Preconception Care Health Education for Female Workers of Reproductive Age in Japan Evaluation up to 6 Months after the Program

Objectives: The aim of this study was to implement a health education program for education of preconception care (PCC) for female workers of reproductive age through a seminar and to evaluate the program based on PCC knowledge and awareness and behaviors before the seminar and at 3 and 6 months after the seminar. Methods: A small group health education seminar was implemented using leaflets for 84 female workers of reproductive age, age 20 to 35 years old, and an intervention by group discussion and feedback was provided. Of these participants, 60 (71%) who provided valid survey responses were included in the analysis. The primary outcome indicators were PCC knowledge, PCC awareness and behaviors, and a food frequency questionnaire, and the secondary outcome indicators were self-efficacy and the health awareness and stress management subscales of the Health-Promotion Lifestyle Profile scale. The survey was conducted three times, before the seminar and at 3 and 6 months after the seminar, and the results were compared. Results: The percentage of individuals with PCC knowledge was significantly increased at 3 months after the seminar as compared with before the seminar, and it remained at this level even at 6 months after the seminar. The percentage of individuals with PCC awareness and behaviors was significantly increased for the items actively eat foods containing folic acid, prevent sexually transmitted diseases, and conduct self-examinations for breast cancer at 3 months after the seminar and for the items eat well-balanced meals, make the mind active, prevent sexually transmitted diseases, and conduct self-examinations for breast cancer at 6 months after the seminar. Furthermore, the score for the health awareness subscale of the Health-Promotion Lifestyle Profile scale was significantly increased at 6 months after the seminar. Conclusion: The health education program established PCC knowledge at 6 months after the seminar and improved some PCC awareness and behaviors. Therefore, it was suggested that the program would be effective for education of PCC for female workers of reproductive age.

Sexual and Reproductive Health Knowledge and Behaviour among Adolescents in Rural Burkina Faso

Background: Adolescents in developing countries have limited knowledge about the prevention of STIs and unwanted pregnancies. In several African countries, risky sexual behaviour persists, including early sexual debut, multiple sexual partners, economic and sexual exchange, and low condom and contraceptive use. The purpose of this study is to assess the sexual and reproductive health knowledge and behaviour of adolescents in rural Burkina Faso in order to improve their sexual and reproductive health. Method: This was a descriptive cross-sectional study with prospective data collection conducted from 07 March to 04 April 2022 in the area of the Demographic and Health Surveillance System of the Nouna Research Centre. A questionnaire was administered to a randomly selected sample of 1202 adolescents. Results: The mean age of the adolescents was 14.1 years and 56.6% were male. Only 58.2% of the adolescents had ever heard of HIV/AIDS. Of these, 95.7% did not know their HIV status. In addition, 15.8% had ever had sexual intercourse and 2.4% had been sexually active at an early age. Almost 45% had not used any contraceptive method the last time they had sex. Condoms were the most frequently used contraceptive method (47.4%). Among teenagers, 27.6% had been pregnant at least once, 7.3% were married and the average age at marriage was 18.45 years. Almost 7% (6.9%) of teenagers had more than one sexual partner. Conclusion: Adolescents have limited knowledge about reproductive health. Risky sexual behaviour persists. Awareness campaigns need to be intensified to improve their sexual and reproductive health.

Smart Approaches to Efficient Text Mining for Categorizing Sexual Reproductive Health Short Messages into Key Themes

To promote behavioral change among adolescents in Zambia, the National HIV/AIDS/STI/TB Council, in collaboration with UNICEF, developed the Zambia U-Report platform. This platform provides young people with improved access to information on various Sexual Reproductive Health topics through Short Messaging Service (SMS) messages. Over the years, the platform has accumulated millions of incoming and outgoing messages, which need to be categorized into key thematic areas for better tracking of sexual reproductive health knowledge gaps among young people. The current manual categorization process of these text messages is inefficient and time-consuming and this study aims to automate the process for improved analysis using text-mining techniques. Firstly, the study investigates the current text message categorization process and identifies a list of categories adopted by counselors over time which are then used to build and train a categorization model. Secondly, the study presents a proof of concept tool that automates the categorization of U-report messages into key thematic areas using the developed categorization model. Finally, it compares the performance and effectiveness of the developed proof of concept tool against the manual system. The study used a dataset comprising 206,625 text messages. The current process would take roughly 2.82 years to categorise this dataset whereas the trained SVM model would require only 6.4 minutes while achieving an accuracy of 70.4% demonstrating that the automated method is significantly faster, more scalable, and consistent when compared to the current manual categorization. These advantages make the SVM model a more efficient and effective tool for categorizing large unstructured text datasets. These results and the proof-of-concept tool developed demonstrate the potential for enhancing the efficiency and accuracy of message categorization on the Zambia U-report platform and other similar text messages-based platforms.

