“Be kind to young people so they feel at home”: a qualitative study of adolescents’ and service providers’ perceptions of youth-friendly sexual and reproductive health services in Vanuatu (original) (raw)
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BMC Public Health, 2014
Background: Onset of sexual activity during adolescence is common in Vanuatu, however access to comprehensive sexual and reproductive health (SRH) information is limited. Improving adolescents' knowledge about SRH is necessary to improve health outcomes, however little is known about the information needs and preferences of adolescents in the Pacific to inform policy and programs in this region. Methods: Sixty-six focus group discussions were conducted with 341 male and female adolescents aged 15-19 years from rural and urban communities on two islands of Vanuatu. Twelve key-informant interviews were also conducted with policymakers and health service providers. Data were analysed thematically using an inductive approach. Results: Much of the SRH information targeting adolescents focused on sexually transmitted infections and HIV. While this information was valued, important gaps were identified including prevention of pregnancy, condom use, puberty, sexuality and relationships. Peer educators and health workers were adolescents' preferred sources of information because they were considered knowledgeable and trustworthy. Parents were not a common source but were preferred, particularly by girls, despite considerable socio-cultural barriers. Schools were an important but underutilised source of information, as were a range of media sources. Conclusions: Providing adolescents with comprehensive SRH information can have lifelong protective benefits, however there are important content gaps in information currently provided in Vanuatu. The broad range of sources preferred by adolescents highlights the need to strengthen information provision through multiple channels to reach in and out-of-school youth and respond to individual needs and contexts.
International Journal of Research Publication, 2020
This study was purposed to establish the perception of adolescents on sexual and reproductive health services (SRH) in Chipata Township of Lusaka district in Zambia. The study focused on three main thematic areas, including; identification of factors leading to adolescents' taking up of sexual and reproductive health services; determination of barriers to accessing and utilizing SRH services among adolescents, and identification of the role of guardians/parents and health care providers in the access of SRH services by adolescents. As a case study analysis, the study used a qualitative research approach with purposive and convenient sampling as techniques in which 32 participants who were adolescents' boys and girls, health service providers and parents/guardians featured. Research instruments used included in-depth structured interviews. The data were analysed through thematic and content coding of emerging pertinent commonalities in views of participants. The study revealed that among the several factors which lead adolescents to access the sexual and reproductive health services were: fear of getting pregnant; postponement of early marriages, and finding someone to talk and to know more about sexuality. Contrariwise, among the key barriers to service accessibility were negative attitude by health service providers; lack of information on the services and their availability; long waiting hours and long distances to the health centers; lack of confidentiality among health service providers which lead to lack of trust; non-availability of most essential contraceptives in health centers (method mix); cultural norms which prevent adolescents from accessing contraceptives e.g. no sex before marriage and providers being adults only. The study further established that parents and health care service providers play critical roles such as providing and promoting SRH information and offer curative services respectively. The study recommends that government through the Ministry of Health should strengthen training programs in adolescent health for service providers; adolescents and young people should be involved in program planning, service delivery, and information dissemination; strengthening community structures for supportive environment and use of innovative approaches such as social media in delivering social and behavioral change communication (SBCC) rather than the traditional information, education and communication (IEC) materials.
Research Square (Research Square), 2020
Background: In Ethiopia, lowest utilization of adolescent friendly sexual and reproductive health services (AFSRHs) is recorded among Sub-Saharan African countries. Little is known why adolescents were not accessing the existing services to the side of healthcare providers. Objective: The aim of this study is to explore contextual perceived and actual barriers to accessing AFSRHs by adolescents in Southern Ethiopia. Methods: Phenomenological study design supplemented with observation was used to explore perceived and actual barriers to accessing AFSRHs in 2020. Criterion sampling was used to select study participants. In-depth interviews with key healthcare providers and non-specialist sexual and reproductive health providers were conducted. Transcribed interviews and observation were imported to Open Code 4.02 for coding, categorizing codes, and creating themes. Finally, barriers to assessing the services were explained using thematic analysis. Results: The study explores contextual barriers to accessing sexual and reproductive health services in ve emergent themes. According to providers' view, barriers include ranging from providers (e.g poor providers' competency), health facility (e.g. supply constraints and unsupportive environment), adolescents (e.g perceived lack of information and attitude towards SRHs), community (e.g. lack of parental and social support), and broader health system (e.g. poor implementation and multi-sectorial engagement). Conclusion: As to providers, adolescents face multiple barriers to accessing youth friendly sexual and reproductive health services. Healthcare facilities and the health systems should implement varieties of approaches to increase access to the services for adolescents. The existing strategies should be reevaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.
BMJ Open
IntroductionAdolescence and early adulthood are often critical periods of sexual development. The discovery of sexual intercourse can lead to sexual risk-taking which may impact the incidence of sexually transmitted infections (STIs) and unwanted pregnancies. Despite available sexual health services on Reunion Island, sexual health indicators for adolescents are very poor showing a high number of teenage pregnancies and abortions, low use of contraception and an upsurge of STIs. In contrast, this French region is equipped with many services and resources that enable young adults to make informed sexual health choices. This study protocol describes the methodology to describe adolescent experiences of using sexual health services on Reunion Island.Methods and analysisA monocentric descriptive qualitative study using a phenomenological approach will be conducted from December 2022 to August 2023 and will be based on face-to-face semistructured interviews with participants aged 15–19 y...
