Ethiopia has one of the largest populations in the world, an estimate of 114 million inhabitants. With more than 40% of the population below the age of 15 the country has to make further progress in meeting its family planning needs. The fertility rate has slowly declined, but the population continues to grow. Efforts to reduce gender disparities and empower women have fallen short in many parts of the world. Evidence suggesting a link between women’s empowerment, health outcomes and health care service utilization. A secondary analysis of the 2016 Ethiopian Demographic and Health Survey was conducted. The aim of this study was to determine the association between women’s empowerment, sociodemographic and reproductive factors and contraceptive use among married women and women living with partner aged 15-49 in Ethiopia. Logistic regression, bivariate, and descriptive analysis was conducted. Decision-making role in regard to husband’s money was a strong predictor for contraceptive use. Women who alone or jointly made decision were more likely to use contraceptives. The state of wealth of women was a significant determinant for contraceptive use. Those with lower education were more likely to use contraceptives compared to those with higher education. Women who did not intend to have more children were more likely to use contraceptives. This study showed that contraceptive use is associated with women’s economic decision-making age, and several sociodemographic and reproductive factors. Improving women’s empowerment, through decision making power can improve contraceptive use and therefore achieve better maternal health.

Le 1er juin 2016, la politique nationale de gratuité des soins de santé reproductive est entrée en vigueur au Burkina Faso. Elle vise à réduire la mortalité maternelle en améliorant l’accès aux soins de santé pendant la grossesse, l’accouchement, et en post-partum. Si cette politique a permis d’augmenter la fréquentation dans les centres de santé reproductive par les femmes, d’autres barrières pourraient encore limiter le recours à ces services. Il s’agit, d’une part, de la mauvaise qualité des relations entre les femmes et les soignant·e·s, et d’autre part, du faible pouvoir décisionnel des femmes en matière de santé reproductive et de planification familiale. Notre étude vise à décrire ces deux barrières potentielles dans le contexte de la gratuité des soins au Burkina Faso. Nous avons réalisé une étude qualitative descriptive en milieu rural. Des données ont été collectées à l’aide d’entrevues semi-dirigées et de groupes de discussion, auprès de femmes burkinabè en âge d’avoir des enfants, de leurs maris, et d’informatrices clés. Nos résultats montrent, d’une part, que les relations avec les soignant·e·s et la qualité des soins au centre de santé sont perçues comme satisfaisantes par les femmes. D’autre part, si la gratuité des soins semble efficace pour améliorer l’accès aux soins de santé reproductive et à la planification familiale, le poids des normes sociales semble toujours limiter le pouvoir décisionnel des femmes. Au regard de ces résultats, des pistes d’action seraient à envisager en complément de la gratuité pour améliorer le pouvoir décisionnel des femmes en matière de santé. / On June 1, 2016, the national user fee exemption policy has been introduced in Burkina Faso. It aims to reduce maternal mortality by improving access to healthcare during pregnancy, childbirth, and postpartum. This policy has increased the number of women attending reproductive health centres, however other barriers could still prevent women from seeking healthcare. These barriers are, first, the poor quality of relationships between women and healthcare providers, and second, women’s lack of decision-making power in matters of reproductive health and family planning. Our study aims to describe these two potential barriers in the context of free healthcare in Burkina Faso. We carried out a descriptive qualitative study in rural areas. Data were collected through semi-structured interviews and focus groups from Burkinabe women of childbearing age, their husbands, and key informants. Our results show, on one hand, that relationships with healthcare providers and quality of care at health centres are perceived as satisfactory by women. On the other hand, while the user fee exemption policy seems to be effective in improving access to reproductive care and family planning, social norms seem to limit women’s decision-making power. In view of these results, courses of action could be imagined to improve the decision making power of women regarding reproductive health and family planning.

No description available.

Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder that affects women’s menstrual cycles and their levels of androgens (male hormones) and cysts on the ovaries. There is a variety of symptoms that come with this endocrine disorder, but insulin resistance is a hallmark symptom of the disorder. It’s shown that 65-70% of women with PCOS have insulin resistance and hyperinsulinemia, this is in women that are overweight, obese, or lean (Marshall & Dunaif, 2012). A lot of women with PCOS find themselves struggling to lose weight because their excess weight is tied to lifestyle and not properly nourishing their bodies, as well as their imbalanced hormones. The understanding of PCOS being a metabolic disorder led to the investigation of the need for registered dietitian nutritionists on the health team of women with PCOS could change the quality of life in women. We developed a survey based on the literature available on the topic of PCOS, diet/nutrition interventions, and the role of RDNs in the healthcare team of PCOS women of childbearing age. Only childbearing-age women (18-44) that have been diagnosed with PCOS were allowed to complete the survey. The survey was comprised of three sections and was designed to be a needs assessment on the need for registered dietitian-nutritionists to be included in the healthcare team of PCOS women. The questions were designed also show any gaps of knowledge or misconceptions about nutrition that these women may have. Lastly, it was designed to examine if women understand how nutrition relates to the management of their symptoms of PCOS and future disease risks. The data from this survey will show the need for RDNs in the healthcare team of PCOS women, and give us an understanding of nutrition education and intervention that could be developed for future studies. This understanding of how RDNs could play a role in symptom management could lead to a better quality of life in PCOS women.

Contexte : L'Organisation mondiale de la santé (OMS) demande de « promouvoir » l'autonomie des adolescents dans l'accès aux services de santé. Mais la question de l'autonomie des adolescents en matière de soins de santé soulève des questions éthiques complexes (ex. : la nécessité du consentement parental). Il est donc nécessaire d'étudier empiriquement les questions éthiques liées à la promotion de l'autonomie des adolescents dans l'accès aux services de santé sexuelle et reproductive (SSSR). En raison de son contexte particulier (ex. : l'accès légal pour les adolescents aux SSSR), la Colombie a été choisie pour cette étude. Objectifs : 1) comprendre comment les adolescents interprètent le concept d'autonomie ; 2) explorer les préférences et les expériences des adolescents concernant leur autonomie pour accéder aux SSSR ; 3) examiner comment les adolescents souhaitent que leur autonomie soit promue ; 4) identifier et répondre aux questions éthiques reliées à l'appel de l'OMS à promouvoir l'autonomie des adolescents. Méthodologie : Une approche mixte fut utilisée avec des entretiens semi-structurés et des questionnaires. La recherche a eu lieu dans les départements colombiens d'Antioquia et du Valle del Cauca. Les adolescents qui se présentèrent dans deux cliniques Profamilia ont été invités à répondre à un questionnaire. En parallèle, les entretiens ont permis aux participants de présenter et de partager leurs opinions et expériences concernant leur autonomie pour accéder aux SSSR. Résultats : Au total, 812 adolescents de 11 à 24 ans ont répondu au questionnaire et 45 participants (de 14 à 23 ans) ont participé à un entretien individuel. Les entretiens démontrèrent que la compréhension de l'autonomie par les participants dépendait de leurs expériences personnelles, ce qui influence leur capacité d’accès aux SSSR. Selon un cadre de justice reproductive, les résultats soulignent des inégalités en termes d'autonomie pour accéder à des SSSR. Parallèlement, le questionnaire a démontré que les adolescents colombiens ont des préférences diverses en matière d'accès aux SSSR. Les études antérieures rapportent que les adolescents préfèrent la confidentialité et l'indépendance en lien aux SSSR, s’alignant ainsi sur la tendance d’encadrer le principe d'autonomie selon une perspective individualiste et d’autosuffisance. Cependant, la plupart des participants exprimèrent le souhait de pouvoir parler ouvertement avec leurs parents de leur santé sexuelle et reproductive et plusieurs voulaient aussi être accompagnés dans leur accès au SSSR. Conclusions : Les recommandations suivantes sont présentées en faveur d'un accès plus éthique aux SSSR en Colombie : 1) enseigner aux adolescents les fondements de l'autonomie pour que tous disposent des mêmes bases pour exercer leurs droits d'accès aux SSSR ; 2) investir dans la recherche avec les parents pour déterminer si leur fournir une