Mapping evidence on predictors of adverse sexual and reproductive health outcomes among young women in South Africa: A scoping review

Bolarinwa, Obasanjo Afolabi; Tlou, Boikhutso

doi:10.4102/phcfm.v13i1.3091

Cited by 12 publications

(6 citation statements)

References 53 publications

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“…Given that the family is the primary agency for the socialization of its members, these deficiencies associated with the polygamous family structure is likely to reduce women's capacity to make informed decisions such as practicing protected sex, negotiating for safe sex, etc., thereby contributing to an elevated risk of unplanned pregnancies and HIV among young women in this family structure. Women who had experienced GBV were at higher risk of unplanned pregnancy, which aligns with related studies conducted in South Africa ( 50 – 52 ). GBV that manifests through sexual abuse prevents young women from practicing or negotiating for safe sex, thereby putting them at higher risk of unplanned pregnancy.…”

Section: Discussionsupporting

confidence: 89%

A Mixed-Method Analysis of Inequalities Associated With Adverse Sexual and Reproductive Health Outcomes and the Requisite Interventions Among Young Women in Durban Informal Settlements, South Africa

Bolarinwa

Tlou

2022

Front. Public Health

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BackgroundOver the years, positive sexual and reproductive health (SRH) outcomes have been made possible by a series of policies such as the Sustainable Development Goals, targeted toward different aspects of young women's SRH needs. Nevertheless, inequalities in the levels and trends of adverse SRH outcomes still exist in sub-Saharan Africa (SSA), including South Africa. Thus, this study examines the inequalities associated with adverse SRH outcomes among young women in Durban informal settlements, South Africa, using a mixed-method analysis and suggested requisite interventions to reduce or eliminate the disparity.MethodsA mixed-method sequential explanatory design was used to address the research question. First, a quantitative cross-sectional survey was conducted among 547 young women aged 18 to 24 years in four informal settlements in Durban, South Africa, between April and July 2021. Thereafter, twenty (20) key informant interviews were conducted among different participants but with the same study characteristics. The study's outcome variable was adverse SRH outcomes, including HIV, STIs and unintended pregnancy, while the independent variable was inequality. The quantitative analysis employed binary and multivariable analysis to determine the association between the outcome and explanatory variables, using an alpha level of p < 0.05 to determine significance, while the qualitative analysis was done thematically.ResultsAt the quantitative level, the prevalence of adverse SRH outcomes among young women dwelling in Durban informal settlements was 82.45%, 90.86% and 81.90% for STIs, HIV and unintended pregnancy, respectively. The adjusted odds ratio showed that young women who ever discussed sexual matters with their parents had a lower likelihood of reporting having STIs [aOR = 0.20; 95% (CI = 0.15–1.01)], HIV [aOR = 0.20; 95% (CI = 0.15–1.01)] and unintended pregnancy [aOR = 0.20; 95% (CI = 0.15–1.01)] compared to young women who never had a sexual discussion with their parents. Almost all the key informant interview participants shared the same perspective and proffered possible solutions in the qualitative results.ConclusionThere are disparities in the factors associated with adverse SRH outcomes in Durban's informal settlements. Healthcare proximity, child support grants, cigarette smoking, alcohol consumption, polygamous family structures and gender based violence were associated with higher odds of reporting adverse SRH outcomes.

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Section: Discussionsupporting

confidence: 89%

A Mixed-Method Analysis of Inequalities Associated With Adverse Sexual and Reproductive Health Outcomes and the Requisite Interventions Among Young Women in Durban Informal Settlements, South Africa

Bolarinwa

Tlou

2022

Front. Public Health

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“…Our study found that a large proportion of AGYW who visited the Safe Spaces used the SRH services on offer, and this demonstrates the potential of Safe Space interventions to reduce the unmet need for SRH care in this population. Poverty and poor educational attainment are underlying causes of AGYW's vulnerability to HIV and adverse SRH outcomes [44][45][46]. Safe Spaces with structural interventions such as those supporting AGYW's employment and educational progress address the underlying causes of AGYW's vulnerability to HIV, and they also create an enabling environment for the synergistic preventive action of biomedical and behavioural interventions (https:// www.…”

Section: Discussionmentioning

confidence: 99%

Safe spaces for beneficiaries of a combination HIV prevention intervention for adolescent girls and young women in South Africa: access, feasibility, and acceptability

