Background: Women across many ethnicities and backgrounds experience a lower quality of care compared to men, and have reported lower levels of patient satisfaction, and negative health outcomes. Women of various ethnic backgrounds often have health, cultural and religious needs during pregnancy that are not met by their care providers. While addressing patient needs is a priority, providers also face challenges in understanding, accommodating, and addressing women’s needs due to limited understanding of their cultures and available resources in caring for diverse populations. Objective: The purpose of this study is to describe and synthesize information from the literature regarding the perceptions and experiences of healthcare providers in delivering maternity care to ethnically diverse women. Methods: A scoping review was conducted, and database searching occurred in Ovid Medline, Ovid Embase, Ovid Emcare and Web of Science. Primary studies and literature reviews in English were included if they discussed the perspectives of healthcare providers in delivering maternity care to either ethnically diverse women, immigrant women, or a specific ethnic group of women. No time restrictions were placed on articles. Thematic analysis was applied to analyze the data, and results were reported in tabular format. Results: A total of 11 themes were generated across findings, namely, provider-patient communication difficulties, family involvement, lack of health and health system awareness, delays in care, limited time and resources, cultural conflicts, preference for a female provider, creation of stereotypes, prejudice and superior thinking, motivation to help ethnically diverse women, and cultural sensitivity training. Conclusion: Healthcare providers face challenges in addressing the needs of ethnically diverse women, due to resource and time limitations, lack of awareness of cultural norms, and lack of adequate cultural sensitivity training and education. Therefore, there is a need to increase the number of supports for providers as well as improve cultural sensitivity training in medical education. / Thesis / Master of Science (MSc) / Women of different backgrounds who are pregnant or who have given birth sometimes like to practice certain cultural traditions during pregnancy and birth such as eating cultural foods, fasting, and having family involved. When healthcare providers do not know about these practices or do not have the time or resources to help women practice their cultural traditions, this can cause them and the women they care for to have conflicts. This can cause other problems which can lead to poor mental and physical health. While there is a great amount of research on women’s experiences with their health providers, there is not much research on healthcare providers’ experiences with women. To address this, a scoping review was conducted to summarize research on healthcare providers’ experiences in caring for women of diverse cultures, during and after pregnancy. This review can help bridge the gap between women’s needs and healthcare providers’ abilities in meeting them.

No description available.

Evidence points to that the prevalence of teenage pregnancies is higher within refugee camps than elsewhere. Yet little research attention has been given the subject of teenage pregnancy within refugee situations where the numbers are steadily increasing, an area that therefore needs to be explored further. This thesis is based on a qualitative field study conducted within two Burundian refugee camps in Tanzania, Nduta and Kanembwa. Semi structured interviews were conducted with both teen mothers and Non Governmental Organizations (NGOs) and Bloc leader with knowledge in the area in order to investigate the reasons for and implications of teenage pregnancy within a refugee setting. The research question is why the prevalence of teenage pregnancy is higher within a refugee context. And what can be done to empower young mothers with the knowledge and skills to protect themselves and to successfully claim their reproductive and sexual rights? The findings of the study points to that similar factors contributing to teenage pregnancy such as education, culture, poverty and unstable family relations are also applicable in a refugee situation. Conditions within refugee camps are however more extreme and the prevalence are therefore higher than in other settings. Taking a Liberal feminist standpoint based on the ideas of Amartyra Sen (1999) it is argued that the empowerment of women’s free agency and wellbeing is the key to a decline in fertility rate amongst teen mothers in refugee camps. Thus it follows that if women are to successfully claim their sexual and reproductive rights more efforts needs to be made in promoting the inclusion of women into educational and vocational activities.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01

Yes / Women and the adolescents girls in low-middle income countries continue to be the most vulnerable individuals in times of disasters such as the ongoing COVID-19 pandemic with emphasis on their Sexual Reproductive Health (SRH); yet hardly many studies choose to identify gaps that could improve and bring about well-informed interventions during crisis that do not affect other essential services. Hence, this study aimed to identify the effect of the Covid-19 pandemic mitigation measures on access and utilization of sexual reproductive health services and its related SRH outcomes among women and female adolescents in Kenya. Methods: A systematic literature review was performed to collate findings on the given study using 8 databases. Total of 1352 presumably pertinent publication were retrieved of which 20 studies met the study’s inclusion criteria which included studies with quantitative, qualitative and mixed methods study designs in full text and in English without duplicates. Using a data extraction table, thematic analysis was carried out to yield the study findings. Results: Two themes were identified including; service access related outcomes with the sub-themes of maternal health services and HIV/AIDS services and pandemic specific stressors with the sub-themes of Covid-19 mitigation stressors and socio-economic stressors. The findings implied that, women of reproductive age SRH access and utilization was affected by the COVID-19 pandemic’s mitigation responses with adverse SRH health outcomes. Conclusion: In conclusion, the Covid-19 pandemic adversely affected sexual reproductive health services among women and female adolescents in Kenya. The given main findings indicated and recognized the existence of improper set policies and mitigative measures during crisis management, affecting essential services such as SRH.

