McGranahan, Majel, Nakyeyune, Joselyn, Baguma, Christopher, Musisi, Nakibuuka Noor, Nsibirwa, Derrick, Sekalala, Sharifah and Oyebode, Oyinlola (2021) Rights based approaches to sexual and reproductive health in low and middle-income countries : a systematic review. PLoS One, 16 (4). e0250976. doi:10.1371/journal.pone.0250976 ISSN 1932-6203.

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Abstract

Introduction:
The Sustainable Development Goals, which are grounded in human rights, involve empowering women and girls and ensuring that everyone can access sexual and reproductive health and rights (Goal 5). This is the first systematic review reporting interventions involving rights-based approaches for sexual and reproductive health issues including gender-based violence, maternity, HIV and sexually transmitted infections in low and middle-income countries.

Aims:
To describe the evidence on rights-based approaches to sexual and reproductive health in low and middle-income countries.

Methods:
EMBASE, MEDLINE and Web of Science were searched until 9/1/2020. Inclusion criteria were:

Study design: any interventional study.
Population: females aged over 15 living in low and middle-income countries.
Intervention: a “rights-based approach” (defined by the author) and/or interventions that the author explicitly stated related to "rights".
Comparator: clusters in which no intervention or fewer components of an intervention were in place, or individuals not exposed to interventions, or exposed to fewer intervention components.
Outcome: Sexual and reproductive health related outcomes.
A narrative synthesis of included studies was undertaken, and outcomes mapped to identify evidence gaps.

The systematic review protocol was registered on PROSPERO (CRD42019158950).

Results:
Database searching identified 17,212 records, and 13,404 studies remained after de-duplication. Twenty-four studies were included after title and abstract, full-text and reference-list screening by two authors independently.

Rights-based interventions were effective for some included outcomes, but evidence was of poor quality. Testing uptake for HIV and/or other sexually transmitted infections, condom use, and awareness of rights improved with intervention, but all relevant studies were at high, critical or serious risk of bias. No study included gender-based violence outcomes.

Conclusion:
Considerable risk of bias in all studies means results must be interpreted with caution. High-quality controlled studies are needed urgently in this area.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RG Gynecology and obstetrics
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Social Sciences > School of Law Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Sexual health , Sexual health -- Developing countries, Reproductive health , Reproductive health -- Developing countries
Journal or Publication Title:	PLoS One
Publisher:	Public Library of Science
ISSN:	1932-6203
Official Date:	29 April 2021
Dates:	Date Event 29 April 2021 Published 18 April 2021 Accepted
Volume:	16
Number:	4
Article Number:	e0250976
DOI:	10.1371/journal.pone.0250976
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	15 September 2021
Date of first compliant Open Access:	17 September 2021
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID UNSPECIFIED University of Warwick http://dx.doi.org/10.13039/501100000741 UNSPECIFIED Health Education England http://viaf.org/viaf/305200827 UNSPECIFIED National Institute for Health Research http://dx.doi.org/10.13039/501100000272

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