No description available.

This study examines the accessibility and barriers that Polish immigrants face in public gynecological care in Sweden and explains their attitudes towards and frequency of gynecological visits. To understand attitudes of the research group, the study explores their knowledge about basic gynecological health topics such as Pap and HPV tests, HPV infections and vaccinations. Qualitative ethnographic methods were used in this research. Thirteen semi-structured interviews were conducted with 25 to 45-year old Polish women living in Stockholm, Sweden. Analysis was performed using descriptive and theoretical approaches. The results indicate several barriers to fully adapt to the Swedish healthcare system for Polish women. The barriers included the lack of understanding of how Swedish gynecological care works (division of specializations), problems in finding specialist care, an insufficient number of specialists, a lack of information in English or Polish, and a limited amount of knowledge among study participants about HPV tests and vaccinations. The adaptation of Polish immigrants to the Swedish system and their level of trust is influenced by their first experiences in Sweden, health literacy, experiences with the Polish private gynecological system, and the attitudes of partners and family with Swedish backgrounds or those who have long term experiences in Sweden.

Sexual and reproductive rights, like other human rights, are to be respected, protected and fulfilled by the state. Public authorities and welfare organizations thus have an obligation to conduct a work practice accordingly. Social services' supportive and promotive mission for individuals' living conditions should include SRHR in general, not least in the work with children and youths. Yet previous research points out many obstacles that obstruct a practice grounded in sexual and reproductive rights within different social work environments. This in turn makes it difficult to achieve better sexual and reproductive health. The aim of this study is to obtain a deeper understanding of how professional​​s at residential care centers within Malmö Stad experience the work related to youths sexual and reproductive health. Additionally the aim is to highlight the challenges involved in incorporating sexual and reproductive rights of placed youths. In order to achieve the purpose, a qualitative method was applied. Semi structured interviews have been conducted with six employees within said organizations. These objects of study all had professional experience in working close to the clients on behalf of social service's assignments. The empirics has been analyzed and interpreted based on theoretical concepts such as street-level bureaucracy and discretion. The findings are also related to previous research and state of knowledge presented in the study. The result indicates that all of the informants experience difficulties in executing a social work practice grounded in SRHR. These difficulties are experienced at different levels such as in relation to clients, colleagues, management and the mission itself. Unclear or lacking of priorities, different normative attitudes among staff, deficient or various knowledge and ambiguity seem to be prevalent factors. These results suggest that discretion plays a substantial role in regards to the SRHR grounded practice within residential care.

Aim: The aim of this study was to broaden the understanding of the role of communitygroups in the prevention of intimate partner violence (IPV) in Bolivia. Therefore, this work assessed the connection between community group membership and the justification ofphysical IPV among women in Bolivia. IPV justification was chosen as an outcome, as it is strongly correlated to IPV experience. Methods: Data from a quantitative survey by the World Values Survey involving 988 womenin Bolivia was used for the analysis. To assess possible confounders, bivariate analysis was conducted. Logistic regression analysis between women’s community group membership andtheir justification of physical IPV has been performed. Results: The results indicate that 19.6% of women in Bolivia partly or always justify IPV.There has not been a significant association between community group membership and IPVjustification. The factors that were significantly associated to IPV justification in the final model were age and educational level of the women. Women aged 50 + had lower odds ofjustifying physical IPV than women aged 18-29 (OR 0.59, 95% CI: 0.35-0.97, p= <0.05). Similarly, women in the highest educational group had lower odds of justifying IPVcompared to women in the lowest educational group (OR 0.63, 95% CI: 0.41-0.98, p= <0.05). Conclusion: The association between community group membership and IPV justification inthis study was insignificant. This could be due to limitations in the study design. Futureresearch in the area should conduct studies with focus on different types of community groups singularly.

