Introduction: Despite policy actions and strategic efforts for improving the reproductive and sexual health of adolescents by promoting the uptake of adolescent reproductive and sexual health (ARSH) services, the utilisation rate remains significantly low, especially in rural areas of India. This study aimed to assess the utilisation of these services by adolescents in rural West Bengal and its associated determinants. Methods: This mixed-method study was conducted from May to September 2021 in the Gosaba rural block of South 24 Parganas, West Bengal. Quantitative data were collected from 326 adolescents using a pre-tested structured questionnaire. Qualitative data were collected via four focus group discussions among 30 adolescents and key-informant interviews among six healthcare workers. Quantitative data were analysed using SPSS, while qualitative data were analysed thematically. Results: Ninety-six (29.4%) adolescents had utilised ARSH services at least once during adolescence. The factors associated with non-utilisation of ARSH services were younger age, female sex, increasing reproductive health stigma and decreasing parent–adolescent communication related to sexual health. Qualitative exploration revealed that unawareness regarding services, perceived lack of privacy and confidentiality at healthcare facilities and disruption of services post-emergence of the COVID-19 pandemic were some major barriers to ARSH service utilisation. Conclusion A multi-component strategy, including promotion of adolescent-friendly health clinics, community support interventions associated with motivation and counselling of parents regarding the importance of adolescent reproductive health, is needed to improve the utilisation of ARSH services. Necessary steps to correct the deficiencies at the facility level should also be prioritised.
Adolescent ; Reproductive Health Services ; Sexual Health ; Qualitative Research ; Rural Population

BACKGROUND AND OBJECTIVE: In order to alleviate the reproductive health status of mothers in the Philippines, there should be a better understanding of the factors influencing their compliance to reproductive health services. The study examined the association of topography with demographic and socioeconomic characteristics on the compliance of reproductive health services.

METHODOLOGY: This study analyzed survey data collected in 2017 among mothers in the rural community of Maasin, Iloilo, Philippines. The statistical tools Chi-square, T-test and logistic regression were used to determine the factors associated with the likelihood of mothers to comply with prenatal care, family planning and delivery care services.

RESULTS: There is no significant difference in the number of mothers who comply with prenatal care services and family planning services between lowland and highland barangays. However, mothers from the highland barangays are more likely to have non facility-based delivery (NFBD). Only educational attainment was found to be significantly associated for prenatal services. Only parity was significantly associated with compliance to family planning services. Age, parity, educational attainment and occupation were significantly associated with compliance to delivery care service. The odds of NFBD in the highland area is 2.44 (95% CI: 1.40 to 4.23) times higher as compared to the mothers residing in the lowland area. The odds of NFBD also increases by 7% (95% CI: 3% to 11%) per year increase in age.

CONCLUSION: There is a great need to restructure the delivery of reproductive health services to accommodate mothers from highland barangays who still opt for NFBD. Topography, demographic and socioeconomic factors should be considered in developing strategies and implementation of reproductive health care services in the Philippines. Furthermore, the researchers recommend to include in future studies other reproductive health services such as postnatal care in order to fully grasp the reproductive health in the country. 

Human ; Female ; Family Planning Services ; Prenatal Care ; Reproductive Health Services

Objective: To investigate the utilization of reproductive health services and relating factors among internal migrant population in Beijing, Shanghai and Chongqing. Methods: A multi-stage cluster sampling method was adopted in this cross-sectional study, conducted in Beijing, Shanghai and Chongqing from August 2014 to August 2015. Standard methods on statistics and nonlinear canonical correlation were applied. Results: Out of the 6 545 internal migrant persons, 41.76% ever used the reproductive health services in the past year. Results from the nonlinear canonical correlation analysis revealed that the utilization of reproductive health services was correlated with the demographic features (=0.28, P<0.000 1) and characteristics of the population mobility (=0.21, P<0.000 1), respectively. For the above said demographic features, canonical variable L(1) which represented the demographic features was mainly determined by area, occupation and education attainment. Canonical variable M(1) that reflected the utilization of reproductive health services, was mainly determined by factors as free contraceptives, education on contraception/reproductive health, and pregnancy diagnosis/antenatal care. As for the characteristics of the population mobility, canonical variable U(1), which represented population mobility characteristics, was mainly determined by factors as purpose of migration, current pattern of residence and the length of annual stay in the area. Again, the canonical variable V(1), reflecting the use of reproductive health services was mainly determined by factors as free contraceptives, check-up on reproductive tract infection, education on contraception/reproductive health, and pregnancy diagnosis/antenatal care. Conclusions: The utilization of reproductive health services was low among the internal migrant population under study. Responsible departments for health and family planning in those cities should make internal migrants attach importance to reproductive health.
China ; Cities ; Cross-Sectional Studies ; Demography ; Female ; Health Care Surveys ; Humans ; Patient Acceptance of Health Care ; Pregnancy ; Reproductive Health Services ; Transients and Migrants

