Magister Public Health - MPH / The aim of this study was to describe the health seeking behaviours, knowledge about the available services, as well as experiences, and barriers to access and utilization of the reproductive health services among male adolescents in Lusaka. A descriptive, qualitative study was conducted among male adolescents in a peri-urban setting in Lusaka. Four focus group discussions were conducted with 46 adolescents aged between 13 and 24 years of age, and six key informant interviews. Data was audio-tape recorded and transcribed verbatim. Thematic content analysis was done. Health concerns were related to the social, psychological, societal and puberty needs of participants. Concerns, questions and queries about masturbation were common, especially among the younger adolescents. Most problems related to puberty and body changes rather than sexual and reproductive health matters per se. Knowledge about the available sexual and reproductive health services was generally low, with some young men being completely unaware of the existence of youth friendly services at the local clinic. Contrary to popular opinion, adolescents in this community reported that they did not seek help on sexual matters from friends and did not want to discuss their problems with their peers, due to fears of being marginalized. Perceived gender, cultural and social norms, lack of knowledge about the availability of adolescent reproductive health services, and poor attitudes among the health care providers were some of the identified barriers to seeking health care. Adolescents perceived health providers to be judgmental, not helpful and condescending towards young people. Lack of privacy and confidentiality were also reported as barriers to access and utilization of sexual and reproductive health services

This paper deals with the Deaf community in sub-Saharan Africa, with particular focus on the Republic of Congo, and Senegal. It explores how the humanitarian sector is reaching out to this community, especially regarding Sexual and Reproductive Health. Projects set up by UNFPA Congo and Senegal’s ONG Jeunesse Et Dévelopment, are examined within the framework of communication for development. By researching the nexus between the international organizational world and the deaf community, the plan is to gain understanding through methodological approaches such as semi structured interviews, a focus groups and document analysis including videos, that eventually will provide input that can lead to a more comprehensive and informative communication strategy for this group. As a large part of the Deaf community in the developing world isn’t able to read and write, their fundamental human rights are undermined, this is especially true when it comes to Sexual and Reproductive Health. Research from Kenya and Senegal have shown that people living with disabilities got slightly higher HIV seroprevalence compared to the rest of the population, while a study from Cameroun demonstrates that deaf individuals are three times more likely to contract an STI. Communication for development, behavior change communication, communication for social change as well as media development, got a significant role to play to lead the deaf community towards integration, inclusion and better access to information on Sexual and Reproductive Health. By including the deaf community and let them define their own needs through genuine participation, it is possible to strengthen their rights. Researching the deaf community in the developing world is like studying a micro-cosmos of the entire development debate, as many of the main challenges are present. By empowering the deaf community in Africa, the whole continent is empowered.

Abortion is a controversial issue. It is subject of heated debates stemming from morality and ethics. Abortion is also, however, a question of rights. Access to abortion weighs the rights of the foetus against the rights of the mother. Women being denied access to safe and legal abortion due to criminalisation and restrictive abortion laws, is also a matter of human rights. Women die every year as the result of unsafe abortion methods. This thesis focuses on access to safe and legal abortion, and examines if and how public international law protects women’s access to abortion. It addresses the topic of reproductive rights and health, and whether this set of rights constitutes any protection for access to safe and legal abortion. Human rights that are actualised in relation to abortion include for example the right to life, right to privacy and right to health. Relevant provisions in CEDAW, ICCPR and ICESCR are analysed, together with general comments and reports issued by the treaty monitoring bodies of the UN. The second part of the thesis focuses on access to safe and legal abortion under the ECHR and examines relevant case-law from ECtHR on the topic. In addition to the legal dogmatic method, a feminist legal theory is used to critically evaluate whether the current protection of access to safe and legal abortion is sufficient from a women’s rights perspective. The author concludes that public international law does not offer any direct protection of access to safe and legal abortion. Instead, access to safe and legal abortion can be protected indirectly by other human rights. Restrictive abortion laws that results in risking the health and life of the mother can violate women’s human rights. Case-law from the ECtHR shows that European states are under a positive obligation to provide an effective access to abortion under the right to privacy, if the national law guarantees such a right. The result from the discussion based on feminist legal theory shows that public international law fails to recognise the abortion issue as a question of gender equality and discrimination against women.

The study was conducted in Moshi, the regional Capital of Kilimanjaro region, Tanzania. It was financed by Sida’s Minor Field Study scholarship in March and April 2019. This study was carried out at a Secondary school and focuses on students’ attitudes and knowledge about sexual and reproductive health and rights, SRHR, as well as examine how different actors influence the students’ decision-making and attitudes in Form 4. Qualitative semi-structured interviews are conducted, combined with the use of flashcards, as a method. Each flashcard contains topics within the concept of SRHR and was based on previous research and definitions. The use of flashcards was conducted in two steps. Firstly, the students’ categorized SRHR-topics in five different categories. Secondly, the students’ ranked ten actors in which affect them the most to least. Most of the students believe that most of the topics are important to learn about but in a future context. They also believe that education in some topics will result in increased sexual behavior. The students identify that authorities, such as parents and school, affect them the most in their decision-making and attitudes. To conclude, the students were found to have limited education focusing on attitudes as well as access to evidence-based education.