éducation sexuelle aiderait les adolescents à accéder aux SSSR ; 3) adopter une approche « d’autonomie relationnelle » pour respecter les préférences des adolescents colombiens en matière d'accès aux SSSR. Lorsque les adolescents commencent à développer leur autonomie et avoir des relations sexuelles, il est essentiel de leur fournir les outils et les ressources nécessaires pour accéder aux SSSR dont ils ont besoin. / Background: The World Health Organization (WHO) advocates “fostering” the autonomy of adolescents to access health services. But the question of adolescents’ autonomy in healthcare raises complex ethical questions (e.g., necessity of parental consent). Hence, there is a need to investigate empirically the ethical questions around fostering adolescents’ autonomy to access sexual and reproductive health services (SRHS). Because of its particular context (e.g., adolescents’ legal access to SRHS), Colombia was chosen for this study. Objectives: The objectives of this project were to 1) understand how adolescents comprehend the concept of autonomy, 2) explore the preferences and experiences of adolescents regarding their autonomy to access SRHS, 3) examine how adolescents wish for their autonomy to be fostered, and 4) identify the ethical issues and provide ethically informed solutions in line with the WHO’s call to foster adolescents’ autonomy. Methodology: A mixed-method approach was used with semi-structured interviews and surveys for cross-sectional analysis. The research took place in the Colombian departments of Antioquia and Valle del Cauca. Adolescents who presented themselves at two Profamilia clinics were invited to answer a survey. In parallel, the interviews offered an opportunity for participants to present and share their opinions and experiences concerning their autonomy to access SRHS. Results: A total of 812 participants aged 11-24 completed a survey, and 45 participants (aged 14-23) participated in an individual interview. The interviews demonstrated that participants’ understanding of autonomy was highly dependent on personal experiences, which influenced their choice and ability to access SRHS. Seen through the ethical lens of a reproductive justice framework, the results highlight the unequal opportunities of adolescents in terms of autonomy to access SRHS. In parallel, the survey showed that Colombian adolescents have a variety of preferences regarding how to access SRHS. Previous research has shown that adolescents prefer privacy and independence where SRHS are concerned, findings that align with the longstanding tendency to frame the ethical principle of autonomy from the perspective of individuality and self-reliance. However, most participants in this study expressed a strong wish to be able to talk openly with their parents about sexual and reproductive health, and many also wanted to be accompanied when they access SRHS. Conclusions: Based on the study findings, the following recommendations are put forward in support of a more ethical access to SRHS in Colombia: 1) teach adolescents the basis of autonomy, so they can equally benefit from the necessary knowledge and skills to exercise their rights to access SRHS; 2) invest in research with parents to determine if providing them with comprehensive sex education could help adolescents access SRHS; 3) adopt a nuanced “relational autonomy” approach to respect the myriad of preferences that Colombian adolescents have regarding access to SRHS. As adolescents start developing their autonomy and engaging in sexual relations, it is critical to provide them with the necessary tools and resources to access needed SRHS. / Contexto: La Organización Mundial de la Salud (OMS) llama a "fomentar" la autonomía de los adolescentes en el acceso a los servicios de salud. Sin embargo, la cuestión de la autonomía de los adolescentes en la atención de salud plantea complejas cuestiones éticas (por ejemplo, la necesidad del consentimiento de los padres). Por lo tanto, es necesario estudiar empíricamente las cuestiones éticas relacionadas con la promoción de la autonomía de los adolescentes en el acceso a los servicios de salud sexual y reproductiva (SSSR). Debido a su contexto particular (por ejemplo, el acceso legal de los adolescentes a los SSSR), se eligió a Colombia para este estudio. Objetivos: (1) entender cómo los adolescentes comprenden el concepto de autonomía; (2) explorar las preferencias y experiencias de los adolescentes con respecto a su autonomía para acceder a los SSSR; (3) examinar cómo los adolescentes desean que se fomente su autonomía para acceder a los SSSR; (4) identificar las cuestiones éticas y proponer soluciones éticamente informadas en línea con el llamamiento de la OMS para fomentar la autonomía de los adolescentes. Métodos: Se utilizó un enfoque de método mixto: entrevistas semiestructuradas