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“Our mothers do not tell us”: a qualitative study of adolescent girls’ perspectives on sexual and reproductive health in rural Nepal

Adolescent girls in low- and middle-income countries continue to face poor sexual and reproductive health (SRH). In Nepal, early marriage and motherhood, gender-based violence, and unmet need for contraception remain pervasive. Adolescent girls in rural areas bear a disproportionate burden of poor r...

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Autores principales: Tiwari, Aparna, Wu, Wan-Ju, Citrin, David, Bhatta, Aasha, Bogati, Bhawana, Halliday, Scott, Goldberg, Alisa, Khadka, Sonu, Khatri, Rekha, Kshetri, Yashoda, Rayamazi, Hari Jung, Sapkota, Sabitri, Saud, Sita, Thapa, Aradhana, Vreeman, Rachel, Maru, Sheela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225746/
https://www.ncbi.nlm.nih.gov/pubmed/35695251
http://dx.doi.org/10.1080/26410397.2022.2068211
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author Tiwari, Aparna
Wu, Wan-Ju
Citrin, David
Bhatta, Aasha
Bogati, Bhawana
Halliday, Scott
Goldberg, Alisa
Khadka, Sonu
Khatri, Rekha
Kshetri, Yashoda
Rayamazi, Hari Jung
Sapkota, Sabitri
Saud, Sita
Thapa, Aradhana
Vreeman, Rachel
Maru, Sheela
author_facet Tiwari, Aparna
Wu, Wan-Ju
Citrin, David
Bhatta, Aasha
Bogati, Bhawana
Halliday, Scott
Goldberg, Alisa
Khadka, Sonu
Khatri, Rekha
Kshetri, Yashoda
Rayamazi, Hari Jung
Sapkota, Sabitri
Saud, Sita
Thapa, Aradhana
Vreeman, Rachel
Maru, Sheela
author_sort Tiwari, Aparna
collection PubMed
description Adolescent girls in low- and middle-income countries continue to face poor sexual and reproductive health (SRH). In Nepal, early marriage and motherhood, gender-based violence, and unmet need for contraception remain pervasive. Adolescent girls in rural areas bear a disproportionate burden of poor reproductive health outcomes, but there are limited context-specific data. This is a qualitative study to identify factors that impact adolescent girls’ utilisation of and access to SRH services in a rural district of Nepal. We conducted 21 individual interviews with adolescent girls aged 15–19 years, and three focus group discussions with community health workers. We used an inductive analytic approach to identify emergent and recurrent themes and present the themes using the social ecological model. Individual-level factors that contribute to low uptake of services among adolescent girls include lack of knowledge, self-perceived lack of need, low decision-making autonomy, and shyness. Interpersonal factors that impact access include unsupportive family norms, absence of open communication, and need for permission from family members to access care. At the community level, disparate gender norms, son preference, and judgment by community members affect adolescent SRH. Inadequate sex education, far travel distance to facilities, lack of female healthcare providers and teachers, and inability to access abortion services were identified as organisational and systems barriers. Stigma was a factor cross-cutting several levels. Our findings suggest the need for multi-level strategies to address these factors to improve adolescent girls’ SRH.
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spelling pubmed-92257462022-06-24 “Our mothers do not tell us”: a qualitative study of adolescent girls’ perspectives on sexual and reproductive health in rural Nepal Tiwari, Aparna Wu, Wan-Ju Citrin, David Bhatta, Aasha Bogati, Bhawana Halliday, Scott Goldberg, Alisa Khadka, Sonu Khatri, Rekha Kshetri, Yashoda Rayamazi, Hari Jung Sapkota, Sabitri Saud, Sita Thapa, Aradhana Vreeman, Rachel Maru, Sheela Sex Reprod Health Matters Research Article Adolescent girls in low- and middle-income countries continue to face poor sexual and reproductive health (SRH). In Nepal, early marriage and motherhood, gender-based violence, and unmet need for contraception remain pervasive. Adolescent girls in rural areas bear a disproportionate burden of poor reproductive health outcomes, but there are limited context-specific data. This is a qualitative study to identify factors that impact adolescent girls’ utilisation of and access to SRH services in a rural district of Nepal. We conducted 21 individual interviews with adolescent girls aged 15–19 years, and three focus group discussions with community health workers. We used an inductive analytic approach to identify emergent and recurrent themes and present the themes using the social ecological model. Individual-level factors that contribute to low uptake of services among adolescent girls include lack of knowledge, self-perceived lack of need, low decision-making autonomy, and shyness. Interpersonal factors that impact access include unsupportive family norms, absence of open communication, and need for permission from family members to access care. At the community level, disparate gender norms, son preference, and judgment by community members affect adolescent SRH. Inadequate sex education, far travel distance to facilities, lack of female healthcare providers and teachers, and inability to access abortion services were identified as organisational and systems barriers. Stigma was a factor cross-cutting several levels. Our findings suggest the need for multi-level strategies to address these factors to improve adolescent girls’ SRH. Taylor & Francis 2022-06-13 /pmc/articles/PMC9225746/ /pubmed/35695251 http://dx.doi.org/10.1080/26410397.2022.2068211 Text en © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Tiwari, Aparna
Wu, Wan-Ju
Citrin, David
Bhatta, Aasha
Bogati, Bhawana
Halliday, Scott
Goldberg, Alisa
Khadka, Sonu
Khatri, Rekha
Kshetri, Yashoda
Rayamazi, Hari Jung
Sapkota, Sabitri
Saud, Sita
Thapa, Aradhana
Vreeman, Rachel
Maru, Sheela
“Our mothers do not tell us”: a qualitative study of adolescent girls’ perspectives on sexual and reproductive health in rural Nepal
title “Our mothers do not tell us”: a qualitative study of adolescent girls’ perspectives on sexual and reproductive health in rural Nepal
title_full “Our mothers do not tell us”: a qualitative study of adolescent girls’ perspectives on sexual and reproductive health in rural Nepal
title_fullStr “Our mothers do not tell us”: a qualitative study of adolescent girls’ perspectives on sexual and reproductive health in rural Nepal
title_full_unstemmed “Our mothers do not tell us”: a qualitative study of adolescent girls’ perspectives on sexual and reproductive health in rural Nepal
title_short “Our mothers do not tell us”: a qualitative study of adolescent girls’ perspectives on sexual and reproductive health in rural Nepal
title_sort “our mothers do not tell us”: a qualitative study of adolescent girls’ perspectives on sexual and reproductive health in rural nepal
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225746/
https://www.ncbi.nlm.nih.gov/pubmed/35695251
http://dx.doi.org/10.1080/26410397.2022.2068211
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