Independent Consultant, Nairobi, Kenya.
Population Council, One Dag Hammarskjold Plaza, New York, NY, 10017, USA.
J Urban Health. 2023 Jun;100(3):525-561. doi: 10.1007/s11524-023-00724-z. Epub 2023 Apr 13.
By 2050, the Global South will contain three-quarters of the world's urban inhabitants, yet no standardized categorizations of urban areas exist. This makes it challenging to compare sub-groups within cities. Sexual and reproductive health and rights (SRHR) are a critical component of ensuring that populations are healthy and productive, yet SRHR outcomes within and across urban settings vary significantly. A scoping review of the literature (2010-2022) was conducted to describe the current body of evidence on SRHR in urban settings in the Global South, understand disparities, and highlight promising approaches to improving urban SRHR outcomes. A total of 115 studies were identified, most from Kenya (30 articles; 26%), Nigeria (15; 13%), and India (16; 14%), focusing on family planning (56; 49%) and HIV/STIs (43; 37%). Findings suggest significant variation in access to services, and challenges such as gender inequality, safety, and precarious circumstances in employment and housing. Many of the studies (n = 84; 80%) focus on individual-level risks and do not consider how neighborhood environments, concentrated poverty, and social exclusion shape behaviors and norms related to SRHR. Research gaps in uniformly categorizing urban areas and key aspects of the urban environment make it challenging to understand the heterogeneity of urban environments, populations, and SRHR outcomes and compare across studies. Findings from this review may inform the development of holistic programs and policies targeting structural barriers to SRHR in urban environments to ensure services are inclusive, equitably available and accessible, and direct future research to fill identified gaps.
到 2050 年,全球南方将容纳四分之三的世界城市居民,但目前还没有对城市地区进行标准化分类。这使得比较城市内部的亚群变得具有挑战性。性健康和生殖健康及权利(SRHR)是确保人口健康和生产力的关键组成部分,但城市环境中的 SRHR 结果存在显著差异。本研究对文献(2010-2022 年)进行了范围综述,以描述目前有关全球南方城市环境中 SRHR 的证据,了解差异,并强调改善城市 SRHR 结果的有前途的方法。共确定了 115 项研究,其中大部分来自肯尼亚(30 篇文章;26%)、尼日利亚(15 篇;13%)和印度(16 篇;14%),主要集中在计划生育(56 篇;49%)和艾滋病毒/性传播感染(43 篇;37%)。研究结果表明,在获得服务方面存在显著差异,同时还存在性别不平等、安全问题以及就业和住房不稳定等挑战。许多研究(n=84;80%)侧重于个体层面的风险,而没有考虑到邻里环境、集中贫困和社会排斥如何塑造与 SRHR 相关的行为和规范。在统一分类城市地区和城市环境的关键方面存在研究空白,这使得难以理解城市环境、人口和 SRHR 结果的异质性,并对研究进行比较。本综述的研究结果可能为制定针对城市环境中 SRHR 的全面计划和政策提供信息,以确保服务具有包容性、公平地提供和获取,并指导未来的研究以填补已确定的空白。
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