Adolescent fertility rates in Latin America and the Caribbean (LAC) remain unacceptably high, especially compared to the region’s declining total fertility rates. The Region has experienced the slowest progress of all regions in the world, and shows major differences between countries and between subgroups in countries. In 2013, LAC was also noted as the only region with a rising trend in pregnancies in adolescents younger than 15 years. In response to the lack of progress in the LAC region, PAHO/WHO, UNFPA and UNICEF held a technical consultation with global, regional and country-level stakeholders to take stock of the situation and agree on strategic approaches and priority actions to accelerate progress. The meeting concluded that there is no single portrait of an adolescent mother in LAC and that context and determinants of adolescent pregnancy vary across and within countries. However, lack of knowledge about their sexual and reproductive health and rights, poor access to and inadequate use of contraceptives resulting from restrictive laws and policies, weak programs, social and cultural norms, limited education and income, sexual violence and abuse, and unequal gender relations were identified as key factors contributing to adolescent pregnancy in LAC. The meeting participants highlighted the following seven priority actions to accelerate progress:1. Make adolescent pregnancy, its drivers and impact, and the most affected groups more visible with disaggregated data, qualitative reports, and stories.2. Design interventions targeting the most vulnerable groups, ensuring the approaches are adapted to their realities and address their specific challenges.3. Engage and empower youth to contribute to the design, implementation and monitoring of strategic interventions.4. Abandon ineffective interventions and invest resources in applying proven ones.5. Strengthen inter-sectoral collaboration to effectively address the drivers of adolescent pregnancy in LAC.6. Move from boutique projects to large-scale and sustainable programs.7. Create an enabling environment for gender equality and adolescent sexual and reproductive health and rights.
Health Issue: This chapter investigates (1) the association between ethnicity and migration, as measured by length of residence in Canada, and two specific self-reported outcomes: (a) selfperceived health and (b) self-reports of chronic conditions; and (2) the extent to which these selected determinants provide an adequate portrait of the differential outcomes on Canadian women's self-perceived health and self-reports of chronic conditions. The 2000 Canadian Community Health Survey was used to assess these associations while controlling for selected determinants such as age, sex, family structure, highest level of education attained and household income.
This article explores the matching process at micro-, meso-, and macro-levels in health services in order to arrive at culturally competent and gender-sensitive health care. We provide a brief overview of sex, gend~ ethnicity, and health, specifically in terms of sex and ethnic matching at micro-, meso-, and macro-levels. Throughout the article we raise some controversial elements surrounding matching by providing a discussion of studies conducted in this field. In conclusion we examine the challenges to sex and ethnic matching in order to provide recommendations and alternative strategies toward the achievement of culturally competent and gender-sensitive health care. Cet article examine le processus de jumelage aux niveaux micro-, mdso-, et macro-dans les services de santd afin d'en arriver ?z des services de santd qui soient culturellement compdtents et adaptds aux diff&ences entre les hommes et Ies femmes. Nous donnons un bref apercu du sexe, de l'origine ethnique et de l'dtat de sant~ surtout en ce qui concerne le jumelage du point de vue du sexe et de l'ethnie aux niveaux micro-, mdso-et macro-. Tout au long de l' article, nous soulevons certains dl~rnents controversds qui entourent Ie jumelage en discutant d'dtudes mendes dans ce domaine. En conclusion, nous examinons les difficultds que repr~sente le jumelage du point de vue du sexe et de l'ethnie afin de formuler des recommandations et des strategies de rechange pour en arriver dL des services de santd culturellement compdtents et adapt~s aux diffdrences entre les hommes et les femmes.
Focus groups have become increasingly popular in health research. However, their feasibility depends on the context of such research. Through discussion of focus groups they conducted in rural India, the authors argue that successful focus groups in rural contexts must be culturally sensitive, with a research team that goes beyond the mere technicalities of collecting data. A culturally competent focus group can result when the research team has geographic, political, economic, and sociocultural knowledge related to the research area and its population. With extensive local collaboration, foreign researchers are better able to conduct data collection respectfully. The authors provide recommendations for future studies toward increasing the cultural appropriateness of focus groups in areas such as rural India.
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