Male reproductive health research needs and research agenda:Asian and Chinese perspective

Research that addresses male reproductive health should assist in the development of reproductive healthprogrammes and policy; identify and test new leads in male contraceptive technology; establish effective maleinvolvement initiatives which are likely to have a positive impact on the reproductive health of men and women; guidethe allocation of health care resources to ensure cost-effectiveness of interventions; generate new knowledge, developdiagnostic technology in reproductive health and offer optimal treatment/care regimens. In considering the needs and demands of male reproductive health research in Asia and the Pacific, the followingsix research topics are recommended as the priority research areas: male contraceptive technology; male reproductivehealth behaviour and male adolescent reproductive health; male reproductive aging including male menopause and otherdiseases; male RTIs, STDs, HIV/AIDS; prevalence, management and prevention of male infertility; environment andsemen quality and other male reproductive problems. One of the major challenges now facing us is the elaboration of a comprehensive, yet realistic male reproductivehealth research agenda that reflect the needs and demands of Asian developing countries. To this end, to make use of aninterdisciplinary approach is of strategic importance. The most creative insights and productive leads are likely toemerge from a research team that is interdisciplinary especially in the field of reproductive health.

Attitude of Health Care Providers towards Adolescent Sexual and Reproductive Health Services in Developing Countries: A Systematic Review

The aim of the review was to synthesise the best available evidence regarding attitude of health care providers towards adolescent sexual and reproductive health services in developing countries. The review was conducted following qualitative research method. An online search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), British Nursing Index (BNI), EMBASE and MEDLINE databases was conducted to identify relevant studies for the review. There were nine studies that met the inclusion criteria and these were critically assessed by two independent reviewers using the standardised Joanna Briggs Institute (JBI) critical appraisal forms. Data were extracted using the standardised JBI data extraction forms. A narrative synthesis was done on the findings. Key findings from the review indicate that unprofessional attitude of health care professionals and lack of youth friendly reproductive health services, inhibit adolescents from gaining access to sexual and reproductive health services in developing countries. It is recommended that youth friendly reproductive health services be provided to increase uptake of re-productive health services by adolescents.

Reproductive Health Service Utilization and Social Determinants among Married Female Rural-to-urban Migrants in Two Metropolises,China

Reproductive health（RH） education and services of female migrants in China have become an important health issue.This research aimed to investigate the RH knowledge and utilization among married female migrants,and to explore the influencing factors from the perspectives of population and sociology.We conducted a cross-section survey in Shenzhen and Wuhan,China,using the purposive sampling method.A total of 1021 rural-to-urban married migrants were recruited,with 997 valid survey results obtained.A face-to-face structured questionnaire survey was used,with primary focus on knowledge of fertility,contraception,family planning policy and sexual transmitted diseases/acquired immunodeficiency syndrome（STD/AIDs）,and RH service utilization.The results showed that the RH service utilization（38.0%） was at a low level in married migrants and the accessibility of RH service was poor.Females who migrated to（OR=0.32） Wuhan obtained fewer RH consultations than those in Shenzhen.The workers with high school education received additional RH consultations and checkup services than those with other background education,apart from the white collar workers who received extra RH consultations and checkup services than the blue collar workers（P〈0.05）.We can draw a conclusion that the utilization of RH services in married female migrants remains at a low level in China.RH service utilization can be improved via the relevant health departments by enhancing the responsibility of maternal and health care in the community health service center.

