scholarly journals Access to information and use of adolescent sexual reproductive health services: Qualitative exploration of barriers and facilitators in Kisumu and Kakamega, Kenya

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241985
Author(s):  
Lilian Mutea ◽  
Susan Ontiri ◽  
Francis Kadiri ◽  
Kristien Michielesen ◽  
Peter Gichangi
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Health Information ◽  
Adolescent Health ◽  
Health Workers ◽  
Cultural Influences ◽  
Health Problems ◽  
Reproductive Health Services ◽  
Sustainable Solutions ◽  
Sexual Reproductive Health

Background Kenya has a high prevalence of adolescent pregnancy and low access to and use of adolescent sexual reproductive health services. Despite the enactment of evidence-based policies to address this problem, adolescents continue to face health problems and barriers to adolescent sexual reproductive health information and services. Main objective This study describes barriers to and facilitators of access to adolescent sexual and reproductive health services in Kisumu and Kakamega counties, Kenya. Methodology We used a qualitative design. Through 61 data collection sessions, 113 participants were engaged in key informant interviews, in-depth interviews, and/or focus group discussions. Trained Research Assistants (RAs) engaged adolescents, health care workers, teachers, county leaders, and community representatives. Data were captured using audio recorders and field notes. Socio-demographic data were analyzed for descriptive statistics, while audio recordings were transcribed, translated, and coded. Thematic analysis was done with NVivo. Results Findings show that the barriers of access to sexual reproductive health services and information were negative health workers’ attitudes, distance to the health facility, unaffordable cost of services, negative social cultural influences, lack of privacy and confidentiality. Facilitators to adolescent sexual reproductive health services were few and included getting priority for school going adolescents and enabling environment for partnerships on adolescent health issues. Conclusions Adolescents in Kakamega and Kisumu face a myriad of barriers when seeking sexual reproductive health information and/or health services. We recommend that counties sensitize all stakeholders on adolescent sexual reproductive health problems, and support development of multi-sectoral, sustainable solutions to adolescent health needs.

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
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Health Workers ◽  
Sub Saharan Africa ◽  
Inclusion Criteria ◽  
Reproductive Health Services ◽  
Factors Influencing ◽  
Sub Saharan ◽  
Youth Friendly

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.

School-Level Efforts to Address Sexual Health and Risky Sexual Behavior Among Students in Texas Alternative High Schools

2020 ◽  
pp. 105984052095043
Author(s):  
Karen E. Johnson ◽  
Kathryn L. Conn ◽  
Cynthia Osborne ◽  
Kelly L. Wilson ◽  
Lynn Rew
Keyword(s):  
High Schools ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual Risk ◽  
Risk Behaviors ◽  
Sexuality Education ◽  
Sexual Risk Behaviors ◽  
Alternative High Schools ◽  
Reproductive Health Services ◽  
Sexual Reproductive Health

We compared sexual/reproductive health services and sexuality education topics provided in Texas alternative high schools (AHSs) with the prevalence of sexual risk behaviors among students in AHS. Using cross-sectional data from convenience samples of 14 principals, 14 lead health educators, and 515 students, we calculated descriptive statistics for 20 services and 15 sexuality education topics provided by AHSs and seven sexual risk behaviors among students in AHS. AHSs provided few sexual/reproductive health services and limited educational content, despite high levels of sexual risk taking among students. For example, no AHSs taught students about proper condom use, yet 84% of students have had sex. Findings provide preliminary evidence of unmet needs for school-based sexual/reproductive health services and comprehensive sexuality education in AHS settings. Future investigation with larger, representative samples is needed to assess the provision of sexual/reproductive health services and sexuality education in AHSs and monitor sexual risk behaviors in the AHS population.

scholarly journals Do home pregnancy tests bring women to community health workers for antenatal care counselling? A randomized controlled trial in Madagascar

2019 ◽  
Vol 34 (8) ◽  
pp. 566-573
Author(s):  
Alison B Comfort ◽  
Randall C Juras ◽  
Sarah E K Bradley ◽  
Justin Ranjalahy Rasolofomanana ◽  
Anja Noeliarivelo Ranjalahy ◽  
...  
Keyword(s):  
At Risk ◽  
Randomized Controlled Trial ◽  
Reproductive Health ◽  
Health Services ◽  
Antenatal Care ◽  
Health Workers ◽  
Controlled Trial ◽  
Control Group ◽  
Reproductive Health Services ◽  
Randomized Controlled

