Suchergebnisse

This report's overarching objective is the examination of key trends in the evidence base of female genital mutilation and cutting (FGM/C) and gaps in knowledge for Nigeria, building on a scoping review of peer-reviewed and "grey" literature along with quantitative analysis of relevant data. What is clear from prevalence levels identified over the last 15 years is how widespread different types of FGM/C are, in Nigeria's different ethno-geographical zones, and the little change that has taken place over time, despite increased international, and renewed national, political commitment to eradicate the practice. The findings show that much work remains to be conducted on the evaluation of FGM/C abandonment efforts, particularly the need for methodologically rigorous intervention evaluations. This review reveals that we need to collect data to understand FGM/C prevalence over time and identify contributing factors among regional cultures that will be necessary to inform specific future policy and program interventions. The need for strengthening monitoring and of interventions to establish what works and what does not work, together with investments in methodologically robust data collection and analysis will be important parts of the process for generating credible evidence to inform FGM/C policy and action.

Estimates suggest that over 90% of population increase in the least developed countries over the next four decades will occur in urban areas. These increases will be driven both by natural population growth and rural-urban migration. Moreover, despite its status as the world's least urbanized region, the urban population in the sub-Saharan Africa region is projected to increase from under 40% currently to over 60% by 2050. Currently, approximately 70% of all urban residents in the region live in slums or slum-like conditions. Sexual and reproductive health (SRH) risks for the urban poor are severe and include high rates of unwanted pregnancies, sexually transmitted infections, and poor maternal and child health outcomes. However, the links between poverty, urbanization, and reproductive health priorities are still not a major focus in the broader development agenda. Building on theoretical and empirical data, we show that SRH in urban contexts is critical to the development of healthy productive urban populations and, ultimately, the improvement of quality of life. We posit that a strategic focus on the sexual and reproductive health of urban residents will enable developing country governments achieve international goals and national targets by reducing health risks among a large and rapidly growing segment of the population. To that end, we identify key research, policy and program recommendations and strategies required for bringing sexual and reproductive health in urban contexts to the forefront of the development agenda.

Rural-to-urban migration is increasingly common among youths in developing countries and could affect sexual activities with consequences for premarital pregnancies. We use life history data collected in Kisumu, Kenya, to investigate how the timing and number of rural-to-urban moves are associated with premarital pregnancy. Among sexually experienced young women aged 18 to 24 ( N = 226), 60 percent had moved at least once in the past 10 years and 38 percent had experienced a premarital pregnancy. Results of the event history analysis show that those who experienced one or two moves were at increased risk for premarital pregnancy compared to nonmovers. Also at increased risk were movers whose most recent move occurred in the past 7 to 12 months. Finally, those whose last move occurred at age 13 or younger were also at an elevated risk. Migration brings about specific risks and needs for youths, including the need for sexual and reproductive health education and services, which should be made available and accessible to new urban residents.

Migration during the formative adolescent years can affect important life‐course transitions, including the initiation of sexual activity. In this study, we use life history calendar data to investigate the relationship between changes in residence and timing of premarital sexual debut among young people in urban Kenya. By age 18, 64 percent of respondents had initiated premarital sex, and 45 percent had moved at least once between the ages of 12 and 18. Results of the event history analysis show that girls and boys who move during early adolescence experience the earliest onset of sexual activity. For adolescent girls, however, other dimensions of migration provide protective effects, with greater numbers of residential changes and residential changes in the last one to three months associated with later sexual initiation. To support young people's ability to navigate the social, economic, and sexual environments that accompany residential change, researchers and policymakers should consider how various dimensions of migration affect sexual activity.

As urbanization continues unabated in Kenya, the wellbeing of the urban poor ‐ whose majority live in slum settlements ‐ will increasingly drive national development indicators including Vision 2030, SDGs and FP2020 goals. It is therefore central to understand and identify ways to address the poor reproductive health outcomes among poor urban slum populations in the country. Taking advantage of APHRC's NCSS surveys conducted in 2000 and 2012 among a representative sample of slum households across Nairobi, we show that there has been a considerable increase in use of modern contraception among women in Nairobi slums, from 34% in 2000 to 53% in 2012, and a reduction in inequity in access through much higher increases among previously disadvantaged groups. Using decomposition analysis techniques, we show that much of the observed increase is due to behavioral changes in the effect of fertility preferences on contraceptive use; and to compositional changes in woman's education, child survival and exposure to FP information. This may be the result of efforts by the government of Kenya and its development partners to reduce the disparities in uptake and use of FP services through various programs and policies targeting the poor segments of the Kenyan population.