Sexual & reproductive health self-care measurement tool

The Sexual and Reproductive Health Self-Care Measurement Tool aims to provide a global standard approach to practical and accurate measurement of sexual and reproductive (SRH) self-care interventions, with a focus on three specific interventions: self-injectable hormonal contraception, HIV self-testing, and self-managed abortion. Led by the SCTG’s Evidence and Learning Working Group (ELWG), the SRH Self-Care Measurement Tool was developed through a consensus-driven process by a group of global experts, including academics, implementers, donors, and intergovernmental bodies, with the goal of identifying a minimum set of priority indicators for each of these self-care interventions

Identifying and prioritizing evidence needs in self-care interventions for sexual and reproductive health

BackgroundSelf-care as an extension of health care systems can increase access to care. The development of programs and generation of evidence to support self-care in sexual and reproductive health (SRH) is a relatively nascent field. We undertook a study to identify and prioritize evidence gaps for SRH self-care.MethodsWe used the CHNRI methodology and administered two online surveys to stakeholders affiliated with major self-care networks. The first survey was used to identify evidence gaps, and the second to prioritize them using predetermined criteria.ResultsWe received 51 responses to the first survey and 36 responses to the second. Many evidence gaps focused on awareness of and demand for self-care options and best mechanisms for supporting users of self-care with information, counseling and linkages to care.ConclusionA priority area of work ahead should be determining which aspects of the learning agenda reflect gaps in evidence and which reflect a need to effectively synthesize and disseminate existing evidence

The individual level cost of pregnancy termination in Zambia: a comparison of safe and unsafe abortion

Zambia has one of the most liberal abortion laws in sub-Saharan Africa. However, rates of unsafe abortion remain high with negative health and economic consequences. Little is known about the economic burden on women of abortion care-seeking in low income countries. The majority of studies focus on direct costs (e.g.: hospital fees). This paper estimates the individual-level economic burden of safe and unsafe abortion care-seeking in Zambia, incorporating all indirect and direct costs. It uses data collected in 2013 from a tertiary hospital in Lusaka, (n=112) with women who had an abortion. Three treatment routes are identified: i) safe abortion at the hospital ii) unsafe clandestine medical abortion initiated elsewhere with post-abortion care at the hospital and iii) unsafe abortion initiated elsewhere with post-abortion care at the hospital. Based on these three typologies, we use descriptive analysis and linear regression to estimate the costs for women of seeking safe and unsafe abortion and to establish whether the burden of abortion care-seeking costs is equally distributed across the sample. Around 39% of women had an unsafe abortion, incurring substantial economic costs before seeking post-abortion care. Adolescents and poorer women are more likely to use unsafe abortion. Unsafe abortion requiring post-abortion care costs women 27% more than a safe abortion. When accounting for uncertainty this figure increases dramatically. For safe and unsafe abortions, unofficial provider payments represent a major cost to women. This study demonstrates that despite a liberal legislation, Zambia still needs better dissemination of the law to women and providers and resources to ensure abortion service access. The policy implications of this study include: the role of pharmacists and mid-level providers in the provision of medical abortion services; increased access to contraception, especially for adolescents; and, elimination of demands for unofficial provider payments

Pregnancies, abortions, and pregnancy intentions: a protocol for modeling and reporting global, regional and country estimates

Background Estimates of pregnancies, abortions and pregnancy intentions can help assess how effectively women and couples are able to fulfil their childbearing aspirations. Abortion incidence estimates are also a necessary foundation for research on the safety of abortions performed and the consequences of unsafe abortion. Furthermore, periodic estimates of these indicators are needed to help inform policy and programmes. Methods We will develop a Bayesian hierarchical times series model which estimates levels and trends in pregnancy rates, abortion rates, and percentages of pregnancies and births unintended for each five-year period between 1990 and 2019. The model will be informed by data on abortion incidence and the percentage of births or pregnancies that were unintended. We will develop a data classification process to be applied to all available data. Model-based estimates and associated uncertainty will take account of data sparsity and quality. Our proposed approach will advance previous work in two key ways. First, we will estimate pregnancy and abortion rates simultaneously, and model the propensity to abort an unintended pregnancy, as opposed to modeling abortion rates directly as in prior work. Secondly, we will produce estimates that are reproducible at the country level by publishing the data inputs, data classification processes and source code. Discussion This protocol will form the basis for updated global, regional and national estimates of intended and unintended pregnancy rates, abortion rates, and the percent of unintended pregnancies ending in abortion, from 1990 to 2019

