Level of Young People Sexual and Reproductive Health Service Utilization and Its Associated Factors among Young People in Awabel District, Northwest Ethiopia

Background

Currently in Ethiopia, young people’s sexual and reproductive health services are limited and there is a growing issue of confidentiality and affordability of these health services. Moreover, the available services provided are not sensitive to the special needs of young people. Therefore, this study was aimed to assess young people’s sexual and reproductive health service utilization and its associated factors in Awabel district, Northwest Ethiopia.

Methods

A community based cross-sectional study was conducted among 781 randomly selected young people using a pre-tested structured questionnaires in Awabel district, Northwest Ethiopia. Data were entered into Epi data version 3.1 and analyzed using SPSS version 16.0 software.

Results

The mean age of respondents were 17.80 (+ 2.65) years. About 41% of young people had utilized sexual and reproductive health services. Young people from families of higher family expenditure, lived with mothers, participated in peer education and lived near to a Health Center were more likely to utilize sexual and reproductive health services. Furthermore, those who had a parental discussion on sexual and reproductive health (AOR (95% C.I): 2.23 (1.43, 3.46)) and ever had sexual intercourse (AOR (95% C.I): 1.88 (1.30, 2.71)) were more likely to utilize the service than their counterparts. On the other hand, those young people lived with their father and had a primary level of educational attainment was less likely to utilize the service.

Conclusion

Utilization of sexual and reproductive health services is low which needs a great attention where; if not intervened, young people might engage in risky sexual activities. Therefore, it needs a concerted effort from all the concerned bodies to improve their service utilization and thereby reduce the burden of young people’s disease and disabilities associated with sexual and reproductive health.

Below:  Situations how first sexual intercourse was started among young people in Northwest Ethiopia, 2015 (n = 474).

Below:  Reasons of young people for not utilizing SRH services in Northwest Ethiopia, 2015 (n = 439)

Full article at:   http://goo.gl/KrHnht

By:  Atitegeb Ayehu,1 Teketo Kassaw,2,* and Getachew Hailu2

¹Students Clinic, Debre Markos University, Debre Markos, Ethiopia

²Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia

National Institute of Health, ITALY

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Resilience & Professional Quality of Life in Staff Working with People with Intellectual Disabilities & Offending Behavior in Community Based and Institutional Settings

Staff in forensic services for people with intellectual disabilities (ID) are expected to deal with a wide range of emotional challenges when providing care. The potential impact of this demanding work has not been systematically explored previously. This article explores the professional quality of life (QoL) and the resilience (hardiness) of the staff in this setting. The Professional QoL questionnaire and the Disposional Resilience Scale were completed by staff (n=85, 80% response rate) in the Norwegian forensic service for ID offenders. Responses from staff working in institutional settings were compared to those from staff in local community services. Staff in the local community services had higher resilience scores compared to the staff in the institutional setting, (t=2.19; P<0.05). However in the other QoL and resilience domains there were no differences between the staff in the two settings. The greater sense of resilient control among community staff may be a function of both the number of service users they work with and the institutional demands they face. Even though these participants worked with relatively high risk clients, they did not report significantly impaired quality of life compared to other occupations.

...People with intellectual disabilities (ID) who are also offenders are some of the most difficult health service users to treat and historically they have also received little attention from researchers or the wider society.⁵The research that has been conducted has concentrated on offenders with mild ID within secure placements. Offenders with a moderate or more severe level of ID seldom enter the criminal justice system (CJS), as they are diverted into mental health services, ID services, or forensic mental health services. As a result, there is a dearth of studies exploring the needs and living conditions of offenders with moderate ID compared with offenders with mild ID.

Offenders with ID have many characteristics in common with offenders in the general population.^6,7 They tend to be young and male and have experienced social disadvantage, unstable environments, and financial instability.⁸ There is little research on how the characteristics of people with ID who are labeled offendersmay differ from those with ID who do not offend.⁹ Holland et al.⁷ proposed that two groups of offenders with ID can be distinguished according to whether they are known to the ID services. Amongst the smaller group who are known to services the term offence may often be confused with challenging behavior.¹⁰

The Norwegian system has quite restrictive policies regarding diversion of offenders with ID from the criminal justice system. There has been some focus on intellectual impairment among offenders,¹¹ but the government’s priorities are focused elsewhere on, for instance, building more prison accommodation, encouraging multidisciplinary cooperation in preventing recidivism, developing alternatives to imprisonment alongside better rehabilitation services and evidence-based research...¹²

Full article at:   http://goo.gl/EnYyTD

By:  Erik Søndenaa,1,2 Christian Lauvrud,1 Marita Sandvik,3 Kåre Nonstad,1 and Richard Whittington1,4

¹St. Olavs University Hospital, Forensic Department, Brøset, Trondheim, Norway, UK

²University College of Sør-Trøndelag, Department of Social Education, Trondheim, Norway, UK

³St. Olavs University Hospital, Forensic Unit for Offenders with Intellectual Disabilities, Brøset, Trondheim, Norway, UK

⁴University of Liverpool, Institute of Psychology, Health and Society, Health & Community Care Research Unit, Liverpool, UK

St. Olavs University Hospital, Forensic dep. Brøset, Postbox 1803, Lade, 7440 Trondheim, Norway. Phone: +47.992.44771.