Caretaker’s Perceptions on Caretaker-Adolescent Communication on Sexual and Reproductive Health in Unguja-Zanzibar: Implication for Intervention

Caretaker-adolescent communication is an appealing source for influencing adolescents’ knowledge, attitudes and behavior, because caretakers are an accessible and often willing source of information for their children. With the realization of the importance of caretakers in influencing adolescent behaviours, it becomes interesting to explore their perceptions about caretaker-adolescent communication on Sexual and Reproductive Health (SRH). An exploratory qualitative research design was conducted in all six districts of Unguja-Zanzibar. Twelve focus group discussions (FGDs) with caretakers who were purposively selected were conducted. Thematic analysis guided the interpretation of the data. The main themes that were identified are perceived the risk of adolescents;style, time and content of communication;barriers to parent-child communication on SRH;and helping our children pass through adolescence safely. The findings show that participants have acknowledged the apparent risky sexual behaviors of their adolescents, and that information on SRH should be offered to children before they reach puberty. Participants had the opinion that communication on SRH should be in the form of warning, threat and unidirectional. Topics such as teenage pregnancy, STIs and HIV, and drug and alcohol were proposed to be openly discussed. However, topics on condom and contraceptives use faced strong opposition. Lack of favorable time, caretakers’ limited knowledge and skills, myth on SRH communication, and being uncomfortable were among the caretaker-adolescent communication barriers identified by caretakers. The findings suggest that participants are keen to help their adolescents to avoid SRH problems, most importantly they emphasised on the need to empower caretakers by equipping them with knowledge of SRH, good communication skills and religious knowledge. Communal parenting on the other hand has been identified as the major weapon in shaping adolescents’ behaviour. This information provides insight in designing family-based intervention aiming at increasing communication about SRH between caretakers and adolescents.

Caretaker-Adolescent Communication on Sexuality and Reproductive Health: My Perceptions Matter;A Qualitative Study on Adolescents’ Perspectives in Unguja-Zanzibar

This study was conducted to explore the perceptions of adolescents on caretaker-adolescent communication on sexuality. Using an Information-Motivation-Behavioural Skills model, this article highlights areas to emphasise when planning strategies to improve caretaker-adolescent communication on sexuality. Twelve focus group discussions were held with adolescents aged between 15 and 19 years, and data were analysed using content analysis. The participants found it important for caretakers to communicate with adolescents about sexuality to avoid sexual and related health risks. Caretakers were the most preferred communicators, by adolescents, on sexuality matters. It became apparent that information about the use of condoms was the most unpopular topic during the discussions, while information about the use of contraceptives seemed to be more interesting to the majority of the participants. From the adolescents’ point of view, the barriers to communication about sexuality on the caretakers’ side, include, the belief that such information might encourage promiscuity;some caretakers do not find it easy to discuss matters related to sexuality with their children;and others feel that some adolescents know more about sexuality than themselves. On the other hand, barriers on adolescents’ side include, “fear” of the caretakers, some of whom seem harsh, unfriendly, and sometimes unapproachable. Following the findings, it is being suggested that intervention strategies that would help to alleviate communication barriers would consequently facilitate caretaker-adolescent discussions about sexuality and reproductive health.

Healthcare Providers' Perceptions of the Sexual and Reproductive Health Needs (Including Family Planning) of Elderly Women from Selected Sites in Botswana

Much of the sexual and reproductive health services and service delivery including family planning target women of child bearing ages (15 - 49 years) and sometimes men. Hardly are there programmes/interventions that specifically target the needs of the elderly women (50 years and above), yet this group has serious sexual and reproductive health needs as many of them are still sexually active. This cross-sectional study obtained the views of a stratified random sample of 169 healthcare providers (doctors, nurses and pharmacists) from four selected sites, Gaborone, Selibe Phikwe, Barolong and Kweneng East health districts in Botswana on how the healthcare system in the selected sites is meeting the SRH/FP needs of the elderly women. The study found out that while overwhelming majority of the healthcare providers feltthat the healthcare system has no programme that specifically target the SRH/FP needs of this significant others and their SRH/FP needs are not being met ,less than 15% indicated that Pap smear screening as well as screening of cervical cancer were on-going. Although there are SRH/FP services available in the healthcare system, the elderly women are minimally accessing these services. Only condom, combined oral contraceptives, progestogen-only pills, treatment of STIs, screening for HIV/AIDS and screening for cervical cancer are accessed and information is also limited to these services. Reasons given by the healthcare providers for the non-accessibility of these services were cultural diversity (80%), people's sexual behavior and perceptions about sex (79%), lack of knowledge about the desired SRH/FP services (76%), religion (73%) and gender issues (62%). The study, advocates as part of policy options to mitigate the obstacles to accessing SRH/FP services, the expansion of counseling programmes, screening and treatment for breast cancer, public awareness campaigns, production and circulation of appropriate educational materials, effective training of healthcare providers and the establishment of separate clinic days for the elderly women' SRH/FP services.

