Master of Public Health - MPH / Background- Sexual and Reproductive Health (SRH) problems continue to affect adolescents’ health and well-being even into their adulthood. Globally and especially within sub-Saharan Africa with a heavy burden of adolescent SRH problems, increased attention is being paid to these issues. This study looks at adolescents’ awareness, utilisation of and experiences of the available SRH services in Omaruru District, Namibia. Methodology- This analytical cross-sectional study used a two-stage cluster sampling method. Data from students aged 15-19 years in secondary schools were collected and analysed using a structured self-administered questionnaire and STATA statistical software respectively. Ethical approval was obtained from the Biomedical Research and Ethics Committee (University of the Western Cape) and the Namibian Health Ministry. Written parental/caregiver informed consent and written participant assent, as per the Namibian law were obtained. Results- While 87% of respondents had heard of SRH, 46% had ever used SRH services. Of these 44% were contraceptive services. Fifty-one percent had ever had sex (of which 17% had given birth to or fathered their first child), 56% of their first sexual experiences were between ages 15-17 years. Twelve percent had used illegal drugs three months prior to the survey. In multivariate analyses female sex, urban residence and reported sexual debut had significant independent relationships with contraception use. Use of SRH services was independently significantly associated with having had sexual debut. Among SRH services users: 71% would recommend these services to their friends, 51% and 56% found health providers welcoming, with good attitudes, and guaranteeing their privacy and confidentiality. Conclusion Greater effort is needed to curb teenage pregnancy in school-going adolescents by promoting the use of all SRH services especially contraception among sexually active adolescents. It is encouraging that respondents who had used SRH service reported that their privacy and, confidentiality were respected and that healthcare providers’ attitudes generally satisfactory. Lower SRH knowledge, service use and use of contraception and condoms needs further investigation in rural youth and then programmatic and service changes tailored to their needs. Gender norms that underpin adolescent females disadvantage in a number of SRH areas needs to be addressed

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Research question: What is the difference in prevalence of LARCs between women living in urban and rural areas of Latin America and the Caribbean (LAC)? Background, significance, and rationale: While LARCs have been shown to be effective, approved for long duration of use, and cost-effective there is an unmet need for this type contraception in rural areas. The LAC region has a need for improved family planning services, evidenced by the high percentage of maternal deaths due to unsafe abortions. Methods: Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) conducted between 2010 and 2015 in LAC countries were reviewed and analyzed to determine difference in prevalence of LARC use between women living in urban versus rural areas. Additionally, a systematic literature review was performed resulting in selection of 11 primary research articles evaluated for LARC prevalence and sociodemographic factors associated with LARC use.

ABSTRACT Background: The Rwandan government has set family planning (FP) as one of the goals and strategies to improve the health of the population. However, unmet needs for modern contraceptive methods are still a problem, as is the variance of modern contraceptive use among the five regions of Rwanda.   Aim: This study aimed at assessing key factors that contribute to the variance of modern contraceptive use between five regions of Rwanda. Methods: This study was a secondary analysis of the Rwanda Demographic health survey, 2010. A total of 492 clusters (urban/rural), composed by 12,792 households were selected in the survey; 13,790 women of reproductive age were systematically selected from selected households and interviewed about maternal and reproductive health issues. 6834 married women or living with their partners at the time of the survey were selected for this study. Results: Socio-economic and demographic characteristics of women, access to family planning (FP) information and women’s empowerment were associated with the variance of modern contraceptive use between the regions. Women’s empowerment was positively associated with modern contraceptive use in all regions. Access to information was associated with modern contraceptive use in all regions except in the North region (AOR: 1.24, 95%CI: O.8- 1.92). Conclusion: This study highlights that the variance of modern contraceptive use was associated to the way in which FP factors are associated with modern contraceptive use vary between regions and how different FP factors occur among regions. Further researches are needed to investigate potential factors on supply side that influence such variance.

