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Capturing adolescent realities in the global data revolution
No full textThe 2030 Agenda for Sustainable Development\u27s call to leave no one behind has brought a renewed focus on vulnerable populations historically overlooked by researchers and policy makers. Key to this inclusive mission is generating data which is high quality, accessible, timely, reliable and disaggregated by income, sex, age, race, ethnicity, migration status, disability and geographic location. Halfway to the endpoint of the Agenda 2030, tracking of the Sustainable Development Goals (SDG) has revealed substantial gaps in data on adolescence, despite increasing recognition that the ages of 10–19 years are a crucial life stage for accelerating progress against poverty, inequity, and discrimination. We outline challenges in generating robust adolescent-specific SDG data and identify approaches that can deliver the age-disaggregated and sex-disaggregated data that are crucial to tailoring policies and interventions to improve adolescent wellbeing across domains
Recap of the Sixth International Symposium on Intrauterine Devices and Systems for Women\u27s Health
No full textDue to the COVID-19 pandemic, the Sixth International Symposium on Intrauterine Devices and Systems for Women\u27s Health was held as a series of seven 2-hour webinars between May 28, 2020, and June 22, 2021. This Symposium featured 48 different presenters and moderators covering a wide range of topics to highlight new IUD issues and update general IUD knowledge, just as it was done in previous symposia dating back to 1962. A total of 1346 people attended remotely to observe the events live. In this article, we share summaries of the presentations from the sixth symposium. These summaries, provided by the presenters, are meant to archive the symposium. This article gives the reader an overview of the topics and identifies the sessions’ moderators and speakers charged with providing the content. Those interested in further detail, references, and information about the speakers can find more information on the conference website: www.iud2020.com. After the summaries, we share ideas for future IUD research and programmatic needs, as provided by Symposium\u27s presenters and organizers. The authors’ summaries are personal opinions and do not necessarily reflect the perspectives of the Symposium\u27s organizers or the medical community at large. The Symposium was recorded and the sessions are available for viewing free of charge at the website, www.iud2020.com or on YouTube. As of July 2022, approximately 1700 visitors have viewed the recordings
A3 Policy Checklist User Guide
Get PDFThe Adolescent Atlas for Action (A3) is a suite of tools that summarizes the lives and needs of adolescents around the world to promote evidence-based decision-making. Through accessible and easy-to-grasp data just one click away, the A3 bridges the gap between decisionmakers and evidence to inform policies and programs. The A3 Policy Checklist, created by the Population Council’s GIRL Center, features a curated list of national policies relevant to adolescents under 9 thematic domains, and whether countries have enacted each policy. The checklist presents a snapshot of commitments made to achieving adolescent wellbeing through adolescent-focused policies. As of July 2022, the Policy Checklist includes 56 policies, which were tracked for 113 low- and middle- income countries (LMICs). This list of policies is not exhaustive, and additional policies will be added to the checklist every year. This guide provides a step-by-step overview of how to use the A3 Policy Checklist
Gender-related barriers to schooling: What do we know about the effects of sexuality and life skills education?
Get PDFEffect of adolescent female fertility and healthcare spending on maternal and neonatal mortality in low resource setting of South Asia
No full textBackground: Maternal and neonatal mortality is high in South Asia. Recent studies have identified factors such as adolescent female fertility, healthcare spending is reducing maternal and neonatal mortality. The objective of this study is to examine the effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality in South Asian countries. Methods: A retrospective panel study design was used, a total of 8 South Asian countries (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) data from World development indicator 1990–2020 considered for analysis. Descriptive statistical method was used for summary. The effect of adolescent female fertility and healthcare spending on maternal and neonatal mortality were analysed using fixed and random effect regression with multiple imputation. Findings: Adolescent female fertility, maternal, and neonatal mortality is very high in the aforementioned countries, and considerably varies among countries. A significant relationship between the maternal mortality and healthcare spending, neonatal mortality and adolescent female fertility was observed. We found neonatal and maternal mortality are more likely to decrease depends on healthcare spending. Healthcare spending has a significantly negative effect on neonatal mortality (− 0.182, 95% CI: [− 0.295 to −.069]; P-value \u3c 0.01) and maternal mortality (− 0.169, 95% CI: [− 0.243 to − 0.028]; P-value \u3c 0.05). A change in 1 % increases in healthcare spending should decrease by 0.182 neonatal mortality per 1000 live births and maternal mortality by 0.169 per 100,000 live births. Conclusions: In south Asian countries, increasing healthcare spending and decreasing adolescent female fertility may contribute to reduce maternal and neonatal mortality. In addition, number of service providers such as physicians supplied contributed to the decline of neonatal mortality. These findings have important implications for future improvement of healthcare spending in maternal and neonatal health programs
Migrant women’s health and safety: Why do Ethiopian women choose irregular migration to the Middle East for domestic work?
No full textBackground: Low-wage labour migration is an increasing determinant of global health, associated with risks of exploitation, abuse, and unsafe conditions. Despite efforts to prevent irregular migration and initiatives to warn individuals of the risks of trafficking, many migrants still opt for irregular channels, particularly women seeking jobs as domestic workers. Ethiopia is one of the largest source countries for female migrants entering the domestic labour market in the Middle East. This qualitative study explored migration decision making by Ethiopian women traveling to the Middle East for domestic labour, focusing on the use of irregular channels. Methods: We conducted semistructured interviews with policy stakeholders, migration recruiters, and returnee domestic workers. Results: We identified three main themes that help explain decision making by female migrants and their communities. First, women were not always clear whether they were using legally approved processes, particularly because of the range of individuals involved in arranging migration plans. Second, irregular migration was seen to be quicker and easier than regular migration procedures. Third, study participants believed the risks between irregular and regular migration were similar. Conclusion: Our study highlights challenges associated with antitrafficking initiatives that discourage irregular migration and suggests new perspectives to address the health risks linked to labour migration
Quels sont les principaux obstacles et facteurs de facilitation associés à la communication intergénérationnelle sur la SSR au Niger et en Côte d’Ivoire?
