Engaging providers, community members, and young women to adapt and pilot a youth-friendly sexual and reproductive health package in low-income communities in India

让服务提供者、社区成员和年轻女性参与，在印度低收入社区调整和试点适合青年的性健康和生殖健康一揽子计划

基本信息

批准号：
10616787
负责人：
Marie Amanda Brault
金额：
$ 13.23万
依托单位：
UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-04 至 2024-05-31
项目状态：
已结题

项目摘要

Project summary/abstract Impoverished adolescent girls and young women (ages 15-25 years) in low- and middle-income countries (LMICs) face inequitable gender norms that limit their educational opportunities, social support, and healthcare access. These inequities also place them at higher risk for maternal morbidity and mortality, psychological trauma, violence, and STIs/HIV. Consistent with these patterns, many young women in India marry early and face similar sexual and reproductive health and rights (SRHR) challenges. Adolescent services in India are unequally distributed leaving marginalized adolescents, including those not in school, without services or access. In 2013, India launched the “Rashtriya Kishor Swasthya Karyakam” (National Adolescent Health Program) framework for improved adolescent health services and education to be provided in the healthcare system and community through adolescent health clubs and adolescent-friendly health clinics. However, implementation of the framework has been uneven, with poor fidelity in the adaptation of programs to make them youth-centered. In this proposal, I will adapt and pilot an integrated community and facility intervention to improve uptake of adolescent-friendly services for married and unmarried AGYW (ages 15-25) in a low-income area with a population of 600,000 in Mumbai, India. Formative research will characterize the SRHR landscape in the study area and adapt the intervention using the systematic ADAPT-ITT approach. The community component will adapt a health curriculum for the peer adolescent health clubs to incorporate participatory activities to build AGYW’s resources and agency, promote use of newly available adolescent services, and obtain participants’ viewpoints and preferences. The facility component consists of adapted sensitization training on adolescent- friendly care for health providers and staff at both public and private clinics in the study area. This hybrid pilot study will assess both implementation outcomes and a pilot set of health/behavioral outcomes including clinic service uptake, contraceptive use, mental health, gender norms/agency, and health knowledge. My longstanding commitment to global health research with adolescent girls and young women has led me to pursue training opportunities to gain experience in international collaborative research projects. This K award builds on my doctoral and post-doctoral training in medical anthropology and adolescent SRHR, and the relationships I have developed with multidisciplinary mentors and organizations in the United States and Mumbai, India. This proposal extends my previous training and K12 work on youth-centered approaches to SRHR communication in the U.S. by providing training in adolescent health quality improvement, implementation science, and advanced quantitative methods in an international context. This K01 award also facilitates my development into an independent global health researcher focused on improving adolescent girls’ health and well-being in low-income communities.

项目概要/摘要低收入和中等收入地区的贫困少女和年轻女性（15-25 岁）中低收入国家（LMIC）面临不平等的性别规范，限制了他们的教育机会、社会支持和这些不平等也使她们面临更高的孕产妇发病率和死亡率风险，心理创伤、暴力和性传播感染/艾滋病毒与这些模式相一致，印度的许多年轻女性。早婚并面临类似的性健康和生殖健康及权利 (SRHR) 挑战。印度的青少年服务分布不均，导致青少年被边缘化，包括那些不在学校，没有服务或通道 2013 年，印度启动了“Rashtriya Kishor Swasthya Karyakam”。（国家青少年健康计划）改善青少年健康服务和教育的框架通过青少年健康俱乐部和青少年友好型组织在医疗保健系统和社区提供然而，该框架的实施并不均衡，适应的保真度较差。使他们以青年为中心的计划。在本提案中，我将调整并试点综合社区和设施干预措施，以改善低收入地区已婚和未婚 AGYW（15-25 岁）接受青少年友好型服务印度孟买有 600,000 人口，形成性研究将描述该地区的 SRHR 景观。研究区域并使用系统的 ADAPT-ITT 方法调整干预措施。将为同伴青少年健康俱乐部调整健康课程，纳入参与性活动，以建立 AGYW 的资源和机构，促进使用新提供的青少年服务，并获得参与者的该设施的组成部分包括针对青少年的适应性宣传培训。该混合试点项目为研究区域的公共和私人诊所的医疗服务提供者和工作人员提供友好的护理。研究将评估结果和健康/行为结果的试点实施集，包括临床服务的采用、避孕药具的使用、心理健康、性别规范/机构和健康知识。我对少女和年轻女性全球健康研究的长期承诺导致我寻求培训机会以获得国际合作研究项目的经验。该奖项建立在我在医学人类学和青少年 SRHR 方面的博士和博士后培训的基础上，以及我与美国的多学科导师和组织建立了关系印度孟买。该提案将我之前关于以青年为中心的方法的培训和 K12 工作扩展到了通过提供青少年健康质量改善培训，在美国进行 SRHR 交流，该K01奖还获得了国际范围内的实施科学和先进定量方法。促进我发展成为一名独立的全球健康研究员，专注于改善少女的健康状况低收入社区的健康和福祉。