Este estudo teve como objetivo analisar o conhecimento sobre métodos anticoncepcionais (MAC) e identificar as variáveis associados ao conhecimento adequado sobre o tema, em adolescentes de escolas públicas municipais de Ribeirão Preto-SP. Consiste em um estudo do tipo transversal, desenvolvido segundo uma abordagem quantitativa. Foram escolhidas, intencionalmente, duas escolas municipais. A amostra foi constituída por cento e vinte (120) adolescentes, de ambos os sexos, com idade de 13 a 16 anos. A coleta de dados ocorreu no período de 05/03/2007 a 16/03/2007, sendo que o instrumento para a coleta foi um questionário semi-estruturado. Os resultados mostraram que os adolescentes deste estudo pertenciam ao grupo de idade entre 13 - 14 anos (81,7%), sendo que adolescen tes com 15-16 anos represen taram a menor parte (18,3%). O sexo masculino representou 51,6% da amostra e, o feminino, 48,4%. A iniciação sexual ocorreu com 13 anos para ambos ,no sexo feminino com (71,43%)e no sexo masculino (41,18%). Com relação ao uso da camisinha masculina 57,5% dos adolescentes entrevistados não utilizaram a camisinha e 28,3% a utilizaram em suas relações sexuais. Quanto ao uso de métodos anticoncepci onais, para a primeira relação, os resultados mostraram que 36,7% não fizeram uso de nenhum tipo de método e 54,2% não responderam. Em relação segundo o local de obtenção dos MAC os resultados mostraram que 75,8% obtinham no posto de saúde através do médico e 50,7% em farmácias. Sobre a diversidade de métodos anticoncepcionais, o trabalho mostrou que 45% não conheciam nenhum método, seguido de 20,8% que conheciam apenas um; 5,8% conheciam dois tipos e 10,8% conheciam três. Os métodos anticoncepcionais mais conhe cidos foram os de barreira, como o preservativo masculino (45,8%) e o feminino (30,8%), seguidos os anticon cepcionais orais (28,3%). No que diz respeito às fontes de informações e orientações desses métodos, a escola foi a mais citada pelos alunos, com 51,7% e, logo em seguida, surge a família, com 40,8% e a televisão, também com cerca de 40%. O estudo evidenciou que as estratégias mais utilizadas pela escola para informar sobre sexualidade, gravidez na adolescência e os métodos anticoncepcionais foram: no decorrer das aulas (40,8%),e em seguida com a palestra (32,5%). Entre os temas discu tidos em sala de aula com o professor, o mais citado foi sexualidade, com 57,4%. Sobre o diálogo em família, os entrevis tados consideraram a mãe o elo de comunicação mais importante sendo avaliado como bom por 79,2% dos entrevistados. Dos diversos tipos de atendimento à saúde, recebido na Unidade Básica pelo adolescente, a consulta médica foi o mais citado pelos entrevistados, com 48,2%. O estudo mostrou ainda que o conhecimento sobre os métodos anticoncepcionais não garante o seu uso. Entretanto, a disponibilidade de maior número de serviços e orientações sistematizadas sobre tais métodos podem favorecer a mudança de atitudes dos adolescentes em relação a uma prática de uso eficiente e preventivo em relação aos MAC. / The present study aimed to assess knowledge on contraceptive methods and identify variable associated with appropriate knowledge among students in the municipal school system of Ribeirão Preto -SP. This transversal study was developed through a quantitative approach. Two schools belonging to the Health District of Vila Virgínia were purposely selected and the sample size was a fixed number of 120 adolescent students of both genders, aged between 13 and 16. Data collection was conducted from 03/05/2007 to 03/16/2007 and a semi-structured questionnaire was used as data collection instrument. The research showed that the subjects consisted of a group of adolescents between13 and14 years old (81,7%) and a smaller group of adolescents between 15 and 16 years old (18,3%), with males representing 51.6% and females 48.4%. The sexual initiation occurred around the age of 13 for both genders(71,43%) of females and (41,18%) male sex . The use condom was reported by (57,5%) of subjets group did not using, while among the group within the same, 28.3% reported using it. The findings also showed that 36,7% of the subjects did not use any kind of contraceptive method in their first sexual intercourse, and 54,2% did not answer this question. Regarding ways to obtain contraceptive methods, the results showed that 75,8% of the subjects received them from a Health Unit and a doctor of them prescription, 50,7% bought them at a drugstore. The study showed that 45% of the students did not know any kind of contraceptive method, followed by 20.8% that knew only one kind, 5.8% knew two methods, and 10.8% knew three kinds of methods. The most widely known method was the male condom (45,8%) and the female kind (30.8%), followed by the oral contraceptive (28.3%). As for sources of information and advice on contraceptive methods, the most common source was the school (51.7%), followed by the family (40.8%), and TV (40%). The study showed that the advice and information on sexuality, pregnancy in adolescence, and contraceptive methods received at school were delivered through lectures (32.5%) and during lessons (40.8%). According to the data, among the topics associated with health in adolescence discussed in class with the teacher, sexuality was the most common one (57.4%). In terms of conversations with the family, the mother was shown to be the most important bond. In addition, the level of communication with the mother was considered good by 79.2% of the students. Health attention received at the Health Unit and consultation with a doctor was the most common option mentioned by adolescents (48.2%). The research showed that knowing contraceptive methods does not guarantee their use. However, availability of more services and extensive advice on contraceptive methods can assist in changing adolescents\' behavior as regards the efficient and preventive use of contra ceptive methods.

