2019 Dec;27(3):1-5. doi:10.1080/26410397.2019.1697103. In every class a new challenge emerged, and I learned something new about the girls’ needs and about the best way to present information to them. Stigma has permeated attitudes toward recipients of sexual and reproductive health services, and at times to service providers. And a lack of education or awareness – whether it’s about family planning techniques, their own body, or the importance of screenings in preventing STIs, cancer, and other conditions. Infertility stigma is one of the greatest challenges in most societies for reproduction and sexual health of infertile women. Furthermore, adolescent girls in Latin America and the Caribbean continue to be at high risk of adolescent pregnancy, which is associated with negative health outcomes for the mother and the child in addition to social and economic disadvantages. The fifth graders felt like they had unlocked a beautiful secret; they felt like they were part of an exclusive menstruation and puberty club. As soon as we started the workshop, the students realized it was like nothing they had experienced before. Resort to contraceptive products, to voluntary sterilization and abortion, and now to medically assisted reproductive care to overcome infertility has attracted stigma. Proposed review date: This National Sexual and Reproductive Health Policy should be reviewed every two years or as is deemed necessary in response to changes in the environment. Stigma, understood as a mark of disgrace or discredit, has permeated attitudes often taken toward recipients of sexual and reproductive health services, and at times to providers of such services. Request PDF | Reducing stigma in reproductive health | Stigmatization marks individuals for disgrace, shame, and even disgust—spoiling or tarnishing their social identities. These graphic images send the wrong message to students and further stigmatize people living with STIs. The girls’ initial negative attitude in class emphasized the shortcomings of sexual and reproductive health education in the public school system. Innovating Education in Reproductive Health is a program within the UCSF Bixby Center for Global Reproductive Health and is a part of UCSF’s Department of Obstetrics, Gynecology & Reproductive Sciences. Sexual and reproductive health must be comprehensive, honest, innovative, but most importantly, it has to create a comfortable space for everyone. Copyright © 2014 International Federation of Gynecology and Obstetrics. The UN’s sexual and reproductive health agency, UNFPA, on Wednesday appointed supermodel, philanthropist, and impact investor Natalia Vodianova as its newest Goodwill Ambassador, in … Public health studies have shown that scare tactics can lead to healthy behaviors only if a person feels capable to make the recommended changes and if they feel susceptible to the health issue. Social stigma related to women’s reproductive decision-making negatively impacts the health of women. And a lack of education or awareness – whether it’s about family planning techniques, their own body, or the importance of screenings in preventing STIs, cancer, and other conditions. Author information: (1)Editor-in-Chief, Sexual and Reproductive Health … I can’t wait to tell my mom everything I learned!” At that moment I knew my co-teacher and I had accomplished something important—the girls had learned that sexual and reproductive health could be fun and empowering. Stigmatization marks individuals for disgrace, shame, and even disgust—spoiling or tarnishing their social identities. After discussing different ways in which we could prepare them for the workshop, we decided to introduce the idea of reproductive systems in our plant biology class. We need to continue talking about menstrual cycles in ways that don’t reinforce the narrative of pain and shame. By Saumya Sao. Sexual and reproductive health stigma. Respondents perceived that stigma was a barrier to young people accessing sexual and reproductive health services and identified excessive questioning, scolding and requirements to bring sexual partners or parents to receive services at health facilities as obstacles to accessing care. My time at Mariposa confirmed my passion for sexual and reproductive health education and made me realize the importance of tailoring science-based education materials to the needs and personalities of individual girls. Throughout our menstrual hygiene discussion, my co-teacher and I fostered a comfortable environment by being vulnerable and honest about our own experiences menstruating and going through puberty. I had the pleasure of moderating the panel, which was made up by: Megan Huchko, MD, MPH who is an OB/GYN and directs the Center for Global Reproductive Health at DGHI; Michael Relf, PhD, RN … Instead, we should be normalizing menstruation and teaching girls at a young age that their menstrual cycle is a way for their bodies to communicate with them. Gynecologists and their professional associations, ethically committed to uphold human dignity and equality, especially for vulnerable women for whom