Orientador: Ione Morita / Banca: Margareth Ap. Santini Almeida / Banca: Maria Rauter Mancuso / Resumo: As questões relacionadas à sexualidade e à saúde sexual e reprodutiva dos adolescentes são objeto de preocupação dos diversos setores sociais. Dentre os estudos sobre a juventude, a gravidez na adolescência tem sido objeto privilegiado, muitas vezes evidenciando discursos pautados em percepções preconceituosas, punitivas e associadas à irresponsabilidade e exposição a riscos. As discussões centram-se na mulher e com menor ou nenhum enfoque, na paternidade. Assim, há um esquecimento do adolescente homem que, na maioria das vezes, não encontra seu espaço junto às politicas públicas, principalmente quando se trata de gravidez na adolescência. Desta forma, o presente estudo tem como objetivo compreender as representações sociais sobre o processo de paternidade; o tornar-se pai e apreender os significados e as vivências estabelecidas neste processo. A pesquisa foi realizada com 9 adolescentes com 17 e 18 anos, moradores de um bairro periférico no municipio de São Manuel-SP. Considerando o objeto de estudo, adotou-se como referencial teórico as Representações Sociais e como recurso metológico a pesquisa qualitativa, com uma entrevista semi- estruturada. Ao término da coleta, as entrevistas foram transcritas e submetidas à técnica de análise de conteúdo de Bardin. A partir dessa técnica foram identificadas três categorias centrais: a descoberta da gravidez; dificuldades e mudanças vivenciadas pelo adolescente ao tornar-se pai e o significado da paternidade. Após análise dos dados, constatou-se que a vivência da paternidade trouxe mudanças significativas na vida destes adolescentes, tanto no plano econômico, como também no afetivo, pessoal e social. Destaca-se que essa experiência gerou sentimentos de satisfação ao ultrapassar a função de ser apenas um pai provedor, o que é mostrado pelo cuidado com o filho e principalmente através do estabelecimento de relações afetivas entre estes / Abstract: Issues related to sexuality and to reproductive and sexual health of adolescents is a main concern of many social sectors. Among the studies on youth, teen pregnancy has been privileged, often revealing speeches guided by punitive and prejudicial perceptions, which are associated with irresponsibility and exposure to risks. The discussions focus almost solely on women, with less or no focus on fatherhood. Thus, there is a forgetfulness of the teenage man, who most often doesn't find his place together with public policies, especially when it comes to teen pregnancy. Thereby, this study aims to understand the social representations about the paternity process and to grasp the meanings and experiences set forth in this process. The survey was conducted with 17 adolescents from 9 to 18 years old, residents of a suburb in the municipality of São Manuel - SP. According to the object of study, the Social Representations were adopted as the theoretical framework, and the qualitative research as a methodological resource, together with a semi-structured interview. At the end of the collection, the interviews were transcribed and subjected to the content analysis technique of Bardin. From this technique, three core categories were identified: the discovery of pregnancy, difficulties and changes experienced by adolescents when becoming fathers and the meaning of fatherhood. After analyzing the data, it was found that the experience of fatherhood has brought significant changes in the lives of these adolescents in economic, emotional, personal and social terms. It is noteworthy that this experience has generated feelings of satisfaction to overcome the function of being just a provider father, which is shown by caring for their child and primarily through emotional relationships between them / Mestre

Essa tese trata da prática de parteiras na cidade de Melgaço, na região marajoara e fluvial do estado do Pará, no contexto globalizado entre 2004 e 2006. Seguindo uma abordagem antropológica, minha proposta foi me aproximar da “visão nativa”, integrando a prática de parteiras dentro da análise do modo de vida “local”. Optei por centrar a discussão na etnografia pormenorizada da vida cotidiana (práticas e conhecimentos) das parteiras, sem, no entanto, cair no erro de monografias anteriores, isto é, sem me limitar a uma “história natural” do grupo, como se fosse “exótico” e “isolado”. A importância que estas mulheres conferem à atenção da saúde gineco-obstétrica envolveu analisar elementos tão diversos quanto a massagem abdominal empregada (conhecida localmente como puxação), as relações conjugais e de parentesco, a interação com o sistema de saúde institucional e os cursos de treinamento organizados por ONGs. A originalidade dessa pesquisa é pretender suplantar as dicotomias usuais (tradição/modernidade, biológico/cultural etc.), além da preocupação funcionalista (como modificar as práticas locais), para ressaltar a dimensão social (redes familiares etc.) e simbólica (saberes locais, hierarquias de prestígio) que englobam os elementos que vêm “de fora”, conferindo um sentido à prática atual das parteiras. / This thesis addresses the practice of midwives in the city of Melgaço, in the fluvial region of the Marajó, State of Pará, in the globalized context from 2004 to 2006. Following an anthropological approach, my intention was to become closer to the “native view”, integrating midwives’ practice within the analysis of the “local” way of life. I chose to center this discussion on a detailed ethnography of the midwives’ daily life (practices and knowledge) without, although, committing the mistake of previous monographies, that is, without limiting myself to a “natural history” of the group, as if they were “exotic” and “isolated”. The importance that these women confer to gynecological and obstetrical health issues involved the analysis of elements as diverse as the abdominal massage (known locally as puxação), the kinship and marital relations, the interaction with the institutional health system and the training courses organized by NGOs. The originality of this research is to intend to overcome usual dichotomies (e.g. tradition/modernity, biological/cultural etc.), beyond the functionalist worries (how to modify the local practices), in order to enhance the social (family networks etc.) and symbolic (local knowledge, prestige hierarchies etc.) dimensions that involve the elements coming “from outside” and that confer a meaning to the current practice of these midwives.