A sexualidade se estabelece por um conjunto de possibilidades que necessitam de serem exploradas, haja vista que a adolescência que corresponde ao período de 10 a 19 anos, é marcada pela transição da infância para a fase adulta e por uma série de transformações, tanto anatômicas, fisiológicas, psicológicas como também sociais. Nesse contexto associa-se a este ciclo da vida a necessidade de compreender e refletir o conhecimento que os adolescentes possuem tanto sobre as infecções sexualmente transmissíveis quanto a gravidez na adolescência, já que, é nesse momento da vida que os mesmos têm um maior risco tanto quanto as infecções advindas do sexo inseguro como também a uma gravidez não planejada, sendo essencial nessa conjuntura que estes temas sejam interiorizados de forma cotidiana, atual e preventiva tanto na escola quanto na família. Parte-se do pressuposto das perspectivas de ação das práticas de educação em saúde, além dos conteúdos se são, explícita e implicitamente, veiculados acerca do tema sexualidade e seus desdobramentos, além do acometimento psicossocial de uma gravidez precoce. Nessa perspectiva, este trabalho objetiva avaliar o conhecimento dos adolescentes de uma escola pública sobre as práticas, percepções necessidades de diálogo sobre as IST e de uma gravidez durante o período da adolescência. A metodologia consistiu em um estudo transversal, de natureza quantitativa, sendo escolhida de forma intencional uma escola pública da cidade de Pouso Alegre-MG; o número de participantes desta pesquisa foi de 499, de ambos os sexos do 8º ano do ensino fundamental II ao ensino médio. Esse processo somente se deu a partir da aprovação do Comitê de Ética da EERP, e da assinatura do Termo de Consentimento Livre e Esclarecido e do Termo de Assentimento Livre e Esclarecido; o instrumento utilizado para a coleta de dados foi um questionário semiestruturado. Quanto aos resultados, o estudo mostrou que os adolescentes participantes pertenciam ao grupo de idade entre 12 - 17 anos (99,8%), sendo que adolescentes com 12 anos representam a menor parte (9,6%) e os de 17 a maior (37,7%). O sexo feminino representou 58,5% da amostra e o sexo masculino 41,5%. A iniciação sexual ocorreu em média aos 13,8 anos com os meninos e 14,4 anos em relação as meninas. Além disso, demonstrou-se que 90,18% dos participantes valorizam e concordam com a ocorrência de oficinas e projetos de sexualidade no interior do ambiente escolar. Dessa forma, é pertinente a necessidade de programas e políticas públicas voltadas a informar, conscientizar e estimular esses indivíduos a se prevenirem e entenderem as modificações dessa fase da vida. Além disso, é pertinente discutir entre os adolescentes as emoções e valores que impedem o uso das informações que os mesmos possuem em suas práticas sexuais. Nota-se também a necessidade de a escola assumir um trabalho cotidiano de abordagem da sexualidade como intrínseca a saúde, como prática sexual saudável e segura através do uso de métodos anticoncepcionais e preventivos contra a IST / Sexuality is established by a set of possibilities that need to be explored, since the adolescence that corresponds to the period from 10 to 19 years is marked by the transition from childhood to adulthood and by a series of transformations, both anatomical, physiological, psychological as well as social. In this context, it is associated with this cycle of life the need to understand and reflect the knowledge that adolescents have as much about sexually transmitted infections as teenage pregnancy, since it is at that moment of life that they have a greater risk both as well as the infections due to unsafe sex, as well as to an unplanned pregnancy, and it is essential at this juncture that these themes are internalized in a daily, current and preventive manner, both at school and in the family. It is based on the assumption of the perspectives of action of health education practices, in addition to the contents