaborative community-based participatory research and integrated knowledge translation approach was adopted to explore food/nutrition needs as they relate to MH among Arab immigrants/refuges (AIR) in Ontario, Canada. The goal was to co-identify areas that require social change and co-produce applicable knowledge for service improvement. The CAN-HEAL study used a multi-methodological approach, employing qualitative interviews, photovoice and a questionnaire survey. A combination of three sampling approaches (convenience, snowball and purposive) was used to recruit sixty socio-demographically-diverse adult AIR participants. The research was guided by an integrated bio-psycho-socio-cultural framework. Participants reported various socio-economic and structural barriers to nutritious eating. Food quality/safety was a significant concern and source of anxiety among AIR; food mislabeling, the widespread presence of genetically/chemically modified foods and expired/rotten food products were associated with negative MH. Participants experienced an alarming prevalence of food insecurity (65%), which was associated with negative MH. Intersections among age, gender, religion, socio-economic status, parenthood, disability, and place of residence played a considerable role in how nutrition, food security, and dietary intake impacted AIR's MH and caused substantial disparities within the AIR community. The food/nutrition-MH relationship among AIR is multi-faceted, and various psycho-socio-cultural pathways/processes were found to shape MH. Intersectoral collaboration between health and non-health sectors is needed to implement a co-proposed socio-political and community-level action plan to achieve nutrition and health equity for AIR and other similar marginalized groups.

'Parents are gudlists!' Experiences of puberty and parent-child sexual communication in rural KwaZulu-Natal, South Africa.

This paper explores young people's experiences of puberty and their perspectives on parent-child sexual communication in rural northern KwaZulu-Natal. In-depth individual interviews, focus group discussions, and participatory visual research methodology were employed with 18 and 19-year-old young women (n = 30) and young men (n = 16) attending three primary health care facilities and a local high school in Jozini municipality. The findings suggest a complex interplay between unequal gender and socio-cultural norms that results in divergent puberty experiences and ambiguous and inconsistent patterns of parent-child sexual communication. Young people referred to their parents as gudlists, a local colloquialism for someone who is evasive, vague, ambiguous and indirect. Lack of open parent-child sexual communication hinders discussion of healthy sexuality, neglecting the sexual and reproductive health education and needs of young people. Reflective of their desire for change, young women in particular contest current parenting norms and suggest returning to cultural practices linked to traditional forms of courtship and sexual communication among young Zulu people.

The primacy of ocular perception: a narrative review on the role of gender identity in eating disorders.

BACKGROUND: Phenomenological research has enriched the scientific and clinical understanding of Eating Disorders (ED), describing the significant role played by disorders of embodiment in shaping the lived experience of patients with ED. According to the phenomenological perspective, disorders of embodiment in ED are associated with feelings of alienation from one's own body, determining an excessive concern for external appearance as a form of dysfunctional coping. The purpose of the present narrative review is to address the role of gender identity as a risk factor for EDs in the light of phenomenological approaches. METHODS: Narrative review. RESULTS: The current study discusses the interplay between perception, gender identity, and embodiment, all posited to influence eating psychopathology. Internalized concerns for body appearance are described as potentially associated with self-objectification. Furthermore, concerns on body appearance are discussed in relation to gendered social expectations. The current review also explores how societal norms and gender stereotypes can contribute to dysfunctional self-identification with external appearances, particularly through an excessive focus on the optical dimension. The socio-cultural perspective on gender identity was considered as a further explanation of the lived experience of individuals with ED. CONCLUSIONS: By acknowledging the interplay between these factors, clinicians and researchers can gain a deeper understanding of these disorders and develop more effective interventions for affected individuals. LEVEL OF EVIDENCE: Level V narrative review.

Socio-cultural factors influencing Indonesian nurses to stay working in Indonesia: A qualitative study.