Abstract Task-shifting the provision of pregnancy tests to community health workers (CHWs) in low-resource settings has the potential to reach significantly more underserved women at risk of pregnancy with essential reproductive health services. This study assessed whether an intervention to supply CHWs with home pregnancy tests brought more clients for antenatal care (ANC) counselling. We implemented a randomized controlled trial among CHWs providing reproductive health services to women in Eastern Madagascar. We used ordinary least squares regressions to estimate the effect of the intervention, with district- and month-fixed effects and CHW baseline characteristics as control variables. Our outcomes of interest included whether the intervention increased: (1) the number of women at risk of pregnancy who sought services from CHWs; (2) the number of these women who knew they were pregnant by the end of visit; and (3) the number of these women who received ANC counselling during visit. We found that providing pregnancy tests to CHWs to distribute to their clients for free significantly increased the number of women at risk of pregnancy who sought services from CHWs. At follow-up, treatment-group CHWs provided services to 6.3 clients compared with 4.2 clients among control-group CHWs, which represents a 50% relative increase from the control-group mean. A significantly higher number of these clients knew they were pregnant by the end of the visit, with a mean of 0.95 in treatment compared with 0.10 in control (Coeff. 0.86; 95% CI 0.59–1.13). A significantly higher number of these clients received antenatal counselling at the visit (Coeff. 0.4; 95% CI 0.14–0.64). Introducing free home pregnancy tests as part of community-based health services can improve pregnancy care by attracting more clients at risk of pregnancy to services at the community level, enabling more women to confirm they are pregnant and receive antenatal counselling.

Sexual and Reproductive Health Services and Related Health Information on Pregnancy Resource Center Websites: A Statewide Content Analysis

2018 ◽  
Vol 28 (1) ◽  
pp. 14-20 ◽  
Author(s):  
Andrea Swartzendruber ◽  
Anna Newton-Levinson ◽  
Ashley E. Feuchs ◽  
Ashley L. Phillips ◽  
Jennifer Hickey ◽  
...  
Keyword(s):  
Content Analysis ◽  
Reproductive Health ◽  
Health Services ◽  
Health Information ◽  
Sexual And Reproductive Health ◽  
Reproductive Health Services ◽  
Resource Center

scholarly journals Perceptions and barriers toward sexual reproductive health services accessibility, availability and quality among adolescents in selected cities of Rwanda

2020 ◽  
Author(s):  
Pacifique Ndayishimiye ◽  
Roseline Dzekem Dine ◽  
Aline Dukuze ◽  
Isabelle Kubwimana ◽  
Jean Baptiste Nyandwi ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Health Services Accessibility ◽  
Community Outreach ◽  
Health Facilities ◽  
School Level ◽  
Female Participant ◽  
Reproductive Health Services ◽  
Cross Sectional ◽  
Sexual Reproductive Health

Abstract Background: A fifth of the global population is made up of adolescents. Sexual reproductive health needs for young people is largely ignored by existing health, education and other social programs. In Rwanda, there is still an increase in teen pregnancies, HIV/ STIs as well as reports on the lack of access to accurate SRH information. The study aimed to explore the perceptions and barriers toward sexual reproductive health services accessibility, availability and quality among adolescents in the second cities of Rwanda.Methods: Cross-sectional study was conducted in six selected cities of Rwanda. In-depth interviews were conducted using semi-structured questionnaires among 121 adolescents aged 10-19 years old living in six selected cities.Results : Majority of the participants were female 62.8% and aged between 15-17 years old 32.8%. Females adolescents were more aware, and adolescents with primary school level 62.5% were not aware about SRH services provision at health facilities. Adolescents were mostly aware about the availability of HIV testing and circumcision services at 102 ( 86.4%). Results indicate that utilization of SRH services remains low (34.7%) among adolescents. A recent utilization of a particular service was linked to a use in the past: “I am aware of my HIV status because I was tested when I was going to receive a transfusion at a hospital” (Female participant, Rwamagana). Family, socio-cultural, religious influences and lack of privacy, high costs for the services, unavailability of some services at private facilities as well as lack of comfortable separated rooms, were the barriers reported by adolescents that prevented them from utilising SRH services.Conclusion : Accessibility to SRH services for adolescents remains low and SRH services provision doesn’t offer confidentiality to adolescents who seek services at health facilities. Family influences, socio-cultural stigma and religious barriers remain a burden to adolescents’ SRH services utilization. Increasing community outreach and adolescent’s engagement is needed to enable access to accurate SRH information. Multidisciplinary stakeholders should collaborate and cooperate to address the stigma associated with access to SRH services for adolescents.

Adolescent Sexual Reproductive Health Services in Bindura Urban of Zimbabwe

2019 ◽  
Vol 9 (2) ◽  
pp. 1-20
Author(s):  
Jeffrey Kurebwa
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Healthcare Providers ◽  
Cultural Norms ◽  
Service Utilisation ◽  
Reproductive Health Services ◽  
Factors Associated ◽  
Moral Framework ◽  
Sexual Reproductive Health ◽  
Norms And Values

This study seeks to understand the capacity of adolescent-friendly reproductive health services (AFRHS) in promoting sexual reproductive health (SRP) among adolescents in Bindura Urban of Zimbabwe. The data collection methods used allowed the researcher to get insight on adolescents' experience and the factors associated with their accessing SRH services from AFRHS, the meaning of AFRHS for adolescents, healthcare providers' attitudes towards adolescents seeking SRH services, and community perceptions and readiness to accept AFRHS. The findings showed that both socio-cultural and health facility factors influence utilisation of SRH services. Many of these factors stem from the moral framework encapsulated in socio-cultural norms and values related to the sexual health of adolescents and healthcare providers' poor value clarification. This study provides an empirical understanding of the reasons and factors associated with SRH service utilisation, which goes much deeper than program provision of AFRHS in Zimbabwe.

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