Bulletin of the World Health Organization最新文献

Achieving the sexual health components of sexual and reproductive health and rights as outlined in the sustainable development goals (SDGs) is integral to overall physical and mental well-being and a core part of universal health coverage. However, tracking national and global progress towards advancing the sexual health and rights of people is challenging because of the paucity of indicators to examine many of its components. To assess the state of sexual health in populations, determine service provision needs, evaluate the effectiveness of health system interventions and monitor progress in optimizing health, a comprehensive set of indicators is needed to cover every component of sexual health. Without comparable global indicators for each component of sexual health across the individual, health systems and policy levels, and disaggregated across subgroups including all genders, there is a considerable lack of insight into people's sexual health needs and progress towards meeting those needs. This article explores the availability of global indicators for the different components of sexual health by analysing two key sources: the global indicator framework of the SDGs and the indicator index of the Global Health Observatory. We summarize the indicators for each component of sexual health using the Guttmacher-Lancet Commission framework, highlighting gaps in current indicators, and recommend areas where additional indicators are needed along with strategies on how to improve data availability, quality and inclusiveness.

Objective: To refine a standard questionnaire on sexual practices, experiences and health-related outcomes to improve its cross-cultural applicability and interpretability. We aimed to explore participants' willingness and ability to answer the draft questionnaire items, and determine whether items were interpreted as intended across diverse geographic and cultural environments.

Methods: We conducted cognitive interviews (n = 645) in three iterative waves of data collection across 19 countries during March 2022-March 2023, with participants of diverse sex, gender, age and geography. Interviewers used a semi-structured field guide to elicit narratives from participants about their questionnaire item interpretation and response processes. Local study teams completed data analysis frameworks, and we conducted joint analysis meetings between data collection waves to identify question failures.

Findings: Overall, we observed that participants were willing to respond to even the most sensitive questionnaire items on sexual biography and practices. We identified issues with the original questionnaire that (i) affected the willingness (acceptability) and ability (knowledge barriers) of participants to respond fully; and/or (ii) prevented participants from interpreting the questions as intended, including poor wording (source question error), cultural portability and very rarely translation error. Our revisions included adjusting item order and wording, adding preambles and implementation guidance, and removing items with limited cultural portability.

Conclusion: We have demonstrated that a questionnaire exploring sexual practices, experiences and health-related outcomes can be comprehensible and acceptable by the general population in diverse global contexts, and have highlighted the importance of rigorous processes for the translation and cognitive testing of such a questionnaire.