Although the world has experienced great progress in the area of Sexual and Reproductive Health and Rights (SRHR), the contemporary transnational turn towards nationalist, right-wing and populist politics has generated a backlash, primarily affecting women and members of the LGBTQ-community (lesbian, gay, bisexual, transgender and queer/questioning). Yet, opposition to gender and sexual equality, particularly in the European context, is undertheorized. Hence, this thesis sets out to explore and understand the dynamics of political homophobia as a conscious political strategy in Poland and how the homophobic rhetoric pursued by the governing party PiS and their allies has achieved resonance. That is, how anti-LGBTQ ideas have gained support as they echo the ideas, beliefs and values central to potential adherents. The advancements of political homophobia in today’s Poland is rather puzzling since there has not been an upswing in homophobic values among the population. Although the Polish society is not intrinsically homophobic, the dominating values, norms, rules and practices are generally patriarchal and heteronormative. Due to the heteropatriarchal bias of the institutional context, this thesis suggests that both informal and formal institutions may enhance the resonance of the ideas embedded in the anti-LGBTQ ideas framing. Drawing on framing theory and new institutionalism, this thesis develops a framework to analyze this dynamic and reciprocal relationship between framing strategies and the institutional context. The first section of the two-stepped analysis describes how LGBTQ has been framed by identifying the core framing tasks and various framing strategies while the second part outlines various formal rules and informal norms that have facilitated the campaign and identifies how these institutions are heteronormative. The main findings suggest that conservative elites have managed to enhance resonance for their anti-LGBTQ ideas by framing the issue in congruence with heteronormative informal norms, which are perceived to be fundamental for Polish national identity and by exploiting pre-existing formal regulations, which are seemingly neutral but produce heteronormative effects.

No description available.

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.

Syftet med studien var att undersöka om det digitala inlärningsprogrammet Privatliv kan vara ett adekvat stöd för speciallärare i undervisning inom ämnesområdet sexualitet, samtycke och relationer i den anpassade grundskolan. Valet grundar sig i en avsaknad av anpassade läromedel som vänder sig till elever i anpassad grundskola. Undersökningen syftade till att synliggöra vilka normer läromedlet förmedlar, om alla delar i läroplansmålen för år 7–9 finns med, om det förmedlar ett riskperspektiv eller ett friskperspektiv gällande ämnesområdet samt hur läromedlet är anpassat för att möta elevers olika behov och förutsättningar. För att undersöka detta användes en kvalitativ metod med en socialkonstruktivistisk ansats. Inspirerad av den kritiska diskursanalysen har vi genomfört en läromedelsanalys för att komma åt det mer implicita innehållet. Resultat som framkommit visar att Privatliv kan vara ett adekvat stöd i undervisning, men däremot behöver några delar tillföras för att kunna innehålla alla läroplansmål. Några delar från läroplansmålen saknas och vissa delar anser vi kräver lite mer fördjupad kunskap kring. Anpassningar finns men programmet skulle nå fler elever och vara ett fördelaktigare stöd för undervisande speciallärare om innehållet skulle anpassas ytterligare. Privatliv förmedlar i överlag ett friskperspektiv. Läromedlet avviker från heteronormen genom att belysa homosexualitet och bisexualitet och en HBTQ-norm är framträdande. En slutsats i studien visar hur viktigt det är att granska läromedel, men även betydelsen av kompetent personal som ska undervisa eleverna med hjälp av läromedlet.