AIM: To explore push, pull and retention factors affecting indonesian nurses decision to stay in the nursing profession. INTRODUCTION: Identifying influencing factors that determine Indonesian nurses' decisions to remain working in Indonesia gives a better understanding of nurses' migration and therefore are necessry to explore. BACKGROUND: Studies examining nurse migration's push and pull factors have been carried out extensively. A study exploring factors that make nurses stay in their home countries, such as Indonesia needs to be conducted to provide different insights for related parties. METHODS: A qualitative descriptive study was conducted with 52 managers and 181 nurses from hospitals and community health centres across four different regions in Indonesia, including DKI Jakarta, Lampung, South Kalimantan and West Nusa Tenggara. A purposive sampling method was used. The data were collected online (via Zoom) and offline through semi-structured interviews and focus group discussions. A content analysis was performed. The Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed. RESULTS: Five categories were developed: non-financial support, sense of togetherness, following the husband, social image and powerlessness. DISCUSSION: Socio-cultural factors influence Indonesian nurses to stay working in their country despite their economic and career development difficulties. CONCLUSION: Socio-cultural circumstances have become powerful factors affecting Indonesian nurses to stay working in Indonesia. IMPLICATIONS FOR NURSING PRACTICE AND POLICY: There is a need for harmonisation of policies related to nursing migration between recipient and source countries. Moreover, policies should go beyond education, competency and credentialing regulations and include addressing social costs and needs, such as the possibility of migrating nurses' families to the recipient countries.

Breaking the Silence: An Epidemiological Report on Asian American and Pacific Islander Youth Mental Health and Suicide (1999-2021).

BACKGROUND: Limited studies have focused on recent trends in Asian American and Pacific Islander (AAPI) youth suicide. This study aimed to evaluate epidemiological trends in AAPI youth suicide and reports of depressive symptoms among Asian and Pacific Islander youth in the USA. METHODS: This cross-sectional study analyzed mortality data from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) and reports of depressive symptoms from the Youth Risk Behaviour Surveillance System (YRBSS). Data from 1999 to 2021 were analyzed for suicide rates and methods used among AAPI youth aged 5-24 years. YRBSS data from 1991 to 2021 were analyzed for depressive symptoms reported by Asian American (AA) 9th-12th graders. RESULTS: From 1999 to 2021, 4747 AAPI youth died by suicide in the USA. Rates of suicide doubled from 3.6 to 7.1 per 100,000 during 1999-2021, with an increasing trend observed from 2014 onwards. The most common methods of suicide deaths in this population were suffocation, firearms and poisoning. Rates of suicide were higher among AA males than females, although more AA females reported depressive symptoms, including suicidal planning and attempts. CONCLUSION: This study shows a concerning increase in suicide rates among AAPI youth over 1999-2021. Suffocation, firearms and poisoning were the most common methods used. While more AAPI males died by suicide, AA females reported higher rates of depressive symptoms. These findings highlight the urgent need for targeted prevention strategies and clinical interventions for this vulnerable population. The study also emphasizes the importance of addressing mental health stigma to improve reporting and support for Asian American, Native Hawaiian and Pacific Islander (AANHPI) youth.

Socio-cultural power of social media on orthorexia nervosa: An empirical investigation on the mediating role of thin-ideal and muscular internalization, appearance comparison, and body dissatisfaction.

As social media continues to penetrate users' daily lives, concerns about its negative impact on body image issues and eating disorders are becoming focuses of research. It remains unclear whether social media should be held responsible for promoting orthorexia nervosa-a problematic and extreme fixation on healthy eating. The present study draws on socio-cultural theory and tests a social media-based model in the context of orthorexia nervosa to enhance knowledge of social media's influence on body image issues and orthorectic eating tendencies. The socio-cultural model was tested using structural equation modeling based on responses from a German-speaking sample (n = 647). The results indicate that social media users' involvement with health and fitness accounts is associated with higher orthorectic eating tendencies. Thin-ideal and muscular internalizations mediated this relationship. Interestingly, body dissatisfaction and appearance comparison were not mediators, which can be attributed to the characteristics of orthorexia nervosa. Higher involvement with health and fitness accounts on social media was also related to higher appearance comparisons. The results highlight the powerful influence of social media on orthorexia nervosa and the relevance of socio-cultural models in investigating the mechanisms underlying this influence.