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Guardianship Law versus Supported Decision-Making Policies: Perceptions of Persons with Intellectual or Psychiatric Disabilities and Parents

Article 12 of the Convention for the Rights of Persons with Disabilities recognizes all persons with disabilities as having legal capacity in all areas of life. However, in adherence to the Israeli Legal Capacity and Guardianship Law (1962), many persons with intellectual disability (ID) or mental illness (MI) have these rights revoked because of the appointment of a guardian. Little is known about these persons' perceptions about guardianship and supported decision making (SDM). 

Using focus groups, we examined the perceptions of persons with ID, persons with MI, and parents regarding guardianship and SDM. Most participants expressed their desire to adopt a model of SDM in their daily decision making, though differences were found among the groups. 

Persons with MI emphasized their right to be independent in decisions regarding their lives, and parents of these persons aspired to support their children to reach independence, except in times of crisis. 

Persons with ID also desired more independence, but they were uncertain if this would be possible for them. Some individuals with ID preferred that decisions regarding their lives be made on their behalf. Parents of persons with ID felt that it was critical for them to serve as guardians of their children. 

Recommendations are provided on how to promote the legal capacity of individuals with disabilities.

Purchase full article at:  http://goo.gl/Wi0T9u

By:  Werner S, Chabany R.

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Disability and the Context of Boys' First Sexual Intercourse

Purpose

The context in which first sexual intercourse takes place has lasting implications for subsequent sexual behavior. This study examines how adolescent disability associates with boys' age of sexual debut, relationship at first sexual intercourse, degree of discussion about birth control before first sexual intercourse, and contraceptive use at first sexual intercourse.

Methods

Data were used from the National Longitudinal Survey of Youth 1997, a nationally representative survey collected annually in the United States. Multinomial logistic regression of a base sample of 2,737 boys examines the likelihood of (1) sexual debut at ages 12–14, 15–17, or ≥18 years; (2) first intercourse with a stranger, casual acquaintance, dating partner, in a committed relationship, or in an undefined relationship; (3) level of discussion about birth control; (4) contraception; and (5) condom use among those who contracept.

Results

Compared to boys without disability, those with learning or emotional conditions are more likely—and those with sensory conditions are less likely—to report very early sexual debut. Boys with chronic illness are both more likely to have sex in a committed relationship and in an undefined relationship and also more likely to contracept at first intercourse. Boys with learning or emotional conditions are more likely to discuss birth control but less likely to use condoms if they do contracept.

Conclusions

Boys with and without disabilities—and boys with different types of disabilities—vary significantly in multiple aspects of their first sexual experiences. It is pertinent that sexual health interventions are tailored to address this diversity.

Purchase full article at:   http://goo.gl/T54SlU

By:   Carrie L. Shandra, Masra Shameem, M.P.H., Sadaf J. Ghori, M.P.H.

Department of Sociology/Program in Public Health, State University of New York at Stony Brook (http://publichealth.stonybrookmedicine.edu/), Stony Brook, New York

Correspondence

Address correspondence to: Carrie L. Shandra, Ph.D., Department of Sociology, State University of New York at Stony Brook, Stony Brook, New York 11794-4356. 

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Prevalence & Risk of Violence Against People With & Without Disabilities: Findings from an Australian Population-Based Study

OBJECTIVES:

There are no population-based estimates of the prevalence of interpersonal violence among people with disabilities in Australia. The project aimed to: 1) estimate the prevalence of violence for men and women according to disability status; 2) compare the risk of violence among women and men with disabilities to their same-sex non-disabled counterparts and; 3) compare the risk of violence between women and men with disabilities.

METHODS:

We analysed the 2012 Australian Bureau of Statistics Survey on Personal Safety of more than 17,000 adults and estimated the population-weighted prevalence of violence (physical, sexual and intimate partner violence and stalking/harassment) in the past 12 months and since the age of 15. Population-weighted, age-adjusted, logistic regression was used to estimate the odds of violence by disability status and gender.

RESULTS:

People with disabilities were significantly more likely to experience all types of violence, both in the past 12 months and since the age of 15. Women with disabilities were more likely to experience sexual and partner violence and men were more likely to experience physical violence.

CONCLUSIONS:

These results underscore the need to understand risk factors for violence, raise awareness about violence and to target policies and services to reduce violence against people with disabilities in Australia.

