Search

While sexuality education can support children and young people with disabilities in their sexual development and contribute to their wellbeing, challenges to its provision exist. This study identifies barriers to sexuality education for children and young people with disabilities in the WHO European Region via a scoping review of research published since 2006. Using the PRISMA-ScR Guidelines and predefined selection criteria, 14 studies were selected for inclusion. Together, these studies identified seven barriers to sexuality education for children and young people with disabilities, including the social misperception of people with disabilities as asexual and in need of protection which, combined with limited support for educators, resulted in noncomprehensive and normative sexuality education. Educators seemed inclined to redirect responsibility for sexuality education to others, and diversity among children and young people with disabilities, as well as cultural and religious diversity, makes it difficult to define a general approach. Finally, competing priorities related to the general health and wellbeing of children and young people with disabilities may appear to render sexuality education less important. We identify gaps in the research and highlight implications for the reduction of the barriers to sexuality education for children and young people with disabilities within the WHO European Region.

The successful implementation of sexuality education policy for young people has been shown to depend on a sound legislative and institutional framework. This article shows that both institutional factors and contextual obstacles have impeded the implementation of sexuality education policy in Uganda. Qualitative research techniques were employed in the form of systematic document reviews and extensive field-work with 64 participants, of which 32 were in-depth interviews with policymakers and key stakeholders in Kampala and Mbarara districts. In addition, four focus group discussions (n = 32) were conducted with teachers. The analysis was carried out thematically and manually, using open and axial coding. It was found that policy success was primarily limited by two broad factors: firstly, by institutional weaknesses such as a lack of capacity, inadequate financial commitment, poor coordination between relevant ministries and ineffective monitoring, and regulatory frameworks; secondly, by social, cultural and religious norms that give informal power to religious and cultural leaders. Two strategies are suggested as potential ways forward: (i) a commitment to both the human and financial resources needed to monitor adolescent sexual, and reproductive health programmes, but more importantly (ii) the initiation of negotiations with cultural and religious leaders to yield more positive outcomes.

This study aims to understand how gender diversity and gender attitudes are linked to the sexual well-being of young adolescents. Data was collected among 561 adolescents in secondary schools in Flanders and binary logistic regressions were performed. Gender diversity was conceptualized as gender identity, gender expression, sex assigned at birth, sexual orientation and personal gender attitudes. Whereas "like to become a wo/man" and body image were used as measures for sexual well-being. Age and migration were added as covariates.The data illustrates that gender diversity is present among young adolescents and that it can be linked to young adolescent's body image and liking to become a wo/man. In addition, it shows how diverse sets of gender attitudes are differently associated with sexual well-being outcomes. The findings also suggest the internalization of patriarchal and heterosexual societal norms by the respondents. The results indicate an association between on the one hand gender diversity and gender attitudes and on the other hand adolescent sexual well-being. Furthermore, it suggests that gender transformative research and programs that aim to improve adolescent sexual health and well-being should carefully choose their gender focus and invest in improving gender equity beyond the individual level. Additional research is needed to investigate the association between gender diversity and adolescent sexual wellbeing among diverse sexual well-being conceptualizations and specific groups (gender, ethnic, and others) of young adolescents. [ABSTRACT FROM AUTHOR]

Employment linked with social venues has long been described as permissive environments for excessive drinking, disruptive/aggressive behaviors, and overt sexual behaviors, which are known risk factors for HIV. Yet, our understanding of the extent to which workers in such high-risk work settings cope with the various risks therein is still limited. This study explored the coping strategies employed by workers at social venues. We interviewed 47 workers at 22 social venues through small group discussions (15) and in-depth interviews (10) in 2021 in Rakai district, Uganda. All discussions were audiorecorded and transcribed verbatim before analysis. Data were analyzed using thematic content analysis. We found two main categories of coping strategies used by workers: acceptance of sexual risks and keeping safe. Acceptance of risks such as transactional sex was the most used strategy, hence highlighting negative coping. This calls for interventions for improving workers' coping efficiency and adjustment as well as interventions ameliorating the conditions underpinning increased risk of HIV at the venues. [ABSTRACT FROM AUTHOR]