if they are explicitly and implicitly conveyed about the theme sexuality and its unfolding, in addition to the psychosocial involvement of an early pregnancy. In this perspective, this study aims to evaluate the knowledge of the adolescents of a public school about the practices, perceptions, needs for dialogue about STIs and a pregnancy during adolescence. The methodology consisted of a transversal study, of quantitative nature, being chosen intentionally a public school in the city of Pouso Alegre-MG; the number of participants in this research was 499, of both sexes from the 8th year of elementary school II to high school. This process only occurred after the approval of the Ethics Committee of the EERP, and the signing of the Term of Free and Informed Consent and the Term of Free and Informed Assent; the instrument used for data collection was a semi-structured questionnaire. Regarding the results, the study showed that the adolescents belonged to the age group between 12 - 17 years (99.8%), with 12 year olds representing the smallest part (9.6%) and those 17 years old (37.7%). The female sex represented 58.5% of the sample and the male sex 41.5%. Sexual initiation occurred on average at 13.8 years for boys and 14.4 years for girls. In addition, 90.18% of the participants have been shown to value and agree with the occurrence of sexuality workshops and projects within the school environment. In this way, the need for public policies and programs to inform, raise awareness and stimulate these individuals to prevent and understand the modifications of this phase of life is pertinent. In addition, it is pertinent to discuss among adolescents the emotions and values that prevent the use of the information they have in their sexual practices. It is also noted the need for the school to take on a daily work of approaching sexuality as intrinsic to health, as a safe and healthy sexual practice through the use of contraceptive and preventive methods against STI

Este estudo teve como objetivo analisar o conhecimento sobre métodos anticoncepcionais (MAC) e identificar as variáveis associados ao conhecimento adequado sobre o tema, em adolescentes de escolas públicas municipais de Ribeirão Preto-SP. Consiste em um estudo do tipo transversal, desenvolvido segundo uma abordagem quantitativa. Foram escolhidas, intencionalmente, duas escolas municipais. A amostra foi constituída por cento e vinte (120) adolescentes, de ambos os sexos, com idade de 13 a 16 anos. A coleta de dados ocorreu no período de 05/03/2007 a 16/03/2007, sendo que o instrumento para a coleta foi um questionário semi-estruturado. Os resultados mostraram que os adolescentes deste estudo pertenciam ao grupo de idade entre 13 - 14 anos (81,7%), sendo que adolescen tes com 15-16 anos represen taram a menor parte (18,3%). O sexo masculino representou 51,6% da amostra e, o feminino, 48,4%. A iniciação sexual ocorreu com 13 anos para ambos ,no sexo feminino com (71,43%)e no sexo masculino (41,18%). Com relação ao uso da camisinha masculina 57,5% dos adolescentes entrevistados não utilizaram a camisinha e 28,3% a utilizaram em suas relações sexuais. Quanto ao uso de métodos anticoncepci onais, para a primeira relação, os resultados mostraram que 36,7% não fizeram uso de nenhum tipo de método e 54,2% não responderam. Em relação segundo o local de obtenção dos MAC os resultados mostraram que 75,8% obtinham no posto de saúde através do médico e 50,7% em farmácias. Sobre a diversidade de métodos anticoncepcionais, o trabalho mostrou que 45% não conheciam nenhum método, seguido de 20,8% que conheciam apenas um; 5,8% conheciam dois tipos e 10,8% conheciam três. Os métodos anticoncepcionais mais conhe cidos foram os de barreira, como o preservativo masculino (45,8%) e o feminino (30,8%), seguidos os anticon cepcionais orais (28,3%). No que diz respeito às fontes de informações e orientações desses métodos, a escola foi a mais citada pelos alunos, com 