Purchase full article at:   http://goo.gl/7Rn9C8

By:   Krnjacki L¹, Emerson E^2,3, Llewellyn G^2,4, Kavanagh AM¹.

¹Melbourne School of Population and Global Health, The University of Melbourne, Victoria.

²Centre for Disability Research and Policy, The University of Sydney, New South Wales.

³Centre for Disability Research, Lancaster University, United Kingdom.

⁴WHO Collaborating Centre for Health Workforce Development in Rehabilitation and Long Term Care, The University of Sydney, New South Wales. 

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Mental Disorders and Disabilities among Low-Income Children

Children living in poverty are more likely to have mental health problems, and their conditions are more likely to be severe. Of the approximately 1.3 million children who were recipients of Supplemental Security Income (SSI) disability benefits in 2013, about 50% were disabled primarily due to a mental disorder. An increase in the number of children who are recipients of SSI benefits due to mental disorders has been observed through several decades of the program beginning in 1985 and continuing through 2010. Nevertheless, less than 1% of children in the United States are recipients of SSI disability benefits for a mental disorder. 

At the request of the Social Security Administration, Mental Disorders and Disability Among Low-Income Children compares national trends in the number of children with mental disorders with the trends in the number of children receiving benefits from the SSI program, and describes the possible factors that may contribute to any differences between the two groups. 

This report provides an overview of the current status of the diagnosis and treatment of mental disorders, and the levels of impairment in the U.S. population under age 18. The report focuses on 6 mental disorders, chosen due to their prevalence and the severity of disability attributed to those disorders within the SSI disability program: attention-deficit/hyperactivity disorder, oppositional defiant disorder/conduct disorder, autism spectrum disorder, intellectual disability, learning disabilities, and mood disorders. 

While this report is not a comprehensive discussion of these disorders, Mental Disorders and Disability Among Low-Income Children provides the best currently available information regarding demographics, diagnosis, treatment, and expectations for the disorder time course - both the natural course and under treatment.

Sections

The National Academies of SCIENCES • ENGINEERING • MEDICINE

COMMITTEE TO EVALUATE THE SUPPLEMENTAL SECURITY INCOME DISABILITY PROGRAM FOR CHILDREN WITH MENTAL DISORDERS

Reviewers

Preface

Acknowledgments

Acronyms and Abbreviations

Summary

I. Background and Context of the Supplemental Security Income Disability Benefit Program for Children

1. Introduction

2. The SSI Program for Children

3. National-Level Trends in the SSI Program for Children with Mental Disorders, 2004–2013

4. State Variation in the SSI Program for Children

5. Poverty and Childhood Disability

II. Clinical Characteristics of Selected Mental Disorders

6. Clinical Characteristics of Attention Deficit Hyperactivity Disorder

7. Clinical Characteristics of Oppositional Defiant Disorder and Conduct Disorder

8. Clinical Characteristics of Autism Spectrum Disorder

9. Clinical Characteristics of Intellectual Disabilities

10. Clinical Characteristics of Learning Disabilities

11. Clinical Characteristics of Mood Disorders

III. Prevalence of Selected Mental Disorders

12. Prevalence of Attention Deficit Hyperactivity Disorder

13. Prevalence of Oppositional Defiant Disorder and Conduct Disorder

14. Prevalence of Autism Spectrum Disorder

15. Prevalence of Intellectual Disabilities

16. Prevalence of Learning Disabilities

17. Prevalence of Mood Disorders

IV. Medicaid Analytic eXtract Study

18. Medicaid Analytic eXtract Study

Appendixes

Via:  http://goo.gl/2MsaFD

By:  Committee to Evaluate the Supplemental Security Income Disability Program for Children with Mental Disorders; Board on the Health of Select Populations;Board on Children, Youth, and Families; Institute of Medicine; Division of Behavioral and Social Sciences and Education; The National Academies of Sciences, Engineering, and Medicine; Boat TF, Wu JT, editors.

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Disability and Living with HIV: Baseline from a Cohort of People on Long Term ART in South Africa

Background

Through access to life saving antiretroviral treatment (ART) in southern Africa, HIV has been reconceptualised as a chronic disease. This comes with new challenges of HIV-related co-morbidities and disabilities. We still lack an understanding of the types and scope of disabilities experienced by people on long term ART and how this impacts health, adherence, and livelihood. This paper describes the results of a cohort study examining the new health- and disability-related needs of the millions of people on ART in the region.

Methods

Data was collected from a cohort of people who had been on ART for six months or longer in a semi-urban public health care setting in South Africa. 1042 adults (18 and older) participated in the cross-sectional study which investigated disabilities/activity limitations, health, ART adherence, depression symptoms, and livelihood. We analysed the associations between these constructs using descriptive statistics, and bivariate and multivariate analyses.