Fragmented understanding: exploring the practice and meaning of informed consent in clinical trials in Ho Chi Minh City, Vietnam.

BACKGROUND: The informed consent process in clinical trials has been extensively studied to inform the development processes which protect research participants and encourage their autonomy. However, ensuring a meaningful informed consent process is still of great concern in many research settings due to its complexity in practice and interwined socio-cultural factors. OBJECTIVES: This study explored the practices and meaning of the informed consent process in two clinial trials conducted by Oxford University Clinical Research Unit in collaboration with the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam. METHODS: We used multiple data collection methods including direct observervations, in-depth interviews with study physicians and trial participants, review of informed consent documents from 2009 to 2018, and participant observation with patients' family members. We recruited seven physicians and twenty-five trial participants into the study, of whom five physicians and thirteen trial participants completed in-depth interviews, and we held twenty-two direct observation sessions. RESULTS: We use the concept "fragmented understanding" to describe the nuances of understanding about the consent process and unpack underlying reasons for differing understandings. CONCLUSIONS: Our findings show how practices of informed consent and different understanding of the trial information are shaped by trial participants' characteristics and the socio-cultural context in which the trials take place.

Fertility intentions and family size among married men in Khartoum, Sudan.

Numerous factors contribute to high fertility within a specific context some of which are related to women's fertility practices. What has been less frequently examined, however, is how men's preferences and behaviours contribute to high fertility rates. This is imperative in a country such as Sudan which has reported continuously high fertility rates. This study aimed to analyse the socio-cultural factors affecting husbands' preferences and behaviours contributing to high fertility in Sudan. Participants were recruited from the Fertility and Reproductive Health Services Centre in Khartoum and Ahfad Family Health Centre in Omdurman city. Qualitative interviews were used to examine men's fertility preferences and behaviours. The main study findings suggest that husband's fertility preferences and the desire for a large family were prominent, being determined by local socio-cultural factors and religious norms. The data presented offers insight into key factors sustaining high fertility.

Mother-child dyad support needs to be expressed by mothers diagnosed with breast cancer.

AIMS AND OBJECTIVES: To investigate the support needs identified by Taiwanese breast cancer diagnosed mothers for themselves and their 6-12-year-old children for implementation in a support group. BACKGROUND: Mothers with dependent children are burdened with diverse child-centered concerns while battling breast cancer. A better understanding of the concomitant support needs of mothers and their children can yield tailored support for ill mothers and their children. DESIGN: A qualitative descriptive study employing content analysis of collected data. METHODS: Between February and June of 2020, semi-structured individual interviews were conducted with 20 mothers who had been diagnosed with breast cancer in the last 2 years. Qualitative content analysis was used. This study followed the COREQ guidelines. RESULTS: Ill mothers favoured a hybrid format for support groups, consisting of mother-only, child-only, and mother-child group sessions. The content analysis yielded four themes for mother-only group sessions: (1) learning to reach out to children; (2) dealing with negative emotions; (3) how to say goodbye to children; and (4) resetting for the future. Three themes related to child-only group sessions emerged: (1) emotional and health education; (2) getting along with a sick mother; and (3) preparing for uncertainty. The core theme for mother-child group sessions was relationship enhancement. CONCLUSION: The findings revealed that mother-reported support needs of ill mothers and their children included support for improving children's emotional well-being and mothers' emotional coping, preparing for uncertainty, and promoting intimacy in the mother-child relationship. RELEVANCE TO CLINICAL PRACTICE: A relation-focused approach to psychosocial support group development that allows mother-child mutual influences on each other's coping to be addressed bilaterally is suggested. PATIENT OR PUBLIC CONTRIBUTION: Mothers diagnosed with breast cancer were interviewed for data collection and invited to review and validate the synthesised data for enhancing the credibility of the study.