y encuestas. La investigación tuvo lugar en los departamentos colombianos de Antioquia y Valle del Cauca. Los adolescentes que se presentaron en dos clínicas de Profamilia fueron invitados a responder una encuesta. Paralelamente, las entrevistas permitieron a los participantes presentar y compartir sus puntos de vista y experiencias sobre su autonomía en el acceso a la salud sexual y reproductiva. Resultados: Un total de 45 participantes de 14 a 23 años participaron en una entrevista, y 812 participantes de 11 a 24 años completaron una encuesta. Las entrevistas demostraron que la comprensión de la autonomía de los participantes dependía en gran medida de sus experiencias personales, lo que influyó en su elección y capacidad para acceder a los SSSR. Visto a través de la lente ética de un marco teórico de justicia reproductiva, los resultados ponen de manifiesto la desigualdad de oportunidades de los adolescentes en términos de autonomía para acceder a los SSSR. Paralelamente, las encuestas mostraron que los participantes tienen una variedad de preferencias para acceder a los SSSR. Las investigaciones anteriores muestran que los adolescentes prefieren la privacidad y la independencia en lo que respecta a los SSSR. Dichos hallazgos se alinean con la tendencia a enmarcar el principio ético de la autonomía sobre la base de una perspectiva individualista y de autosuficiencia. Sin embargo, la mayoría de los participantes expresaron su deseo de poder hablar abiertamente con sus padres sobre su salud sexual y reproductiva y muchos también querían recibir apoyo para acceder a los SSSR. Conclusión: Según los resultados de la investigación, se proponen las siguientes recomendaciones: (1) enseñar a los adolescentes las bases de la autonomía, con el objetivo de que todos los adolescentes tengan las mismas bases para ejercer sus derechos de acceso a los SSSR; (2) invertir en estudios con los padres para determinar si proporcionarles una educación sexual integral ayuda a los adolescentes a acceder a los SSSR; (3) adoptar un enfoque de “autonomía relacional” para respetar la miríada de preferencias que tienen los adolescentes colombianos para acceder a los SSSR. A medida que los adolescentes comienzan a desarrollar su autonomía y a tener relaciones sexuales, es fundamental proporcionarles las herramientas y los recursos necesarios para acceder a los SSSR que necesitan.

Introduktion: Den sexuella hälsan kan förslagsvis främjas genom insatser som en god sexualundervisning. Skolan har ingen kursplan i sexualitet, samtycke och relationer vilket medför att skillnaden på sexualundervisningen i Sveriges skolor är stor vilket kan leda till riskfyllda sexualvanor, fler partners och låg kondomanvändning.  Syfte: Det primära syftet var att undersöka hur människor upplever den nuvarande sexualundervisningen i skolan. Det sekundära syftet var att ta fram ett konkret material som skolväsendet kan använda för att kunna bedriva en hälsofrämjande sexualundervisning för barn och unga.  Metod: En empirisk kvantitativ enkätstudie har tillämpats. En webbenkät lades ut på Facebook och resultatet sammanställdes i Google Forms. Sen användes enkätresultaten från denna studie tillsammans med resultat från tidigare studier som har granskats i samband med detta arbete för att skriva en kursplan.  Resultat: 51 stycken respondenter svarade på enkäten i åldrarna 20-41 år. Majoriteten av respondenterna upplevde att de inte var nöjda med den sexualundervisning de har fått. Många av respondenterna uppgav att samtliga ämnen inte har tagits upp i tillräckligt stor utsträckning och många upplevde att de inte hade tillräckligt med information i dessa ämnen. 1 av 3 tyckte att undervisningen saknade en övergripande kvalitet och flertalet lyfte att de saknade en behörig lärare.  Diskussion: En möjlighet är att den sexuella hälsan blir lidande av den bristfälliga undervisningen i form av att eleverna missar tillfällen att utveckla empowerment och säkerhet kring sin sexualitet och identitet. En kursplan i sexualitet, samtycke och relationer kan skapa en ökad trygghet hos lärarna vilket också ökar kvaliteten på undervisningen. Ett förslag är att universitetsstudenter som har kompetens inom detta område, exempelvis studenter på sjuksköterskeprogrammet, hälsovägledarprogrammet eller andra studenter inom andra relevanta utbildningar, undervisar studenter på grundskolenivå som en del av båda parters utbildning. / Introduction: Sexual health can be promoted through initiatives such as good sex education. The school has no curriculum in sexuality, consent and relationships, which means that the difference in sexuality education in Sweden's schools is large, which can lead to risky sexual habits, more partners and low condom use. Purpose: The primary purpose was to investigate how people experience the current sex education in school. The secondary