OBJECTIVE: North Korean women defectors have suffered from anxiety, depression, and somatization after defection. Also they have had many menstrual problems like amenorrhea. This study was done to identify the correlations of anxiety, depression, and somatization to menstrual problems among North Korean woman defectors in South Korea. METHODS: The participants in this study were 126 women from 5 government resettlement centers throughout South Korea. Questionnaires which included State-Trait Anxiety Inventory (STAI), Center for Epidemiological studies-Depression Scale (CED-S), and Symptom Checklist-90-Revised (SCL-90-R) were used to identify anxiety and somatization. Data were collected between June and September, 2012. RESULTS: The women reported the following problems; amenorrhea (9.5%), hypomenorrhea (13.6%), menorrhagia (19.8%), polymenorrhea (13.5%), oligomenorrhea (4.8%), changes in amount of menstrual discharge (4.0%), and changes in amount of blood clot (9.5%). Anxiety (r=0.20, p=0.002), depression (r=0.25, p=0.005), and Somatization (r=0.35, p<0.001) were correlated with number of menstrual problems. CONCLUSION: The results of this study indicate that mental health services need to be taken into account in interventions for North Korean woman defectors to improve their reproductive health including addressing menstrual problems.
Amenorrhea ; Anxiety* ; Depression* ; Female ; Humans ; Korea* ; Menorrhagia ; Menstruation ; Menstruation Disturbances ; Mental Health Services ; Oligomenorrhea ; Reproductive Health

Traditionally, programs related to maternal health are regarded as purely a woman's domain. Nevertheless, the role of the male as the decision maker in the household gave way to the recognition of the male's role in maternal and reproductive health. This paper aimed to provide a review on male involvement strategies and their impact on maternal health based on related studies, discuss the strategies in the Philippine context and suggest interventions given the current state of the Philippine health care system. These strategies utilize the decision-making role of the male by positing itself on the reproductive, sexual and maternal health aspects encompassing important factors, such as birth spacing, first pregnancy, family planning, utilization of skilled birth attendants (SBAs), and delivery in health facilities, antenatal and postpartum care and nutrition. However, negative repercussions include stigmatization of single mothers and reinforcement of the notion of a man's control over a woman's body. Given the current state of the Philippine health care system, the suggested interventions try to veer away from it as much as possible. These include integration of the male involvement strategy into the Pantawid Pamilyang Pilipino Program (4Ps), coursing it through a public-private partnership (PPP) and non-government organizations (NGOs), involvement of educational institutions, strengthening of the health service delivery at the grassroots level, reinforcement of existing laws, and research on its institutionalization. With carefully-planned strategies that recognize existing gender norms and other sociocultural factors, male involvement in maternal health could be a possible catalyst in decreasing the Philippine maternal mortality rate (MMR).