The attachment of adult women to the Italian labour market in the shadow of COVID-19.

We investigate the attachment to the labour market of women in their 30s, who are combining career and family choices, through their reactions to an exogenous, and potentially symmetric shock, such as the COVID-19 pandemic. We find that in Italy a large number of women with small children, living in the North, left permanent (and temporary) employment and became inactive in 2020. Despite the short period of observation after the burst of the pandemic, the identified impacts appear large and persistent, particularly with respect to the men of the same age. We argue that this evidence is ascribable to specific regional socio-cultural factors, which foreshadow a potential long-term detrimental impact on female labour force participation.

Silent Mourning: Infant Death and Caring for Iranian Parents Under the Influence of Religious and Socio-cultural Factors.

Despite all the advances in healthcare technology and all the care services in the field of neonates, many infants die in neonatal intensive care units (NICUs). This qualitative study investigated socio-cultural factors influencing the care for bereaved parents in three main NICUs of northwest Iran between March 2018 and April 2019. The purposeful sampling method with the maximum variation was used, and data collection was continued until obtaining rich data to answer the research question. Twenty-eight interviews were conducted with 26 healthcare providers. The thematic analysis method was applied to analyze the data, and two main themes, including "Religious context as a restriction on the parental involvement in the infant's end-of-life care" and the "Socio-cultural challenges of the grieving process among parents", were generated accordingly. The religious and socio-cultural contexts in the NICUs of Iran are a restriction to the presence of parents at their infants' end-of-life phase, and health care providers are less inclined to have parents in the NICU at the time of infant death.

The transition from school to university in mathematics education research: new trends and ideas from a systematic literature review.

Investigating the transition between educational levels is one of the main themes for the future of mathematics education. In particular, the transition from secondary school to STEM degrees is problematic for the widespread students' difficulties and significant for the implications that it has on students' futures. Knowing and understanding the past is key to imagine the future of a research field. For this reason, this paper reports a systematic review of the literature on the secondary-tertiary transition in Mathematics Education from 2008 to 2021. We constructed two corpuses: one from the proceedings of three international conferences in mathematics education (PME, ICME, and INDRUM) and the other from peer reviewed research papers and book chapters returned by the databases ERIC and Google Scholar. A clear evolution in perspectives since 2008 emerges from the analysis of the two corpuses: the research focus changed from a purely cognitive to a more holistic one, including socio-cultural and - to a lesser extent - affective issues. To this end, a variety of research methods were used, and specific theoretical models were developed in the considered papers. The analysis also highlights a worrisome trend of underrepresentation: very little research comes from large geographical areas such as South America or Africa. We argue that this gap in representation is problematic as research on secondary tertiary transition concerns also consideration of socio-cultural and contextual factors.

Annual Research Review: Cross-cultural similarities and differences in parenting.

This article reviews contemporary research on cross-cultural similarities and differences in parenting. The article begins by providing a definition of culture and how both parenting and culture can change over historical time. The article then presents some classic theoretical frameworks for understanding culture and parenting before considering why parenting may be similar across cultures and why parenting may be different across cultures. The article next turns to a review of cross-cultural similarities and differences in several aspects of parenting, including physical caregiving, cognitive stimulation, warmth and acceptance, control and monitoring, and discipline. Cultural normativeness and beliefs on the legitimacy of parental authority are then considered as potential moderators that contribute to cross-cultural similarities and differences in relations between parenting and child outcomes. The article then considers implications for parenting interventions and laws and policies related to parenting. Finally, the article suggests directions for future research.

Motivators and demotivators to accessing malaria in pregnancy interventions in sub-Saharan Africa: a meta-ethnographic review.

