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.

Background: Increasing numbers of women veterans (WV) present an organizational challenge to a healthcare system that primarily serves men. WV use reproductive services traditionally not provided by the Veterans Health Administration (VHA). Objective: Examine the association of organizational factors and adoption of comprehensive women’s health (WH) care in the VHA. Study Design: Cross-sectional secondary analysis of the 2007 VHA Survey of Women’s Veterans Health Programs and Practices. Methods: Dependent measures were (a) model of women’s health care: separate women’s health clinic (WHC), designated women’s health provider within primary care (DWHP), both (WHC/DWHP), or neither and (b) availability of five basic WH services: cervical cancer screening and evaluation and management of: vaginitis, menstrual disorders, contraception and menopause. Exposure variables were organizational factors drawn from an adaptation of the Greenhalgh model of diffusion of innovations including structural factors, measures of absorptive capacity and system readiness for innovation. Results: Compared to sites with DWHP or neither, WHC and WHC/DWHP were more likely at facilities with: a gynecology clinic, an academic affiliation, a WH representative on high impact committee, and a greater number of WV. Academic affiliation and high impact committee remained significant in multivariable analysis. All five basic WH services were more likely to be offered at sites with WHC or WHC/DWHP, remaining significant after adjusting for organizational factors. Conclusion: Facilities that adopt WHC are associated with greater absorptive capacity (academic affiliation and WH representation on high-impact committees) and are more likely to deliver basic WH services. Separate WHCs may promote more comprehensive care for WV.

BACKGROUND: Women seeking abortion services in the U.S. often encounter challenges of stigma, cost, transportation, and other logistics. In 2011, 1.7% of women aged 15–44 had abortions, and 89% of counties had no abortion clinic. Many states regulate abortion through prohibition of insurance coverage and other restrictions. Accurate, non-judgmental referrals from health care professionals may lessen obstacles and counteract stigma. STUDY QUESTION: What are women’s experiences accessing abortion care, and what is the role of professional referrals? METHODS: I conducted semi-structured qualitative interviews with 45 women seeking abortions to learn what steps they took to obtain abortion care, whether they sought or received professional referrals, and what obstacles or supports they encountered. All interviews were conducted at three clinics in South Carolina. Using Zurek et al’s (2015) conceptual framework, process mapping and thematic analysis were conducted to understand the sequence and variations of steps taken. RESULTS: Nearly half of participants had contact with a health professional for pregnancy confirmation, but only seven received referrals. Professional referrals ranged in their perceived helpfulness. Positive referrals included direct, supportive communication without judgment. Negative experiences were characterized by stigmatizing action or language. Some women indicated they did not seek a referral due to social pressure or stigma. Without a referral, women located abortion clinics through online searches, previous experience, and information from friends or family. Women encountered structural and social obstacles when arranging abortion care, such as out of pocket costs, transportation challenges, and stigma at multiple levels. Social support and help with logistics and finances counteracted these obstacles. CONCLUSIONS: Resourcefulness is evident in women’s stories of accessing abortion, particularly in the absence of referrals, but positive professional referrals carry some benefit. Abortion access may be improved through expanding health provider capacity to make accurate, supportive referrals. IMPLICATIONS: To improve abortion access, obstacles and stigma must be reduced through increased support and reduction of systematic obstacles. Health system policies should ensure that providers know how to appropriately refer for abortion, and how to support women navigating predictable challenges. / 2017-11-05T00:00:00Z

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.

