scholarly journals Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lesley Rose Ninsiima ◽  
Isabel Kazanga Chiumia ◽  
Rawlance Ndejjo

Abstract Background Despite the global agreements on adolescents’ sexual and reproductive health and rights, access to and utilisation of these services among the youth/adolescents remain unsatisfactory in low- and middle-income countries which are a significant barrier to progress in this area. This review established factors influencing access and utilisation of youth-friendly sexual and reproductive health services (YFSRHS) among the youth in sub-Saharan Africa to inform programmatic interventions. Methodology A systematic review of studies published between January 2009 and April 2019 using PubMed, Web of Science, EMBASE, Medline, and Cochrane Library, and Google Scholar databases was conducted. Studies were screened based on the inclusion criteria of barriers and facilitators of implementation of YFSRHS, existing national policies on provision of YFSRHS, and youth’s perspectives on these services. Findings A total of 23,400 studies were identified through database search and additional 5 studies from other sources. After the full-text screening, 20 studies from 7 countries met the inclusion criteria and were included in the final review. Structural barriers were the negative attitude of health workers and their being unskilled and individual barriers included lack of knowledge among youth regarding YFSRHS. Facilitators of utilisation of the services were mostly structural in nature which included community outreaches, health education, and policy recommendations to improve implementation of the quality of health services and clinics for adolescents/youth to fit their needs and preferences. Conclusion Stakeholder interventions focusing on implementing YFSRHS should aim at intensive training of health workers and put in place quality implementation standard guidelines in clinics to offer services according to youth’s needs and preferences. In addition, educating the youth through community outreaches and health education programs for those in schools can facilitate utilisation and scale up of the service.

2021 ◽  
Vol 9 (01) ◽  
pp. 100-115
Author(s):  
Bhabani Adhikari ◽  
Ramesh Adhikari

This study has attempted to assess the access and utilization of youth-friendly sexual and reproductive health services in Nepal. Different literature regarding youth-friendly sexual and reproductive health services has been reviewed using online databases. A total of 125 relevant articles were assessed for the study. The literature was categorized and analyzed with five key thematic areas: knowledge on SRH among youths, the prevalence of child marriage and teenage pregnancy, attitudes towards premarital sex, utilization of SRHs, and barriers to utilizing the SRHS. This study has found that youths do not always utilize SRHS. Various barriers exist for providing and using YFSRHs in Nepal. Nepal's adolescents and youths face problems of STIs, HIV/AIDS, early pregnancy and parenthood, difficulties accessing contraception, and safe abortion. The study has also found that many countries have single youth-friendly sexual and reproductive health policies and that utilization of SRHS is also high in those countries. Moreover, this review has also found that because of inadequate knowledge and information on SRHS, Nepalese youths are facing numerous reproductive health problems. Multiple factors contribute as barriers to utilizing the SRHS. Therefore, there is a need for a program to motivate youths to respect their right to access reproductive health information and service, ensure the availability of peer counselors in the health centers, and increase the awareness level of the community so that they can utilize the quality of SRHS.


2021 ◽  
Author(s):  
Yitagesu Habtu ◽  
Mirgissa Kaba ◽  
Hussen Mekonnen

Abstract Background: In Ethiopia, the utilization coverage of adolescent-friendly health services (AFSRHs) ranged only from 9% to 55% and it was the lowest of all Sub-Saharan African countries in 2016. 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 healthcare providers and non-specialist sexual and reproductive healthcare providers were conducted. Transcribed interviews and observations were imported to Open Code 4.02 for coding, categorizing, and creating themes. Finally, barriers to accessing existing services were explained using thematic analysis. Results: The study explores contextual barriers to accessing sexual and reproductive health services in five emergent themes. According to providers’ points of view, the barriers include ranging from providers (e.g poor providers’ competency), health facilities (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 all levels of the healthcare system should implement varieties of approaches to increase access to the services for adolescents. Given the lack of progress in utilization of adolescents- youth friendly sexual and reproductive services, the existing strategy should be re-evaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.


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