BACKGROUND: Despite the introduction of efficacious interventions for malaria control, sub-Saharan Africa continues to bear the highest burden of malaria and its associated effects on vulnerable populations, such as pregnant women and children. This meta-ethnographic review contributes to literature on malaria in pregnancy interventions in sub-Saharan Africa by offering insights into the multiple factors that motivate or demotivate women from accessing MiP interventions. METHODS: A meta-ethnographic approach was used for the synthesis. Original qualitative research articles published from 2010 to November 2021 in English in sub-Saharan Africa were searched for. Articles focusing on WHO's recommended interventions such as intermittent preventive treatment with sulfadoxine-pyrimethamine, long-lasting insecticidal nets and testing and treatment of Malaria in Pregnancy (MiP) were included. Selected articles were uploaded into Nvivo 11 for thematic coding and synthesis. RESULTS: Twenty-seven original qualitative research articles were included in the analysis. Main factors motivating uptake of MiP interventions were: (1) well organized ANC, positive attitudes of health workers and availability of MiP services; (2) Women's knowledge of the effects of malaria in pregnancy, previous experience of accessing responsive ANC; (3) financial resources and encouragement from partners, relatives and friends and (4) favourable weather condition and nearness to a health facility. Factors that demotivated women from using MiP services were: (1) stock-outs, ANC charges and health providers failure to provide women with ample education on the need for MiP care; (2) perception of not being at risk and the culture of self-medication; (3) fear of being bewitched if pregnancy was noticed early, women's lack of decision-making power and dependence on traditional remedies and (4) warm weather, long distances to health facilities and the style of construction of houses making it difficult to hang LLINs. CONCLUSIONS: Health system gaps need to be strengthened in order to ensure that MiP interventions become accessible to women. Additionally, health managers need to involve communities in planning, designing and implementing malaria interventions for pregnant women. It is important that the health system engage extensively with communities to facilitate pregnant women and communities understanding of MiP interventions and the need to support pregnant women to access them.

Socio-cultural factors influencing adolescent pregnancy in Ghana: a scoping review.

BACKGROUND: Adolescent pregnancy is a public health challenge that has well-defined causes, associated health risks, and social and economic consequences for adolescent, their families, communities, and society. The purpose of this scoping review is to summarize studies published on socio-cultural determinants of adolescent pregnancy in Ghana. METHODS: Search for records was done in four major databases, including PubMed CENTRAL, Science Direct and JSTOR. Records from Google and Google Scholar were also added, and results and findings from published and unpublished studies were included. All the 22 studies that met the eligibility criteria, were critically appraised. The guidelines for conducting scoping reviews by Arksey and O'Malley were followed. RESULTS: The result revealed that poverty, peer influence, low level of education, dysfunctional family, lack of communication between parents and their daughters, lack of sexual and reproductive health education, child marriage, coerced sex, misconception and non-usage of contraceptives, and decline in cultural values such as puberty rites and virginity inspection are some of the determinants of adolescent pregnancy in Ghana. The study also showed that there is a lack of high-quality observational studies that adjust for confounding variables. CONCLUSION: Interventions and policies should be designed to take into consideration the needs, context, and background of adolescents. Programmes to enhance adolescent reproductive health need to consider multilevel factors such as person, family, community, institutions, national, and global issues that affect such programmes.

Intimate partner violence against women in Southern Punjab, Pakistan: A phenomenological study.

BACKGROUND: Intimate Partner Violence (IPV) refers to behavior by an intimate partner that can cause physical, sexual, or psychological harm; is a common global public health issue requiring immediate attention. IPV is the most common form of violence in rural areas of Punjab, Pakistan. METHODS: This qualitative phenomenological study collected 46 in-depth interviews from married women who experienced IPV in the rural areas of South Punjab. A semi-structured interview guide was used for data collection. These women were selected through a snowball sampling technique from October 2018 to March 2019. Researchers accessed the study setting with the help of gatekeepers (Lady Health Workers and Village Heads). The interviews were audio-recorded in the local language (Saraiki) and were translated into English. The data were analyzed using the thematic inductive analysis technique. RESULTS: The study has presented multifaceted factors of IPV by using the socio-ecological framework in rural areas of South Punjab, Pakistan. The current study introduced culturally contextualized terminologies of "protection," "physical submissiveness," "mental delicacy," and "social security". For married women, culturally embedded terms became the primary cause of IPV. In addition, the study also highlighted some of the cultural terminologies (such as run-mureed, watta-satta, beghairat, izzat, etc.) that are ubiquitous in the local context that sometimes intensifies IPV in the family and community sphere. Furthermore, the study discussed how gender-based inequalities trigger a status quo that ultimately creates power discrimination between spouses, which perpetuates violence in the domestic context. CONCLUSIONS: Gender-prejudiced roles and expectations imposed by orthodoxy, misinterpretations of Islamic teachings, and dominant patriarchy can be contested through awareness campaigns among the public, and gender sensitization drives among public institutions of police and judiciary. Education and employment-based can lead to women's empowerment and help to challenge the orthodox anti-feminist societal norms and the role of kinship-based networks in the family and community sphere.

