Adolescent Sexual and Reproductive Health: Global Perspectives

A topical collection in Social Sciences (ISSN 2076-0760).

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Guest Editor
School of Medicine, Keele University, Keele, Newcastle ST5 5BG, UK
Interests: social determinants of health and well-being

Topical Collection Information

Dear Colleagues,

The issue of adolescent sexual and reproductive health (SRH) remains a major global challenge, especially in low and middle-income countries (LMICs), most of which are classified as “multi-burden countries” in terms of adolescent health, with complications of early pregnancy/childbirth and HIV being among the leading challenges (UNFPA and WHO, 2017). Although the period of adolescence offers opportunities for health gains through prevention and early clinical intervention, development of health intervention systems for adolescents has been weak and lags behind those for early childhood or adulthood, and for present global health agendas such as HIV and maternal mortality, data sources are incomplete for adolescents (Fatusi 2016). Concerns around adolescent SRH have intensified amidst recent pandemics. Evidence from previous international health emergencies suggest that epidemics tend to (i) have disproportionate impacts on the SRH of certain subgroups of the population, especially poor and socially marginalized women and youth, and (ii) exacerbate prevailing gender inequalities, increasing risks of gender-based violence and sexual abuse (Ahonsi, 2020). Adolescent girls have been recognized as a particularly vulnerable group during the COVID-19 pandemic, especially in relation to SRH aspects where teenage girls disproportionately drop out of school due to an increased risk of sexual exploitation, pregnancy and forced marriage (Hall et al. 2020). This is consistent with lessons learnt from the Ebola crisis which showed that school closures can lead to increases in gender-based violence, teenage pregnancies, child marriage, exploitation and other forms of abuse against adolescent girls, including online sexual exploitation and grooming, all of which can be particularly devastating for girls with greater vulnerabilities, including refugees, the internally displaced and those living with disabilities (UNAIDS, 2020). This Special Issue invites interdisciplinary papers based on theoretical/systematic reviews or empirical (quantitative or qualitative) research on adolescent SRH, including papers addressing the impact of the COVID-19 pandemic on adolescent SRH. 

References

Ahonsi B. (2020). A Research Agenda on the Sexual and Reproductive Health Dimensions of the COVID-19 Pandemic in Africa. Afr J Reprod Health. 24(1):22-25.

Fatusi, AO. (2016). Young People's Sexual and Reproductive Health Interventions in Developing Countries: Making the Investments Count. Journal of Adolescent Health. 59(3), S1 - S3.

Hall KS, Samari G, Garbers S, Casey SE, Diallo DD, Orcutt M, Moresky RT, Martinez ME, McGovern T. (2020). Centring sexual and reproductive health and justice in the global COVID-19 response. Lancet. 395(10231):1175-1177.

UNAIDS (2020). Global AIDS update 2020: Seizing the moment – tackling entrenched inequalities to end epidemics. Available from: https://www.unaids.org/sites/ default/files/media_asset/2020_global-aids-report_en.pdf. (Accessed 03 February 2021).

UNFPA and WHO (2017). Prioritizing adolescent health: a technical guidance. Global Strategy of Every Woman Every Child. UNFPA and WHO-led Working Group.

Prof. Dr. Monica Magadi
Guest Editor

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Keywords

  • adolescents
  • sexual and reproductive health (SRH)
  • teenage/early pregnancy/childbirth
  • unintended pregnancy
  • SRH service access/use
  • gender-based violence
  • early/child marriage
  • sexual exploitation/abuse
  • HIV/AIDS
  • impact of Covid-19

Published Papers (6 papers)

