Sexual and reproductive health services to meet men’s needs

Latino population in the United States has a lower prevalence of vasectomy than the non-Hispanic white population. A body of research has considered that cultural perceptions about masculinity might explain why Latinos are less likely to undergo vasectomy. Latino population has experience a limited access to health care which might explain the lower prevalence of vasectomy among Latino population in the United States. We conducted logistic regression to analyze the relationship between the perception about the decision of men to undergo vasectomy and the frustrated demand for female sterilization. We also observed how other women’s experience might influence attitudes toward partners’ willingness to obtain a vasectomy. Finally, in order to have an insight into attitudes toward vasectomy among Latino men, we analyzed the information from the two focus groups conducted in El Paso, Texas. We find evidence that although some Latino men are willing to undergo vasectomy, they face economic and labor situations that prevent them to obtain the procedure.

The HIV epidemic is a serious public health concern globally. South Africa is home to the largest population living with HIV in the world (UNAIDS, 2010). Migration is an important factor in the study of the spread of HIV as the process of migration increases migrants’ susceptibility to HIV (IOM: 2010). There are approximately 1.6 million cross-border migrants in South Africa; this is equivalent to 3.4% of the total population (CoRMSA, 2009). Knowledge of one’s status is a crucial first step in management of the disease; however HIV testing remains a challenging aspect of public health programmes due to various social determinants of health, especially amongst key at risk populations such as migrants (WHO, 2010). Therefore, in order to expand our understanding of Migration and HIV testing; this quantitative study aims to investigate the determinants of HIV testing amongst migrants living in Johannesburg. Secondary data analysis will be conducted using the RENEWAL survey of 2008 comprising of 441 people stratified into international (n=293) and internal (n=150) migrants. Analysis will be done at three levels: Univariate, Bivariate and Multivariate; Logistic Regression being the main model.
Key Words: Migration; South Africa; HIV testing; Determinants.

DOC 04: Oral presentation

Title: Gender, Human rights and socio-cultural dimension of HIV/AIDS in Rurual African communities: the case of Nigeria.
Author: Bob, B. B and Bob,B.B (2012)Journal: The 1st African Regional Educational HIV/AIDS submits,Abuja, ICEDCP. 2011, Nov (1) 12-20)
Source: African Journal: The 1st African Regional Educational HIV/AIDS Submit/ICEDCP

Abstract:
The epidemic of HIV/AIDS spread, within the context of Gender, human Rights and Sociocultural phenomenon or factor in many rural communities in Africa is largely invisible and insidious. until very recently, there was hardly any consideration of the influence of the existing inequalities, Human Rights abuse and cultural issues on the spread in the spread of HIV/AIDS and on the outcomes of the infection between the sexes. For instance: The phenomenon of increasing Male Sexual Risk during wife pregnancy, by the traditional proscription against sex for women during pregnancy in Oyo state south west Nigeria, cultural practices in south east Nigeria(Awka) that encourage the establishment od sexual network by men in the community with some marrie

Male circumcision has been proven In recent studies as one of the interventions that help in decreasing HIV transmission from infected women (or men) to uninfected men. The publicity of such studies has led to increased confidence among circumcised males to have unprotected sex in belief that they are shielded against acquiring HIV. The ministry of health in Uganda basing on such studies has embarked on a national strategy aimed at promoting and encouraging male circumcision as a preventive measure against HIV.
However despite such studies there is need to investigate the perceptions and beliefs of male circumcision especially in communities that have historical practiced it, for example amongst the Bagishu of Mbale in Uganda. Do they view male circumcision as an intervention of preventing HIV or simply as a cultural practice being adopted by others cultures and from their perspective what are the benefits of male circumcision. This study will be aimed at understanding the perceptions of male circumcision as an intervention against HIV using a case study of Bagishu men from Mbale Town in eastern Uganda.

Introduction: Unmet need is an important indicator of demand for family planning services. Unmet need is typically calculated for currently married women, but excluding husbands from the calculation may provide misleading estimates of demand since husbands’ preferences are related to reproductive behaviors.

Methods: This study proposes a method of calculating couples’ unmet need for family planning based on spouses’ independent fertility intentions among fecund nonusers of contraception. Demographic and Health Survey couple data from Benin, Burkina Faso and Mali are used.

Results: Across the three countries, less than half of the couples with unmet need had concordant unmet need (39.2-43.2%). A similar proportion of couples had wife-only unmet need (35.8-43.5%). A smaller proportion of couples had husband-only unmet need (17.3-21.0%).

Conclusions: Calculating unmet need based only on women’s fertility intentions overestimates couples’ concordant unmet need. Additionally, that approximately one-fifth of couples have husband-only unmet need suggests that men could be an entry point for contraceptive use for some couples. To calculate husbands’ unmet need, population-based surveys such as the DHS should consider collecting the necessary data consistently between men and women and across countries and survey years.