51,7% e, logo em seguida, surge a família, com 40,8% e a televisão, também com cerca de 40%. O estudo evidenciou que as estratégias mais utilizadas pela escola para informar sobre sexualidade, gravidez na adolescência e os métodos anticoncepcionais foram: no decorrer das aulas (40,8%),e em seguida com a palestra (32,5%). Entre os temas discu tidos em sala de aula com o professor, o mais citado foi sexualidade, com 57,4%. Sobre o diálogo em família, os entrevis tados consideraram a mãe o elo de comunicação mais importante sendo avaliado como bom por 79,2% dos entrevistados. Dos diversos tipos de atendimento à saúde, recebido na Unidade Básica pelo adolescente, a consulta médica foi o mais citado pelos entrevistados, com 48,2%. O estudo mostrou ainda que o conhecimento sobre os métodos anticoncepcionais não garante o seu uso. Entretanto, a disponibilidade de maior número de serviços e orientações sistematizadas sobre tais métodos podem favorecer a mudança de atitudes dos adolescentes em relação a uma prática de uso eficiente e preventivo em relação aos MAC. / The present study aimed to assess knowledge on contraceptive methods and identify variable associated with appropriate knowledge among students in the municipal school system of Ribeirão Preto -SP. This transversal study was developed through a quantitative approach. Two schools belonging to the Health District of Vila Virgínia were purposely selected and the sample size was a fixed number of 120 adolescent students of both genders, aged between 13 and 16. Data collection was conducted from 03/05/2007 to 03/16/2007 and a semi-structured questionnaire was used as data collection instrument. The research showed that the subjects consisted of a group of adolescents between13 and14 years old (81,7%) and a smaller group of adolescents between 15 and 16 years old (18,3%), with males representing 51.6% and females 48.4%. The sexual initiation occurred around the age of 13 for both genders(71,43%) of females and (41,18%) male sex . The use condom was reported by (57,5%) of subjets group did not using, while among the group within the same, 28.3% reported using it. The findings also showed that 36,7% of the subjects did not use any kind of contraceptive method in their first sexual intercourse, and 54,2% did not answer this question. Regarding ways to obtain contraceptive methods, the results showed that 75,8% of the subjects received them from a Health Unit and a doctor of them prescription, 50,7% bought them at a drugstore. The study showed that 45% of the students did not know any kind of contraceptive method, followed by 20.8% that knew only one kind, 5.8% knew two methods, and 10.8% knew three kinds of methods. The most widely known method was the male condom (45,8%) and the female kind (30.8%), followed by the oral contraceptive (28.3%). As for sources of information and advice on contraceptive methods, the most common source was the school (51.7%), followed by the family (40.8%), and TV (40%). The study showed that the advice and information on sexuality, pregnancy in adolescence, and contraceptive methods received at school were delivered through lectures (32.5%) and during lessons (40.8%). According to the data, among the topics associated with health in adolescence discussed in class with the teacher, sexuality was the most common one (57.4%). In terms of conversations with the family, the mother was shown to be the most important bond. In addition, the level of communication with the mother was considered good by 79.2% of the students. Health attention received at the Health Unit and consultation with a doctor was the most common option mentioned by adolescents (48.2%). The research showed that knowing contraceptive methods does not guarantee their use. However, availability of more services and extensive advice on contraceptive methods can assist in changing adolescents\' behavior as regards the efficient and preventive use of contra ceptive methods.