The Influence of PAC on Female Reproductive Health

[Purpose]To discuss the influence of PAC on female reproductive health after abortion. [Method] It selects 3020 patients of voluntarily making abortion operation in our hospital from 2011.3-2013.03, where the PAC patients are 1860 cases in the system, and the non- PAC patients are 1160 cases, conducting analysis of its clinical materials. [Result]The selection rate of reliable contraception measures in PAC group is obviously higher than non-PAC group, and the difference is of statistics significance（P〈0.05）. The repeated abortion rate in PAC group is obviously lower than the control group, and the difference is of statistics significance（P〈0.05）. [Conclusion] PAC service has a positive influence on the female reproductive health, which can improve the selection rate of patients for reliable contraception measures, reducing the repeated abortion rate, which plays a positive role in protecting the patients＇ reproductive health aspect.

What Does Research Say for Improving the Efficiency of Lady Healthcare Workers in Pakistan? Review Article

Background: In Pakistan, the crucial role of Lady Health Workers (LHWs) cannot be over looked and must be supported. Their alliance position between the community and health system allows them to provide services to the most marginalised groups. However, LHWs face numerous challenges and issues resulting in reduced efficiency and effectiveness of LHW program. Aims: The study aims to identify the challenges highlighted in various studies that undermine the performance of LHWs and attempts to combine the recommendations of the studies for addressing these challenges. Methods: Literature search included articles from 2000 to 2024. PubMed and Google Scholar were the main search engines utilized. Initial search resulted in 1380 articles, out of which only those showing a link to the study title were included in the study. From the total articles searched, 55 were selected for writing this article. Results: Literature highlighted the importance of community selection, monitoring, monetary as well as non-financial incentives;trainings;availability of supervision, workload balance, monitoring;recognition, clarity on roles, resources and uninterrupted supply of logistics, support and embedment of LHWs in community and health system. Lack or poor quality of these aspects may lead to low performance of LHWs. Conclusions: This paper explores the extent of issues and challenges faced by LHWs in Pakistan. A number of interventions appear to be effective in improving the efficiency of LHWs in Pakistan. The review may serve as an essential resource for program planners and decision-makers in improving the effectiveness and efficiency of LHW programs.

Sexual and reproductive health service needs of university/ college students： updates from a survey in Shanghai, China

Aim： To promote the provision of reproductive health services to young people by exploring the attitudes and perceptions of university students in Shanghai, China, toward reproductive health. Methods： From July 2004 to May 2006, 5 243 students from 14 universities in Shanghai took part in our survey. Topics covered the demands of reproductive health-care services, attitudes towards and experience with sex, exposure to pornographic material, and knowledge on sexual health and sexually transmitted infections （STIs）/AIDS. Results： Of the 5 067 students who provided valid answer sheets, 50.05% were female and 49.95% were male, 14.86% were medical students, and 85.14% had non-medical backgrounds. A total of 38.4% of respondents had received reproductive health education previously. The majority of students supported school-based reproductive health education, and also acquired information about sex predominantly from books, schoolmates, and the Internet. Premarital sexual behavior was opposed by 17.7% of survey participants, and 37.5% could identify all the three types of STIs listed in the questionnaire. Although 83.7% knew how HIV is transmitted, only 55.7% knew when to use a condom and 57.8% knew that the use of condoms could reduce the risk of HIV infection. Conclusion： The reproductive health service is lagging behind current attitudes and demands of university students. Although students＇ attitudes towards sexual matters are liberal, their knowledge about reproductive health and STIs/AIDS is still limited. It is therefore necessary to provide effective and confidential reproductive health services to young people.

