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Previous studies have pointed out an interesting fact: the use of hormonal contraceptives modifies the partner preferences of women towards men more feminine and genetically less compatible. This master thesis first tried to experimentally verify whether these different preferences are reflected in real mate choice outside the context of the laboratory. It includes two studies comparing partner satisfaction and relationship dynamics in couples that have been formed under the influence of pills versus under the influence of the natural menstrual cycle. Study 1 includes 3116 mothers and was conducted through an online questionnaire. The second study collected representative data from 1605 Czech men and women aged 35 to 65 years representing the population of the CZ also through a hand-to- hand questionnaire. Study 1 confirmed the assumption in several ways: hormonal contraception users (during the mate choice) assessed their partners as less attractive and masculine compared with women who naturally cycled at that time. We also found their sexual satisfaction was reduced, however, they were more satisfied with non-sexual aspects of the relationship. In contrast to established hypotheses Study 1 found that the partnerships formed under the influence of hormonal contraceptives separated significantly...

BACKGROUND: Most women within reproductive ages living in Low- and Middle-Income Countries, have limited or no access to education on sexual and reproductive health and contraception, yet about 1.9 billon women in LMICs own a mobile phone. The exposure to digital health services has the potential to contribute to improving awareness, influencing positive perceptions, beliefs and promoting SRH and contraception.AIM: To explore user views and perceptions on the Grace Health’s (a digital health service) ability to improve awareness on sexual reproductive health and contraception among Ghanaian, Nigerian and Kenyan women aged 18-35.METHODOLOGY: A qualitative design using phenomenography to interview women remotely on women’s perception of digital health services through their own experience with using the Grace health chat bot and app. Also, their views were sought on how other women are gaining awareness and impacts on sexual reproductive health and contraception from the digital health services.RESULTS: Seven categories on digital health services emerged, with key findings presented as Safe days, ovulation as contraception, impacts on SRH, Avoiding or seeking pregnancy and influence on perception.CONCLUSION: This qualitative study gives insight for research community, public health professionals, app designers, health care providers, stakeholders and civil society organisations in making decisions regarding the use of digital health service as strategic, innovative instruments for interventions in major key indicators of Sexual Reproductive Health and Rights.

Thesis (MPH.) -- University of Limpopo, 2021 / Refer to document

Patient-centered contraceptive care is key for ensuring that individuals achieve their personal reproductive goals. Despite public health efforts, preventing undesired pregnancies and improving maternal and child health outcomes remains unresolved in the United States (US). In Tennessee (TN), the rate of unintended pregnancies remains higher than the national rate (32.4% vs. 30.3%). Long-acting reversible contraceptives (LARCs) are 99% effective in preventing undesired pregnancies; however, uptake remains low in rural and underserved communities. Previous research has provided some insight into women’s perceptions of LARCs; however, those guided by conceptual frameworks to understand the multiple influences that impact perceptions towards LARCs, especially among rural regions, are scarce. This multimethod qualitative study explored multiple influences that impact northeast Tennessee women’s perceptions and attitudes toward LARCs using the Socio-ecological Model (SEM) as a guiding framework. The qualitative study comprised six focus groups and seven individual interviews of women aged 18-44, not pregnant, and current residents of five Counties in Northeast TN. Participants’ demographics were captured through an anonymous survey administered through REDCap. Qualitative data from these sessions were recorded via Zoom, an online audio/video conferencing platform. Each interview and focus group lasted 60 to 90 minutes. Focus group and interview data were combined, transcribed, and uploaded into NVivo for thematic analysis. A priori list of codes identified from the constructs of the SEM was initially used to deductively code the data. Subsequently, the data were analyzed inductively for new codes and themes that did not apply to the a priori categories. Quotations that were representative of or inconsistent with the codes of interest were identified. Fifteen themes and 20 sub-themes were identified using the SEM; On the intrapersonal level of the SEM, participants’ attitudes towards a method, perception of method features, and perceived side effects were identified as themes that delineate influences on their LARC utilization. On the interpersonal level, perception of partner support, perceived support from peer/social networks, and provider trust were themes that describe influences on participants’ LARC utilization. On the community level, the cost of the method, access to information, perceived accessibility to a method, social services, and cultural norms themes were identified as influences on participants’ use of LARCs. On the organizational level, the availability of preferred methods in a clinic, the need for multiple clinic visits to enable the use of a method, and provider counseling practices were salient themes impacting LARC utilization. On the policy level, insurance, and billing policies, sex education policies were identified as impacting LARC utilization. The study presents multi-layered influences on LARC utilization among Northeast TN women, highlighting the utility of the SEM in understanding factors that influence contraceptive use. Findings are critical for programming as they highlight the areas of influence that can be addressed to increase LARC uptake and enable women in rural and underserved regions of the US to achieve personal reproductive goals.

Uganda currently hosts 1.4 million refugees and conflict-affected people. Known as the “best place” in Africa to be a refugee, Uganda’s policies encourage self-sufficiency and local integration. However, many refugees, particularly women and girls, face persistent challenges. Understanding the reproductive health needs of this population and exploring the accessibility of services for conflict-affected populations in this low-income host country is a priority. This multi-methods study aimed to assess the reproductive health needs of displaced Congolese women in camp- and urban-based settings in Uganda. We interviewed key informants, facilitated focus group discussions with refugee women, and conducted in-depth interviews with Congolese women of reproductive age to better understand knowledge, attitudes, practices, and services. Our results suggest that Congolese refugees have significant unmet reproductive health needs. Maternal health and delivery care is characterized by insufficient human resources, inconsistent medication availability, discrimination, bribery, and communications challenges. The availability of contraceptive products, including emergency contraception, is limited in camp-based settings due to supply-chain management challenges and theft by staff; lack of contraceptive knowledge among Congolese refugees shapes use. Finally, the legal restrictions on abortion lead to unsafe practices among refugees and pose a barrier to the provision of post-abortion care. This study provides insight for opportunities to improve the delivery of sexual and reproductive health services to refugees in Uganda to ensure that the infrastructure and processes align with national policies and international guidelines.