they care, should be active to guard against, counteract, and relieve stigmatization of their patients and of related service providers. It can be imposed accidentally by thoughtlessness or insensitivity; incidentally to another purpose; or deliberately to deter or punish conduct considered harmful to actors themselves, others, society, or moral values. In multivariable models, higher SRH stigma scores were associated with history of pregnancy (β = 1.53, CI = 0.51,2.56) and excellent/very good self-rated health (β = 0.89, CI = 0.20,1.58), while lower stigma scores were associated with older age (β = -0.17, 95%CI = -0.24,-0.09), higher educational attainment (β = -1.22, CI = -1.82,-0.63), and sexual intercourse experience (β = -1.32, CI = -2.10,-0.55). By continuing you agree to the use of cookies. Factors associated with sexual and reproductive health stigma among adolescent girls in Ghana. How do I protect myself from HIV? In many Latin American countries, girls do not receive proper education on puberty and menstrual hygiene management before entering puberty. Stigma has permeated attitudes toward recipients of sexual and reproductive health services, and at times to service providers. I don’t need to be here.” I was reminded of the same I-already-know-it-all attitude the eighth graders had demonstrated in our sexual and reproductive health class. Abortion and contraceptive use stigma: a cross-sectional study of attitudes and beliefs in secondary school students in western Kenya Ulrika Rehnström Loi , Beatrice Otieno , Monica Oguttu , Kristina Gemzell-Danielsson , Marie Klingberg-Allvin , Elisabeth Faxelid & Marlene Makenzius Image courtesy of Betty D. We held our menstruation workshop on a Saturday, a day when only the middle and high schoolers usually come to the center for special programs. I promise it will not be boring.”. Stigma, which could prevent someone from seeking care in a reproductive health facility where they might run into someone they know. reproductive autonomy and abortion stigma. Responses to the SRH Stigma Scale, sub-scales, and individual items are presented in Table 2. I had not revealed the topic of the workshop to the fifth graders so as soon as they arrived at the center, they pestered me with questions. The purposes of the study were to validate a newly constructed scale to measure the stigma of contraceptive use and to adapt a scale to measure the stigma of abortion. Sexual behavior for adolescents in the Dominican Republic is heavily influenced by the lack of comprehensive sexual and reproductive health education, the harmful total abortion ban, and stigmatization of sexual behavior for adolescent girls. Organizations that work with young girls, such as the Mariposa DR Foundation, have the potential to fill the gaps in reproductive health education by providing inclusive, science-based, and comprehensive sexual and reproductive health education, as well as help adolescent girls find non-stigmatizing health services in their community. You can protect yourself by: 1) Knowing your partner's HIV status, and if HIV positive, are on antiretroviral therapy. Ethical and Legal Issues in Reproductive Health. reproductive health.Stigma,discrimination and the violation of human rights are intimately connected,reinforcing and legitimising each other.Their manifestations are varied, occurring in families and communities,in health services, at places of work, and in schools. 2019 Dec;27(3):1-5. doi: 10.1080/26410397.2019.1697103. Stigma and Unmet Sexual and Reproductive Health Needs Among International Migrant Sex Workers at the Mexico-Guatemala Border Teresita Rocha-Jiménez 1 2 , Sonia Morales-Miranda 3 , Carmen Fernández-Casanueva 4 , Kimberly C Brouwer 1 , Shira M Goldenberg 1 5 6 Stigma surrounding young people’s sexual behavior and sexuality reduces the availability of HIV and reproductive health services for youth and makes young people—who may seek to conceal their sexual activity to avoid stigma—reluctant to access services. Additionally, I received research-based materials from a registered HIV clinic in the eastern region of the Dominican Republic. 3) Taking oral daily PrEP. Resort to contraceptive products, to voluntary sterilization and abortion, and now to medically assisted reproductive care to overcome infertility has attracted stigma. Betty volunteered in the Dominican Republic with the help of a Christianson Fellowship, from the InterExchange Foundation. Sexual and reproductive health stigma. Crossing her arms and with a frown on her face, she told me, “I already had the puberty talk with my mom and I fell asleep because of how boring it was. Image courtesy of Betty D. At the end of the workshop, I felt the high energy in the room and the empowerment everyone, including my co-teacher and I, radiated. Conclusion Finally, one of the girls figured out we were going to be discussing puberty. 