Sexuality and reproductive health

Despite theoretical reasons to expect a positive association between women’s individual level autonomy and fertility, previous research has yielded largely negative results. In this literature dimensions of autonomy such as freedom of movement and association, power over economic decision making and freedom from domestic abuse are often operationalized using discrete survey questions or additive indexes. Such operationalizations have two principle drawbacks. First, the dimensionality assumed is a priori and untested. Second, the use of indexes assumes that each measure has an equal impact on its underlying latent dimension. This paper uses latent class measurement models with data from the 2004 Cameroon DHS to test the dimensionality of autonomy (whether, for example economic decision making and participation of association are actually separate dimensions or are part of a more general dimension of autonomy), as well as the relative impact of specific measures on the underlying latent dimensions of autonomy identified.

Cameroon has one of the upper adolescent fertility rates in West and Central Africa. According to data collected in 2004 as part of the DHS, 22, 7% of adolescents (15-19-year-old) were mother of at least one child. 5, 7 % t of these women had not yet terminated their pregnancy. Adolescents who had ever been pregnant did not differ significantly from those who had not by demographic characteristics. Multiple logistic regression analysis identified seven factors associated with pregnancy: having had four or more sexual partners; not having used contraceptives at first intercourse; ever use of less-effective contraceptive methods; having used illicit drugs during the last 30 days; living apart from one's parents; recently experiencing stress; and perceiving a lack of future prospects.

After having been a country of emigration for a long time, Italy has become one of the countries with the greatest foreign presence in Europe. The rapid increase in the number of foreign women – i.e. feminization process - and the fact that free health care is provided regardless of legal status, makes Italy an interesting case to study reproductive, maternal and perinatal health of foreign women. For our analyses we use Certificates of Healthcare at Delivery (CeDAPs), a nationwide system that cover births that have occurred in Italy since 2002. The data allowed us to identify differences between the various degrees of structural integration of foreign population. First results show that inequalities in perinatal outcomes between Italian and foreign women have persisted; especially for the less stable population.

This study examines the timing of first sexual intercourse of females’ adolescents and young adults in three middle sized cities in the state of Minas Gerais, Brazil. The data used in the analysis are drawn from a survey entitled: “Projects and trajectories reproductive, scholars and professionals of young men and women between 15 and 29 years old in Minas Gerais: The role of teenage motherhood and fatherhood” (META, 2011). This survey was carried out over the period of June and July of 2011 in three Brazilian middle sized cities of Minas Gerais, a state located in the southeast region of Brazil. The main analytical tool used in the study is the discrete time survival analysis. Main results show that education, religious affiliation and living with the mother are important variables affecting the age of first sexual intercourse among adolescents and young Brazilian women living in middle sized cities of Minas Gerais.

This paper is an attempt to examine whether women’s empowerment is associated with maternal health service utilization in the context of Nepal. This paper has used data from the cross sectional population-based Nepal Demographic and Health Survey, 2011. The analysis is confined to women who had given birth in the five years preceding the survey (n=4,148). The net effect of women’s empowerment related variables on adequate prenatal, delivery and postnatal care after controlling for the effect of other predictors has been measured through multivariate analysis (multivariable logistic regressions). The findings indicate that utilization of maternal health services was low. Higher level of women’s empowerment was associated with greater use of prenatal, delivery and postnatal care. It can be concluded that programs should aim to increase use of maternal health services by improving women’s empowerment so that the overall well-being of the family maintained and enhanced.

The study examined factors that drive/inhibit reforms in sexual and reproductive health (SRH) policymaking in Kenya in order to generate learning for future reform efforts. Three policymaking processes (Adolescent RH policy 2003; Sexual Offences Act 2006; National RH Policy 2007) were deconstructed. Data collection involved in-depth interviews with state/non-state policy actors, meeting notes and document review. Study revealed that four powerful framings of SRH – moral, cultural, medical and human rights - underpinned by interests of different actors mediate the interaction of actors, knowledge, and context, to determine possible SRH reforms. The moral and cultural framings, which are supported by contextually powerful institutions (government, parliament and religious) dominate SRH policymaking in Kenya. Although the medical framing has partially unsettled the moral/cultural frames to facilitate some reforms, it remains highly moralised, effectively marginalising sensitive issues. The rights framing is marginalised because it threatens the power of dominant actors (male politicians and religious leaders). For Kenya to realise comprehensive SRH policy reforms, efforts must focus on challenging underlying interests of control that underpin powerful framings and reframing rights in the less threatening medical/health arguments.