Guatemala signed the peace accords in 1996, ending a 36-year civil war marked by Mayan Indigenous genocide. Underinvestment in the public health system has resulted in inequalities in accessing healthcare, particularly sexual and reproductive health (SRH), for Indigenous adolescents. Alta Verapaz is the most affected department, reporting the second-highest number of adolescent pregnancies and gender-based violence nationwide. The Guatemalan government implemented the National Plan for the Prevention of Adolescent Pregnancy (PLANEA) 2018-2022; however, it falls short of addressing the situation and reaching the target population. This doctoral dissertation explores the perceptions of adolescent pregnancy, early motherhood, fatherhood, and reproductive health practices, as well as the perceptions of implementing the national action plan. An exploratory descriptive methodology and reflexive thematic approach were employed to collect and analyze the perspectives among adolescents, community members, and stakeholders. This involved four focus group discussions with Indigenous adolescents (n=30), 18 semi-structured interviews with community members, and 20 interviews with stakeholders. Findings revealed that underlying factors, such as poverty, discrimination, deep-rooted family and community values, harmful gender stereotypes, stigma, fear, cultural, moral, and religious norms, and communication challenges hinder adolescent access to SRH information and services. Additionally, limited access to maternal, neonatal, and mental health services often leads to forced marriages, unsafe abortions, higher risk of maternal and neonatal mortality, and mental health problems, including suicide. These factors contribute to a heightened risk for sexual violence and pregnancy, especially among adolescents under 14 and during the COVID-19 pandemic. Moreover, budget constraints, government shifts, limited multisectoral and interinstitutional coordination, and insufficient monitoring and evaluation capacity threaten initiatives’ continuity and long-term sustainability. However, opportunities exist to enhance adolescent SRH interventions through stronger partnerships, community participation, youth leadership, demographic changes, technology use, and mental health integration. The dissertation concludes with reflections on the implications and recommendations for designing and implementing equitable adolescent SRH programs and policies. / Dissertation / Doctor of Philosophy (PhD) / Despite significant progress in understanding what strategies work to address adolescents’ sexual and reproductive (SRH) needs, a conclusive global agenda remains elusive. Various strategies, including comprehensive sexuality education (CSE) and youth-friendly spaces (YFSs), have been implemented as part of multi-component and multi-level interventions. The Guatemalan government has implemented the National Plan for the Prevention of Adolescent Pregnancy (PLANEA, Spanish acronym) 2018-2022 to reduce adolescent pregnancies in the country, exemplifying efforts within low-middle-income countries (LMICs) in the Latin America region to address this situation. However, the plan is far from reaching the most vulnerable Indigenous adolescents living in rural and isolated areas. This doctoral dissertation aims to contribute to the existing literature by deepening the understanding of diverse perspectives among adolescents, community members, and stakeholders on adolescent pregnancy, early motherhood, fatherhood, and reproductive health practices in four rural communities in Alta Verapaz, Guatemala. Additionally, it seeks to explore the perceptions of implementing the national action plan in this context. Findings indicate a variability of perspectives among Indigenous adolescents, community members, and stakeholders, highlighting underlying factors that exacerbate this situation. These factors include poverty, gender-based violence, discrimination, stigma, fear, cultural, moral, family, and religious values, communication challenges, harmful traditional gender roles, and limited life options. Future research should focus on engaging adolescents and community members through participatory methods to listen and incorporate their perspectives into research initiatives, future action plans, and policies, amplifying their voices and effectively addressing their unique needs.

<p>The study findings were thematically grouped into three themes including the coordination and partnerships, culture and implementation challenges. Poor coordination and failure of systems in place appeared to characterise the many challenges. Gender inequalities and masculine dominated cultural practices like polygamy and widow inheritance are associated with consequences of ill health among women / including high HIV/AIDS prevalence, early marriage, high teenage pregnancies and high maternal mortality. Although these practices are in favor of men, they hardly protect them from the wrath of poor RH like STDS, HIV/AIDS, stressful big families and vast poverty. Hence, Tanzanian men are also victims of their own behavior.</p>

<p>The study findings were thematically grouped into three themes including the coordination and partnerships, culture and implementation challenges. Poor coordination and failure of systems in place appeared to characterise the many challenges. Gender inequalities and masculine dominated cultural practices like polygamy and widow inheritance are associated with consequences of ill health among women / including high HIV/AIDS prevalence, early marriage, high teenage pregnancies and high maternal mortality. Although these practices are in favor of men, they hardly protect them from the wrath of poor RH like STDS, HIV/AIDS, stressful big families and vast poverty. Hence, Tanzanian men are also victims of their own behavior.</p>

Magister Public Health - MPH / The study findings were thematically grouped into three themes including the coordination and partnerships, culture and implementation challenges. Poor coordination and failure of systems in place appeared to characterise the many challenges. Gender inequalities and masculine dominated cultural practices like polygamy and widow inheritance are associated with consequences of ill health among women; including high HIV/AIDS prevalence, early marriage, high teenage pregnancies and high maternal mortality. Although these practices are in favor of men, they hardly protect them from the wrath of poor RH like STDS, HIV/AIDS, stressful big families and vast poverty. Hence, Tanzanian men are also victims of their own behavior. / South Africa

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