Essa tese trata da prática de parteiras na cidade de Melgaço, na região marajoara e fluvial do estado do Pará, no contexto globalizado entre 2004 e 2006. Seguindo uma abordagem antropológica, minha proposta foi me aproximar da “visão nativa”, integrando a prática de parteiras dentro da análise do modo de vida “local”. Optei por centrar a discussão na etnografia pormenorizada da vida cotidiana (práticas e conhecimentos) das parteiras, sem, no entanto, cair no erro de monografias anteriores, isto é, sem me limitar a uma “história natural” do grupo, como se fosse “exótico” e “isolado”. A importância que estas mulheres conferem à atenção da saúde gineco-obstétrica envolveu analisar elementos tão diversos quanto a massagem abdominal empregada (conhecida localmente como puxação), as relações conjugais e de parentesco, a interação com o sistema de saúde institucional e os cursos de treinamento organizados por ONGs. A originalidade dessa pesquisa é pretender suplantar as dicotomias usuais (tradição/modernidade, biológico/cultural etc.), além da preocupação funcionalista (como modificar as práticas locais), para ressaltar a dimensão social (redes familiares etc.) e simbólica (saberes locais, hierarquias de prestígio) que englobam os elementos que vêm “de fora”, conferindo um sentido à prática atual das parteiras. / This thesis addresses the practice of midwives in the city of Melgaço, in the fluvial region of the Marajó, State of Pará, in the globalized context from 2004 to 2006. Following an anthropological approach, my intention was to become closer to the “native view”, integrating midwives’ practice within the analysis of the “local” way of life. I chose to center this discussion on a detailed ethnography of the midwives’ daily life (practices and knowledge) without, although, committing the mistake of previous monographies, that is, without limiting myself to a “natural history” of the group, as if they were “exotic” and “isolated”. The importance that these women confer to gynecological and obstetrical health issues involved the analysis of elements as diverse as the abdominal massage (known locally as puxação), the kinship and marital relations, the interaction with the institutional health system and the training courses organized by NGOs. The originality of this research is to intend to overcome usual dichotomies (e.g. tradition/modernity, biological/cultural etc.), beyond the functionalist worries (how to modify the local practices), in order to enhance the social (family networks etc.) and symbolic (local knowledge, prestige hierarchies etc.) dimensions that involve the elements coming “from outside” and that confer a meaning to the current practice of these midwives.

This dissertation study utilized the National Longitudinal Study of Adolescent to Adult Health to analyze empirical relationships between social determinants of health and adolescent pregnancy. Although rates of adolescent pregnancy are at an all-time low in the United States, disparities persist. Examining relationships between the social determinants of health and adolescent pregnancy provides support for funding and interventions that expand on the current focus of individual and interpersonal level factors. Based on the Healthy People 2020 Social Determinants of Health Framework, proxy measures for social determinants of health were identified within the Add Health study and analyzed in relationship with adolescent pregnancy. Results indicated that six of 17 measures of social determinants of health had an empirical relationship with adolescent pregnancy. These measures included the following: feeling close to others at school, receipt of high school diploma, enrollment in higher education, participation in volunteering or community service, litter or trash in the neighborhood environment, and living in a two parent home. The results of this study can inform future research, allocation of funds and interventions based on social determinants of health that show an association with adolescent pregnancy.

