Diante da importância que a gravidez não planejada vem adquirindo no cenário mundial, apesar da melhoria nas tecnologias contraceptivas e ampliação do acesso aos serviços de saúde e métodos contraceptivos, faz-se necessário mensurar com maior precisão este fenômeno. Por esta razão, pesquisadores da área de saúde sexual e reprodutiva têm procurado desenvolver medidas que possam oferecer estimativas confiáveis de mulheres que vivenciam a gravidez não planejada. A maior parte dos instrumentos utilizados para mensurar a gravidez não planejada são unidimensionais e não levam em consideração a parceria, a intencionalidade ou o uso de métodos anticonceptivos de forma simultânea, aspecto não observado no London Measure of Unplanned Pregnancy (LMUP), desenvolvido no Reino Unido. Nesse contexto, este estudo transversal tem como objetivo traduzir e adaptar o instrumento LMUP para a língua portuguesa e validar suas propriedades, visando à sua utilização como instrumento de mensuração de gravidez não planejada no Brasil. A adaptação cultural e validação do LMUP foram realizadas conforme o método preconizado pela literatura. O cenário de estudo foram unidades da rede de Atenção Básica do município de Marília-SP. A população de estudo foi composta por 126 mulheres com idade 18 e 42 anos, usuárias dessas unidades, que procuraram a Unidade para confirmação do diagnóstico da gravidez por meio de um teste imunológico para gravidez cujo resultado foi positivo. Os resultados obtidos demonstraram que em relação às propriedades psicométricas, o instrumento apresenta um valor de apha de Cronbach de 0,75 para a escala total. A análise fatorial exploratória dos componentes principais do instrumento LMUP na versão Português aqui apresentada resultou em um único fator, que explicou 66,5% da variância total dos dados. As propriedades psicométricas do instrumento foram demonstradas e, portanto ele pode ser utilizado para mensurar a gravidez não planejada na população brasileira. / Facing the impact that unplanned pregnancy is acquiring world wide, despite the improvement in contraceptive technologies and increasing access to health services and contraceptive methods, it is necessary to measure this phenomenon more accurately. For this reason, researchers in the sexual and reproductive health field have sought to develop measures that can provide reliable estimates of women experiencing unplanned pregnancies. Most instruments used to measure the unplanned pregnancy are unidimensional and do not take into account the partnership, the intent or the use of contraceptive methods simultaneously, a not observed aspect at London Measure of Unplanned Pregnancy (LMUP), developed in the United Kingdom. Thus, this cross-sectional study is aimed to translate and adapt the instrument LMUP to Portuguese and validate its properties, aiming at its use as an instrument for measuring unintended pregnancy in Brazil. Cultural adaptation and validation of LMUP were done according to the method recommended by the literature. The scenery for the study was units of the network of Primary Care in Marília-SP. The studied population consisted of 126 women aged between 18 and 42 years, users of these units, who sought for this Unit to confirm the diagnosis of pregnancy by means of an immunological test for pregnancy and the result was positive. The results showed that in relation to psychometric properties, the instrument has a Cronbach\'s alpha value of 0.75 for the total scale. The factor analysis of the main components of the LMUP to the Portuguese version presented here has resulted in one factor, which explained 66.5% of the total variance of the data. The instrument\'s psychometric properties were demonstrated, and, therefore, it can be used to measure the unplanned pregnancy of the Brazilian population.

The aim of this paper is to explore how the Rwandan state has motivated its increased prioritization of family planning (FP). The paper seeks to understand whether the state’s increased promotion of FP is a result of Rwanda’s strong commitment to gender equality or part of a broader development agenda. By applying theories of substantive representation of women and smart economics, the paper investigates if the state considers enhancing women’s sexual and reproductive health and rights (SRHR) as a goal in itself or as a means to reach their broader development goals. The method which has been selected is text analysis. The texts which are analyzed are government documents from the time of the emergence of the FP programme. The main findings of this paper suggest that the state’s main motive for the increased prioritization of FP is driven by the development agenda rather than a gender-sensitive approach. Nevertheless, there are statements in the texts which the paper connects to theories of substantive representation of women, however, the development rational corresponding with the idea of smart economics is more recurrent. The paper finds that the hypothesis building on the theory of smart economics finds the strongest support and therefore suggests that the Rwandan states consider FP to be a means to achieve broader development goals.

