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.

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)

O conceito de saúde sexual e reprodutiva (SSR) ganha visibilidade na década de 1990, marcada por ativismo social e pela IV Conferência Internacional sobre População e Desenvolvimento e a IV Conferência Internacional sobre Mulheres, que afirmam a atenção primária à saúde (APS) como prioritária. No Brasil, a APS é considerada estratégica para efetivar políticas de SSR no Sistema Único de Saúde (SUS). Com o objetivo de avaliar a implementação de ações de SSR em serviços de APS, no SUS, no estado de São Paulo (SP), foi desenvolvida avaliação que adota a teoria do trabalho em saúde e a integralidade como referenciais, e utiliza banco de respostas de 2735 serviços ao questionário QualiAB - Avaliação da qualidade da Atenção Básica em Municípios de SP, em 2010. Construiu-se um modelo teórico da avaliação de práticas de SSR na APS - compreendendo os domínios promoção à SSR, prevenção e assistência às doenças sexualmente transmissíveis (DST)/aids, e atenção à saúde reprodutiva, com 25, 43 e 31 indicadores, respectivamente. As respostas dos serviços apontam: pré-natal com início e exames adequados, melhor organização para puerpério imediato do que tardio, planejamento reprodutivo seletivo para alguns contraceptivos; prevenção baseada em proteção específica, limites na prevenção da sífilis congênita, no tratamento de DST, no rastreamento do câncer cervical e mamário; atividades educativas pontuais, com restrita abordagem das vulnerabilidades, e predomínio do enfoque da sexualidade centrado na reprodução. A média geral de desempenho em SSR é 56,84%. O domínio atenção à saúde reprodutiva tem maior participação, seguido por prevenção e assistência das DST/aids e promoção à SSR (teste de Friedman estimou a contribuição no escore; Dunn, a participação relativa). Os três domínios são correlacionados (Spearman > 0,5). Técnica de agrupamento por k-médias mostrou 5 grupos de desempenho: A, B, C, D e E, compostos por 675, 811, 346, 676 e 227 serviços, com médias de 74,71; 61,95; 55,19; 45,57; e 21,56%, respectivamente. Arranjos organizacionais com saúde da família, ou saúde da família com Unidade Básica de Saúde; localização urbana periférica; delimitação da área de abrangência por planejamento; uso de dados de produção e epidemiológicos para organização do trabalho; presença de serviço especializado de atenção à aids no município, são variáveis associadas ao pertencimento do serviço de APS ao grupo A. Ajustadas em modelo de regressão logística, duas variáveis se apresentam independentemente associadas à maior chance de o serviço pertencer ao grupo A: uso de dados de produção e de dados epidemiológicos para organização do trabalho. Os resultados indicam que a implementação das ações de SSR na APS paulista é incipiente e corroboram a hipótese do reconhecimento inadequado da SSR como objeto de trabalho na APS; bem como de definição inapropriada das tecnologias, que limitam a tradução operacional do programa de SSR. Faz-se necessário: rever o objeto SSR para a APS, enfatizando sua abordagem integral; disseminar tecnologias de atenção à SSR; investir em capacitações, sobretudo, de gerências realmente técnicas; e ainda, fortalecer redes regionais temáticas para SSR. O modelo teórico da avaliação construído mostra-se viável e pode ser utilizado em futuras avaliações / The concept of sexual and reproductive health (SRH) gains visibility in the 1990s, a decade characterized by social activism and by the IV International Conference on Population and Development and the IV World Conference on Women, which affirm that primary health care (PHC) is a priority. In Brazil, PHC is considered strategic for the implementation of SRH in the Unified Health System (Sistema Único de Saúde - SUS). An evaluation was developed with the purpose of assessing the implementation of SRH actions in PHC at the SUS units in the state of São Paulo (SP), adopting the theory of work in health and comprehensiveness as references and using response database from 2735 units to the Questionnaire PHC Quality Evaluation in SP Municipalities - QualiAB in 2010. A theoretical model of evaluation for SRH actions in the PHC was designed - comprising the following domains: SHR promotion, prevention and assistance of sexually transmitted disease (STD)/AIDS, and reproductive care, with 25, 43 and 31 indicators, respectively. The responses from the units indicate: early start of antenatal care with proper test delivery, more effective organization for immediate postpartum than for late postpartum, and selective reproductive planning for some contraceptives; predominance of specific protection actions, limits in prevention of congenital syphilis, STD syndromic treatment and cervical and breast screening; occasional education activities with a restricted approach to vulnerabilities, an approach to sexuality predominantly through reproduction. The general performance score for dimension SRH at the units is 56,84%. The Reproductive care domain has a bigger participation in the general score, followed by STD/AIDS prevention/assistance and SRH promotion (Friedman test estimated contribution to the general score; Dunn, relative participation). The three domains are correlated (Spearman > 0,5). K-means clustering method showed 5 performance groups: A, B, C, D and E, consisting of 675, 811, 346, 676 and 227 units, with an average of 74,71; 61,95; 55,19; 45,57; and 21,56%, respectively. Organizational arrangements for work in PHC with family health, or the traditional health center combined with family health; urban outskirts, delimitation of area through management criteria; use of epidemiological and production data for work organization; specialized AIDS care in the municipality, are variables associated with PHC units taking part in group A. Adjusted in logistic regression model, two variables are independently associated to a higher chance of the unit to belong to group A: use of epidemiological and production data for work organization. The results indicate that the implementation of SRH services in PHC in the state of São Paulo is incipient and corroborate with the hypothesis of inadequate recognition of SRH as a PHC object of work; as well as inappropriate definition of technologies, which limit the operational translation of the SRH program. It is necessary to: review the SRH object for the PHC emphasizing its comprehensive approach; disseminate technologies of SRH care; invest in training, mainly in technical management, as well as strengthen thematic regional networks for SRH. The theoretical evaluation model designed is feasible and can be used in future evaluations