2022

Jump to: 2021

17 pages, 345 KiB  
Article
Adults’ Perceptions on Adolescent Attitudes towards Pregnancy and Abortion in Maputo and Quelimane Cities, Mozambique: An Exploratory Qualitative Study
by Mónica Frederico, Carlos Arnaldo, Rehana Capurchande, Peter Decat and Kristien Michielsen
Soc. Sci. 2023, 12(1), 29; https://doi.org/10.3390/socsci12010029 - 31 Dec 2022
Cited by 1 | Viewed by 1940
Abstract
Background: In Mozambique, 76% of adolescents have been pregnant before the age of 20 years. Thus, this study explores adults’ perceptions on adolescent attitudes towards pregnancy and abortion in Maputo and Quelimane cities. Methods: A qualitative study was conducted in Maputo [...] Read more.
Background: In Mozambique, 76% of adolescents have been pregnant before the age of 20 years. Thus, this study explores adults’ perceptions on adolescent attitudes towards pregnancy and abortion in Maputo and Quelimane cities. Methods: A qualitative study was conducted in Maputo and Quelimane, with four focus group discussions. A cross-sectional household survey was used to select adult women participants. Data were analysed applying a thematic analysis approach. Results: Intrapersonal, interpersonal, cultural, and environmental factors influence pregnancy and abortion decision making among adolescents. Generational conflicts reduce the importance paid to traditional knowledge transfer, contraceptive beliefs, denial of paternity, lack of parental support, and procreation value were found to influence abortion decision making and early pregnancy among adolescents. Conclusions: There is a need to improve relationships between adults and adolescents to reduce girls’ vulnerability to early pregnancy, as well as empowering adolescents in order to negotiate safe sex, reducing unwanted pregnancy and induced abortion. Full article
18 pages, 452 KiB  
Article
Sexual and Gender-Based Violence and Vulnerability to HIV Infection in Uganda: Evidence from Multilevel Modelling of Population-Level HIV/AIDS Data
by Patrick Igulot
Soc. Sci. 2022, 11(7), 301; https://doi.org/10.3390/socsci11070301 - 12 Jul 2022
Cited by 3 | Viewed by 2613
Abstract
Background: Sexual and gender-based violence (SGBV) is highly prevalent in Uganda and its link with HIV infection and compromising access to HIV/AIDS services is known. However, current evidence is controversial. Most of the studies indicate a positive relationship but a few indicate otherwise. [...] Read more.
Background: Sexual and gender-based violence (SGBV) is highly prevalent in Uganda and its link with HIV infection and compromising access to HIV/AIDS services is known. However, current evidence is controversial. Most of the studies indicate a positive relationship but a few indicate otherwise. Moreover, there is no research examining the effects of community-level SGBV on HIV infection. Objectives: This research explores the association between SGBV and vulnerability to HIV infection. Methods: Multilevel binary logistic regression is applied to secondary data of Uganda AIDS Indicators Survey conducted in 2011. The survey data comprises 12,153 women and 9588 men. Results: SGBV significantly increases the likelihood of HIV infection, with victims having 34%, 1.34 [1.06–1.70] higher odds than non-victims. At the community level, wealth, and pre-sex alcohol abuse are important determinants. Conclusions: Vulnerability to the risk of HIV infection in Uganda is associated with individual-level and community factors. Effective HIV prevention policies need to pay attention to victims of SGBV using individual- and community-level strategies. Full article
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15 pages, 282 KiB  
Article
Unmarried Adolescents’ Experiences of Using Reproductive and Maternal Health Services in Nigeria and Uganda: A Qualitative Study
by Franklin Onukwugha, Peninah Agaba, Mark Hayter and Bev Orton
Soc. Sci. 2022, 11(5), 203; https://doi.org/10.3390/socsci11050203 - 06 May 2022
Cited by 1 | Viewed by 2860
Abstract
Adolescents’ access and use of reproductive and maternal health (RMH) services is a critical part of the global strategy for achieving the Sustainable Development Goals (SDGs). However, previous studies have shown that a complex range of factors, including restrictive policies and punitive laws, [...] Read more.
Adolescents’ access and use of reproductive and maternal health (RMH) services is a critical part of the global strategy for achieving the Sustainable Development Goals (SDGs). However, previous studies have shown that a complex range of factors, including restrictive policies and punitive laws, limit adolescents from accessing a full range of RMH services in Sub-Saharan Africa (SSA). Our study explores the experiences of unmarried adolescents’ access and use of RMH services in Nigeria and Uganda to understand the extent to which the diverse policy environment in both countries enables or hinders adolescents’ access to and use of RMH services. Our qualitative research design involved eight focus group discussions (FGDs) in Nigeria and in Uganda, 14 in-depth interviews, and eight FGDs among adolescents. The data were analysed thematically and organised according to the WHO’s five broad dimensions for assessing youth-friendly health services. Our findings show that RMH services were inequitably delivered in both countries. Adolescents were restricted from accessing services based on age and marital status. Being unmarried and having no partner, especially in Uganda, was a cause for discrimination during antenatal appointments. We also observed that the expectations of adolescents were not adequately met. Service providers tended to be impolite, judgemental, and unwilling to provide services, especially contraceptives, to younger and unmarried adolescents. Our findings suggest that the existence of a youth-friendly health policy does not translate into effective youth-friendly service provision. This underscores the need for further studies to understand the complexities surrounding this by using a realist evaluation method to examine how adolescent and youth-friendly health services can be designed to improve uptake of reproductive and maternal health services among adolescents in Sub-Saharan Africa. Full article
26 pages, 374 KiB  
Article
Perspectives of Adolescents, Parents, Service Providers, and Teachers on Mobile Phone Use for Sexual Reproductive Health Education
by Beverly M. Ochieng, Lesley Smith, Bev Orton, Mark Hayter, Margaret Kaseje, Charles O. Wafula, Penina Ocholla, Franklin Onukwugha and Dan C. O. Kaseje
Soc. Sci. 2022, 11(5), 196; https://doi.org/10.3390/socsci11050196 - 29 Apr 2022
Cited by 6 | Viewed by 3783
Abstract
Mobile health (mHealth) programs offer opportunities to improve the sexual and reproductive health (SRH) of adolescents by providing information. This paper reports the findings of a study carried out in Homabay County, Kenya, to assess stakeholders’ perspectives on access to and use of [...] Read more.
Mobile health (mHealth) programs offer opportunities to improve the sexual and reproductive health (SRH) of adolescents by providing information. This paper reports the findings of a study carried out in Homabay County, Kenya, to assess stakeholders’ perspectives on access to and use of mobile phones by adolescents for SRH education. We aimed to establish whether mobile phones could facilitate access to SRH information by adolescents and the barriers to be addressed. This was a qualitative exploratory study involving adolescents, parents, teachers, health care workers, and community health volunteers. Data were collected through focus group discussions (FGDs) and key informant interviews (KIIs), and were analyzed through thematic and content analysis. Respondents lauded mHealth as an effective and efficient approach to adolescent SRH education with a potential to promote the learning of useful SRH information to influence their behavior formation. Respondents pointed out bottlenecks such as the limited ownership of and inequitable access to phones among adolescents, logistical barriers such as lack of electricity, internet connectivity, and the impact of phones on school performance, which must be addressed. The usefulness of mHealth in adolescent SRH education can be enhanced through inclusive program formulation and co-creation, implemented through safe spaces where adolescents would access information in groups, and supported by trained counselors. Full article