This MA thesis examines the decision-making capacity of young women married during adolescence within the context of their sexual and reproductive health in an urban ghetto in the city of Ahmedabad, India. Specifically, the development literature on married female adolescents (MFAs) is characterized by negative health indicators such as higher rates of unwanted pregnancies, reproductive tract infections, sexually transmitted diseases, high infant and maternal mortality and morbidity coupled with the phenomenon of early marriage, poverty and an overall lower social status. The result is a disempowering discourse that constructs and presents them as powerless victims who lack any decision-making capacity and are perpetually oppressed. This research is an effort to move the discussions of “Other third world women” outside the realm of victimization by challenging and destabilizing this disempowering, hegemonic discourse. We must ask what does decision making look like for these women, as exercised within the context of their sexual and reproductive health. This qualitative analysis is informed by primary research through focus groups and semi-structured interviews with young married women, and was conducted with the help of a local NGO, Mahila Patchwork Co-operative Society. The study provides insights on the young married women’s participation and role in determining their own health outcomes (negative and positive) to better inform programs and services offered by the community NGOs.

Magister Public Health - MPH / This study analyses media representations of Female Genital Mutilation/Cutting (FGM/C) in two Ugandan daily English newspapers. FGM/C is recognized by the World Health Organization as an extreme form of violation of the rights, health and integrity of women and girls. In Uganda, although the overall prevalence of FGM/C is 0.3 percent of the population, FGM/C remains a harmful practice that constitutes a serious threat to the health of women and girls in communities that practice it. Despite existence of a national legal and policy framework that discourages FGM/C, progress in the eradication of the practice remains slow.

This thesis sets out to investigate if the proportion of women in the national parliament correlates with the extent to which national laws and policies guarantee women's sexual and reproductive health and rights. By conducting a cross-national comparison, this thesis contributes to the existing literature by offering an analysis of the relationship, utilizing a comprehensive measurement of states national legal and regulatory framework relating to women's sexual and reproductive health and rights. Further, it aims to offer an analysis of how the relationship appears in different regime-types, including both democratic and non- and partial democratic states. The results did not provide any support for a correlation between the proportion of women in the national parliament and the extent to which national laws and policies guarantee women's sexual and reproductive health and rights, regardless of the regime-type. While the results are inconsistent with the predictions of a correlation, this thesis is able to conclude that the concept of women's representation and how it may be connected to substantial changes in national legislation and policy is a complex relationship, worthy of further research.

Magister Artium (Development Studies) - MA(DVS) / Background: Sexual and reproductive health (SRH) is a right that should be guaranteed to every woman worldwide in order to have a healthy and safe sex life. In most Arab countries, including Egypt, there are different cultural, political, and religious factors that have contributed significantly to the manner that the society views and treats women’s bodies and sexuality. As a result, it is difficult to provide solid data and information to guide policymakers, policies, and to implement awareness and preventive programs. This thesis sought to address this gap by conducting a study looking at the intersectionality of women’s access to sexual and reproductive health services and information in Ismailia, Egypt. Methods: The relevant information was collected using qualitative methods. Semi-structured interviews were conducted with twelve married women and two key informant interviews with health professionals in the study area. Results: Intersectional theory was used to critically examine the various interacting factors such as gender, patriarchy, economic disadvantages, and other discriminatory systems that that can undermine women’s access to SRH information and services. The study revealed that married women suffer from the lack of access to proper SRH services and information. Conclusion: Married women’s experiences of accessing SRH services and information were affected by different intersecting factors. These factors are socio-economic, policy, cultural norms, power structure contexts, and privilege structures, and religious institutions. Recommendations were drafted to add more information and evidence related to Egyptian women and their SRH rights.