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)

O conceito de saúde sexual e reprodutiva (SSR) ganha visibilidade na década de 1990, marcada por ativismo social e pela IV Conferência Internacional sobre População e Desenvolvimento e a IV Conferência Internacional sobre Mulheres, que afirmam a atenção primária à saúde (APS) como prioritária. No Brasil, a APS é considerada estratégica para efetivar políticas de SSR no Sistema Único de Saúde (SUS). Com o objetivo de avaliar a implementação de ações de SSR em serviços de APS, no SUS, no estado de São Paulo (SP), foi desenvolvida avaliação que adota a teoria do trabalho em saúde e a integralidade como referenciais, e utiliza banco de respostas de 2735 serviços ao questionário QualiAB - Avaliação da qualidade da Atenção Básica em Municípios de SP, em 2010. Construiu-se um modelo teórico da avaliação de práticas de SSR na APS - compreendendo os domínios promoção à SSR, prevenção e assistência às doenças sexualmente transmissíveis (DST)/aids, e atenção à saúde reprodutiva, com 25, 43 e 31 indicadores, respectivamente. As respostas dos serviços apontam: pré-natal com início e exames adequados, melhor organização para puerpério imediato do que tardio, planejamento reprodutivo seletivo para alguns contraceptivos; prevenção baseada em proteção específica, limites na prevenção da sífilis congênita, no tratamento de DST, no rastreamento do câncer cervical e mamário; atividades educativas pontuais, com restrita abordagem das vulnerabilidades, e predomínio do enfoque da sexualidade centrado na reprodução. A média geral de desempenho em SSR é 56,84%. O domínio atenção à saúde reprodutiva tem maior participação, seguido por prevenção e assistência das DST/aids e promoção à SSR (teste de Friedman estimou a contribuição no escore; Dunn, a participação relativa). Os três domínios são correlacionados (Spearman > 0,5). Técnica de agrupamento por k-médias mostrou 5 grupos de desempenho: A, B, C, D e E, compostos por 675, 811, 346, 676 e 227 serviços, com médias de 74,71; 61,95; 55,19; 45,57; e 21,56%, respectivamente. Arranjos organizacionais com saúde da família, ou saúde da família com Unidade Básica de Saúde; localização urbana periférica; delimitação da área de abrangência por planejamento; uso de dados de produção e epidemiológicos para organização do trabalho; presença de serviço especializado de atenção à aids no município, são variáveis associadas ao pertencimento do serviço de APS ao grupo A. Ajustadas em modelo de regressão logística, duas variáveis se apresentam independentemente associadas à maior chance de o serviço pertencer ao grupo A: uso de dados de produção e de dados epidemiológicos para organização do trabalho. Os resultados indicam que a implementação das ações de SSR na APS paulista é incipiente e corroboram a hipótese do reconhecimento inadequado da SSR como objeto de trabalho na APS; bem como de definição inapropriada das tecnologias, que limitam a tradução operacional do programa de SSR. Faz-se necessário: rever o objeto SSR para a APS, enfatizando sua abordagem integral; disseminar tecnologias de atenção à SSR; investir em capacitações, sobretudo, de gerências realmente técnicas; e ainda, fortalecer redes regionais temáticas para SSR. O modelo teórico da avaliação construído mostra-se viável e pode ser utilizado em futuras avaliações / The concept of sexual and reproductive health (SRH) gains visibility in the 1990s, a decade characterized by social activism and by the IV International Conference on Population and Development and the IV World Conference on Women, which affirm that primary health care (PHC) is a priority. In Brazil, PHC is considered strategic for the implementation of SRH in the Unified Health System (Sistema Único de Saúde - SUS). An evaluation was developed with the purpose of assessing the implementation of SRH actions in PHC at the SUS units in the state of São Paulo (SP), adopting the theory of work in health and comprehensiveness as references and using response database from 2735 units to the Questionnaire PHC Quality Evaluation in SP Municipalities - QualiAB in 2010. A theoretical model of evaluation for SRH actions in the PHC was designed - comprising the following domains: SHR promotion, prevention and assistance of sexually transmitted disease (STD)/AIDS, and reproductive care, with 25, 43 and 31 indicators, respectively. The responses from the units indicate: early start of antenatal care with proper test delivery, more effective organization for immediate postpartum than for late postpartum, and selective reproductive planning for some contraceptives; predominance of specific protection actions, limits in prevention of congenital syphilis, STD syndromic treatment and cervical and breast screening; occasional education activities with a restricted approach to vulnerabilities, an approach to sexuality predominantly through reproduction. The general performance score for dimension SRH at the units is 56,84%. The Reproductive care domain has a bigger participation in the general score, followed by STD/AIDS prevention/assistance and SRH promotion (Friedman test estimated contribution to the general score; Dunn, relative participation). The three domains are correlated (Spearman > 0,5). K-means clustering method showed 5 performance groups: A, B, C, D and E, consisting of 675, 811, 346, 676 and 227 units, with an average of 74,71; 61,95; 55,19; 45,57; and 21,56%, respectively. Organizational arrangements for work in PHC with family health, or the traditional health center combined with family health; urban outskirts, delimitation of area through management criteria; use of epidemiological and production data for work organization; specialized AIDS care in the municipality, are variables associated with PHC units taking part in group A. Adjusted in logistic regression model, two variables are independently associated to a higher chance of the unit to belong to group A: use of epidemiological and production data for work organization. The results indicate that the implementation of SRH services in PHC in the state of São Paulo is incipient and corroborate with the hypothesis of inadequate recognition of SRH as a PHC object of work; as well as inappropriate definition of technologies, which limit the operational translation of the SRH program. It is necessary to: review the SRH object for the PHC emphasizing its comprehensive approach; disseminate technologies of SRH care; invest in training, mainly in technical management, as well as strengthen thematic regional networks for SRH. The theoretical evaluation model designed is feasible and can be used in future evaluations