Bakgrund: Alla individer innehar grundläggande rättigheter just i egenskap av att vara människa. Rätten till hälsa är en av dessa, och ska bland annat inkludera säker sexuell och reproduktiv hälsa. I den georgiska utbrytarprovinsen Abchazien tillgodoses inte hela befolkningen denna rättighet. Gali-distriktet är beläget nära gränsen till övriga Georgien och anses som ett lågprioriterat område. Kvinnors position beskrivs där extra utsatt, då exempelvis våld i nära relationer är vanligt förekommande. Inom Abchazien finns icke-statliga organisationer som arbetar för att tillgodose människors grundläggande rättigheter. Avangard är en av dessa och arbetar med sexuell och reproduktiv hälsa för kvinnor i Gali-distriktet. Syfte: Studiens syfte var att belysa hur vårdpersonalen på en icke-statlig organisation kan möjliggöra säker sexuell och reproduktiv hälsa för kvinnor i Gali, Abchazien. Metod: Empirisk studie med kvalitativ metod, baserad på deltagande observationer med etnografisk ansats. Materialet har bearbetats genom innehållsanalys, där kategorier samt teman arbetats fram. Resultat: Framkomna fynd presenteras utifrån tre teman med totalt sex inkluderande kategorier: Kompetens – Utbildad personal och Engagemang, Sammanhang - Undervisning i sexuell och reproduktiv hälsa och gynekologisk vård, Resurser – Miljö och Material. Slutsats: Studien belyser hur flertalet komponenter möjliggjorde den sexuella och reproduktiva hälsan. Genom utbildad och lokalt förankrad personal, kunde Avangard bidra till att hälso- och sjukvård samt kunskapsförmedling genomfördes trots vissa hinder. Klinisk betydelse: Denna studie kan bidra till ökad förståelse i hur rättigheter inom sexuell och reproduktiv hälsa kan möjliggöras. Vidare förhoppning är att sjuksköterskan ska reflektera över kvinnors situation världen över, för att kunna bidra till ökad sexuell och reproduktiv hälsa. / Background: Everyone has fundamental rights just of being human. The right to health is one of these, which includes safe sexual and reproductive health. In the Georgian breakaway region Abkhazia, all the people can’t claim the right to health. Gali district, near the border to the rest of Georgia, is considered as a low priority area. Domestic violence is common in the region and women’s positions are described as extra vulnerable. In Abkhazia several non-governmental organizations operates to incorporate people's basic rights. Avangard is one of them, and they’re working with women’s sexual and reproductive health in Gali district. Aim: The aim of this study was to illuminate how the staff of a non-governmental organization incorporate safe sexual and reproductive health for women in Gali, Abkhazia. Method: An empirical study using a qualitative method, based on participant observations with ethnographic approach. The data were processed through content analysis, which ended up in categories and themes. Results: The presented findings are collected in three themes, including total six categories: Competence – Educated staff and Engagement, Context - Training in sexual and reproductive health and gynecological care, Resources - Environment and Materials. Conclusion: The study illuminated how several components incorporated safe sexual and reproductive health. By local and educated staff, Avangard created opportunities that made the work possible, despite some obstacles. Implications for practice: This study may contribute to an increased understanding of how fundamental rights in sexual and reproductive health can be made possible. Furthermore, there is a hope that nurses should reflect on women's situations worldwide, to improve the sexual and reproductive health. / <p>Röda Korsets sjuksköterskeförening stipendium 2013</p>

In 2015, TN had the 9th highest teen birth rate in the United States. School-based sex education programs have shown promise in curbing teen pregnancy rates. In TN public schools, sex education could be taught by teachers of subjects like biology, health education, or invited guests from ministries, or national or local nonprofit agencies. The content, rigor, and approach of sex education taught by these diverse groups of providers remains unknown. This pilot study tested a survey questionnaire and methodology, while providing information on the providers’ sex education practices and perspectives. We adapted validated measures from past sex education surveys to reflect the context of TN. The survey items were reviewed and refined by diverse groups of experts on school-based health education, teen pregnancy prevention programs, and adolescent health. The survey was created and distributed via a web-based tool. A recruitment email or letter with a weblink to the survey was sent to 3,249 potential sex education providers, from April to June 2017. Of all contacts, 509 completed the survey, yielding a response rate of 15.7%. Of those who completed the survey, 137 taught sex education in the 2015-2016 school year to any of grades 5 through 12 students. Survey responses were analyzed using descriptive tests. Abstinence (83.9%) was taught by most respondents, by grade 12, but far less respondents taught topics related to birth control (65.0%) and condoms: how to use condoms (22.6%), how to use and where to get other birth control (31.4%). Providers with more years of experience, and those who expressed that they had received enough training, were more likely to teach more number of topics, including controversial topics, such as condoms and birth control. Most providers indicated that sex education topics should be taught in earlier grades. This study identified the job titles of providers, content being taught, approach to teaching, and how providers would want to teach sex education. Identifying providers is crucial to designing sex education training programs, tracking program effectiveness, and changes in practices over time, to achieve the goal of curbing TN teen pregnancy rates through quality sex education.

