RESUMEN
Sexual and reproductive health (SRH) of unmarried youth is an important issue, particularly in Indian society, where premarital sex is socially restricted. It is an uncomfortable subject for most people, including healthcare providers, who are responsible for catering to the reproductive health needs of youth. This is because of the prevailing social norms, where sex outside marriage is discouraged and stigmatised. These social norms give importance to virginity, and children outside marriage are not welcome. The present qualitative study was conducted in public health facilities (primary and secondary) to explore the attitudes of healthcare providers in providing contraceptive services to unmarried youth. In-depth interviews were conducted with family planning (FP) service providers (frontline healthcare workers [ASHAs] nurses and FP counsellors) between October 2017 and September 2018. Almost a quarter of the providers were either hesitant or against providing contraceptives to unmarried youth. Providers stated that they preferred emergency contraceptive pills for unmarried girls if they had already engaged in unprotected sex. Providers expressed strong personal views against premarital sex because they believed it was against existing social norms. Some providers were concerned about the possible negative reactions of the community if they recommended any contraceptive to unmarried youth. A few providers even considered it illegal to provide contraceptives to unmarried youth, though there is no such law in the country. Findings further indicated that though the country had launched programmes for improving adolescents and youth SRH, service providers were still conflicted between medical eligibility and social beliefs.
Asunto(s)
Anticonceptivos , Servicios de Salud Reproductiva , Femenino , Niño , Adolescente , Humanos , Persona Soltera , Investigación Cualitativa , Servicios de Planificación FamiliarRESUMEN
BACKGROUND: Tetanus toxoid immunization is an integral part of the maternal and child health programme in developing countries. It is likely that many women may have had childhood immunization and so already have antitetanus antibodies at the time of their first antenatal visit. A single dose of tetanus toxoid injection can boost the levels of antitetanus antibodies in these women. This study was undertaken to assess the previous immunization status by verbal history and assess the effect of a single tetanus toxoid injection in young women. METHODS: Ninety-nine unmarried women between 18 and 22 years of age were enrolled for the study. The history of childhood immunization was obtained from their mothers. Blood samples were collected to measure IgG antibody levels to tetanus using ELISA. Antibody levels were also measured on day 14 after a dose of tetanus toxoid injection. RESULTS: Of the 99 women studied, 81 had a history of childhood immunization while 18 did not. Overall, 92% of the women had protective levels of antibodies at the time of first testing and 99% of the women were protected with a single dose of tetanus toxoid. CONCLUSION: In areas with good maternal and child health services, a single booster dose of tetanus toxoid can be considered adequate for primigravidae with a history of childhood immunization.