A la croisée de l’anthropologie de la maladie et de l’anthropologie de la santé, cette thèse explore la diversité des savoirs et des pratiques de soins dédiés à la prévention ainsi qu’au traitement des problèmes de santé considérés comme spécifiquement féminins en France rurale. L’ethnographie a été menée sur la presqu’île du Médoc, territoire où l’imaginaire lié à la nature fait naître des représentations sur la population entre fantasmes et stigmates, et où se pose régulièrement la question de la désertification médicale, à l’instar d’autres campagnes françaises. Dans ce contexte, des observations et des entretiens qualitatifs ont été réalisés auprès d’une soixantaine de femmes et d’une quarantaine d’acteurs du soin aux profils variés, afin de dessiner les contours et les dynamiques du pluralisme thérapeutique local consacré aux « maux de femmes ». Cette catégorie opératoire regroupe l’ensemble des malaises, mal-être et maladies, souvent sensibles et tabous, qui m’ont été confiés par mes interlocutrices. La thèse éclaire les diverses logiques de recours aux soins qu’elles développent au cours de ces itinéraires thérapeutiques particuliers, constitués de soins biomédicaux, spécialisés ou non dans le domaine de la « santé sexuelle et reproductive », de soins non conventionnels et de soins domestiques. La réflexion globale porte sur la complémentarité des soins façonnée par les usagères du pluralisme thérapeutique au fil de leurs quêtes de soins efficaces, en même temps qu’elle questionne les quêtes de soi suscitées chez les femmes selon que les soins normalisent ou non leurs conduites, les rendent ou non actrices de leur santé, ou qu’ils réifient ou réinventent les normes de genre. / This thesis in medical anthropology explores the diversity of knowledge and care practices dedicated to prevention and treatment of health problems considered as specifically feminine in rural France. The ethnography was conducted in the Medoc peninsula, an area where nature related imaginary leads to representations between fantasy and stigmas from the local population. It is also an area discussed for its medical desertification alike other French rural areas. In this context, observations and qualitative interviews were conducted with about sixty women and forty care actors with various profiles in order to understand and present the contours and dynamics of local therapeutic pluralism dedicated to “women health issues”. This operational category stands for all illness, sickness and diseases, often sensitive, taboo and revealed to me in confidence. This thesis enlightens women’s diverse uses of healthcare in their singular therapeutic itineraries, made of biomedical care, specialized or not in the sexual and reproductive health sector, of non-conventional or alternative medicines and of domestic cares. The overall reflection addresses the complementarity of treatments developed by users of therapeutic pluralism in their quest for health, and questions women’s personal quest according to the way treatments normalize or not their practices, make them actor of their own health or not, or re-invent or re-conduct gender norms.