Background: Transgender or nonbinary (TNB) individuals in the United States experience higher rates of sexual and reproductive health disparities when compared to their cisgender counterparts, along with lower access to care. TNB people in the south experience higher rates of disparities. Societal, interpersonal, and individual barriers contribute to these disparities in the TNB population. However, there is a paucity of research examining the sexual and reproductive health experiences of TNB people living in Central Appalachia. Methods: An interpretive phenomenological analysis (IPA) research design was used to collect and analyze semi-structured interviews with TNB individuals living in central Appalachia regarding their sexual and reproductive health experiences. Transcribed interviews were analyzed repeatedly by the primary investigator and the study equity committee to identify emergent themes which focused on understanding an individual’s lived experiences through interpretation. Results: Twenty participants from eastern Tennessee and western North Carolina from four Appalachian states within three Appalachian sub-regions participated in this study. Four themes were identified: a) perceptions and/or experiences receiving SRH healthcare shaped the individual’s self-agency regarding accessing and receiving SRH care, along with influencing their sense of self regarding their gender; b) heteronormative expectations within the medical field influenced interactions with providers and the care system; c) community is integral to SRH experiences, and d) policy and laws impact willingness and ability to access SRH care. Discussion: TNB individuals living in central Appalachia experience individual, interpersonal, community, and social factors that impact their sexual and reproductive healthcare experiences. By addressing these factors based on recommendations from participants, public health leaders, policy makers, and providers can improve sexual and reproductive healthcare experiences of TNB people living in central Appalachia.

Background: As growing numbers of people may be forced to migrate due to climate change and variability, it is important to consider the disparate impacts on health for vulnerable populations, including sexual and reproductive health (SRH). This scoping review aims to explore the relationship between climate migration and SRH. Methods: We searched PubMed/MEDLINE, CINAHL Plus, EMBASE, Web of Science, Scopus, Global Health and Google for peer-reviewed and gray literature published before 2nd July 2021 in English that reported on SRH in the context of climate migration. Data were extracted using a piloted extraction tool and findings are reported in a narrative synthesis. Results: We screened 1,607 documents. Ten full-text publications were included for analysis: five peer-reviewed articles and five gray literature documents. Reported SRH outcomes focused on maternal health, access to family planning and antiretroviral therapy, sexual and gender-based violence, transactional sex, and early/forced marriage. Recommendations to improve SRH in the context of climate migration called for gender-transformative health systems, education and behavior change programmes, and the involvement of local women in policy planning and programme implementation. Discussion: While the disparate impacts of climate change and migration are well-established, primary data on the scope of impact due to climate migration is limited. The SRH outcomes reported in the literature focus on a relatively narrow range of SRH domains, emphasizing women and girls, over men. Achieving holistic and equitable SRH in the context of climate migration requires engaging all genders across the range of SRH outcomes and migration contexts. This review highlights the need for further empirical evidence on the effect of climate migration on SRH, with research that is context-specific and engages communities in order to reflect the heterogeneity of outcomes and impact in the climate-migration-SRH nexus.

Though much research exists on LGBT+ exclusion from school-based sexual and reproductive health (SRH) education, the strategies used by LGBT+ individuals during their search for knowledge regarding the subject are not as widely documented. Using the ethnographic research method of semi-structured interviews, this research explores the experiences of young LGBT+ adults with formal sexual and reproductive health education and examines the self-education methods employed by this population in the context of exclusionary and cisheteronormative curricula. This project also functions to contribute to existing literature in the field of anthropology and other social sciences regarding the subject of SRH education, particularly LGBT+ SRH education. Furthermore, this study supports the need for additional research through the use of applied anthropology concerning interactions between institutions, policy and individual experiences of health.

Yes / Adolescent sexual and reproductive health (SRH) remains a challenge globally. High school youths without comprehensive sexuality education (CSE) are more likely to engage in high risk sexual behaviors than their peers in schools with CSE. Fiji continues to have very poor adolescents SRH indicators. This study aimed to gauge the perceptions of students towards the delivery of SRH education in schools in Fiji. A qualitative study design was used to collect data from students in year 11-13 in public secondary schools in Suva, Fiji in 2018. Schools with equal ethnic mix were selected. A semi-structured open-ended questionnaire was used to guide Focus Group Discussions (FGDs). A male research facilitator conducted FGD with males while a female research facilitator facilitated that amongst the females. Data collected was analyzed thematically. Seven FGDs were conducted. A total of 46 students (29 males) participated with the age range from 17-19 years old. Eight themes emerged: current SRH education; students' knowledge on adverse consequences of SRH; sources of SRH information; need for sex education; provision of SRH education in schools; characteristics of teachers of SRH education; age-appropriate incremental sex education; and ideal version of SRH. The study shows that Fijian students desired a lot more from sex education than what is currently offered for sexual decision-making. There is a need for mandatory and comprehensive sex education for young people.