Nigeria is a patriarchal society, which puts women in subordinate positions that may prompt gender-based discrimination. While evidence of this phenomenon has been investigated in Nigeria and other African countries, no such investigation has been conducted with immigrant and first-generation Nigerian women in the United States. The purpose of this study was to examine the role of a Nigerian woman's perceived empowerment and status on her willingness to access reproductive health services. The research questions examined views of Nigerian traditional beliefs' influence on status and how attitudes around traditional beliefs relate to access to reproductive health services and/or knowledge. Data were gathered through semi structured interviews with 9 Nigerian women in the Washington DC-Maryland-Virginia area. The women were recruited using purposive and snowball sampling. Data were analyzed using the ecological systems theory as a framework, which theorizes that a woman's status is related to her ability to access services or information; empowerment increases that access of services/information, and that traditional Nigerian beliefs have mostly positive effects on their status. However, the findings revealed that, among these 9 women, traditional beliefs did not have an overwhelming direct effect to access to services or information. Empowering women is vital for social growth, no matter what the place of origin. This study contributes to positive social change by providing a resource that demonstrates the importance of these women's contributions to society, thus helping to move society forward.

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.

INTRODUCTION: Half of all pregnancies in South Carolina are unintended (mistimed or unwanted) and are associated with a higher risk for adverse maternal and infant health outcomes. South Carolina has a wide network of publicly supported clinics providing reproductive health services, including the Department of Health and Environmental Control, Federally Qualified Health Centers, and Rural Health Clinics. Having a better understanding of the geographic distribution of women in need of publicly funded contraceptive services is crucial for health planning and improving health delivery systems. METHODS: The total number of reproductive-aged women (15-44 years) in South Carolina was drawn from the 2017 American Community Survey (ACS) 5-Year Estimate files housed by the U.S. Census Bureau. A four-step process was used to estimate the number of reproductive-aged women in need of publicly funded contraceptive services at the county-level. First, the number of women between 15-19 years of age in each county was established. Next, the number of women with family incomes <100% of the federal poverty level in each county was identified. Data from the South Carolina Statewide Survey of Women, conducted by NORC at the University of Chicago, were used to estimate the number of reproductive-aged women (18-44) at-risk for experiencing an unintended pregnancy. The proportion of the women who were not sterile, not currently pregnant or not trying to get pregnant in the next 3 months was considered at-risk (76.24% of the total sample). The proportion of women at-risk was used to adjust the estimates of the total number of low-income women between 20-44 years of age in need of publicly funded contraceptive services in each county. The adjusted number of low-income women and the number of women less than 20 years of age were combined to estimate number of women in need of publicly funded contraceptive services. FINDINGS: There are an estimated 950,978 women of reproductive age living in South Carolina; of these women, about 40% (N=374,000) are considered in need of publicly funded contraceptive services. County-level need estimates ranged from 33.5% to 57.8% (M = 42.2%, SD = 4.8%) of the total reproductive-aged female population. While the number of women in need followed a typical population density pattern, rural communities had higher proportions of women in need of publicly funded contraceptive services, relative to the total population of reproductive-aged women. Rural counties comprised 91% of counties with the greatest need for publicly funded contraceptive services. CONCLUSIONS: Proportionally, the need for publicly funded contraceptive services is greater in rural and low-resource counties. While ensuring services are available among large population centers is certainly warranted, these findings also suggest that access to contraceptive services in rural counties is also needed and should be considered in health planning and service allocation policies and practices.

This study sets out to investigate Sahrawi women’s understanding of maternities as bodily and embodied experiences of collective and individual resistance within the Sahrawi liberation struggle against the occupation of Western Sahara. By using the Sahrawi liberation front’s pronatalist politics as a starting point to explore Sahrawi women’s positioning in the liminal space between reproductive health and biological reproduction as a socio-political action, I draw on a decolonial understanding of agency to analyse the relationship between individual health and collective resistance – especially in correlation with the increase of humanitarian projects targeting sexual and reproductive health. As a result of semi-structured interviews, focus groups and desk review, I argue that the change in the social landscape of the camps with the arrival of humanitarian aid provided Sahrawi women with new perspectives on biological reproduction that, in turn, affected the way they contribute to the revolutionary cause, confirming their role as socio-political agents implementing new strategies of survival as acts of individual resistance.

No description available.