Contexte et objectifs : Les services de santé sexuelle et reproductive des adolescents (SSRA) ont fait l’objet de peu d’études au Niger. Cette thèse avait pour objectif d’analyser les relations entre les capacités des organisations, la mobilisation et l’utilisation des ressources en SSRA. La thèse propose tout d’abord une description rétrospective des interventions en SSRA et une analyse de l’offre des services de SSRA et du profil des acteurs impliqués dans la conception et la mise en œuvre des interventions en SSRA pour comprendre le contexte de l’étude. Méthodologie : Une revue documentaire narrative et des entrevues individuelles ont été réalisées pour examiner l’historique des interventions en matière de SSRA mises en œuvre au Niger depuis 1975 jusqu’en 2021. De même, cela nous a permis d’identifier les acteurs impliqués et leur rôle dans le processus de mise en œuvre de ces interventions (article 1). Des données secondaires ont été utilisées à travers un modèle Generalized estimating equation (GEE) et une approche comparative entre trois pays : Burkina Faso, Ghana et Niger pour analyser le profil des structures de santé, l’offre du panier de services planification familiale (PF) aux adolescents non mariés et les déterminants de cette offre (article 2). Des données primaires ont été collectées auprès de 250 organisations ayant mis en œuvre des interventions en SSRA sur la période de 2017 à 2021 au Niger. Ces données ont été utilisées pour analyser la relation entre les capacités organisationnelles et la mobilisation des ressources (article 3) en utilisant un modèle de régression logistique multinomiale ordonnée. De même, ces données ont été utilisées pour analyser la relation entre les capacités organisationnelles et l’utilisation effective et efficiente des ressources mobilisées. Un modèle Logit binaire a été estimé pour examiner la relation entre les capacités organisationnelles et l’utilisation effective des ressources mobilisées (article 4). Enfin, un modèle de frontière stochastique et un modèle de Tobit ont été utilisés pour déterminer les scores d’efficience technique et analyser la relation entre les niveaux des capacités des structures de santé et leurs scores d’efficience technique dans l’utilisation des ressources pour offrir les produits et services de SSR aux adolescents (article 5). Résultats : Les résultats de cette thèse font ressortir dans un premier temps un éventail d’interventions en SSRA mises en œuvre et d’acteurs avec des profils variés qui sont impliqués dans le processus d’élaboration et la mise en œuvre de ces interventions au Niger. Les décennies 2000 et 2010 ont constitué les périodes où la plupart des interventions ont été mises en œuvre pour améliorer la SSRA. L’État demeure l’acteur principal, mais il est accompagné techniquement et financièrement par d’autres acteurs. Parmi ces derniers, il y a les bailleurs de fonds constitués par des institutions des Nations unies comme le Fonds des Nations Unies pour la population (UNFPA), l’Organisation mondiale de la santé (OMS) et la Banque Mondiale, des gouvernements des pays amis du Niger, des fondations et des institutions de recherche. L’État reste la deuxième source de financement. Toutefois, bien que beaucoup d’efforts aient été consentis pour améliorer l’accès aux services de SSRA, des adolescents non mariés éprouvent des difficultés d’accès, car beaucoup de structures de santé n’offrent pas ces services à cette population. Au Niger, seuls 29% des structures de santé ont déclaré offrir le panier de services de PF aux adolescents non mariés en 2017 contre 70% et 60% respectivement au Burkina Faso et au Ghana. Plusieurs facteurs expliquent cette offre. Parmi ces derniers, il y a le genre du premier responsable dont les résultats montrent que les structures de santé dirigées par les femmes ont plus de chance d’offrir le panier de services PF aux adolescents non mariés que celles dirigées par un homme. De plus, l’analyse de profil effectuée sur ces structures montre une hétérogénéité. Au Ghana, par exemple, on trouve un profil plus diversifié composé des centres de santé, des hôpitaux et polycliniques et des « Community-based Health Planning and Services » (CHPS) tandis qu’au Burkina Faso et au Niger, ce sont plutôt des structures de santé du premier niveau. Le secteur privé est aussi assez présent alors qu’il ne l’est qu’à une proportion très marginale (moins de 1%) au Burkina Faso et au Niger. Par ailleurs, les résultats indiquent une relation positive entre les niveaux des capacités des organisations et leur niveau de mobilisation des ressources financières. Autrement dit, plus les organisations améliorent leur niveau des capacités, plus leur niveau de mobilisation des ressources financières est important. Toutefois, la relation diffère d’une dimension des capacités organisationnelles par rapport à une autre. Elle est plus importante pour les capacités managériale et opérationnelle et moins prononcée pour les capacités en leadership et adaptative. Il se dégage également une relation positive entre le niveau des capacités organisationnelles et l’utilisation effective des ressources financières mobilisées pour offrir des services de SSR aux adolescents ou pour réaliser des activités en SSRA. Par exemple, lorsqu’une organisation augmente son niveau de capacités organisationnelles augmente d’une unité, sa probabilité d’utiliser effectivement les ressources financières mobilisées augmente de 1,7%. Il apparait aussi que les structures de santé qui offrent les services de santé sexuelle et reproductive aux adolescents ont en moyenne un score d’efficience technique de 58%. Ce score est plus important chez les structures de santé dirigées par les femmes que celles dirigées par les hommes. De même, les structures de santé qui améliorent simultanément le niveau de leurs capacités : managériale, opérationnelle, adaptative et en leadership ont un score d’efficience technique plus important que celles qui ne l’ont pas fait. Toutefois, la relation entre ces capacités diffère d’une dimension à une autre. Contribution : Les résultats de cette thèse améliorent les connaissances sur l’analyse des interventions en SSRA dans les pays en développement. Ils constituent aussi un ensemble de données probantes sur lesquelles les acteurs impliqués dans la problématique de la SSRA peuvent s’appuyer pour mieux concevoir et mettre en œuvre les interventions en SSRA, capables de rendre les services de SSRA disponibles, accessibles et utilisables. / Background and objectives: Adolescent sexual and reproductive health (ASRH) services have been little studied in