Background: Previous initiatives concerning adolescent sexual and reproductive health (SRH) education in Low-or-Middle Income Countries (LMICs) have been limited by cultural norms and misinformation perpetuated within families. Responding to the paucity of research on the implementation of SRH interventions in LMICs and limited knowledge regarding their mechanisms, this study undertakes a process evaluation of a parent-focused intervention to promote parent-adolescent communication about SRH in Uganda. Methods: This paper explores the implementation, contextual factors and mechanisms of impact of the intervention, using the Medical Research Council (MRC) guidelines for process evaluations. Implementation was evaluated through indicators of dose, fidelity and adaptations, acceptability and feasibility. The contextual factors and mechanisms of impact were evaluated to refine the intervention's causal assumptions. Data was collected during April - October 2021 in South-Western Uganda using a mixed-methods approach, including document analysis, intervention observations, interviews, focus group discussions and most significant change stories. Results: The acceptability of the intervention was related to its community engagement, the strong rapport with delivery agents, and individual characteristics of participants. Five contextual factors influencing implementation were highlighted; (i) cultural norms, (ii) perceptions about youth SRH, (iii) poverty, (iv) Covid-19 pandemic, and (v) prior research projects in the community. When considering the intervention's mechanisms of impact, four causal pathways were identified; (i) Awareness of SRH needs helped parents overcome stigma, (ii) Parenting skills training improved SRH communication, (iii) Group learning stimulated shared parenting, and (iv) Group learning improved co-parenting. Conclusion: The paper presented three key learnings and corresponding recommendations for future research. Firstly, implementation success was credited to meaningful community engagement which improved acceptability and uptake. Secondly, the complex influences of contextual factors highlighted the need for contextual analysis in research studies to inform intervention design. Finally, this evaluation recognised the interplay between mechanisms of impact and suggested further research consider such combined impacts when designing intervention content. [ABSTRACT FROM AUTHOR]

Introduction: There are 200 million girls and women alive worldwide that have undergone the practice of Female Genital Mutilation/Cutting (FGM/C) and 4 million girls are at risk of undergoing the practice each year. FGM/C provides no known health benefits, while puts a plethora of medical, psychological, and sexual health risks into perspective. One of the countries where the prevalence of FGM/C is the highest in theWorld, even though local authorities legally banned the practice in 2008, is Egypt. Within the Egyptian context, there are several complex socioeconomic, religious, and cultural drivers that influence the familial decision making of the daughters being cut. Female attitudes hold great significance in the process, because mothers and female family members are typically the prime decision makers at the daughter's circumcision. However, whilst FGM/C is often performed to enhancemarriageability and addressmale preferences, in practicing communities there is little to no open communication between men and women about the practice, making women rely on their perceptions on FGM/C related expectations of men. Even though the connection between female and perceived male attitudes toward the discontinuation was established almost 20 years ago, since then to our knowledge little is known about the further characteristics of this association. Therefore, this study aims to explore the association between female and perceived male attitudes within families of a younger cohort and moreover attempts to provide amore layered picture of it within different levels of education. Methods: To explore the relation between female and perceived male attitudes toward the discontinuation of FGM/C we conducted a 3-step binary logistic regression model. Results: Our results show that women are significantly less likely to favor a continuation of FGM/C if they think men are disapproving of the practice, compared to women that think men want it to continue. The strength of this association partially varies between the different levels of education as it is less pronounced at the level of secondary education, compared to the reference group. Discussion: In alignment with previous findings in the literature, women were more likely to support the discontinuation of FGM/C if they believed that men want the practice to discontinue as well and vice versa. At a higher level of secondary education however this association is less pronounced. This result concludes that the role of perceived male attitudes should be an important factor associated with female ones and studied further, and underlines the importance of education in women empowerment. [ABSTRACT FROM AUTHOR]

Early marriage and pregnancy hinder global commitment to attain gender parity in education. This article discusses educational challenges experienced by parenting college students during the COVID-19 pandemic in Uganda. The study qualitatively assessed the effects of COVID-19 on the National Teacher Colleges' learning environment. On the reopening of schools after the lockdown, colleges were overwhelmed with an increased number of students who returned either pregnant or with young babies. Colleges were not prepared since pregnancy in college is prohibited through denial of on-campus accommodation and other services. Pregnant students were stigmatized, shunned and blamed for having engaged in immoral sexual behaviour and punished for their indiscretions. Pregnant and abandoned is structural gender-based violence that manifests in the physical, emotional, economic and social violence faced by pregnancy and parenting students, the young mothers are abandoned by their families and partners, and are denied child support and other student services. Future studies need to investigate the effects of such tormenting experiences of being abandoned on the academic performance and future parenting decisions of such girls. [ABSTRACT FROM AUTHOR]