Constrained choices? Understanding the help seeking behavior of unmarried young women for sexual and reproductive health needs in a Mumbai slum
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Background: Young unmarried women living in Indian slums are vulnerable to adverse reproductive and sexual health (SRH) outcomes including menstrual problems and poor menstrual hygiene, unwanted pregnancies and STIs, and sexual violence. Their vulnerability to preventable SRH conditions is heightened by their partial and incorrect knowledge of SRH issues, unfavorable societal attitudes towards women, and a paucity of relevant and accessible health services. Objective: This study aims to understand how young unmarried women living in a slum in Mumbai, India perceive and seek help for their sexual and reproductive health needs; identify the sources of help available to them and the challenges mothers and health care providers face in providing help; and propose an intervention plan to enhance the SRH of these young women. Methods: Interviews and focus group discussions were conducted with young unmarried women ages 15-24 years, mothers of young unmarried women, health care providers, and senior staff from non-governmental organizations to understand varying perceptions of young women's SRH needs and help seeking experiences. The data were analyzed using NVivo Version 8. Findings: Young unmarried women perceived menstrual problems, the inability to negotiate romantic relationships, and daily sexual harassment as the main SRH concerns they face, as they significantly interfere with their daily routine and cause emotional distress. Young women's ability and willingness to seek help to address these needs is influenced by a culture of silence that surrounds women's SRH, excessive scrutiny and blaming by the community, and restrictions on their mobility and interactions with peers. The findings underscored the role of mothers as gatekeepers who greatly influence young women's perceptions of SRH and their ability to seek help. Implications: Existing interventions need to be expanded to address young women's need for emotional and social support, and to involve significant gatekeepers such as mothers in promoting the health and wellbeing of young unmarried women in slum communities. This dissertation recommends intervention strategies to enhance the capacity of mothers to recognize, understand, and address their teenage daughters' needs for information, emotional support, and access to essential clinical and social services.
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