2021

Jump to: 2022

17 pages, 339 KiB  
Article
Factors Associated with the Timing and Number of Antenatal Care Visits among Unmarried Compared to Married Youth in Uganda between 2006 and 2016
by Peninah Agaba, Monica Magadi, Franklin Onukwugha and Cyprian Misinde
Soc. Sci. 2021, 10(12), 474; https://doi.org/10.3390/socsci10120474 - 09 Dec 2021
Cited by 8 | Viewed by 3462
Abstract
Antenatal care is an important determinant of pregnancy and childbirth outcomes. Although the youth disproportionately experience adverse maternal complications and poor pregnancy outcomes, including maternal mortality, timely and frequent use of antenatal care services among unmarried youth in Uganda remains low. This study [...] Read more.
Antenatal care is an important determinant of pregnancy and childbirth outcomes. Although the youth disproportionately experience adverse maternal complications and poor pregnancy outcomes, including maternal mortality, timely and frequent use of antenatal care services among unmarried youth in Uganda remains low. This study examines the factors that are important predictors of the use of antenatal health care services among unmarried and married youth. Binary logistic regression was conducted on the pooled data of the 2006, 2011 and 2016 Uganda Demographic and Health Surveys among youth who had given birth within five years before each survey to examine the predictors of ANC use. This analysis was among a sample of 764 unmarried, compared to 5176 married youth aged 15–24 years. Overall, married youth were more likely to have more frequent antenatal care visits (56% versus 53%) and start antenatal care early (27% versus 23%) than unmarried youth. Factors significantly associated with use of antenatal care in the first trimester were education and occupation among unmarried youth, and place of residence and access to the radio among married youth. Key predictors of ANC frequency among unmarried youth were parity, education level, pregnancy desire, age group, sex of head of household and region of residence. Among married youth, significant predictors of ANC frequency were parity, pregnancy desire, occupation, access to the radio and region of residence. These findings will help inform health-care programmers and policy makers in initiating appropriate policies and programs for ensuring optimal ANC use for all that could guarantee universal maternal health-care coverage to enable Uganda to achieve the SDG3. Full article
19 pages, 676 KiB  
Article
A Multilevel Analysis of Risk and Protective Factors for Adolescent Childbearing in Malawi
by Jesman Chintsanya, Monica Magadi and Gloria Likupe
Soc. Sci. 2021, 10(8), 303; https://doi.org/10.3390/socsci10080303 - 12 Aug 2021
Cited by 1 | Viewed by 3955
Abstract
Although teenage pregnancy and childbearing has declined throughout sub-Saharan Africa, the recent increase in teenage pregnancy in countries such as Malawi has prompted interest from social researchers. Using Malawi Demographic and Health Survey (MDHS) data from 2004 to 2015, this study employs multilevel [...] Read more.
Although teenage pregnancy and childbearing has declined throughout sub-Saharan Africa, the recent increase in teenage pregnancy in countries such as Malawi has prompted interest from social researchers. Using Malawi Demographic and Health Survey (MDHS) data from 2004 to 2015, this study employs multilevel logistic regression to examine the magnitude of change over time in risk and protective factors for teenage childbearing. During this period, teenage childbearing declined from 36.1% (C.I.: 31.5–36.7) in 2004 to 25.6% (C.I.: 24.0–27.3) in 2010 before increasing to 29.0% (C.I.: 27.4–30.7) in 2015. Age and being married (compared to never married) were consistently significantly associated with increased odds of teenage childbearing. However, delaying sexual debut, attaining secondary education, belonging to the richest quintile and rural residence offered protective effects against early motherhood, while Muslim affiliation (compared to Christian denominations) was associated with increased likelihood of teenage childbearing among adolescents. Teenage childbearing remains high in the country, largely influenced by adolescents’ early sexual debut and child marriage—risk factors that have hardly changed over time. While individual socioeconomic predictors are useful in explaining the apparent high risk of adolescent fertility among specific subgroups in Malawi, sustained declines in teenage childbearing were not evident at district level. Full article
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