This thesis studies different aspects of reproductive behaviour on the international, national, and local levels in post-communist countries. The main focus is Ukraine, where fertility rates are very low and the population is in severe decline. The studies contribute new knowledge about the applicability of a family policy typology developed on the basis of Western countries’ experience for post-communist countries, and about the influence of family policies on fertility levels in these countries. Moreover, the studies investigate whether and how macro-level influences impact on individuals’ reproductive behaviour. Four articles are included in the thesis: Family policies in Ukraine and Russia in comparative perspective analyses the institutional set-up of family policies in both countries and compares the findings to 31 other countries. The results show that Ukrainian family policies support a male-breadwinner type of family, while the benefit levels of Russian family policies are low, compelling families to rely on relatives or the childcare market. Family policies and fertility - Examining the link between family policy institutions and fertility rates in 33 countries 1995-2010 comparatively explores whether family policies have an effect on fertility rates across the case-countries. Pooled time-series regression analysis demonstrates that gender-egalitarian family policies are connected to higher fertility rates, but that this effect is smaller at higher rates of female labour force participation. To have or not to have a child? Perceived constraints on childbearing in a lowest-low fertility context investigates the influence of the perception of postmodern values, childcare availability and environmental pollution on individuals’ fertility intentions in a city in Eastern Ukraine. It is shown that women who already have a child perceive environmental pollution as a constraint on their fertility intentions. Prevalence and correlates of the use of contraceptive methods by women in Ukraine in 1999 and 2007 examines changes in the prevalence and the correlates of the use of contraceptive methods. The use of modern contraceptive methods increased during the period and the use of traditional methods decreased, while the overall prevalence did not change. Higher exposure to messages about family planning in the media is correlated with the use of modern contraceptive methods.

Norms are something that affects society, of which we are all aware of. Agenda 2030 and the goals for increased gender equality, sexual health and sexual rights contributes to what now is a more spoken about topic. Norms that affect sexual health is something that we are aware of, but which norms affect people the most is something that is rarely talked about. The previous research is split into two themes, women's respectively men's attitude towards contraceptive methods. The previous research shows that studies have been made within this research area, but the previous research does not show the norms impact on individuals. The purpose of this essay is to study how women in the ages 20-25 years who are sexually active in heteronormative relations feel affected by the society's norms about sexual health and contraceptive methods. The empirical material in this essay is based on eight semi-structured interviews where women have shared their experiences. The collected empirical data have been analyzed based on theoretical concepts from Berger and Luckmann and Hirdman. The theoretical concepts that have been used are objective and subjective reality, socialization, internalization, legitimation and the gender system and the gender contract. The results show that women feel affected by the norms which leads to the sexual health being affected. The experienced norms affect that the women use a hormone-based contraceptive and the attitude towards condom is negative. The conclusions in this study are that the experienced norms affect both women's sexual health and sexual behavior / Att normer är något som påverkar samhället är något vi alla är medvetna om, men sällan pratar om. I och med Agenda 2030 och målen för ökad jämställdhet har sexuell hälsa och sexuella rättigheter blivit ett mer omtalat ämne. Normer som påverkar den sexuella hälsan är något vi vet finns, men däremot talas det sällan om vilka normer det handlar om. Den tidigare forskningen är uppdelad i två teman där kvinnors respektive mäns inställning till preventivmedel presenteras. Den tidigare forskningen visar att studier inom området har gjorts, däremot handlar den tidigare forskningen inte om hur normer påverkar individer. Syftet med den här uppsatsen är därför att undersöka hur kvinnor i åldrarna 20-25 år som är sexuellt aktiva i heteronormativa relationer upplever sig påverkade av samhällets normer kring sexuell hälsa och preventivmedel. Det empiriska materialet i uppsatsen grundar sig i åtta kvalitativa semistrukturerade intervjuer där kvinnor har delat med sig av sina erfarenheter och upplevelser. Den insamlade empirin är analyserad utifrån teoretiska begrepp från Berger och Luckmann samt Hirdman. De teoretiska begrepp som presenteras är objektiv och subjektiv verklighet, socialisering, internalisering och legitimering samt genussystemet och genuskontrakten. Resultatet visade att kvinnorna upplever normer och normerna påverkar deras sexuella hälsa på flera olika sätt. De upplevda normerna påverkar bland annat att de använder sig av ett hormonellt preventivmedel och att inställningen till användning av kondom är negativ. Slutsatserna i studien är att de upplevda normerna påverkar både kvinnors sexuella hälsa och sexuella beteende.