Niger. The aim of this thesis was to analyze the relationship between organizational capacity and the mobilization and use of ASRH resources. The thesis begins with a retrospective description of ASRH interventions and an analysis of ASRH service provision and the profile of actors involved in the design and implementation of ASRH interventions to understand the context of the study. Methodology: A narrative literature review and individual interviews were conducted to examine the history of ASRH interventions implemented in Niger from 1975 to 2021. This also enabled us to identify the actors involved and their role in the process of implementing these interventions (article 1). Secondary data were used through a generalized estimating equation (GEE) model and a comparative approach between three countries: Burkina Faso, Ghana and Niger to analyze the profile of health facilities, the supply of the family planning (FP) basket of services to unmarried adolescents and the determinants of this supply (article 2). Primary data were collected from 250 organizations that had implemented ASRH interventions between 2017 and 2021 in Niger. These data were used to analyze the relationship between organizational capacity and resource mobilization (article 3) using an ordered multinomial logistic regression model. Similarly, these data were used to analyze the relationship between organizational capacity and the effective and efficient use of mobilized resources. A binary Logit model was estimated to examine the relationship between organizational capabilities and the effective use of mobilized resources (article 4). Finally, a stochastic frontier model and a Tobit model were used to determine technical efficiency scores and to analyze the relationship between health facility capacity levels and their technical efficiency scores in the use of resources to provide SRH products and services to adolescents (article 5). Findings: The results of this thesis first highlight a range of ASRH interventions that have been implemented and actors with varied profiles who are involved in the process of developing and implementing these interventions in Niger. The decades 2000 and 2010 were the periods when most interventions were implemented to improve ASRH. The state remains the main actor, but it is supported technically and financially by other actors. These include donors such as United Nations agencies like the United Nations Population Fund (UNFPA), the World Health Organisation (WHO) and the World Bank, governments of countries friendly to Niger, foundations and research institutions. The State remains the second largest source of funding. However, although a great deal of effort has been made to improve access to ASRH services, unmarried adolescents still have difficulty gaining access, as many health facilities do not offer these services to this population. In Niger, only 29% of health facilities reported offering the FP basket of services to unmarried adolescents in 2017, compared with 70% and 60% respectively in Burkina Faso and Ghana. Several factors explain this offer. One of these is the gender of the primary caregiver, the results of which show that female-headed health facilities are more likely to offer the FP basket of services to unmarried adolescents than those headed by a man. In addition, the profile analysis carried out on these facilities shows heterogeneity. In Ghana, for example, we find a more diversified profile made up of health centres, hospitals and polyclinics, and Community-based Health Planning and Services (CHPS), whereas in Burkina Faso and Niger, it is more likely to be first-level health facilities. The private sector is also well represented, whereas in Burkina Faso and Niger it is very marginal (less than 1%). Furthermore, the results indicate a positive relationship between the capacity levels of the organizations and their level of mobilization of financial resources. In other words, the more organizations improve their level of capacity, the greater their level of mobilization of financial resources. However, the relationship differs from one dimension of organizational capabilities to another. It is stronger for managerial and operational capabilities and less pronounced for leadership and adaptive capabilities. There is also a positive relationship between the level of organizational capacity and the effective use of financial resources mobilized to provide SRH services to adolescents or to carry out ASRH activities. For example, when an organization increases its level of organizational capacity by one unit, its probability of using the financial resources mobilized increases by 1.7%. It also appears that health facilities offering sexual and reproductive health services to adolescents have an average technical efficiency score of 58%. This score is higher for female-run facilities than for male-run facilities. Similarly, health facilities that simultaneously improve their managerial, operational, adaptive and leadership capacities have a higher technical efficiency score than those that do not. However, the relationship between these capabilities differs from one dimension to another. Contribution: The results of this thesis improve knowledge on the analysis of ASRH interventions in developing countries. They also provide a body of evidence on which ASRH stakeholders can draw to better design and implement ASRH interventions, capable of making ASRH services available, accessible and usable.

This study was intended to explore the role male partners play in preventing adolescent pregnancy in the Letlhabile area, of Brits district, which is located in the North West Province. Adolescent males and females whose ages ranged between 13-20 years were included in the sample. The inclusion criteria was determined on the basis of the adolescents who were pregnant and non- pregnant, as well as males who had already became parents and those who hadn't experienced fatherhood. Focus group discussions and individual in-depth interviews were conducted.ObservaJions and the review of existing documents were triangulated to gather valid and reliable information. Quantitative and qualitative data analysis were blended. The findings revealed significant factors that ranged from the reaction of parents and/or partner to the announcement of pregnancy, to issues that impact on consequences of multiple sex partners. The recommendations of this project deal with aspects that include contraception, sexuality education, parental involvement among many relevant policy issues. / Health Studies / M.A. (Nursing Science)