scholarly journals Transition into the sexual and reproductive role: a qualitative exploration of Iranian married adolescent girls’ needs and experiences

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Shahnaz Kohan ◽  
Shirin Allahverdizadeh ◽  
Ziba Farajzadegan ◽  
Morteza Ghojazadeh ◽  
Zahra Boroumandfar

Abstract Background It is necessary to invest in married adolescent girls’ health because of their roles in promoting the community and health of the next generation. Meanwhile, there are many concerns about their sexual and reproductive health. The International Conference on Population and Development emphasized the importance of access to adolescent girls to reproductive health services and counseling. In Iran, about 24% of registered marriages are to girls under 19, while their sexual and reproductive health needs have neglected. Therefore, this study aimed to identify married adolescent girls’ reproductive and sexual needs. Methods/design Data were obtained through in-depth, semi-structured individual interviews with 36 participants, including 11 women who got married at 10 to 21 years of age, two mothers whose daughters were married in adolescence, and 23 healthcare providers and policymakers. The participants were selected through purposive sampling with maximum variation. Data collection continued until data saturation. The interviews were analyzed by qualitative content analysis. Similar codes were merged, and sub-categorization was performed, whereby similar categories were combined until the main categories that emerged. Results The results revealed five main categories: preparing for marriage, enhancing awareness and decision—making power on sexual and reproductive health issues, developing adolescent-friendly sexual and reproductive services, providing tailored pregnancy and childbirth services, and preparing adolescents for motherhood. Conclusion Adolescents step into marital life without the required life skills or physical and mental preparedness. They often become pregnant due to social pressures and lack of access to contraception. Therefore, in countries like Iran, where there is a high frequency of early marriage, families, education, and the health system should prepare the necessary foundation to support these adolescents and provide tailored and comprehensive sexual and reproductive health services.

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
A. Metin Gülmezoglu ◽  
Anne Ammerdorffer ◽  
Manjulaa Narasimhan ◽  
Alyce N. Wilson ◽  
Joshua P. Vogel ◽  
...  

Abstract Self-care interventions and remote care offer innovative and equitable ways to strengthen access to sexual and reproductive health services. Self-isolation during COVID-19 provided the opportunity for obstetric facilities and healthcare providers to integrate and increase the usage of interventions for self-care and remote care for pregnant women and to improve the quality of care overall.


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.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yitagesu Habtu ◽  
Mirgissa Kaba ◽  
Hussein 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.


2020 ◽  
Author(s):  
Yitagesu Habtu ◽  
Mirgissa Kaba ◽  
Hussen Mekonnen

Abstract 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 five 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 re-evaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.


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

Abstract 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 five 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 re-evaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.


2021 ◽  
Author(s):  
mwifadhi mrisho ◽  
Michaela Mantel ◽  
Abdunoor M Kabanywanyi ◽  
Bakar Fakih ◽  
Manzi Fatuma ◽  
...  

Abstract Background Teenage marriage and adolescent pregnancy present a significant health challenge in the Tanzania. About 36% of women aged 15-49 are married before the age of 18, and 32% of rural adolescents (10-19 years) gave birth, compared with 19% of urban. In Mwanza region, one third of currently married adolescent and women aged 15-49 experienced unmet need for family planning and had low use of modern contraceptives. Here we present a study that explored the gaps in accessing and utilization of quality adolescent sexual and reproductive health services (ASRH). Methods This was a descriptive and exploratory cross-sectional formative study utilizing multiple qualitative research methods. Purposive sampling was used to select an urban district (Nyamagana), rural district (Magu) and an island (Ukerewe). Sixty-seven IDI and 30 focus group discussions (FGDs) stratified by gender (12 out-of-school, 12 in-school), and (3 male, 3 female adults) were purposefully sampled. Vignettes were done with 15-19 years old in-school and out-of-schools boys and girls. An experienced moderator, along with a note-taker, led the discussions while taking notes. The FGDs were recorded using an MP3 voice recorder. Thematic analysis approach was undertaken and data was analysed using NVivo 12, a qualitative software. Results The identified the most important pressing needs of the adolescents in relation to SRH. Adolescent girls needed specific services such as counselling on menstrual health, sexual consent, HIV/AIDS, and prevention of pregnancies. Sanitary pads during menstrual period were very important pressing need of the adolescent girls. Adolescents both girls and boys preferred to receiving friendly health care services in a respectful manner. Girls mentioned that they would like to receive SRH support from nurses in health facilities, mothers, sisters, aunties and friends. With regards to boys, they preferred to receive the SRH from health care providers followed with their peer’s friends. Several obstacles were reported to hinder access to SRHS predominantly among the adolescent girls as compared to the boys. Poor infrastructure tended to impair the privacy at the health facilities, and rarely there were specific buildings to provide friendly adolescent sexual and reproductive health services. Conclusions The strategies to guide delivery of ASRH should involve the inclusion of duty bearers, promotion of friendly health care services where health workers provide services in friendly-manner, provision of ASRH education for awareness creation to adolescents and supportive parents/ care takers.


2020 ◽  
Author(s):  
Pacifique Ndayishimiye ◽  
Rosine Uwase ◽  
Isabelle Kubwimana ◽  
Jean de la Croix Niyonzima ◽  
Roseline Dine Dzekem ◽  
...  

Abstract Background : Access and utilization of quality and comprehensive sexual and reproductive health services (SRHS) is a very crucial point for young adolescents worldwide. This study assessed the quality of SRHS provided to Rwandan adolescents in urban health facilities in terms of availability, accessibility, cost, counseling, with particular emphasis on HIV and family planning-related cases. Method : The study was a descriptive cross-sectional survey conducted during the year 2019 in six selected cities of Rwanda using a mixed-methods approach, including s emi-structured questionnaire administration and in-depth interviews with social and healthcare workers. The study sample consisted of 159 social and healthcare providers ( 54.5 % men and 45.5% women) enrolled by convenience based on their responsibilities in the selected entities. All survey tools were pre-tested. SPSS version 20 served for descriptive statistics analysis of quantitative data, whereas ATLAS TI version 5.2 helped to code and analyze the qualitative data thematically. Results : Overall, the availability of adolescents sexual reproductive health services is satisfactory in more than 80% of health facilities surveyed, but the accessibility is a little bit low for some services. According to the respondents dire, some products available like female condoms are less demanded and often expire unused. 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. Conclusion : SRHS were generally physically available at most of the facilities but limited in access as not all facilities were allowed to deliver some services. 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 innovative methods to broaden access to services.


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