Scaling up Adolescent Sexual and Reproductive Health Interventions Through Existing Government Systems? A Detailed Process Evaluation of a School-Based Intervention in Mwanza Region in the Northwest of Tanzania

Renju, Jenny; Andrew, Bahati; Medard, L.; Kishamawe, Coleman; Kimaryo, Michael; Changalucha, John; Obasi, Angela

doi:10.1016/j.jadohealth.2010.05.007

Cited by 21 publications

(21 citation statements)

References 23 publications

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“…However, our study found school curriculum as a risk factor for poor sexual health knowledge. This may be because curriculum is incomplete or irrelevant, or teachers and staff are not trained properly to impart information or students are not comfortable in discussing the subject with the teachers [34,35]. In addition, teachers at times are reluctant and not open to the subject.…”

Section: Discussionmentioning

confidence: 99%

Determinants of sexual health knowledge in adolescent girls in schools of Riyadh-Saudi Arabia: a cross sectional study

2013

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BackgroundThere are many social and cultural factors affecting the sexual knowledge of adolescents. This study measured the sexual health knowledge level of adolescents and identified its association with role of parents, friends and school environment in adolescent girls in Riyadh, Saudi Arabia.MethodsFour hundred and nineteen Saudi female students belonging to intermediate and secondary grades were randomly selected from four public and private girl schools. 255 (69.8%) students were ≤15 years and 164 (39.2%) were >15 years. A self-administered structured questionnaire comprising of socio-demographic information, role of parents and teachers, availability of school curriculum on sexual health was used. Sexual health knowledge was assessed through questions on identification of physical changes during puberty for ≤15 years and separate questions on sexually transmitted infections for >15 years.Results54% of ≤15years and 70.7% of >15 years had poor sexual health knowledge. Multivariate analysis found determinants for poor sexual health education in ≤15years are: lower education level of both parents (OR 10.87; 95% CI 2.44–48.38), second birth order or more (OR 2.32; 95% CI 1.24–4.33) and absence of school curriculum on sexual health (OR 0.56; 95% CI 0.33–0.95). Determinants for >15 years of age are : mothers with low literacy (OR 3.08, 95% CI 1.42–6.71), as for sources of poor sexual knowledge : parents (OR 10.10; 95% CI 2.70–37.74), schools (OR 6.95; 95% CI 1.95–24.78) maids (OR 4.57; 95% CI 1.26–16.59) and media (OR 5.12; 95% CI 1.29–20.07) were statistically significant factors.ConclusionGovernment agencies with collaboration of all stake holders should develop policies and programs for implementing and evaluating integrated and comprehensive sexual educational programs for adolescents in Saudi Arabia.

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Section: Discussionmentioning

confidence: 99%

Determinants of sexual health knowledge in adolescent girls in schools of Riyadh-Saudi Arabia: a cross sectional study

2013

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“…To fully understand these differences and their relation to the social determinants of maternal health care utilization is of outermost importance for targeting scarce resources efficiently. Empowering ethnic minority groups and involving them in the planning and implementation of interventions through open dialogues have shown to be successful elsewhere [31-33]. …”

Section: Discussionmentioning

confidence: 99%

Inequity in maternal health care utilization in Vietnam

Goland

Hoa

Målqvist

2012

International Journal for Equity in Health

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IntroductionVietnam has succeeded in reducing maternal mortality in the last decades. Analysis of survey data however indicate that large inequities exist between different segments of the population. We have analyzed utilization of antenatal care and skilled birth attendance among Vietnamese women of reproductive age in relation to social determinants with the aim to reveal health inequities and identify disadvantaged groups.MethodData on maternal health care utilization and social determinants were derived from the Multiple Indicator Cluster Survey (MICS) conducted in Vietnam in 2006, and analyzed through stratified logistic regressions and g-computation.ResultsInequities in maternal health care utilization persist in Vietnam. Ethnicity, household wealth and education were all significantly associated with antenatal care coverage and skilled birth attendance, individually and in synergy. Although the structural determinants included in this study were closely related to each other, analysis revealed a significant effect of ethnicity over and above wealth and education. Within the group of mothers from poor households ethnic minority mothers were at a three-fold risk of not attending any antenatal care (OR 3.06, 95% CI 1.27–7.41) and six times more likely not to deliver with skilled birth attendance (OR 6.27, 95% CI 2.37–16.6). The association between ethnicity and lack of antenatal care and skilled birth attendance was even stronger within the non-poor group.ConclusionsIn spite of policies to out rule health inequities, ethnic minority women constitute a disadvantaged group in Vietnam. More efficient ways to target disadvantaged groups, taking synergy effects between multiple social determinants into consideration, are needed in order to assure safe motherhood for all.

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“…While some programs have experienced success [8], often YFHS are plagued by poor coverage, inadequate implementation, or brief follow-up periods [9,10]. Despite this, there have been calls for YFHS to be brought to scale and to be implemented over a longer period of time [11-13]. …”

Section: Introductionmentioning

confidence: 99%

A review of generalist and specialist community health workers for delivering adolescent health services in sub-Saharan Africa

2013

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BackgroundThe health of adolescents is increasingly seen as an important international priority because the world’s one point eight billion young people (aged 10 to 24 years) accounts for 15.5% of the global burden of disease and are disproportionately located in low- and middle-income countries (LMICs). Furthermore, an estimated 70% of premature adult deaths are attributable to unhealthy behaviors often initiated in adolescence (such as smoking, obesity, and physical inactivity). In order for health services to reach adolescents in LMICs, innovative service delivery models need to be explored and tested. This paper reviews the literature on generalist and specialist community health workers (CHWs) to assess their potential for strengthening the delivery of adolescent health services.MethodsWe reviewed the literature on CHWs using Medline (PubMed), EBSCO Global Health, and Global Health Archive. Search terms (n = 19) were sourced from various review articles and combined with subject heading ‘sub-Saharan Africa’ to identify English language abstracts of original research articles on generalist and specialist CHWs.ResultsA total of 106 articles, from 1985 to 2012, and representing 24 African countries, matched our search criteria. A single study in sub-Saharan Africa used CHWs to deliver adolescent health services with promising results. Though few comprehensive evaluations of large-scale CHW programs exist, we found mixed evidence to support the use of either generalist or specialist CHW models for delivering adolescent health services.ConclusionsThis review found that innovative service delivery approaches, such as those potentially offered by CHWs, for adolescents in sub-Saharan Africa are lacking, CHW programs have proliferated despite the absence of high quality evaluations, rigorous studies to establish the comparative effectiveness of generalist versus specialist CHW programs are needed, and further investigation of the role of CHWs in providing adolescent health services in sub-Saharan Africa is warranted.

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Scaling up Adolescent Sexual and Reproductive Health Interventions Through Existing Government Systems? A Detailed Process Evaluation of a School-Based Intervention in Mwanza Region in the Northwest of Tanzania

Cited by 21 publications

References 23 publications

Determinants of sexual health knowledge in adolescent girls in schools of Riyadh-Saudi Arabia: a cross sectional study

Determinants of sexual health knowledge in adolescent girls in schools of Riyadh-Saudi Arabia: a cross sectional study

Inequity in maternal health care utilization in Vietnam

A review of generalist and specialist community health workers for delivering adolescent health services in sub-Saharan Africa

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