1. By 2018 Christianson Fellow Betty Duran-Becerra. From our sexual and reproductive health charades competition and our menstrual cycle bracelet making to the active ball game we played to learn about fertilization, the girls were engaged and fascinated by the topics of sexual and reproductive health. Responses to the SRH Stigma Scale, sub-scales, and individual items are presented in Table 2. According to the Pan American Health Organization, the Dominican Republic has the highest adolescent pregnancy rate in Latin America and the Caribbean. Stigma is a major cause of discrimination and exclusion: it affects people‘s self-esteem, helps disrupt their family relationships and limits their ability to socialize and obtain housing and jobs. A week before the workshop, we taught the younger Mariposas about the reproductive parts of fruits and flowers, mentioning and explaining important vocabulary such as ovary and ovule. RH Care Info is a non-profit reproductive health information project by the Philippine Society for Responsible Parenthood Inc. (PSRP), and supported by the … We use cookies to help provide and enhance our service and tailor content and ads. It is one based on scare tactics. As the girls headed out with all the new knowledge they had gained and the reusable cloth pads we had given them, the girl who had initially expressed she didn’t want to be in the workshop ran up to me. The panel focused on HIV stigma and reproductive health. Stigma has permeated attitudes toward recipients of sexual and reproductive health services, and at times to service providers. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Zero Discrimination day: The Elimination of Stigma and Discrimination in Sexual and Reproductive Health Care In many countries, laws result in people being treated differently, excluded from essential services or being subject to undue restrictions on how they live their lives, simply because of who they are. The stigma of contracting sexually transmitted infections has been reinvigorated with HIV infection. 13 May 2014. Read about the adventures others have had and get excited for yours. Stigma related to abortion and contraceptive use is a serious public health threat for young people, and validated scales to measure this stigma are scarce. In Georgia, taboos, stigma and lack of education on the topic leave many young people struggling to navigate their own sexual and reproductive health. RECENT PRESS RELEASE: Age of consent laws in India restrict access to sexual and reproductive health for young people, says new SRHM article The authors of a new review published in the SRHM journal say their article could help advocates lobby against restrictive laws which often try to resolve complex social issues without the nuance needed. My co-teacher Amelia and I administered a pre-test during our first class to assess the girls’ baseline knowledge of sexual and reproductive health and their general attitude toward the topic. Stigma, understood as a mark of disgrace or discredit, has permeated attitudes often taken toward recipients of sexual and reproductive health services, and at times to providers of such services. The conversation about reproductive health is so stigmatized and so walled off from the rest of the healthcare conversation that we still have to make the case to some that this area of healthcare should be treated just like all other disciplines. Unmarried motherhood has a long history of shame, projected onto the “illegitimate” (bastard) child. Abortion Stigma: What is it and how does it affect sexual and reproductive health? Lack of access to proper sexual and reproductive health services compounds the problem. Promoting young people's sexual and reproductive health: stigma, discrimination and human rights. In 2018, the United Nations (UN) declared that shame, stigma, and misinformation surrounding menstruation contribute to serious human rights concerns and lead to detrimental health outcomes for women. Moreover, multiple girls had written on the pre-test that they were not interested in sitting in a three-hour class twice a week to talk about sexual and reproductive health. When girls do not have access to the proper resources and facilities, they are more likely to have trouble participating in school and can feel disempowered. She told me with a radiant smile on her face, “I thought this was going to be boring but I ended up having so much fun. Hussein J(1), Ferguson L(2). We consulted with the on-site psychologist, a Dominican woman who had been working with Mariposa for years, to make sure the materials were culturally appropriate. In general, women experience more stigma and discrimination than men. International Journal of Gynecology & Obstetrics, https://doi.org/10.1016/j.ijgo.2014.01.002. Taking their interests into consideration, Amelia and I incorporated engaging activities such as: skits, a contraception method “Heads Up” game, and art breaks between class lessons. Stigma, embarrassment and taboos surround reproductive issues making it difficult for women to talk about them and creating a barrier to women accessing the care they need. SRHR/HIV linkages are bidirectional synergies in policy, programmes, and service delivery that support comprehensive sexual and reproductive health needs and rights of all people, including people living with HIV, within a framework of gender equality and human rights. Stigma appeared to be salient in abortion providers’ lives. A study nested in a cluster-randomised trial. Social pressure and stigma was another key sub-theme identified in this study. In many Latin American countries, girls do not receive proper education on puberty and menstrual … Secrecy was associated with increased psychological distress and social isolation. In the adjusted model, a total reproductive autonomy score was significantly negatively associated with a total abortion stigma score ( 0.43, p .001). 