 

Human ; Male ; Female ; Pregnancy ; Maternal Mortality ; Reproductive Health ; Birth Intervals ; Family Planning Services ; Public-private Sector Partnerships ; Stereotyping ; Maternal Health ; Mothers ; Postnatal Care ; Parturition ; Family Characteristics ; Gender Identity ; Delivery, Obstetric ; Decision Making ; Institutionalization ; Health Facilities

OBJECTIVES: With access to antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV) are able to consider childbearing to a greater extent than previously. In many cases, ART has transformed their intentions to have children. The present study aimed to assess changes in fertility intentions 12 months after ART initiation among HIV-positive women in Addis Ababa, Ethiopia. METHODS: An institution-based follow-up study was conducted among 360 HIV-positive women in Addis Ababa. A logistic regression model was used to assess the influence of socio-demographic, reproductive health, and clinical characteristics on changes in the fertility intentions of women. RESULTS: Overall, 40.8% (147 of 360) of the women reported that they desired to have a child in the future at the baseline visit, while 48.3% (174 of 360) did so at the 12-month follow-up. The proportion of women who reported that they desired to have a child 12 months after ART initiation was higher among ART-initiated women (55.8%, 106 of 190) than ART-naïve women (40.0%, 68 of 170). The adjusted analysis indicated that a change in fertility intentions between baseline and the follow-up visit was significantly associated with ART use (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.20 to 5.20) and marital status, with single (aOR, 5.33; 95% CI, 1.10 to 25.92) and married (aOR, 6.35; 95% CI, 1.44 to 27.99) women being more likely to report fertility intentions than divorced/widowed women. CONCLUSIONS: ART use was a significant predictor of change in fertility intentions between the baseline and follow-up visit, which suggests that additional efforts are necessary to integrate family planning and HIV services to address the safe fertility goals of women in the study area.
Child ; Ethiopia* ; Family Planning Services ; Female ; Fertility* ; Follow-Up Studies* ; HIV ; Humans* ; Intention* ; Logistic Models ; Marital Status ; Odds Ratio ; Prospective Studies* ; Reproductive Health

OBJECTIVES: With access to antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV) are able to consider childbearing to a greater extent than previously. In many cases, ART has transformed their intentions to have children. The present study aimed to assess changes in fertility intentions 12 months after ART initiation among HIV-positive women in Addis Ababa, Ethiopia.METHODS: An institution-based follow-up study was conducted among 360 HIV-positive women in Addis Ababa. A logistic regression model was used to assess the influence of socio-demographic, reproductive health, and clinical characteristics on changes in the fertility intentions of women.RESULTS: Overall, 40.8% (147 of 360) of the women reported that they desired to have a child in the future at the baseline visit, while 48.3% (174 of 360) did so at the 12-month follow-up. The proportion of women who reported that they desired to have a child 12 months after ART initiation was higher among ART-initiated women (55.8%, 106 of 190) than ART-naïve women (40.0%, 68 of 170). The adjusted analysis indicated that a change in fertility intentions between baseline and the follow-up visit was significantly associated with ART use (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.20 to 5.20) and marital status, with single (aOR, 5.33; 95% CI, 1.10 to 25.92) and married (aOR, 6.35; 95% CI, 1.44 to 27.99) women being more likely to report fertility intentions than divorced/widowed women.CONCLUSIONS: ART use was a significant predictor of change in fertility intentions between the baseline and follow-up visit, which suggests that additional efforts are necessary to integrate family planning and HIV services to address the safe fertility goals of women in the study area.
Child ; Ethiopia ; Family Planning Services ; Female ; Fertility ; Follow-Up Studies ; HIV ; Humans ; Intention ; Logistic Models ; Marital Status ; Odds Ratio ; Prospective Studies ; Reproductive Health

In Korea, international marriage and inflow of foreigners have increased, as globalization leads to increase of human and resource movement, unbalanced sex ratios in marriage markets, and aging phenomenon, and decrease of fertility rate. The number of marriage-based immigrant women and their children is expected to be growing continuously. Because the majority of immigrant women are between 18 and 49 years old and permanently reside in Korea, there is a high possibility for them to give birth in the country. Many immigrant women get pregnant before acquiring nationality in Korea or without having enough time to adapt themselves to new circumstances. Thus, it is critical for them to have basic reproductive health care and health protection services. Also, there is a great need of maternal and child health services for multi-cultural family. marriage-based immigrant women are more likely to be vulnerable to injuries and diseases due to the relatively low level of income, education, and language skill, as well as cultural and environmental differences from their home country. Despite of the great health care needs for women and children in multi-cultural family, it lacks decent health care services for them and also there is no integrated national survey on their health. Therefore, it is necessary to establish integrated research system to understand the current health conditions and problems of women and children in multi-cultural family. Additionally, we need to set up the long-term life-support policies concerning different situations in multi-cultural families.
Aging ; Birth Rate ; Child Health Services ; Child Health* ; Child* ; Delivery of Health Care ; Education ; Emigrants and Immigrants ; Ethnic Groups ; Female ; Humans ; Internationality ; Korea* ; Marriage ; Parturition ; Reproductive Health ; Sex Ratio

