Research gaps and emerging priorities in sexual and reproductive health in Africa and the eastern Mediterranean regions

Abstract

BackgroundIn-country research capacity is key to creating improvements in local implementation of health programs and can help prioritize health issues in a landscape of limited funding. Research prioritization has shown to be particularly useful to help answer strategic and programmatic issues in health care, including sexual and reproductive health (SRH). The purpose of this paper is to present the results of a priority setting exercise that brought together researchers and program managers from the WHO Africa and Eastern Mediterranean regions to identify key SRH issues.MethodsIn June 2015, researchers and program managers from the WHO Africa and Eastern Mediterranean regions met for a three-day meeting to discuss strategies to strengthen research capacity in the regions. A prioritization exercise was carried out to identify key priority areas for research in SRH. The process included five criteria: answerability, effectiveness, deliverability and acceptability, potential impact of the intervention/program to improve reproductive, maternal and newborn health substantially, and equity.ResultsThe six main priorities identified include: creation and investment in multipurpose prevention technologies, addressing adolescent violence and early pregnancy (especially in the context of early marriage), improved maternal and newborn emergency care, increased evaluation and improvement of adolescent health interventions including contraception, further focus on family planning uptake and barriers, and improving care for mothers and children during childbirth.ConclusionThe setting of priorities is the first step in a dynamic process to identify where research funding should be focused to maximize health benefits. The key elements identified in this exercise provides guidance for decision makers to focus action on identified research priorities and goals. Prioritization and identifying/acting on research gaps can have great impact across multiple sectors in the regions for improved reproductive, maternal and children health.

Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind?

“…This proportion is expected to increase to 24% by 2030 1. Adolescent sexual and reproductive health (ASRH) is a major public health issue both from the perspective of the prevention of unintended pregnancies and sexually transmitted infections (STIs) including HIV 2 3…”

Determinants of contraceptive use among sexually active unmarried adolescent girls and young women aged 15–24 years in Ghana: a nationally representative cross-sectional study

“…Improving adolescent and youth sexual and reproductive health (AYSRH) is important in preventing unintended pregnancies (UP), sexually transmitted infections and unsafe abortion. 1 In recent years, there has been a significant improvement in the outcomes of AYSRH in sub-Saharan Africa (SSA), including a decline in child marriage, 2 adolescent fertility rate, increase in school enrolment and contraceptive use. 3 Despite this improvement, there remains disproportionately low AYSRH outcomes in SSA compared with other parts of the world, with the region having the highest adolescent pregnancy rate and the lowest rate of contraceptive use.…”

Setting Regional Research Priorities for Sexual and Reproductive Health and Rights Services in Humanitarian Settings

“…Safe abortion was unavailable across settings, despite unsafe abortion having been estimated to cause 25% -50% of maternal deaths in refugee settings [15]. Certain groups, such as adolescents and older women, male survivors of sexual violence, sex workers, people living with disabilities or those of diverse sexual orientations and gender identity and/or expression continue to face significant obstacles in accessing information and services in humanitarian settings [16] [17]. Since the 1990's recognition of SRHR needs for crisis affected persons has grown slowly in the international community starting with the development of the UNHCR guidelines on protection of refugee women [20] and to date a global action declaring access to comprehensive SRHR is a basic human right.…”