Sexual and Reproductive Health Matters最新文献

Indiana consistently ranks among the states with the highest maternal and infant mortality in the United States, particularly affecting Black and Latine communities, endangering their right to safe and respectful maternal care. Providers working with these communities are crucial in identifying challenges faced by their clients, and to inform programs and policies. We interviewed 32 clinical and community-based providers from February to April 2021 to understand their perspectives on the challenges faced by their Black and Latine clients. Participants were identified through online sources and referrals. Interviews, conducted over online video, were recorded, transcribed, and analysed following a six-step thematic approach. Six areas of challenges emerged: non-medical infrastructure and policy problems, effects of systemic racism and bias, insecurity of the Latine community, dissatisfaction with maternal care delivery, issues in navigating maternal healthcare, and limitations to holistic models of care. The results demonstrate the interconnected structural, organisational, and interpersonal nature of the challenges. Though challenges were described at structural and organisational levels, the focus of state maternal care programs is largely at personal and interpersonal levels. Obstetric racism, citizenship restrictions, shortage of Black and Latine providers, and transportation issues are complex problems, requiring multilevel interventions and policies to ensure Black and Latine women can exercise their right to safe and respectful maternal care. A rights-based approach centring the needs of Black, Latine and other minoritised communities should be implemented to make effective changes with an equity focus.

The main objective of this study is to identify the barriers that prevent Roma women and girls from accessing reproductive rights derived from reproductive justice by analysing the discourses of service providers as a facilitating source of information. A qualitative study including nine semi-structured in-person interviews with community service providers was conducted in April-June 2019. The interview script addressed intercultural competences, views on gender discrimination against Roma women, resources available to fight against this discrimination, knowledge and use of these resources in reproductive justice, as well as the networks of actors involved. The qualitative analysis involved a discourse analysis. In the analysis, three focal areas were defined around which barriers to access spaces inspired by reproductive justice for Roma women could be identified. In each of the focal areas (stereotypes, discrimination and intercultural competences), discourses and practices have been observed in contrasting ways that can prevent access, as well as others that can facilitate access based on prejudices about Roma culture and people. The relationship models between professionals and users of the Roma population project stereotypes that are an obstacle in terms of accessing reproductive justice. The right of Roma women to preserve their culture and to actively participate in policies that affect them is not included and guaranteed in public policies. The intention to include the Roma population's situation in an inclusive narrative exists, although without short-term effects. Reproductive justice is an absent framework within professional intervention and the institutional system. DOI: 10.1080/26410397.2024.2439661.

Since menstrual health and menstrual inequity are determined by social power structures, this study proposes to analyse, from an intersectional perspective, the experiences of menstrual inequity of women and people who menstruate (PWM) (≥18 years) under circumstances of socioeconomic vulnerability in an urban and rural setting in Catalonia (Spain), focusing on menstrual poverty, menstrual management and access to health care for menstrual health. An exploratory and interpretative qualitative study was conducted. Venue-based convenience sampling was carried out, recruiting women from a non-governmental organisation and a primary health care centre. Eighteen individual semi-structured interviews were conducted between October 2022 and February 2023. Data were analysed through reflexive thematic analysis. Analysis revealed that menstrual care was generally a distant preoccupation that revolved around circumstances of socioeconomic vulnerability, housing, and productive/reproductive work. Menstrual poverty, menstrual management and menstrual self-care challenges, barriers to accessing health care for menstrual health, and menstrual taboo, stigma and discrimination were commonplace and deepened by socioeconomic vulnerability. In this way, women's menstrual experiences were rooted in intersecting axes of inequity, based on gender, race and class. Intersectional and critical participatory research, policy and practice are imperative to develop counter mechanisms that confront systems of privilege-oppression to modulate menstrual experience, health and equity.

Drawing on an interdisciplinary approach, this study adopts and appropriates critical cultural theories such as Julia Kristeva's abjection and Pierre Bourdieu's social theories to examine the entangled and affective complexities of intending mothers, their reproductive trauma, and disenfranchised grief through the lens of Indian films such as Filhaal (2002) and works of fiction such as Baby Makers: A Story of Indian Surrogacy (2014) and Kartikeya: The Destroyer's Son (2017). Ample research has examined surrogate mothers' precarious position in the context of a surrogacy arrangement. However, not much has been discussed to reflect on the vulnerable status of the intending mothers who resort to surrogacy to fulfil their desire for motherhood. Thus, this study aims to highlight the significance of the selected fictional accounts to unfold the vulnerable and marginalised status of the intending mothers in a patriarchal society like India, where they find acceptance for their womanhood and earn respect and autonomy only through the power of their womb. The paper adopts generic fluidity and intersectionality as a methodology to critically analyse how the selected literature and film narratives can aid in instilling in us sensitivity towards the complex sociocultural positionality of the intending mothers who are normatively represented in popular discourses as immoral and monstrous. Emphasising the significance of the human rights-based approach to sexual and reproductive health, this research advocates for developing a non-discriminatory attitude towards intending mothers whose reproductive decision-making, privacy, and confidentiality related to the use of reproductive technology should be treated with respect and dignity.