PLOS ONE, 2023
Background The number of young people utilising sexual and reproductive health services in Pacific Island Countries and Territories remains poor despite the availability and the existence of the fundamental rights to access these services. Adolescents and youth need accurate information and timely access to contraceptives to prevent adverse consequences associated with unintended pregnancies, abortion, childbirth and untreated sexually transmitted infections. This scoping review identifies and analyses factors contributing to young people's low access to sexual and reproductive health information and services in this region. Methods Guided by the PRISMA Scoping review guidelines, we searched three databases (Medline Ovid, Scopus and CINAHL Complete) for peer-reviewed articles published between 1 st January 2000 and 31 st August 2020 that reported on factors, including barriers and enablers, affecting access to sexual and reproductive health information and services by young people living in Pacific Island Countries and Territories. We assessed the quality of each study according to the study designs, methods of data collection, data analysis and ethical considerations. All information was sorted and organised using an Excel Spreadsheet. Text data from published articles were charted inductively using thematic analysis with no predetermined codes and themes. Findings Five hundred eighty-nine articles were screened, and only eight met the inclusion criteria outlined in this scoping review protocol. These eight articles reported studies conducted in
Youths’ Perceptions Regarding Access to Sexual and Reproductive Health Services
Pacific Rim International Journal of Nursing Research
Sexual and reproductive health services in Thailand have been provided in accordance with a national policy and strategic plan, but youths’ sexual and reproductive health problems remain relatively high. A significant problem is youths’ low access to appropriate services. This paper reports the first qualitative descriptive phase of participatory action research project, which aimed to develop a model for improving access to sexual and reproductive health services among youths. The study’s purpose was to explore perceptions of youths regarding access to sexual and reproductive health services in northern Thailand. Qualitative data were collected from September 2019 to March 2020 through focus group discussions with 59 youths aged 15-24 years and in-depth interviews with four youths who had experienced an adolescent pregnancy. All participants were purposively recruited and volunteered. The data were recorded, transcribed verbatim, and analyzed using content analysis.Reflecting facto...
Research Square (Research Square), 2020
Background: Access and utilization of quality and comprehensive sexual and reproductive health services (SRHS) is crucial for the health of young adolescents worldwide. This study assessed the quality of SRHS provided to Rwandan adolescents in urban health facilities in terms of availability, accessibility, cost, and counseling, with particular emphasis on HIV and family planning-related education. Method: The study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach, including semi-structured questionnaire administration and in-depth interviews with 159 conveniently selected SRH services providers. All survey tools had been previously validated. SPSS version 20 was used for descriptive statistical analysis of quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically. Results: Overall, the availability of adolescent SRHS is satisfactory in more than 80% of health facilities surveyed, including access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV, and counselling. However the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. In-depth interviews revealed that 94.3% of centers provide information to adolescents on SRHS available and 51.6% affirmed delivering services at a low cost. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Private health facilities offer HIV testing for free, but for treatment and other services, they channel adolescents to public health facilities. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities. Religious leaders and family members may hinder adolescents from seeking behavior by promoting only abstinence and discouraging using protective means. Conclusion: SRHS were generally available for distribution to adolescents at most of the facilities but limited in access. Adolescents were said to face structural and social challenges towards accessing services. There is a need to improve the accessibility of SRH services delivery sites while considering
Adolescents perception of reproductive health care services in Sri Lanka
BMC health services research, 2008
Background: Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery.
National Adolescent Sexual and Reproductive Health Programme: Mid-Term Evaluation Report
Annex 1. Semi-Structured Interview Guide 37 Annex 2. Focus Group Discussion Guide 38 Annex 3. Peer Ethnography Guide 39 Annex 4. Observation Checklist 40 Although the School Health Programme and the training of peer educators do not form part of the ASRH Programme, health workers mentioned these activities as part of it. They said that these activities have created awareness about ASRH services, which suggests that there should be more coordination between the ASRH Programme and programmes at the school level to create demand for ASRH services among adolescents. Key finding 1: All health workers are aware of the National ASRH Programme and its components, except for a few who said that the programme is only about delivering family planning and maternal health services. While the School Health Programme and the training of peer educators are not part of the National ASRH Programme, health workers stressed that these are effective ways to share about the ASRH services available at health facilities. Health workers were asked what activities have been undertaken to implement the ASRH Programme in their health facilities. In all facilities, health workers reported attending orientations, distributing IEC materials and making physical changes to the facilities, such as erecting curtains for privacy. Facilities had also organised orientations for the members of the health facility operation and management committee (HFOMC), female community health volunteers (FCHVs), students, teachers and members of the village development committee. Researchers observed that all of the health facilities had AFS boards displayed in visible places, except for Doti Hospital. Most HFOMCs did not have any adolescent members although some health workers remembered that adolescents had been members on previous committees. Some health workers mentioned schools, the community and peer educators as important in reaching out to adolescents and imparting SRH messages. Key finding 2: Health facilities have oriented selected FCHVs, teachers and other people in the village development committee about the National ASRH programme and health workers perceive community awareness to be a key factor in facilitating adolescents' access to SRH services. The study also looked at how health workers are recording and reporting data on the ASRH Programme and what difficulties they face in doing so. Health workers stated that they complete the monthly reporting form for the ASRH Programme by referring to different registers and send the data along with the HMIS 32 form. Some health workers said that it is difficult for them to keep records because they have to look through several registers and suggested a separate recording format for the ASRH Programme. Irregular reporting appeared to be an issue, as was lack of follow-up or refresher training. In relation to monitoring, health workers reported that GIZ/GFA staff visited the facilities along with the focal person from the District (Public) Health Office. The issue of limited resources was raised in the interviews-there is no budget to visit health facilities under the programme. An annual review at the district level was suggested by health workers to enable them to address the difficulties and challenges in implementing the ASRH Programme. Key finding 3: The recording and reporting of the ASRH Programme has not been regular and consistent. Health workers mentioned not having a separate recording register for the programme and suggested that the programme be included in the HMIS 32 (monthly reporting format).