Results

A large number of participants (35.5%) obtained a weighted score of two or more on the WHODAS 2.0 indicating possible activity limitations. A positive relationship was found between activity limitations and depression symptoms, adherence, and worse health outcomes, while none was found for BMI or CD4 count. These associations varied by type of activity limitations and, in some cases, by gender.

Conclusion

Activity limitations are potentially experienced by a large portion of people on ART in southern Africa which impacts health and ART adherence negatively. These results highlight the importance of better understanding the new health-related needs of people who are on long term ART, as well as the nuances of the disability they experience. This is urgently needed in order to enable HIV-endemic countries to better prepare for the new health-related needs of the millions of people on ART in southern Africa.

Below:  Percentage of Participants experiencing one or more activity limitations

Below:  Boxplot of converted health scores in percentages split by disability status

Full article at:   http://goo.gl/m2TzIs

By:

Jill Hanass-Hancock, Bradley Carpenter

Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa

Hellen Myezwa

Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa

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Prevalence and Characteristics of Sexual Violence against Men with Disabilities

INTRODUCTION:

Few studies have examined lifetime and past-year sexual violence against men with disabilities and the types of perpetrator-survivor relationships among men with disabilities. The purpose of this study is to document the prevalence of lifetime and past-year sexual violence against men with disabilities in the U.S., compare these estimates with those of men without disabilities and women with and without disabilities, and examine the gender and relationship of the perpetrator of sexual violence against men with disabilities relative to perpetrator characteristics identified in incidents against other adults.

METHODS:

Behavioral Risk Factor Surveillance System 2005-2007 data were analyzed in 2014 using domain analysis and multivariate logistic regression.

RESULTS:

Men with a disability were more likely than men without a disability to report lifetime sexual violence (8.8% vs 6.0%). They were also more likely than men without a disability to report lifetime experience of attempted or completed nonconsensual sex (5.8% and 2.3% vs 4.1% and 1.4%, respectively). There were no statistically significant differences between the two groups of men's reports of their relationship to the perpetrator of the most recent incident of sexual violence or perpetrator gender.

CONCLUSIONS:

Men with disabilities are at heightened risk for lifetime and current sexual violence compared with men without disabilities. Given the relatively high prevalence of sexual violence among people with disabilities of both genders, sexual assault screening, prevention, and response efforts need to be inclusive and attentive to all people with disabilities.

Purchase full article at:  http://goo.gl/u1Xzkv

By:  Mitra M1, Mouradian VE2, Fox MH3, Pratt C4.

• 1University of Massachusetts Medical School, Center for Health Policy and Research, Shrewsbury, Massachusetts. Electronic address: monika.mitra@umassmed.edu.
• 2Massachusetts Department of Public Health, Boston, Massachusetts.
• 3Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia.
• 4University of Massachusetts Medical School, Center for Health Policy and Research, Shrewsbury, Massachusetts. 

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HIV-Related Disabilities: An Extra Burden to HIV and AIDS Healthcare Workers?

Healthcare workers have been at the forefront of dealing with the impact of HIV and AIDS at all stages of the pandemic. This brings new challenges to include disability into HIV care. However, the implications for healthcare workers in an already fragile health system along with HIV-related disabilities in persons living with HIV are little understood. This study examined the healthcare workers' perspective on disability in HIV care.

This article describes a qualitative study using in-depth interviews with 10 healthcare workers in a semi-urban hospital setting in KwaZulu-Natal, South Africa. The study aimed to understand healthcare workers' experiences with disability in the context of HIV. The International Classification of Functioning Disability and Health (ICF) was used as a guiding framework to understand disability.

Healthcare workers described HIV-related disabilities on all three levels of disability, namely impairments/ body function, activity limitations and participation restrictions, as affecting the livelihood of their patients and household members. Issues also arose from disability and stigma that were perceived as affecting adherence to antiretroviral treatment. In addition, healthcare workers encounter challenges in dealing with the increased needs of care and support for those people living with HIV who experience HIV-related disabilities. They indicated a limited ability to cope and respond to these needs. Primarily they arrange additional referrals to manage complex or episodic disabilities. Participants also identified issues such as excessive work load, lack of resources and training and emotional challenges in dealing with disability.

Healthcare workers need support to respond to the increased needs of people living with HIV who have HIV-related disabilities. Responses need to reflect: 1) increase in rehabilitative staff including in community outreach programmes; 2) skills training in HIV-related disability; and 3) psychosocial support for healthcare workers.

Purchase full article at: http://goo.gl/nqVjqq

By: van Egeraat L1,2, Hanass-Hancock J2, Myezwa H3.

• 1 Health Economics and HIV/AIDS Research Division (HEARD) , University of KwaZulu-Natal , South Africa.
• 2 VU University , Amsterdam , The Netherlands.
• 3 University of the Witwatersrand , Johannesburg , South Africa.  

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