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.

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Idag står barnmorskor för 80 procent av förskrivningen av antikonception och 74 procent av kvinnor i 19 årsåldern har vid något tillfälle använt antikonception. Upprepade undersökningar tyder på att unga personer sexdebuterar tidigare, har fler sexpartners och samtidigt blir sämre på att använda skydd. På grund av detta är unga personer i behov av individanpassade och väl fungerande antikonception. För att som barnmorska kunna möta detta behov behövs kunskap om vilka faktorer som påverkar unga kvinnors i sitt val av antikonception. Mot bakgrund av detta finns ett intresse av att sammanställa den befintliga forskningen. Syftet var att belysa vilka faktorer som påverkar kvinnliga ungdomar och unga vuxnas val av antikonception.  Val av metod var en allmän litteraturöversikt med induktiv ansats som bearbetades via en integrerad analysmetod. Datainsamlingen skedde via databaserna PubMed och CINAHL under februari 2023. Artiklarna kvalitetsgranskades genom Caldwells kvalitetsgranskningsmall och sammanställdes i en artikelmatris. Genom numrering och färgkodning identifierades kategorier.  Det inkluderades sexton artiklar varav fem kvalitativa och elva kvantitativa. Resultatet sammanställdes under två huvudkategorier och fem subkategorier. Faktorer som påverkade unga kvinnor när de valde antikonception var metodens effektivitet, dess önskvärda egenskaper samt biverkningar och farhågor de hade om metoden. Mötet med hälso- och sjukvården samt kvinnans familj, vänner och hennes relationsstatus influerade även hennes val.   Slutsatsen var att unga kvinnor har olika prioriteringar när de väljer antikonception. Många kvinnor använder en metod vars egenskaper ej stämmer överens med deras individuella önskemål. Detta tyder på att hälso- och sjukvården brister i informationsöverföringen. Barnmorskan har ett ansvar gentemot unga kvinnor att stödja dem i att uppnå reproduktiv och sexuell hälsa. Vidare forskning om hur unga personer upplever antikonceptionsrådgivningen med barnmorskor hade varit av intresse. Detta skulle kunna resultera i kunskap om vilket stöd de unga personerna är i behov av under rådgivningen. / Today, midwives account for 80 percent of prescriptions of anticonception and 74 percent of women aged 19 have at some point used anticonception. Repeated surveys indicate that young people make their sex debut earlier, have more sex partners and at the same time are becoming worse at using protection. Because of this, young people are in need of individually adapted and well-functioning anticonception. In order for a midwife to be able to meet this need, knowledge is needed about the factors that influence young women's choice of contraception. Against this background, there is an interest in compiling the existing research. The aim is to shed light on which factors influence female adolescents and young adults' choice of contraception. The choice of method was a general literature review with an inductive approach that was processed via an integrated analysis method. The data collection took place via the databases PubMed and CINAHL during February 2023. The articles were quality-reviewed through Caldwell's quality review template and compiled in an article matrix. Through numbering and color-coding categories were identified. The study included sixteen articles, five qualitative and eleven quantitative. The results were compiled under two main categories and five subcategories. Factors influencing young women when choosing an anticonception method were the method's effectiveness, its desirable characteristics and side effects and concerns they had about the method. The meeting with the healthcare personnel as well as the woman's family, friends and her relationship status also influenced her choice. The conclusion was that young women have different priorities when choosing contraception. Many women use a method whose characteristics do not match their individual wishes. This indicates that the healthcare system is lacking in information transfer. The midwife has a responsibility towards young women to support them in achieving reproductive and sexual health. Further research on how young people experience anticonception counseling with midwives would have been of interest. This could result in knowledge of what support the young people need during counseling.

This study assesses cost savings associated with specific contraceptive methods provided to beneficiaries enrolled in South Carolina Medicaid between 2012 and 2018. Incremental cost-effectiveness ratios, defined as the additional cost of contraception provision per live birth averted, were estimated for 4 contraceptive methods (intrauterine devices [IUDs], implants, injectable contraceptives, and pills), relative to no prescription method provision, and savings per dollar spent on method provision were calculated. Costs associated with publicly funded live births were derived from published sources. The analysis was conducted for the entire Medicaid sample and separately for individuals enrolled under low-income families (LIFs), family planning, and partners for healthy children (PHC) eligibility programs. Sensitivity analysis was performed on contraceptive method costs. IUDs and implants were the most cost-effective with cost savings of up to $14.4 and $7.2 for every dollar spent in method provision, respectively. Injectable contraceptives and pills each yielded up to $4.8 per dollar spent. However, IUDs and implants were less cost-effective than injectable contraceptives and pills if the average length of use was less than 2 years. Medicaid's savings varied across Medicaid eligibility programs, with the highest and lowest savings from contraceptive provision to women in the LIFs and PHC eligibility programs, respectively. The results suggest the need to account for unique needs and preferences of beneficiaries in different Medicaid eligibility categories during contraception provision. The findings also inform program administration and provide evidence to justify legislative appropriations for Medicaid reproductive health care services.