aim was to produce concrete material that the school system can use to be able to conduct health-promoting sex education for children and young people. Method: An empirical quantitative survey study has been applied. A web survey was posted on Facebook and the results were compiled in Google Forms. The survey results from this study were then used together with results from previous studies that have been reviewed in connection with this work to write a course plan. Results: 51 respondents answered the survey aged 20-41. The majority of respondents felt that they were not satisfied with the sex education they have received. Many of the respondents stated that all topics have not been covered to a sufficient extent and many felt that they did not have enough information on these topics. 1 in 3 thought that the teaching lacked an overall quality and the majority pointed out that they lacked a qualified teacher. Discussion: One possibility is that sexual health suffers from the inadequate teaching in the form of students missing opportunities to develop empowerment and security around their sexuality and identity. A curriculum in sexuality, consent and relationships can create increased security among teachers, which also increases the quality of teaching. One suggestion is that university students who have competence in this area, for example students in the nursing program, the health guidance program or other students in other relevant educations, teach students at primary school level as part of both parties' education.

La santé reproductive est un concept qui réunit plusieurs aspects, tels que les méthodes de contraception, la grossesse, l’accouchement et le fait d’élever ses enfants. La santé reproductive peut être affectée par de nombreuses inégalités et barrières à la santé. À Montréal, les femmes de la communauté haïtienne peuvent vivre plusieurs de ces inégalités simultanément. Plusieurs caractéristiques individuelles peuvent accroitre les rapports de pouvoir vécus et ressentis au sein du système de soins de santé québécois. Pour les femmes ayant des origines haïtiennes, les rapports de pouvoir s’articulent particulièrement autour du genre et de la couleur de peau. Ces rapports de pouvoir précèdent l’institution de soins de santé actuelle et ceux-ci découlent du colonialisme, de la suprématie blanche et du patriarcat. D’autres éléments peuvent être pris en compte, tels que le statut socioéconomique, les caractéristiques individuelles et les milieux de vie. Les inégalités de santé et barrières à la santé peuvent prendre plusieurs formes : financières, langagières, géographiques et bureaucratiques. Bien qu’il soit connu que le racisme affecte tant la santé que l’accès aux soins de santé, le racisme sous toutes ses formes n’est que peu ou pas abordé en lien avec la santé reproductive au Québec. L’objectif principal de cette recherche est donc d’examiner si le racisme affecte la santé reproductive des femmes de la communauté haïtienne de Montréal, et si tel est le cas, d’explorer de quelles façons, ainsi que les conséquences de ces liens. Pour ce faire, des entretiens avec 16 femmes ayant des origines haïtiennes et vivant à Montréal ont été réalisés. De plus, trois entretiens avec des membres du personnel de soins de santé d’un organisme communautaire ont alimenté la recherche. / Reproductive health is a concept that brings together several aspects, such as contraceptive methods, pregnancy, childbirth, and child rearing. Reproductive health can be affected by many inequalities and barriers to health. In Montreal, women from the Haitian community may experience many of these inequalities simultaneously. Many individual characteristics can increase the power relations experienced and felt within the Quebec health care system. For women of Haitian descent, power relations are particularly articulated around gender and skin color. These power relations precede the current health care institution, which arise from colonialism, white supremacy, and patriarchy. Other elements can be considered, such as socioeconomic status, individual characteristics and living environments. Health inequalities and barriers to health can take many forms: financial, language skills, geographic and bureaucratic. Although it is known that racism affects both health and access to health care, racism in all its forms has received little or no attention in relation to reproductive health in Quebec. The main objective of this research is therefore to determine whether racism affects the reproductive health of women in the Haitian community in Montreal, and if so, to explore the consequences of these links. To do so, interviews were conducted with 16 women of Haitian descent living in Montreal. In addition, three interviews with health care staff at a community organization participated for the research.