Magister Philosophiae - MPhil / Background: In the Democratic Republic of Congo, 22.2% of the total population is in the age group of 15 to 24 years. In this country, this population group faces a large number of reproductive health problems. Even though the concerned health officials have implemented several health care programs, the youth particularly girls still have many problems particularly lack of sexual health information, poor health care, inability to avoid early and unprotected sexual relationships, early marriage, early pregnancies, early childbearing, etc. Objectives: The aim of this study is to examine reproductive health issues among young women and to understand how they utilise the health care systems in their respective socio-economic and demographic characteristic. Data and Methods: Descriptive and multivariate analyses were used. Cross tabulation, Chi-square, Phi coefficient and Cramer‘s V were applied to test for association between independents and outcome variables. At multivariate level of analysis, binary logistic regression was performed. All analyses were performed using the Statistical Package for Social Sciences (SPSS) version 23.0. Results: The study found that young women who faced early sexual intercourse (OR=73.5) and those who experienced it at 16-17 (OR= 42.3) are more at risk of early marriage than those who initiated at the age 18-24. Meanwhile, young women with no education (OR=14.1), primary and secondary education (OR=10.7 and OR=8.6 respectively) have a higher risk of early union than their higher educated counterparts. Furthermore, respondents who married in their early adolescence (OR=38.3) and middle (OR=20.0) adolescence are more at risk of early childbearing than those who married in their emerging adulthood. Moreover, young women from Maniema, Equateur and Bas Congo provinces are 95%, 62% and 58% (respectively) less likely to have had at least four ANC visits than those from Kinshasa. Conclusion: There is an urgent need for formal sex education before first sexual initiation to give better options than early marriage to adolescent girls. Also, the disparities in the antenatal care services utilization between provinces should be addressed. The concerned authorities should balance the distribution of health facilities and qualified personal among provinces.

Although much has been written and discussed on the African Women’s Protocol in recent years, a number of misinterpretations and ambiguities remains regarding the source and scope of the specific rights enshrined in this revolutionary Protocol. From a legal perspective, the author singles out the provision of article 14 of the African Women’s Protocol (sexual and reproductive health rights) and begins with the tricky issue of identifying four aspects namely non-discrimination, abortion, informed consent and HIV/AIDS which in his opinion are fundamental to the protection and promotion of women’s sexual and reproductive health rights. Thereafter, with the help of case law, the author reviews the legal interpretations of these four aspects by some African, American, and Asian courts. At the UN level, decisions of the CEDAW Committee and the Human Rights Council are also reviewed. Of practical interest, reflecting on the four aspects, the author explores the interpretative approach of different social sciences such as sociology, anthropology and psychology in an attempt to introduce a multidisciplinary approach that could supplement legal interpretation and understanding of women’s sexual and reproductive health rights. / Dissertation (LLM)--University of Pretoria, 2011. / Centre for Human Rights / unrestricted

The 2010 elections in Myanmar installed the country’s first civilian-elected government in more than 50 years, and subsequent growth and change have been rapid. However, reproductive health indicators are generally poor and reflect significant regional and geographic disparities. Rural populations are increasingly migrating to urban centers, like Yangon, in search of better economic opportunities and in response to persistent conflict. Many are settling in peri-urban Yangon, a dynamic series of townships characterized by poor infrastructure, slums, and a highly mobile population. However, very little is known about the reproductive health needs of this population. This study was designed to identify the reproductive health needs of women in peri-urban Yangon, and to understand better current practices, available services, and potential avenues for improvement. My research focused on delivery care, contraception, abortion, and post-abortion care. Using a multi-methods approach, and standard qualitative analytic techniques, I identified significant unmet reproductive health needs in peri-urban Yangon. The findings suggest that reproductive health services are often available but inaccessible. Findings demonstrate considerable misinformation, common and unsafe practices surrounding abortion and delivery, and a dearth of comprehensive sexual and reproductive health services for adolescent and unmarried populations.

In a study we conducted with Ontarian women about their abortion experiences (OAS), one third of participants expressed a desire for post-abortion support. Yet, there is some anecdotal evidence to suggest that organizations offering these services are using judgmental frameworks. In order to rigorously investigate this, we explored what post-abortion support services are offered across the province of Ontario. This multi-methods study included an analysis of OAS data, creating a directory of post-abortion support services in the province, conducting an analysis of how these services represent themselves online, and carrying out mystery client interactions. We found that the majority of organizations offering post-abortion support services in Ontario are crisis pregnancy centers. The services offered at these organizations are built upon frameworks that are both shaming and stigmatizing of abortion experiences. Efforts to increase the online visibility and overall accessibility of non-judgmental, medically accurate post-abortion support services in Ontario appear warranted.