Rural, indigenous populations in Mexico face barriers to accessing sexual and reproductive health (SRH) resources and services. Given the lack of information to inform educational materials tailored to the needs of these indigenous communities, we aimed to: (a) quantitatively characterise the SRH awareness and practices among adolescents and adults in a rural, mostly indigenous community in northern Mexico and (b) qualitatively assess community perspectives on an educational pamphlet with SRH information (e.g. contraceptive options). Quantitative data collection occurred in November 2018 and April 2019 using convenience sampling in a community clinic and random sampling for community households. Qualitative data collection occurred in November 2019 via individual interviews and focus group discussions to assess community perspectives about an SRH educational pamphlet developed from quantitative data. Participants in the quantitative phase of our study (n = 217) were a median age of 30 years, 71% were female, and those with children reported having a median of three (range = 1-11). SRH knowledge was low, as were self-reported efforts to obtain contraceptives or testing for HIV/STIs. Most believed that children should learn about SRH by age 10-15 years, and 94% felt that parents should deliver such education. Participants had low knowledge about SRH but high motivation to educate children and adolescents on these topics, indicating potential for SRH campaigns in this community. Health education materials were well-received in the qualitative phase of our study (n = 17 from individual interviews; n = 22 from focus group discussions), and raised interest among community members in learning more about these topics.

Black girls in the United States are disproportionately diagnosed with sexually transmitted infections (STIs), which can increase the risk of contracting HIV (human immunodeficiency virus), compared to adolescent girls of other races. Therefore, this study was designed to understand barriers to impactful HIV/STI and substance use prevention programmes for Black girls. Data was collected between October 2021 and June 2022 from twelve focus groups which included (N = 62) participants who identified as Black and female between the ages of 13 and 18 years old. Using intersectionality theory as a guiding framework, the data were analysed thematically. The analysis revealed three themes: (1) need for parent-child discussions on sex; (2) stigma in schools; (3) suggestions for Black girl-centred prevention programming. Participants described minimal discussion about sex in their household as well as STI/HIV and substance abuse stigma as barriers to impactful sex education. They also indicated that current substance use and STI/HIV prevention interventions are not tailored to the experience of Black girls and offered suggestions for improvement. In sum, participants pointed out several barriers to existing sex education and substance abuse prevention programmes. Findings revealed that HIV and drug use prevention information and knowledge may be best received from older peers in small private settings that can allow for intimate discussion and sharing of reliable information on HIV education, aetiology, and safer sexual practices. In addition, the study findings support the need to develop a racial and gender-specific prevention programming that fosters peer relationships, social support, and empowerment-based principles.

More than 650 million women alive today were married as children. Relative to efforts to prevent child marriage, efforts to support child brides have received much less attention. This review set out to map and describe interventions that support child brides. We performed a scoping review using seven electronic databases coupled with a grey literature search in January 2022. Data were extracted using a piloted extraction tool and findings were reported in narrative synthesis. A total of 34 projects were included in our review. Most projects focused on improving sexual and reproductive health (SRH) knowledge and behaviours among child brides, which was often achieved through a combination of SRH education, counselling and information provision, along with linkages to SRH services. Some interventions were health facility-based and aimed at improving responsiveness of health service providers to the needs of child brides. Very few described economic interventions as one component of a broader health intervention, and only three interventions focused on improving girls' educational outcomes. We also note the paucity of media-based interventions, despite their popularity among adolescents. Over time, interventions addressing the needs of child brides have increased, but the preponderance of evidence has focused on SRH interventions, with interventions that couple education with adolescent-friendly health services demonstrating promise. Interventions addressing other areas of health and social wellbeing of this group, such as mental health, sexual health, and economic independence, have been overlooked in comparison. The review highlights the need for additional empirical evidence on what works to support child brides.