Reproductive health (RH) interventions are often designed to promote equitable gender norms, but there are few published studies that directly examine the relationship between family planning (FP) use and interventions designed to change gender norms. Here we test the hypothesis that promoting gender equity in the context of RH can improve gender norms and increase use of FP by conducting pre/post surveys with participants in community workshops targeting gender norms and FP. Thirty communities in Guatemala and 22 in Tanzania were randomly assigned to intervention and control groups. Data analysis consisted of comparisons of odds ratios estimated with mixed effect logistic models to account for community-level randomization and repeated measures per participant. Analyses showed statistically significant effects on two of three outcomes examined: gender attitudes and contraceptive knowledge. Findings regarding contraceptive use were suggestive but not significant. The results suggest that it is possible to influence both inequitable gender norms and contraceptive knowledge using communication interventions that engage couples in re-thinking gender norms that act as barriers to health. The results are particularly impressive given the brevity of the intervention, four workshop sessions over the period of only a month.

In Bangladesh, women dying for maternal causes remain high. Women face long distance and significant transportation cost to deliver at hospital. To reduce barriers, government introduced demand-side financing program that gives transportation allowance for antenatal, delivery, complication management and postnatal care. A total of 3300 mothers aged 18-49 years given birth preceding year of survey were interviewed in 2010. The self-reported distance and round trip transportation cost from residence to the health facility was recorded. Only 53% women received ANC, 20% delivery and 10% received PNC. On average women travelled six kilometers for ANC and PNC but eight kilometers for complication care or delivery. Majority women used rickshaw or human powered van to reach health facility. On average women spent taka 100 (US$1.4) for ANC, taka 432 (US$6) for delivery and taka 132 (US$1.83) for PNC. For each additional kilometer, cost increased by taka 9 (US$0.12) for ANC, taka 30 (US$0.44) for delivery and taka 7 (US$0.11) for PNC. Currently a flat rate of taka 100 (US$1.4) for each is given; based on findings, the program should reconsider the transportation allowance.

The study aimed at testing the hypothesis that quality of inter-spousal relationship significantly influences abortion risks in peri-urban Nigeria. The data is from the FHWS-2010 closed-cohort study of 784 couples residing in selected households in peri-urban communities in Osun State, Nigeria. Among the 621 women who reported ever been pregnant, 21.9% had experienced either induced or spontaneous abortion. The Cronbach's alpha for the 27 scale index of quality of relationship was 0.877. Two logistic regression models were performed to test the hypothesis. The results from the first model showed that two items on trust, one variables for marital-satisfaction and three for communication were significant predictors of abortion risk. The second model with the inclusion of other spousal variables showed that only one variable on trust, one from marital-satisfaction, one from communication and wealth status were significant in predicting abortion risk.

Despite remarkable worldwide progress in the field of diagnostics, curative and preventive aspects of health, still there are people living in relative isolation, in natural surroundings, maintaining a socio-cultural distance from others. The present study was carried out understand the health and treatment seeking behaviour of the youth of underprivileged tribal groups. Two UTGs were covered under the study. Both quantitative and qualitative techniques were used for data collection.
Result indicates that the tribal people are still inclined towards traditional health care system. Besides traditional perceptions attached to this, some other very real situations like lack of physical accessibility to the modern health care providers, distance and related time and cost factors etc play an important role in determining the treatment seeking behaviour of the tribal people. Low level of education and poor economic condition also plays crucial role. Finally, the very concept of health and illness, especially problems associated with sex related aspects, have some direct bearing on the health seeking behaviour of the people.
Thus, logical induction of traditional aspects in modern health care system is essential, which may be achieved by taking the tribal traditional dignitaries in confidence.

Vasectomy is safe and effective form of male contraception. However, in the Philippines only one percent of Filipino men have undergone vasectomy although16 percent of men in union are willing to undergo this procedure after they have reached their desired number of children. Using the 2003 Philippine National Demographic Health Survey (NDHS), this study seeks to identify the factors associated with the willingness of Filipino men in union to undergo vasectomy. Moreover, it will also investigate the various reasons why Filipino men would never consider getting vasectomised. Results show that men who live in urban areas and have higher number of children are more likely to be willing to undergo male sterilization. Reasons of Filipino men why they would never consider undergoing vasectomy are: bad for man’s health (45%), less intrusive family planning method are available (23%), loss of manliness (15%) and loss of sexual function (12%). Filipino men who have lower levels of education and formally married are more likely to say that they would never consider getting vasectomised because it is bad for man's health while the rich men are less likely to say that it will cause loss of their sexual function.