Introduktion: Sexuell och reproduktiv hälsa är fundamental för människans välbefinnande, både utifrån fysiska, psykiska och sociala aspekter. Forskning har visat att ungdomar är en av de grupper som utgör den största risken för att få och sprida sexuellt överförbara infektioner (sexually transmitted infections, STI) vilket kan leda till problem med den sexuella och reproduktiva hälsan. STI är problematiskt och kan påverka den sexuella hälsan hos ungdomar som i stor utsträckning drabbas även om det finns utökade möjligheter för att inhämta information, tillgängliga resurser och effektiva behandlingsmöjligheter. Denna studie ser det som relevant att undersöka STI relaterat till gruppen ungdomar genom att använda det salutogena perspektivet. Syfte: Syftet med studien var att undersöka och belysa sexuella beteenden och attityder som kan leda till minskad smittrisk för STI och identifiera tidigare interventioner eller framgångsmetoder som har haft positiva effekter för förebyggandet av STI bland ungdomar mellan15–24 år. Metod: Metoden som användes var en strukturerad litteraturstudie. kvalitativa och kvantitativa artiklar som hade publiceringsdatum efter år 2013 användes. Tematisk analys användes för att identifiera olika teman och insamlade data analyserades deduktivt utifrån det salutogena perspektivet. Slutsats: Resultatet belyste att specifikt inriktad sexuell undervisning i skolorna och specifikt utbildade aktörer inom STI hade en positiv effekt bland ungdomar, vilket lede till mindre riskfyllda sexuella beteenden som var STI förebyggande. Resultatet visade även att öppen kommunikation var en väsentlig faktor som bidrar till ungdomarnas attityder kring sex och förebyggande av STI. / Introduction: Sexual and reproductive health are fundamental to human well-being, both from physical, psychological, and social aspects. Research has shown that young people are one of the groups that pose the greatest risk of getting and spreading sexually transmitted infections (STI) which can lead to sexual and reproductive problems. STIs are problematic and can affect the sexual health of young people who are widely affected, even if there are increased opportunities to obtain information, available resources, and effective treatment options. This study considers it relevant to research STIs related to that group by using the salutogenic perspective. Purpose: The purpose of the study was to research and highlight sexual behaviors and attitudes that can lead to reduced risk of STI and to identify previous interventions or methods that have had positive effects on the prevention of STIs among young people between 15-24 years of age. Method: The method used was structured literature review. Qualitative and quantitative articles that had a publication date after the year 2013 were used. Thematic analysis was used to identifydifferent themes and collected data were analyzed deductively based on the salutogenic perspective. Conclusion: The results highlighted that specifically targeted sexual education in schools and specifically STI trained actors had positive effects on young people, which led toless risky behavior which also was STI-reducing. The results also showed that open communicationis an essential factor that contributes to young people´s attitudes about sex and the prevention of STIs.

No description available.

No description available.