Exploration the role of social, cultural and environmental factors in tendency of female adolescents to smoking based on the qualitative content analysis.

BACKGROUND: The aim of this study was to explain the socio-cultural and environmental factors of smoking tendency in female adolescents. METHODS: This qualitative content analysis study was conducted among Iranian female adolescents in Mashhad, Iran. The data was collected through semi-structured interviews with 20 female smokers. The duration of each interview varies from 30 to 70 min. Data collection and management of data were done using MAXQADA software version 10. RESULTS: In exploration the effective socio-cultural and environmental factors in the tendency of female adolescents to smoking, six subcategories of role modeling of friends, membership in groups, parenting patterns, family modeling, the predisposing community, and the negative impact of the media were extracted. CONCLUSIONS: The results obtained in this study indicated that there is a need to formulate policies and adopt environmental and social laws to reduce smoking. The results also showed the effective role of parents in improving personal skills, creating a stress-free environment in the family, and controlling adolescent behavior. Therefore, it is necessary to pay attention to all social and cultural aspects in order to make the smoking prevention programs.

Socio-cultural context of adolescent sexuality and youth friendly service intervention in West Gojjam Zone, Northwest Ethiopia: a qualitative study.

BACKGROUND: Recognizing that adolescents face barriers in accessing services, may feel embarrassed, face stigma on sexual matters, or have concerns about judgmental providers, youth-friendly service (YFS) has been introduced to deliver health services that meet the sexual and reproductive health (SRH) needs of young people. Evidences on the role of YFS in addressing the socio-cultural norms influence unmarried adolescent SRH behaviour are limited. Therefore, this study explore whether the socio-cultural norms influencing adolescent SRH behaviour vary between youth friendly service program and non Program areas in West Gojjam Zone, North West Ethiopia. METHODS: Qualitative case study design was employed to explore the socio-cultural context of adolescent sexuality. Purposive sampling was used to identify study participants. Data were collected from 112 participants both from YFS program and non-program areas using semi-structured in-depth interviews, key informants, and focus group discussions guides. A total of 18 key informant interviews, twelve FGDs and four in-depth interviews were conducted. Participants were comprised from unmarried adolescents, parents, religious leaders, community elders, health professionals, teachers, and unmarried adolescents who experienced SRH problem. Thematic analysis was used to summarized the data. RESULTS: The socio-cultural norms related to adolescent sexuality in both YFS program and non-program areas indicated that the community is intolerant to premarital sex, SRH service utilization (eg., contraceptive use) by unmarried adolescent; and discourage SRH communication with unmarried adolescents. According to the participants, premarital sex and SRH service use were not accepted by the community. Moreover, participants believed that, having communication on SRH issues with unmarried adolescents are equivalent to encouraging them to initiate sex, therefore, should not be practiced. CONCLUSION: The socio-cultural norms influencing adolescent sexual behaviour were more or less the same between settings. In both areas, the socio-cultural context discourages YFS intervention like SRH communication and service use. Also, the YFS program does not modify the socio-cultural norm affecting adolescent sexuality. Therefore, the YFS interventions strategies should give due emphasis to the socially accepted sexual norms like sexual abstinence.