KAP Survey of Turkish University Students on Sexuality,reproductive Health,Drug Addiction and Violence

Objective To investigate the attitudes, behaviours and reflections of the university students, on sexuality, reproductive health, violence, smoking, alcohol and drug use, and to find out their expectations from a youth health service. Methods A total of 5 300 students （1 880 girls, 3 420 boys）from various Jaculties of Kyrykkale University were enrolled into this cross-sectional study. Students completed the self-administered questionnaire as one of the researchers was present at the classroom. Research monitors five categories of priority health-risk behaviours among youth and young adults. Results Mean age of 3 420 male （64.5%） and 1 880female （35.5%） students were 20.3 years. Among all 4 380 （82,9%） students [1 350 girls （71.8%）, 3 030 boys （88.5%）] had some kinds of information about sexuality, however this dropped to 2 730 students （51.5%） within the context of adequacy. Friends were the major source （34%） for the first information on sexuality. Using a condom was the mostly heard method of contraception （46.9%） and interestingly 1.1% of the students had no knowledge on any of the protection methods. Among all 25.3% of the students （33.0% boys, 11.4% girls） had some kind of sexual intercourse, and within this group 58.8% experienced his/her first sexual relationship at 18 years of age and over; 53.9% were protected in all intercourses. Using a condom was the main way of protection for boys （63.7%） and pills were for the girls （73.9%）. None of the female students mentioned having an abortion but 8% had friends who had undergone abortion. Tobacco use was 35.1% among the group, and 8. 7% of the male and 3.6% of the female students were using drugs. Although 67. 4% students claimed they never witnessed violence between their parents, 43.2% witnessed violence among their siblings, 67.0% beween friends, 72.6% in the streets and 64.2% in the school. About 30.0% of the students reported having weight problems, and 14.7% admitted visiting a doctor for that problem. If there would be a service providedfor the adolescents in the university, 67% of the students would attend in case of a problem. Past experiences were important for us and we saw that among all 8% of the participants had some kind of sexual problem, within this group 50.7% felt uncomfortable during the visit and only 60.4% were satisfied with the care of the physician. Conclusion Our study results show the current situation of adolescents in Kyrykkale University and will be used to improve policies and programs to reduce priority healthrisk behaviours among youth of our and surrounding provinces and establish a youth friendly service in Kyrykkale University within this purposes.

How the Reproductive Health Needs of Unmarried Youth Be Concerned in Quality Services in Family Planning/Reproductive Health?

Objective To understand the reproductive health needs of unmarried youth so as to provide them better quality services. Method Data were drawn from a baseline questionnaire survey of provision of reproductive health information and services for unmarried youth aged 16-20 years in rural areas of Chengdu, Southwest China in 2001-2002. Results The study comprised of 1 895 valid subjects. More than 70% subjects felt that the knowledge, information and services in relation to sexual and reproductive health provided by the society were rather insufficient. Near 95% thought that unmarried young people seeking sexual and reproductive health counseling and services were quite normal, although some of them had different misgivings. Their preferred services in reproductive health included： counseling in relation to sexual and reproductive health, how to cope with unexpected sex and unwanted pregnancy, how to select the appropriate contraceptives for unmarried youth, etc. About 2/3 subjects agreed to provide contraceptive services to unmarried youth actively, by the society. A. nd they thought the difficulties and obstacles in provision of contraceptive services for un- married youth were in the following order.＂ restriction of the traditional conceptions, shyness of unmarried youth in accept of such services, disapproval of parents/school teachers, and so forth. Conclusion To improve reproductive health status of unmarried youth and meet their needs is a challenge to quality service of family planning/reproductive health program in China, The related departments and service providers should pay attention to this matter and take the strategies and measures to provide appropriate, specific, friendly and accessibly services for unmarried young people.