As of April 2019, there were over 650,000 Syrian refugees residing in Jordan. A combination of economic, social, and moral imperatives related to the Syrian civil war have led to a threefold increase in early marriage rates. Syrian women and girls, particularly those who marry under the age of 18, are at significant risk of sexual and gender-based violence and unwanted pregnancy. In this context, emergency contraception could play a significant role in supporting Syrian refugees prevent pregnancy. In 2016-2017 we conducted six focus group discussions with Syrian women and girls. We conducted 100 structured interviews with pharmacists in different areas of the country regarding EC provision practices. We also interviewed 13 key informants about available sexual and reproductive health services, including EC, and conducting six focus group discussions with Syrian child brides. We audio-recorded and translated all discussions from Arabic to English and conducted content and thematic analyses using deductive and inductive techniques. Most women and girls became pregnant during the first six months of their marriage, face pressure to become pregnant repeatedly, and experience or had experienced physical and sexual violence. None of the women knew of EC but all expressed curiosity and excitement about this method of pregnancy prevention. Our findings suggest that Syrian women and girls in early marriages have significant unmet contraceptive needs. Child brides, specifically those under the age of 15, reported rarely using any type of contraception, largely due to familial pressures to prove fertility. As a result of this research we undertook a multipronged initiative to respond to the sexual and reproductive health, as well as psychosocial needs, of Syrian child brides.

Sexuell och reproduktiv hälsa och rättigheter är grundläggande för människors hälsa och välbefinnande. Ungdomars sexuella och reproduktiva hälsa ligger till grund för deras framtida hälsa, och även för kommande generationers hälsa. Ungdomar ska ha rätt att själva bestämma över sin sexuella och reproduktiva hälsa. Ungdomstiden är en viktig tid i livet, där det sker fysiska, psykiska och psykosociala förändringar. I Sverige har ungdomsmottagningarna i uppgift att främja en god psykisk och fysisk hälsa för ungdomar, dock är det upp till varje enskild region eller kommun att besluta huruvida de ska ha en ungdomsmottagning, samt hur verksamheten ska utformas. Syftet med denna studie var att undersöka den geografiska fördelningen av ungdomsmottagningar i Sverige. Vidare var syftet att studera sambandet mellan den geografiska fördelningen av ungdomsmottagningar och incidensen av klamydiainfektioner, förlossningar, aborter respektive expediering av preventivmedel bland ungdomar. Metoden som använts för att besvara syftet var en tvärsnittsstudie. Den första delen av syftet har besvarats med deskriptiv statistik, den andra delen har analyserats med hjälp av en en bivariat regressionsanalys. Resultatet visade att fördelningen av ungdomsmottagningar såg olika ut i regionerna. Vidare visade resutatet att det fanns ett samband mellan antal ungdomsmottagningar och antalet ungdomar i regionen. Det fanns också ett samband mellan antal ungdomsmottagningar i regionen och antal expedieringar av korttidsverkande preventivmedel per ungdom, samt ett samband mellan antal ungdomsmottagningar per km² och antal expedieringar av långtidsverkande preventivmedel per ungdom. Slutsatsen av denna studie var att ungdomars sexuella och reproduktiva hälsa kan påverkas av tillgängligheten till en ungdomsmottagning. / Sexual and reproductive health is a fundamental part of human rights. Youths sexual and reproductive health are very important for not just the youth’s future health but also for the health of the next generation. Youths have a right to control and decide their own sexual and reproductive health. Adolescence is an important time period in a young person’s life where they experience changes and development in their physical and mental health. Youth clinics in Sweden have a mission to improve and care for the mental and physical health of all youths although it is up to each individual region within Sweden to determine the number of clinics within that specific region and how the clinics will achieve that mission. The purpose of this study was to compare the number of clinics within the different regions of Sweden and study whether the number of clinics and the accessibility to clinics has a correlation with the number of chlamydia infections, adolescent childbirths, abortions and proscribed contraceptives. This study uses cross-sectionell studies along with descriptive statistics and bivariate regression analysis in order to examine if there is a correlation between the number of clinics and the number of reported cases. The result of this analysis showed that there is a difference between the number of clinics in each region. It also showed that there is a correlation between the number of clinics in a region compared per youth and the amount of proscribed short-time contraceptives. The study also showed a correlation between prescribed long-acting contraceptives to youths compared to youth clinics per square kilometer. The conclusion of this study was that youths sexual and reproductive health is affected to some degree by the accessibility to youth clinics. It shows that if the youths have more access to information regarding sexual and reproductive health it will improve the state of their sexual and reproductive health.