The peri-coital contraceptive pill is a potential method for pregnancy prevention that could be taken in a period before or after unprotected sexual intercourse. However, uptake of a new contraceptive method relies on accessible terminology and frameworks with which to discuss it. I conducted seven focus group discussions across Canada to understand how women talk about different reproductive health technologies, explore the ways these discourses influence language and frameworks women use to talk about peri-coital contraceptives, and identify perceptions of and concerns about this potential method. Women thought the peri-coital contraceptive pill would be a valuable addition to current contraception. They disliked the name ”peri-coital”; although some participants created more resonant names related to unique aspects of this method, many found it challenging to clearly discuss the method with existing language for contraception. Concerted effort to develop terminology that is clearer may help facilitate the eventual introduction of this new contraceptive method in Canada and beyond.

Background: HIV is a major and global public health issue. In 2014, approximately 17.4million women were living with HIV. Regarding HIV, there are socially acquiredprejudices that contributes to stigmatize those living with the infection. Women livingwith HIV are an extra vulnerable group in society, which can negatively affect theirhealth. Aim: To study the experiences of sexual and reproductive health in women livingwith an HIV diagnosis in the Western world. Method: A literature-based study. Themethod used for this study was based on qualitative research, which contribute a deeperunderstanding for a phenomenon. Eight articles were analyzed and resulted in three mainthemes and seven subthemes. Results: The results are presented under three main themes;To face new challenges, To be treated differently and Being emotionally affected. To facenew challenges describe women's experience in managing their sexuality and the needfor information. To be treated differently describes women's experience of beingstigmatized in society and in health care. Being emotionally affected describes howwomen experienced shame and fear, which contributed to the fact that women did notseek care during pregnancy. Conclusion: Women living with an HIV diagnosis are inneed of information as well as emotional and instrumental support. This need can beacknowledged when the nurse takes on the responsibility for nursing and applies personcentered care. / HIV är en viktig global folkhälsofråga. I slutet av 2018 levde 37,9 miljoner människormed HIV-diagnos. Flertalet gravida och ammande kvinnor behandlades ihälsobefrämjande syfte. HIV diagnosen kan bidra till att de som lever med infektionenriskerar att stigmatiseras. Kvinnor som lever med HIV är en extra utsatt och sårbar gruppi samhället, vilket kan påverka deras hälsa negativt. Sjuksköterskan ansvarar bland annatför att främja och återställa hälsa. I mötet med kvinnor som lever med en HIV-diagnos ärsjuksköterskan skyldig att utgå från den gemensamma värdegrund som återfinns i ICN:setiska kod. Åtta artiklar med kvalitativ ansats valdes ut för att belysa HIV-diagnostiseradekvinnors erfarenhet av sexualitet, graviditet och förlossning. Artiklarna resulterade i trehuvudteman; Att ställas inför nya utmaningar, Att bemötas annorlunda och Att varaemotionellt påverkad. Att ställas inför nya utmaningar innehåller tre underteman sombeskriver kvinnornas erfarenheter kring sexualitet, graviditet och förlossning. Deupplevde en osäkerhet kring sexualitet och graviditet som grundades i rädslan av att smittasin partner eller barn. Bristen på information bidrog till en osäkerhet. Trots kvinnornasosäkerhet hade de en längtan efter barn. Att bemötas annorlunda, med två underteman,skildrar de fördomar kvinnorna möter av hälso- och sjukvården samt omgivningen. Ivårdmötet kände sig kvinnorna annorlunda bemötta. Kvinnorna upplevde bristande stödpå grund av negativa antaganden från den sociala omgivningen. Slutligen visade Att varaemotionellt påverkad, med två underteman, att HIV-diagnosen gav upphov till emotionellpåverkan kring den sexuella och reproduktiva hälsan. Detta tog sig i uttryck som känslorav rädsla och skam. Rädslan innebar att bli avslöjad och avvisad som HIV-positiv.Känslan av skam bidrog till att kvinnorna inte uppsökte vård under graviditeten. Studiensresultat kan bidra till en ökad kunskap kring kvinnor som lever med en HIV-diagnos samtderas erfarenheter av sexualitet, graviditet och förlossning. Denna kunskap kan även bidratill att sjuksköterskor har en handlingsberedskap i vårdmötet med dessa kvinnor.Resultatet anses relevant oavsett vilket vårdsammahang som omger kvinnorna.