Reproductive health (RH) education and services of female migrants in China have become an important health issue. This research aimed to investigate the RH knowledge and utilization among married female migrants, and to explore the influencing factors from the perspectives of population and sociology. We conducted a cross-section survey in Shenzhen and Wuhan, China, using the purposive sampling method. A total of 1021 rural-to-urban married migrants were recruited, with 997 valid survey results obtained. A face-to-face structured questionnaire survey was used, with primary focus on knowledge of fertility, contraception, family planning policy and sexual transmitted diseases/acquired immunodeficiency syndrome (STD/AIDs), and RH service utilization. The results showed that the RH service utilization (38.0%) was at a low level in married migrants and the accessibility of RH service was poor. Females who migrated to (OR=0.32) Wuhan obtained fewer RH consultations than those in Shenzhen. The workers with high school education received additional RH consultations and checkup services than those with other background education, apart from the white collar workers who received extra RH consultations and checkup services than the blue collar workers (P<0.05). We can draw a conclusion that the utilization of RH services in married female migrants remains at a low level in China. RH service utilization can be improved via the relevant health departments by enhancing the responsibility of maternal and health care in the community health service center.
Adolescent ; Adult ; China ; Cities ; statistics & numerical data ; Female ; Humans ; Population Dynamics ; Reproductive Health Services ; utilization ; Socioeconomic Factors ; Spouses ; statistics & numerical data ; Transients and Migrants ; statistics & numerical data

OBJECTIVETo investigate the knowledge, attitudes, and practices regarding blood-borne occupational exposure among reproductive health staff in Tianjin, China.

METHODSBy random, stratified, and clustered sampling, 507 reproductive health-related medical workers in Tianjin were selected. A Self-Administered KAP Questionnaire on blood-borne occupational exposure was employed to gauge the general characteristics, awareness of knowledge, attitudes to occupational exposure, implementation of pre-exposure protection, incidence of occupational exposure, and demands for continuing education.

RESULTSAmong all respondents, 63.15% (305/483) were aware of the reporting procedures and related departments after the incidence of occupational exposure. The awareness rate of classification of HIV occupational exposure was 48.45% (234/483). About preventive medication time after HIV and hepatitis B virus exposure, the awareness rates were 37.89% (183/483) and 31.47% (152/483), respectively. The average score of occupational exposure knowledge among respondents was 74.45±14.00. The multivariate analysis indicated that medical staff of obstetrics and gynecology, females, doctors and high-level medical institutions showed significantly higher awareness than urology professionals, males, nurses, and medical staff of primary health care institutions, respectively (t = 12.140, t = 5.428, t = 2.582, F = 4.218, P<0.05). Of the respondents, 93.17% (450/483) and 94.41% (456/483) thought that washing hands properly and wearing protective glasses were effective methods for the prevention of occupational exposure, but only 15.94% (89/483) and 3.93% (19/483) adhered to proper hand washing and wearing protective glasses within nearly one year in practical work. Of the respondents, 60.46% (292/483) had experienced the occupational exposure during their vocation, and 95.65% (462/483) needed respective trainings.

CONCLUSIONThe awareness of occupational exposure among reproductive health-related medical staff is lacking, especially in preventative medication and reporting procedures after the incidence of occupational exposure. The implementation of protective measures is inadequate and incidence of occupational exposure is higher. Therefore, continuing education is necessary to improve the knowledge and attitudes towards occupational exposure in medical staff. At the same time, strict and effective supervision and management system should be established.

Adult ; Blood-Borne Pathogens ; Female ; Health Knowledge, Attitudes, Practice ; Health Personnel ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Occupational Exposure ; prevention & control ; Reproductive Health Services ; manpower ; Surveys and Questionnaires ; Young Adult