et al. 2022

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Background Safe Spaces are a feature of combination HIV prevention interventions for adolescent girls and young women (AGYW) in South Africa. We investigated whether AGYW at risk for adverse sexual and reproductive health (SRH) outcomes accessed Safe Spaces that were part of an intervention, as well as their feasibility and acceptability. Methods In December 2020 to February 2021, as part of a process evaluation of a combination HIV prevention intervention, we randomly sampled 2160 AGYW intervention beneficiaries aged 15–24 years from 6 of the 12 intervention districts. We invited them to participate in a phone survey, with questions about their vulnerability to adverse SRH outcomes, and participation in intervention components including Safe Spaces. We examined factors associated with use of Safe Spaces using bivariate analyses and Pearson’s chi squared tests. We also conducted in-depth interviews with 50 AGYW beneficiaries, 27 intervention implementers, 4 health workers, 7 social workers, and 12 community stakeholders, to explore perceptions and experiences of the intervention. Thematic analysis of the qualitative data was performed. Results At least 30 Safe Spaces were established across 6 districts. Five hundred fifteen of two thousand one hundred sixty sampled AGYW participated in the survey of whom 22.6% visited a Safe Space, accessing HIV testing (52.2%), mobile health services (21.2%) and counselling for distress (24.8%) while there. Beneficiaries of lower socioeconomic status (SES) were less likely to have visited a Safe Space, compared with those of higher SES (13.6% versus 25.3%; p < 0.01). Implementers described political, structural and financial challenges in identifying and setting up Safe Spaces that were safe, accessible and adequately-resourced, and challenges with AGYW not utilising them as expected. AGYW shared positive views of Safe Spaces, describing benefits such as access to computers and the internet, support with homework and job and education applications, and a space in which to connect with peers. Conclusion AGYW are attracted to Safe Spaces by educational and employment promoting interventions and recreational activities, and many will take up the offer of SRH services while there. The poorest AGYW are more likely to be excluded, therefore, an understanding of the obstacles to, and enablers of their inclusion should inform Safe Space intervention design.

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“…We observed that cohabiting women and those previously married were at higher risk of experiencing violence from an intimate partner. The reason why the marital status was the only associated predictor of IPV in South Africa at the individual level could be that the selected variables cannot act on alone except it is exacerbated by community factors such as contextual or cultural perspectives that are beyond the control of the victim [6,10,39]. The result is consistent with previous studies that have reported an elevated likelihood of experiencing IPV among separated and divorced women to be 30 times and 9 times higher, respectively, compared to married women [40].…”

Section: Plos Global Public Healthmentioning

confidence: 99%

“…It is also associated with many mental health issues, including anxiety, depression, suicidal ideation and attempt, and posttraumatic stress disorders [7,8]. Moreover, IPV that manifests in the form of sexual abuse tends to be a conduit for perpetuating unintended pregnancies, which in most cases result in adverse sexual and reproductive health outcomes such as unsafe abortions and facilitate the spread of sexually transmitted infections [9][10][11]. This makes IPV a serious public health concern that affects several millions of women worldwide [2,12].…”

Section: Introductionmentioning

confidence: 99%

Spatial distribution and predictors of lifetime experience of intimate partner violence among women in South Africa

Bolarinwa

Tessema

Okyere

et al. 2023

PLOS Glob Public Health

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In recent times, intimate partner has gained significant attention. However, there is limited evidence on the spatial distribution and predictors of intimate partner violence. Therefore, this study examined the spatial distribution and predictors of intimate partner violence in South Africa. The dataset for this study was obtained from a cross-sectional survey of the 2016 South Africa Demographic and Health Survey. We adopted both spatial and multilevel analyses to show the distribution and predictors of intimate partner violence among 2,410 women of reproductive age who had ever experienced intimate partner violence in their lifetime in South Africa. The spatial distribution of intimate partner violence in South Africa ranged from 0 to 100 percent. Western Cape, Free State, and Eastern Cape were predicted areas that showed a high proportion of intimate partner violence in South Africa. The likelihood of experiencing intimate partner violence among women in South Africa was high among those who were cohabiting [aOR = 1.41; 95%(CI = 1.10–1.81)] and women who were previously married [aOR = 2.09; 95%(CI = 1.30–3.36)], compared to women who were currently married. Women who lived in households with middle [aOR = 0.67; 95%(CI = 0.48–0.95)] and richest wealth index [aOR = 0.57; 95%(CI = 0.34–0.97)] were less likely to experience lifetime intimate partner violence compared to those of the poorest wealth index. The study concludes that there is a regional variation in the distribution of intimate partner violence in South Africa. A high prevalence of intimate partner violence was found among women who live in the Western Cape, Free State, and Eastern Cape. Furthermore, predictors such as women within the poorest wealth index, women who were cohabiting and those who were previously married should be considered in the development and implementation of interventions against intimate partner violence in South Africa.

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Mapping evidence on predictors of adverse sexual and reproductive health outcomes among young women in South Africa: A scoping review

Cited by 12 publications

References 53 publications

A Mixed-Method Analysis of Inequalities Associated With Adverse Sexual and Reproductive Health Outcomes and the Requisite Interventions Among Young Women in Durban Informal Settlements, South Africa

A Mixed-Method Analysis of Inequalities Associated With Adverse Sexual and Reproductive Health Outcomes and the Requisite Interventions Among Young Women in Durban Informal Settlements, South Africa

Safe spaces for beneficiaries of a combination HIV prevention intervention for adolescent girls and young women in South Africa: access, feasibility, and acceptability

Spatial distribution and predictors of lifetime experience of intimate partner violence among women in South Africa

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