Healthcare providers balancing norms and practice : challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study

BACKGROUND: Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. OBJECTIVE: This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. DESIGN: We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. RESULTS: The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. CONCLUSIONS: Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in-service training including value clarification and attitude transformation to equip providers to be able to better cater to young people seeking sexual and reproductive health advice.

Sex, a one mans show : Perceptions and experience of sexuality, contraceptives, unwanted pregnancy and unsafe abortion among young people in Kisumu, Kenya – A qualitative study

This study aimed to explore perceptions and experiences concerning sexuality, contraceptives, unwanted pregnancy and unsafe abortion among young people in Kisumu, Kenya. The design of the study was inductive with a qualitative approach using personal in-depth interviews. Eight participants (four female and four male) were asked to describe their perceptions and experience concerning sexuality, contraceptives, unwanted pregnancies and unsafe abortion. The result showed that culture and norms, misconceptions and gender based power in sexuality are factors that impact Sexual Reproductive Health among young people in Kisumu today. Unwanted pregnancy was described as a shame, a burden and a destroyed life which lead to many unsafely induced abortions. The findings indicate that youth interventions are important, such as engaging young men in unwanted pregnancy and thus unsafe abortions and to empower young women.

What Counts as Young People's Civic Engagement in Times of Accountability? : On the Importance of Maintaining Openness about Young People's Civic Engagement in Education

One aspect of the ICCS study's measurement of young people's citizen competence is 'civic engagement'. In this article it is argued that even though the study's assessment captures important aspects of young people's civic engagement, too strong educational reliance on it may contribute to meagreness in the educaitonal assignment to see to an engaged citizenry. By providing deeper insight into the ICCS study's assessment rationale, and by presenting qualitatively derived examples of young people's civic engagement, it is suggested that in order to see to fruitful ways of approaching the educational task of providing for young people's civic engagement, we need to maintain openness to different depictions of civic engagement. Among them those that matter as such for the young people themselves in and through the social and material practices they take part in.

Are schools able to bring sense into pupils' lives? - an experiment to use Antonovsky's concept sense of coherence from a school perspective. : Paper presented at the ENIRDEM conference in Kilkenny, Ireland 26th-29th September, 2002

Young people now spend a longer and longer period of their lives at school then ever before. Not always because that they want to, but because society has nothing else to offer. The situation in many schools may also, in different aspects, be seen as highly problematic. Andersson (2001) has, for example, found in a large longitudinal study - The Life Project – that schools seem to be adapted to the needs of only a minority of the students - around 30%. On the other hand school is badly adjusted to the requirements of another 30 %. This group of students often find school meaningless, uninteresting and boring. For these students school is mostly a waste of time. In such circumstances, it seems natural that society has a responsibility to offer young people a meaningful time at school, both here and now and to prepare them for a future live as adults, not only as a part of the work force.As a part of departure I briefly describe the model that Antonovsky has developed and try to use it in a school context instead. I have here, of course, no possibility to make a deeper analysis of a complex problem such as this.In Antonovsky’s spirit, using a salutogenic perspective, instead of asking ourselves why do pupils fail or perhaps also not like being at school we have to ask, instead: What it is that makes pupils successful? From this background the purpose of this paper is to discuss some aspects of how pupils may use different strategies to handle their school situation in a proper way.

The Key Role of the School Principal’s Leadership in the Schooling of Newly Arrived Immigrant Pupils in Sweden : Experiences from an Interactive Action Research Project

When newly immigrated children and young people begin school in Sweden, certain challengesarise. These may result from weak Swedish-language skills and different schooling backgrounds,as well as organizational and pedagogical limitations in the schools. This generates demands onschool leaders to lead and develop the organization and teachers competences to meet these pupils’needs. This situation was behind the initiation of the project “New Immigrants and Learning—Competence Development for Teachers and School Principals.” The project ran in schools infour Swedish municipalities, its aim was to develop leadership, organizational and pedagogicalskills that would facilitate the schooling and integration of newly arrived pupils. This article aimsto describe and discuss a Participant Action Research (PAR) based on a think tank and researchcircles, drawing special attention to the role of the school leaders. It will also examine whether theresearch circles and the project overall served to develop educational and intercultural leadership,organizational conditions, collegial learning, pedagogical methods and competence in terms ofschooling for this pupil group.