There is evidence that husbands pose the greatest risk of infecting their wives with STIs and HIV in Africa. The main purpose of this paper is to assess the attitude towards sexual control among married women. Factors influencing the sexual control of these women are also investigated. A survey was recently carried out in Mahikeng, South Africa. A total of 568 married or cohabiting women aged 18-49 years took part in the survey. The survey collected two dependent variables based on the questions can women demand for sex? and can women reject sexual intercourse? The logistic regression analysis was used. 81% of respondents reported that a married woman can demand sex from her husband. However, a significant proportion of married women (41%) do not approve that married women can reject sexual intercourse with their husband under any circumstances. This group of women needs serious consideration in terms of policy. Whilst variables that are significantly related with rejecting sex include age, nature of union, education, occupation, and number of living children, only age and nature of union were related to demand for sex. Women empowerment initiatives should be considered as a means to curb HIV/AIDS in this society.

Based on the policy, Integrated Essential Reproductive Health (IERH) Services should be implemented in Primary Health Care (PHC). In fact, there are only few PHCs that implemented the services. The most of the services in the PHC are related to women, if the government does not provide IERH services, it means that women cannot access their rights. The objective of this research was to identify gender inequity in the reproductive health service. A qualitative approach with a Socialist Feminist Perspective was used, and a series of open-ended interviews were conducted. The study was undertaken in Tasikmalaya District, West Java Province, Indonesia in 2010.

This study found that IERH services policy could not be fully implemented because of most policy makers are men, and their policies are gender biased, which tends to ignore women’s rights. These strong patriarchal and capitalist ideologies have restricted women from making decisions and accessing their reproductive health rights. Privatization of the health sector has decreased the accessibility and affordability of the services for women. Moreover, the health workers and religious leaders have applied radical patriarchal interpretation of the Islamic teaching and values against the services.

Background: The Katanga Province in the south-east of DRC covers an area of 496,877 square kilometers. The estimated population is over 11.462.290 out of 60% are under age of 25. Local authorities’ financial commitment to advance ICPD agenda is strong. Thus, UNFPA is enhancing national ownership and government initiative to increase access of adolescents and youth to RH information, counseling and services.
Objective: Support the provincial government ‘commitment to promote HIV prevention among adolescents & youth.
Strategy: Analyze the provincial budget and provide support where financial commitment is expressed. The entry point was 'Promoting HIV /Voluntary Counseling Testing (VCT)'.
Achievements: A free space was granted by the municipality for the construction of a multifunctional youth center financed by the “Fonds social” in partnership with the World Bank for a total cost of 421.000USD out of 10% was provided by UNFPA as part of youth community contribution.
Since its inauguration (August 2011), about 120 000 adolescents &youth were sensitized on HIV prevention methods; 4000 were HIV tested thanks to mobile VCT; 250 per day are using the services;20 peers’ educators trained in YFS; 14 young journalists in media techniques; youth health clubs in place in 15 schools with 1512 members (1150 boys, 362 girls).

In an effort to reduce the mortality and morbidity associated with unsafe abortion in Ghana, in 2006 the government of Ghana, in association with 5 other organizations, implemented a program for improving comprehensive abortion care in the country. This program was piloted in seven districts across three regions – Greater Accra, Eastern, and Ashanti. In this paper, we use a survey specially collected for this study to assess if the interventions from this program have helped improve the knowledge, attitudes, and practices (KAP) of health care providers towards comprehensive abortion care services. Since the program had not been implemented across the country, the study was set up as an experiment, with the treatment group including the districts where the program was implemented. The control group included districts where the program wasn’t implemented. Propensity score matching techniques will be used to compare the providers in the intervention and control groups, and to evaluate if the program has made any difference where it was implemented. We expect to find that districts where the saturation of interventions was the highest will show the maximum change in the KAP of abortion providers, thereby enabling improved abortion care services and ensuring better reproductive health among women.