Many questions about the relationships between debate, policy, and substantive representation are still unanswered. Two such examples are, the role of gender, but also - how crises affect representation. This study addresses this gap by examining who (related to gender) speaks about sexual and reproductive health (SRH) and in what way, during an especially critical time (the COVID-19 pandemic). Women’s SRH issues have often gone unrecognized during crises because it is not a direct effect of a virus, but an indirect consequence of structural inequalities. It is therefore interesting to analyze men and women MPs’ legislative behavior and policy priorities during COVID-19. For this study, a dataset is created where individual-level MP speech data serve as the indicator for substantive representation. The methodological contribution made in this paper, using a mixed-method approach, highlights some of the problems associated with studying substantive representation using only quantitative methods. While the quantitative content analysis finds support for the fact that women MPs speak more about SRH than men, the frame analysis highlights that mentioning keywords does not necessarily entail substantive representation. Women MPs generelly frame SRH issues as a structural problem of inequality, while male MPs frame it as an urgent problem caused by the pandemic, or in some cases, as not a problem at all. Studying the case of Uganda is especially interesting because it can provide additional knowledge about representation in an African parliament, and in a semi-authoritarian country.

Background: A significant amount of research has previously been conducted in developing countries such as India, to improve women’s sexual and reproductive health. However, women living in North Indian slums still have poor access to proper sexual and reproductive healthcare. The aim of this thesis is to investigate the published literature to create a consolidated understanding of the key barriers faced by women in slum populations when accessing sexual and reproductive health services in Northern India. Methods: A scoping review was carried out following the five stages outlined in Arksey and O’Malley’s framework. Five online databases (MEDLINE, Global Health, Ovid Emcare, Embase, and Web of Science) were searched. An interpretive thematic analysis was conducted to extract meaningful themes from the data using the Conceptual Framework for Reproductive Empowerment developed by the International Center for Research on Women Results: In total, 28 articles were identified to be incorporated into the scoping review. The results of this study were grouped according to the CFFRE to understand how they compared in regard to women’s reproductive empowerment. This scoping review found reproductive empowerment was significantly hindered by women lacking a proper education and understanding of SRH services, lack of employment and financial resources. Additionally, women’s husbands and mothers-in-laws were barriers to contraceptive use. Finally, poor interactions with healthcare providers and the healthcare system, and systemic factors such as behaviours in treatment seeking, son preference and religion were barriers to accessing SRH services. Conclusion: This scoping review investigated the barriers faced by women living in slum populations in Northern India to accessing SRH services. The results of this study contribute to the literature by identifying areas that require improvement to SRH services for women living in slums, and will be integral to implementing strategies and interventions to allow better access to SRH services in the future. / Thesis / Master of Science (MSc) / A significant amount of research has previously been conducted in India, to improve women’s sexual and reproductive health. However, women living in North Indian slums still have poor access to proper sexual and reproductive healthcare. Therefore, this study investigated the key barriers faced by women in slum populations when accessing sexual and reproductive health services in Northern India. A review of previous studies was conducted by searching five electronic databases and a total 28 articles were included into the review. This study found that women lacking a proper education and understanding of SRH services, lack of employment and financial resources, and women’s husbands and mothers-in-laws were barriers to SRH services. Finally, poor interactions with healthcare providers and the healthcare system, and systemic factors such as behaviours in treatment seeking, son preference, and religion were also barriers to accessing SRH services.