Female empowerment to improve sexual and reproductive health outcomes and prevent violence in adolescent girls and young women in Uganda: evidence reviews for policy

Abstract

Background: Adolescent girls and young women in Uganda face numerous public health challenges including high HIV prevalence, teenage pregnancies, poor sexual and reproductive health rights, child marriage, and violence.
 Objectives: This evidence review explores which interventions focusing on the empowerment of adolescent girls and young women to address these challenges are suitable for Ugandan policy.
 Methods: We reviewed the literature to identify experimental studies and systematic reviews of interventions which improve sexual and reproductive health outcomes and/or prevent violence in adolescent girls and young women in low- and middle-income countries (LMICs). Two authors independently reviewed the studies identified through a comprehensive search strategy and assessed their quality. From this evidence base, two policy options were explored in depth considering benefits, harms, equity impacts, and costs, given the Ugandan context.Results: The screen yielded 47 studies, of which 12 remained after applying inclusion and exclusion criteria and relevance, applicability and quality assessment. Feasible policy options included: a vertical cash-incentive approach at a national or local level to support girls’ attainment of education; and a horizontal integrated community approach focusing on skills and knowledge building. A combination of both is recommended for young female empowerment in Uganda, allowing for the full range of socio-cultural and economic drivers to be targeted.Conclusion: Research into the link between female empowerment and sexual and reproductive health outcomes is still in early development. This review contributes to evidence on this topic and outlines an approach that is potentially suitable for adoption across similar LMICs in Africa.
 Keywords: Sexual health; health policy; women's health.

Perceptions of Pre-exposure Prophylaxis (PrEP) for HIV prevention among men living with HIV in the context of reproductive goals in South Africa: a qualitative study

“…Although PrEP implementation and roll out in South Africa began in 2015 [ 17 ], and its effectiveness in preventing HIV transmission is well documented in previous studies [ 18 – 21 ] findings from this study suggests a low PrEP awareness among rural South African men with HIV where a third were in sero-different relationship and desire to have a child with their primary partner. Findings are consistent with other studies on PrEP among men and women living with HIV conducted in South Africa and other African countries [ 13 , 22 , 23 ] While these men in the study are all actively engaged in HIV care, there’s an expectation that they should be knowledgeable about PrEP as an HIV prevention, this suggests that HIV prevention implementers, including clinicians should explore the reproductive goals of men in the context of HIV as a tool to promote HIV prevention, as men who are motivated to have healthy babies are more likely to engage in honest conversation about their HIV status with their partners and allow for shared decision making about safer conception practices including TasP and PrEP and reproductive planning [ 13 ]. This study also suggests that community outreach is a key strategy that should be implemented to ensure that knowledge about Prep is accessible to people who may not typically visit clinics, which is where most people who need PreP are likely to be found.…”

“…Reproductive goals, such as family planning, can be a powerful opportunity to engage men and partners to prevent HIV among women of reproductive age [ 12 ]. In previous work, members of this team developed and piloted a safer conception intervention “Sinikithemba Kwabesilisa ” meaning we give hope to men , designed for men with HIV planning to have children with an HIV uninfected partner [ 10 , 13 ]. We showed feasibility, acceptability, and preliminary data that the intervention successfully supported men with HIV (MWH) to access ART and suppress viral load [ 14 , 15 ].…”

Public Policy and Gender-Based Violence in the Region Tumbes, 2023

“…On this, Lewington et al, (2022), conclude that there are feasible policy alternatives, including a verticality perspective, so that sufficient resources are allocated, at the national or local level to strengthen the educational level of girls, with a comprehensive community approach in a horizontal way, which seeks to generate skills and knowledge, whose sole purpose is to empower young women in Uganda.…”

Editorial: Non-communicable diseases; sexual reproductive issues; infectious diseases and health systems challenges

“…In this issue we bring you a salad of sorts! This includes papers on cancer [1][2][3][4][5][6][7][8][9][10][11][12] ; diabetes mellitus [13][14][15][16] ; surgery [15][16][17][18][19][20][21][22][23][24][25] ; other non-communicable diseases [26][27][28][29][30][31][32][33] , as well as sexual reproductive health [34][35][36][37][38][39][40][41][42][43][44][45][46] . The menu continues with HIV / AIDS papers [47][48][49][50][51][52][53][54] .…”

“…In this issue we bring you a salad of sorts! This includes papers on cancer 1 – 12 ; diabetes mellitus 13 – 16 ; surgery 15 – 25 ; other non-communicable diseases 26 – 33 , as well as sexual reproductive health 34 – 46 . The menu continues with HIV /AIDS papers 47 – 54 .…”