2) Using male or female condoms with all partners. The purposes of the study were to validate a newly constructed scale to measure the stigma of contraceptive use and to adapt a scale to measure the stigma of abortion. Hussein J(1), Ferguson L(2). No other area of healthcare is so politicized or so Sex Reprod Health Matters. Eliminating stigma and discrimination in sexual and reproductive health care: apublic health imperative. Resort to contraceptive products, to voluntary sterilization and abortion, and now to medically assisted reproductive care … She shares her experience implementing a sexual and reproductive health class to help Dominican girls feel autonomy over their own bodies and health. Students participating in a menstruation workshop activity. Menstruation and Sexual and Reproductive Health are Global Health Issues. ... Further research disentangling the complex interrelationships between SRH stigma, health, and social context is needed to guide multi-level interventions to address SRH stigma and its causes and consequences for adolescents worldwide. On November 1 st, 2019, the Center had its first lunch talk in the 2019-2020 Reproductive Health in Africa lunch series. Young people constitute a significant proportion of India’s population, with 21 percent of them in the 10–19-year age group. Some of the barriers to sexual and reproductive health and rights include discrimination, stigma, restrictive laws and policies, and entrenched traditions. Evidence of interventions to reduce abortion stigma was scarce. Beatriz (“Betty”) Duran-Becerra spent eight months volunteering with the Mariposa DR Foundation, an organization devoted to empowering and educating girls and young women in the Dominican Republic to end generational poverty. In 2018, the United Nations (UN) declared that shame, stigma, and misinformation surrounding menstruation contribute to serious human rights concerns and lead to detrimental health outcomes for women. Published by Elsevier Ireland Ltd. All rights reserved. Stigma and Unmet Sexual and Reproductive Health Needs Among International Migrant Sex Workers at the Mexico-Guatemala Border Teresita Rocha-Jiménez 1 2 , Sonia Morales-Miranda 3 , Carmen Fernández-Casanueva 4 , Kimberly C Brouwer 1 , Shira M Goldenberg 1 5 6 The mean score on the SRH Stigma scale was 13.11 (SD 3.78, range 1–20), with mean sub-scale scores highest for enacted stigma (4.55, SD 1.82, range 0–7) and similar for internalized (4.28, SD 1.42, range 0–6) and stigmatizing lay attitudes (4.28, SD 1.47, range … In class, we noticed that the girls loved painting, competing against each other, and performing in front of their peers. Sexual transmission is the most common way of getting HIV. Eliminating stigma and discrimination in sexual and reproductive health care: a public health imperative. Previous to the workshop, my co-teacher and I were teaching a plant biology class to the youngest Mariposas, grades second through fifth. Most studies had limitations regarding generalizability and validity. Like sexual health, reproductive health is a public health issue with far reaching social and economic impacts. In spite of the efforts to provide a comprehensive health education, taboos and the lack of women in leadership positions in the health-care field present major challenges. Stigma has permeated attitudes toward recipients of sexual and reproductive health services, and at times to service providers. Amelia and I creating materials for our sexual and reproductive health class. A study nested in a cluster-randomised trial. Therefore, vasectomy uptake remains dependent on powerful religious constructs and how reproductive health matters are defined by communities. The most rewarding moment I experienced at Mariposa was when I co-led a menstruation workshop for our fifth-graders with the help of my Haitian-Dominican co-teacher. Image courtesy of Betty D. Amelia and I collaborated to develop materials for a pilot sexual and reproductive health class for these students. One of our students, a girl I had trouble connecting with, raised her hand and said “I’ve always had all these questions about puberty but I never felt comfortable asking anyone until now.”. 2004. The stigma and discrimination that young people face, particularly adolescent girls and young women, to access sexual and reproductive health and rights services creates barriers at various levels, including the individual, interpersonal, community and societal levels.
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