Access to and experience of later abortion: accounts from women in Scotland

Context: Except in the presence of significant medical indications, the legal limit for abortion in Great Britain is 24 weeks’ gestation. Nevertheless, abortion for nonmedical reasons is not usually provided in Scotland after 18–20 weeks, meaning women have to travel to England for the procedure. Methods: In-depth interviews were conducted with 23 women presenting for "later" abortions (i.e., at 16 or more weeks’ gestation) in Scotland. Participants were women who sought an abortion at a participating National Health Service clinic between January and July 2013. Interviews addressed reasons for and consequences of later presentation, as well as women's experiences of abortion. Thematic analysis attended to emerging issues and employed the conceptual tool of candidacy. Results: Delayed recognition of pregnancy, changed life circumstances and conflicting candidacies for motherhood and having an abortion were common reasons for women's presentation for later abortion. Women perceived that the resources required to travel to England for a later abortion were potential barriers to access, and felt that such travel was distressing and stigmatizing. Participants who continued their pregnancy did so after learning they were at a later gestational age than expected or after receiving assurances of support from partners, friends or family. Conclusions: Reasons for seeking later abortion are complex and varied among women in Scotland, and suggest that reducing barriers to access and improving local provision of such abortions are a necessity. The candidacy framework allows for a fuller understanding of the difficulties involved in obtaining abortions

Principles of university open spaces design based on vitality model and promotion of training

Background and Objectives:Today, the issue of teaching and learning patterns and group activities is one of the issues of interest in areas related to education in universities. How to achieve teaching-learning patterns has gained a special place among experts. In recent years, due to the increasing growth and scope of changes in educational methods, adapting the learning environment to all aspects of learner needs, has been the focus of education professionals. Because the physical environment, due to its structure, can strengthen or weaken the interactions and subsequent learning process, it is believed that new approaches are required for movement, teamwork and student dynamism. Therefore, defining the needs and how to organize the context in which such learning can emerge is of particular importance. Considering the effect that academic spaces can have on the audience and users of these spaces, the present study aims to provide guidelines for designing open university spaces based on increasing the vitality and social interactions among users and improving the level of education among them. The present research tries to identify the factors affecting the promotion of vitality and social interactions from the users' perspective, drawing the correlation between these factors in an analytical model. In the current study, both quantitative and qualitative research methods have been used. Method and Materials: After formulating the contents of the content table and the questionnaire, the sample size based on Klein's views reached 341 according to the number of questionnaires. Therefore, students from architecture, landscape architecture, urban planning and civil engineering at Iranian universities were randomly selected by cluster sampling. The data were analyzed by SPSS version 22 using R factor analysis. The model was developed by Amos. Findings: The results of this research indicated that social, physical, designing and psychological dimensions of the environment are influential. Conclusion: According to the results of previous studies and the present study, the existence of social, physical, design and environmental traits in the collective spaces of the university, can facilitate the necessary conditions to increase vitality, sociability and group activities. In this way, the existence of a spatial trait in open university public spaces, by increasing the possibility of vitality, facilitates the process of creativity and innovation for researchers and leads to socialization. Also, increasing the desire to do group and group activities and the possibility of solving problems in groups leads to improving the level of education among users. A review of this research reveals the fact that human behavior, collisions, and the use of space can be influenced by space and spatial communication, and ultimately lead to social vitality in collective centers

Features of Pattern & Light TBI in Social and Mental Health

The hidden issues behind the body of Iranian architecture contain meanings, mysteries, and symbols. The aim of this article is to describe the relationship between the function of symbols of Iranian Architecture and the quality of health. This paper investigates 5 case studies namely the traditional bathhouse of Iran (TBI) from 5 cities with a particular approach to light and decorative motifs from the Ghajar and Safavid periods in Iran. The methodology used is the Delphi research with the Q factor analysis. Finally, the profile of the relations of ornaments in a healthy TBI is explained.Keywords: Quality of Bathhouse, Decorative Motifs, Lighting, Healthy Environment.eISSN 2398-4279 © 2018. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. https://doi.org/10.21834/ajqol.v3i11.123