A community-based friendly health clinic:An initiative adolescent reproductive health project in the rural and urban areas of Indonesia

Objective:This study aims to examine the effects of a community-based friendly health clinic(CFHC)program that adopts manual participatory learning(MPL)intervention on the adolescents living in the rural and urban areas of Indonesia to gain further insights into their knowledge,attitudes,and skills related to adolescent reproductive health(ARH).Methods:A quasi-experimental design was used to obtain information on the ARH knowledge,attitudes,and skills of adolescents.Two intervention studies that used similar protocols and measures were conducted.A total of 192 adolescents(96 adolescents from urban and rural areas)participated in the project,and the participants from each area were divided into eight groups.A questionairre was adopted to measure the ARH knowledge,attitudes,and skills of these participants.A content analysis of the logbook entries of these respondents was conducted to identify their ARH-related problems.The questionnairre and self-reported ARH data were collected before and after the eight-week program.Results:The CFHC program significantly increased the ARH attitudes(p=0.045)and skills(p=0.009)of adolescents in the rural area,but only improved the ARH knowledge(p<0.001)of adolescents in both rural and urban areas.Fourteen themes were identified in three dominant categories,namely,schools,families,and communities.Conclusions:The CFHC with MPL intervention can improve the ARH knowledge,attitudes,and skills of adolescents in the rural area,but can only improve the ARH knowledge of adolescents in the urban area.The ARH program must be designed based on the characterictics of these adolescents to improve their life skills during puberty.

Reproductive Health Knowledge Level of High School and University Students in Shanghai

Objective To understand the sexual and reproductive health knowledge level of high school and university students in Shanghai. Methods A total of 628 high school students and 709 college students were surveyed with anonymous self-administrated questionnaire in Shanghai. Results The median knowledge scores of students from colleges and high schools were 58 and 39, respectively. Those who had surfed the Internet, had browsed websites on reproductive health, or had communicated sex-related issues with fathers/classmates/friends had more reproductive health knowledge. In addition, the percentage of college students who had surfed the Internet, had browsed websites on reproductive health or had communicated sex-related issues with classmates/friends was higher than that of high school students. Conclusion The knowledge scores of respondents were rather low. Compared with the high school students, the college students had more reproductive health knowledge and sought the knowledge more actively.

Cross-sectional Study on Their Reproductive Health Status of 604 Fem ale Floating Residents in Beijing

This study on the reproductive health statusw asbased on the data from a survey and an exam ination of severalhundredsof fem ale floating residentsin Beijing. The results w ere compared w ith those from fem ale perm anent residents in Beijing. The study revealed thatm ostof theinvestigated fem alefloating residentshad lived in Bei- jing w ith their fam ily for threeyearson an average. They had a harderlifethan that of Beijing perm anentresidents. Also they did notreceiveadequateprenatalcaresdur- ing their pregnanciesin Beijing and a quarter of thesem othersdid notreceiveany pre- natal exam ination during their pregnancies at all. Again the fem ales had a great prevalence of reproductive tractinfections, reaching 29.3of thoseexam ined, high- er than the w om en perm anently residing in Beijing.

Perception of Adolescents on the Attitudes of Providers on Their Access and Use of Reproductive Health Services in Delta State, Nigeria

This paper examines the perception of adolescents on the attitudes of providers on their access and use of reproductive health services (ARHS) in Delta State, Nigeria, with a view of assessing the impact of providers’ attitude on the use of adolescents’ reproductive health services in Delta State. The study adopted a survey design to collect primary data using questionnaires and focus group discussions (FGDs) from adolescents in a sample of schools. A sample size of 1500 respondents was taken from 12 schools in six Local Government Areas in three Senatorial Districts in Delta State, Nigeria. The locations of the schools were such that six each were in rural and urban communities respectively. The result from the study was that unfriendly attitudes of providers which keep adolescents waiting, inadequate duration of consultations, judgmental attitudes of some providers, lack of satisfactory services provision and lack of confidentiality will put off adolescents from accessing and using adolescents’ reproductive health services irrespective of their sex, age, class, religion, residence, ethnic group, parents’ education or income levels. The paper concludes that medical personnel take all these issues very seriously when dealing with adolescents to enhance access and use adolescents’ reproductive health services in Delta State and indeed Nigeria.