83 Understanding complex community structures to improve sexual reproductive health for adolescents in Uganda
Notice bibliographique
Résumé
Abstract Primary Subject area Global Child and Youth Health Background Based on the 2014 census, 35% of Uganda’s population is between 10-24 years old. Health indicators show concerning sexual and reproductive health (SRH) trends such as high teen pregnancy, unsafe abortions, limited contraceptive use, and access to antenatal and postnatal care. However, the barriers to adolescents seeking and receiving care are complicated due to pre-existing social structures in smaller, closely linked communities. Objectives To understand the social structures and motivation of communities in western Ugandan districts that impact SRH in adolescents to better implement Healthy Adolescent and Young people (HAY!). Design/Methods In September 2020, a qualitative study was conducted in 2 districts, in southwestern Uganda. Fourteen focus group discussions and 3 key informant interviews consisted of 94 participants were carried out with a purposive sample of adolescents, parents, community health workers (CHWs), community leaders, health facility staff, and district health officers. Ethics approval was obtained and COVID-19 prevention guidelines were strictly followed. Data was audio-recorded, transcribed, and thematically analyzed. Results Based on our qualitative inquiry, participants recognized that adolescents face numerous SRH challenges and expressed their tension for change and motivation to support interventions that may positively impact SRH behavior and outcomes in adolescents. However, participants who were mothers highlighted that their motivation was due to better marriage prospects for their daughters, which is determined by respect and social standing in the community. In situations of unwanted pregnancies, participants shared that because of the fear of shame, and desire to keep adolescents in school, mothers often supported unsafe abortion to maintain community standing. This is an unusual and interesting finding. Similarly, aunties and uncles were traditionally regarded as champions for protecting and guiding adolescents, but participants highlighted a negative shift in this dynamic; aunties and uncles put female adolescents at risk by connecting them with interested men in exchange for gifts and money. Consequently, they are no longer trusted. Despite these gaps, volunteer CHWs who work closely within their communities by conducting home visits, educating, and providing referrals, emerged as a trusted resource by adolescent participants in accessing SRH related information. CHW participants also shared that adolescents often confided in them when unable to speak openly with their parents. Conclusion Although participant groups were motivated towards supporting adolescents, interventions must first understand and navigate complex community structures to deliver a comprehensive and targeted intervention to improve SRH outcomes in adolescents.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,005 | 0,003 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,001 | 0,006 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».