A chegada do primeiro filho traduz um cenário de intensas mudanças na rotina das mulheres, o qual é pautado por diferentes percepções a respeito da sexualidade e da maternidade. As formas como as novas mães percebem tais mudanças e, identificam suas necessidades em relação ao exercício da sexualidade exercem influência sobre o cotidiano e a saúde das mulheres. Este estudo teve por objetivo compreender como as mulheres que se tornaram mães pela primeira vez percebem as mudanças e identificam as suas necessidades em relação ao exercício da sexualidade durante o primeiro ano do período pós-parto. Especificamente buscou analisar as perspectivas das participantes sobre a maternidade e a sexualidade; compreender a vivência da sexualidade em função dos significados atribuídos a maternidade; identificar o conhecimento e a importância atribuída aos diferentes métodos contraceptivos e; identificar a importância das orientações profissionais nas questões ligadas à saúde sexual e reprodutiva das mulheres. Em virtude dos fenômenos estudados desenvolvemos uma pesquisa de cunho qualitativo com 12 mulheres primíparas e usuárias de Unidades Básicas de Saúde do município de Ribeirão Preto, interior do estado de São Paulo. O instrumento utilizado para a realização da coleta de dados foi a entrevista semiestruturada e, através da Análise de Conteúdo o material oriundo da transcrição integral das entrevistas foi fragmentado dando origem a categorias, as quais foram reagrupadas por temáticas relevantes ao objeto estudado. Da análise de conteúdo obtivemos categorias que dizem respeito a concepção de sexualidade, ao sexo e maternidade, a concepção de maternidade, a gravidez, ao parceiro e pai e, ao planejamento familiar. Portanto, a compreensão que as mulheres têm acerca do seu novo papel social imprime novos direcionamentos às experiências diárias no ambiente doméstico, nas relações sociais e no relacionamento com o parceiro. Muitas questões permeadas pelo desequilíbrio nas relações de gênero estão envolvidas nesta dinâmica como a qualidade do acesso ao planejamento familiar, a forma como se apropriam das informações recebidas e a qualidade do atendimento pré e pós-natal. A forma como a mulher exerce a sexualidade e a maternidade é indissociável da construção social da identidade feminina, construção esta que determina as práticas relativas a atenção à saúde das mulheres e que pode interferir nas escolhas e no cuidado com a saúde e na procura da assistência. / The coming of a firstborn son represents a scene of intense changes in routine of women which is lined for different perceptions related to sexuality and motherhood. The ways new mothers notice these changes and identify their needs related to sexuality influences their daily lives and the women health. This study had the goal understand how women became mothers for the first time realize the changes and identify their needs in relation to their sexuality during the first year postpartum period. Specifically sought analyze the participants perspective about motherhood and sexuality; understand the experiences of sexuality according to the meanings assigned to motherhood; identify the knowledge and the importance given to different contraceptive methods; identify the importance of professional orientation linked to maters of sexual and reproductive health of the women researched. In view of the phenomena studied we developed a qualitative research with 12 primiparous women and users of public health system in Ribeirão Preto, countryside of São Paulo state. The instrument used to perform the data collection was semi-structured interview and through the content analysis of the material from the whole interviews transcription, it was fragmented originating categories, which were regrouped by relevant themes to the object of study. Content analysis categories obtained concerning the conception of sexuality, sex and motherhood, conception of motherhood, pregnancy, partner and father, and, family planning. Therefore, the understanding women has about their new social role requires new directions to daily experiences in the home environment, in social relations and in the relationship with their partner. Many questions are permeated by the imbalance of gender relation involved in this dynamic with quality familiar planning access, the way they appropriate information received and the quality of pre and postnatal treatment. At long last, the way which the women practice the sexuality and the motherhood is inseparable from the social construction of female identity, construction that determines the practices related to the attention to womens health that could interfere in the choices and care with health and in the search for assistance.

