More evidence needed for effectiveness of rights-based approach to girls’ sexual, reproductive health

Rights-based intervention seem to be effective at improving sexual and reproductive health among adolescent girls in low- and middle-income countries, a recent systematic review has found. However, the quality of evidence available is highly biased, underscoring the need for further, better-quality investigations.

From the databases of Embase, Web of Science, and Medline, the researchers selected 24 studies eligible for inclusion. Only papers that employed a “rights-based” approach, as defined by the respective authors, or those that explicitly mentioned interventions related to “rights” were considered.

Outcomes were various sexual and reproductive health measures, including gender-based violence, sexually transmitted infections (STIs), pregnancy, mental health, contraceptive/condom use, and healthcare attendance.

Several studies showed a significant increase in the use of condoms following a rights-based intervention. At the same time, knowledge of and testing for HIV and other STIs likewise improved. In all cases, however, evidence was of poor quality and showed high risk of bias.

Similarly, awareness of their rights and healthcare attendance/access during pregnancy and for STIs improved following the intervention, though evidence remained at-risk of bias. No impact on partner violence was reported.

“By synthesizing the evidence base, we have illuminated the evidence gaps and what should be done in future research to improve the quality of the evidence base,” the researchers said. “Future research should be more explicit about the use of rights-based approaches and specify more precisely what distinguishes a rights-based approach from others, in a way that would allow evidence to be gathered.”