Get PDFWhen parents communicate with their youth on sexual and reproductive health (SRH) issues, they have a greater influence on youth SRH behaviors. But parents’ lack of knowledge of SRH, low self-efficacy in engaging young people, and unfavorable social norms about communication and youth access to SRH information are barriers to open intergenerational communication. Breakthrough RESEARCH conducted a qualitative study in Niger and Côte d’Ivoire to better understand the specific barriers to intergenerational communication about SRH, and ways in which adult allies can be supported to engage young people and encourage them to lead a healthy life. This research contributes to a nascent body of literature that is specific to the context of francophone West African countries, which have among the highest rates of adolescent pregnancy in the world
Behavioural barriers and perceived trade-offs to care-seeking for tuberculosis in the Philippines
No full textEffective tuberculosis (TB) treatment has existed for more than 50 years, but TB remains a leading cause of death worldwide and in the Philippines, in part because symptomatic individuals delay or avoid seeking care. Through qualitative interviews in Pampanga, Philippines, we investigated barriers to care-seeking using a behavioural science lens. We found barriers to TB care-seeking to be shaped by: (1) ambiguous symptoms; (2) association of TB risk with lifestyle and habits; (3) expectations of stigma, discrimination, and isolation; (4) short-term costs and long-term financial burden of TB; and (5) visibility of care in public sector facilities. Findings suggest that these barriers are deeply intertwined and that, typically, it is a combination of barriers that holds back a particular symptomatic individual from seeking care, as the barriers influence implicit trade-offs related to health, social, and financial consequences of having TB or another serious illness and of seeking care or not seeking care. The findings suggest avenues for more effectively reaching those with symptoms and their family members to encourage care-seeking by elevating the perceived benefits and putting perceived costs in proper perspective
Evaluating the impact of three progestin-based hormonal contraceptive methods on immunologic changes in the female genital tract and systemically (CHIME Study): A prospective cohort study protocol
No full textBackground: Gonadal hormones can modify immune function, which may impact susceptibility to infectious diseases, including Human Immunodeficiency Virus (HIV). There is limited knowledge about how hormonal contraceptives (HC) influence the immune response during the course of use. The CHIME study aims to evaluate the effect of long-acting progestin-based hormonal contraceptives (depot medroxyprogesterone acetate, etonogestrel implant, and levonorgestrel intrauterine device) on immunologic changes in the female genital tract (FGT) and systemic compartment. Methods: CHIME is an observational cohort study where participants attend 2 visits prior to initiating the HC method of their choice, and then attend 6 visits over 12 months with biological sampling (vaginal swabs, cervicovaginal lavage, cytobrush and blood) for immunological, bacteriological, and virological analyses at each visit. Immune profiling will be evaluated by multi-color flow cytometry to determine how different T-cell subsets, in particular the CD4 T-cell subsets, change during the course of contraceptive use and whether they have different profiles in the FGT compared to the systemic compartment. The study aims are (1) to characterize the alterations in FGT and systemic immune profiles associated with three long-acting progestin-only HC and (2) to evaluate the vaginal microenvironment, determined by 16 s rRNA sequencing, as an individual-level risk factor and moderator of genital and systemic immune profile changes following exposure to three commonly used HC. Data collection started in March 2019 and is scheduled to be completed in October 2024. Discussion: The CHIME study aims to contribute to the body of research designed to evaluate the comparative impact of three long-acting progestin-only HC on innate and adaptive immune functions to understand how immunologic effects alter STI and HIV susceptibility
Associations between contraceptive decision-making and marital contraceptive communication and use in rural Maharashtra, India
No full textWomen\u27s contraceptive decision-making control is crucial for reproductive autonomy, but research largely relies on the Demographic and Health Survey (DHS) measure which asks who is involved with decision-making. In India, this typically assesses joint decision-making or male engagement. Newer measures emphasize female agency. We examined three measures of contraceptive decision-making, the DHS and two agency-focused measures, to assess their associations with marital contraceptive communication and use in rural Maharashtra, India. We analyzed follow-up survey data from women participating in the CHARM2 study (n = 1088), collected in June–December 2020. The survey included the DHS (measure 1), Reproductive Decision-Making Agency (measure 2), and Contraceptive Final Decision-Maker measures (measure 3). Only Measure 1 was significantly associated with contraceptive communication (adjusted odds ratio [AOR]: 2.75, 95 percent confidence interval [CI]: 1.69–4.49) and use (AOR: 1.73, 95 percent CI: 1.14–2.63). However, each measure was associated with different types of contraceptive use: Measure 1 with condom (adjusted relative risk ratio [aRRR]: 1.99, 95 percent CI: 1.12–3.51) and intrauterine device (IUD) (aRRR: 4.76, 95 percent CI: 1.80–12.59), Measure 2 with IUD (aRRR: 1.64, 95 percent CI: 1.04–2.60), and Measure 3 with pill (aRRR: 2.00, 95 percent CI: 1.14—3.52). Among married women in Maharashtra, India, male engagement in decision-making may be a stronger predictor of contraceptive communication and use than women\u27s agency, but agency may be predictive of types of contraceptives used