Objetivo: Caracterizar o conhecimento e uso de métodos anticoncepcionais entre adolescentes de escolas públicas. Métodos: Estudo transversal, realizado com amostra probabilística e representativa de 363 adolescentes, de ambos os sexos, que não viviam conjugalmente, com idades entre 13 e 17 anos, matriculados no período diurno, de escolas públicas, da zona urbana do município de Cruzeiro do Sul, Estado do Acre, em 2008. A pesquisa contemplou as exigências éticas. A caracterização de conhecimento e uso de métodos anticoncepcionais foi feita, a partir da aplicação de um questionário estruturado, contendo perguntas fechadas e abertas sobre sexualidade e métodos contraceptivos. Dados coletados foram digitados, revisados e processados. O banco de dados foi constituído e analisado, estatisticamente, com a utilização do software Epi Info (version 3.5.8; 2008). Os dados foram descritos, utilizando a estatística descritiva: distribuição de freqüência, medidas de tendência central e medida de dispersão. Para identificação de diferenças entre grupos de adolescentes foi utilizado o teste Quiquadrado de Pearson ou Exato de Fisher. Resultados: Dos 363 adolescentes, 55,4por cento eram do sexo feminino e 44,6por cento, do masculino, com média de idade de 14,7 (dp=1,3) anos; 32,0por cento afirmaram que haviam iniciado a vida sexual, as moças, com média de idade de 15,0 (dp=1,3) anos e os rapazes, com 13,3 (dp=1,3) anos; 98,9por cento referiram conhecer algum tipo de MAC, especialmente, o preservativo (95,3por cento) e a pílula (80,1por cento). Mais do que metade das moças e rapazes, respectivamente, 58,3por cento e 59,6por cento, referiram conhecer entre 1 e 4 tipos de MAC. Dentre os que iniciaram, ou não, a vida sexual, 78,4por cento e 65,6por cento, respectivamente, já tinham ouvido falar sobre dupla proteção. Dentre aqueles com vida sexual ativa, 79,3por cento das moças e 81,0por cento dos rapazes referiram terem feito uso de preservativo na primeira e na última relação sexual. Igualmente, 87,5por cento das garotas e 72,1por cento dos garotos, referiram fazer uso de camisinha em todas as relações sexuais. Conclusão: O alto nível de conhecimento de MAC e o elevado uso de preservativo sexual masculino entre esses adolescentes podem expressar resultados positivos das políticas públicas de saúde sexual e reprodutiva atuais, contribuindo para diminuição de gravidez não planejada e de infecções por doenças transmitidas por via sexual / To characterize the knowledge and use of contraceptive methods among public school students. Methods: Transversal study, accomplished with probabilistic and representative sample of 363 adolescents, man and woman, who didnt live conjugally, between 13 and 17 years old, matriculated in diurnal period, in public schools, in the urban area of Cruzeiro do Sul District, Acre State, in 2008. The research observed the ethic requirements. The characterization of the knowledge and use of contraceptive methods was done with the application of a structured questionary, containing open and closed questions about sexuality and contraceptive methods. The gathered data were digitated, revised and processed. The data bank was constituded and analyzed, statistically, using the software Epi Info (version 3.5:8; 2008). The data were described, using the descriptive statistic: frequency distribution, central trend measures and dispersion measure. For the identification of the differences among the adolescent groups it was used the Qui-square test of Pearson or Exact of Fisher. Results: From the 363 adolescents, 55,4per cent were female and 44,6per cent male, with average age of 14,7 (dp=1,3) years old; 32,0per cent told that they had begun sexual life, the girls with average age of 15,0 (dp=1,3) years old and the boys, with 13,3 (dp=1,3) years old; 98,9per cent affirmed to know some kind of MAC, especially the preservative (95,3per cent) and the contraceptive pills (80,1per cent). More than half of the girls and boys, respectively, 58,3per cent and 59,6per cent affirmed to know between 1 and 4 kinds of MAC. Among the ones who had begun, or not, sexual life, 78,4per cent and 65,6per cent, respectively, had already heard about double protection. Among the ones with active sexual life, 79,3per cent of the girls and 81,0per cent of the boys affirmed that they had already made use of preservative during the first and the last intercourse. Identically, 87,5per cent of the girls and 72,1per cent of the boys affirmed that they use condom in every intercourse. Conclusions: The high level of knowledge of MAC and the high use of male sexual preservative among those adolescents can express positive results of the current public sexual and reproductive health policies, contributing with the decrease of the non-planned pregnancy and infections by sexually transmitted diseases