scholarly journals Navigating conflicting laws in sexual and reproductive health service provision for teenagers

Curationis ◽  
2016 ◽  
Vol 39 (1) ◽  
Author(s):  
Kelley Moult ◽  
Alexandra Müller
Keyword(s):  
Reproductive Health ◽  
Service Provision ◽  
Sexual And Reproductive Health ◽  
Healthcare Providers ◽  
Policy Framework ◽  
Reproductive Health Services ◽  
Healthcare Provision ◽  
Sexual Offences ◽  
Health Service Provision ◽  
Depth Analysis

Background: The South African legal and policy framework for sexual and reproductive healthcare provision for teenagers is complex.Objective: The article outlines the dilemmas emanating from the legal and policy framework, summarises issues with implementation of the legal and policy framework in practice, and summarises recent changes to the law.Methods: In-depth analysis of the legal and policy framework. Training workshops with a purposive sample of nurses and other healthcare providers in the Western Cape.Findings: Tensions between consent and confidentiality imposed by the Termination of Pregnancy Act, the Children’s Act, the National Health Act and the Criminal Law (Sexual Offences and Related Matters) Amendment Act render conflicting obligations on healthcare providers. Healthcare providers’ experiences with service provision in this context show that the conflicting roles they inhabit render their service provision to teenagers more challenging.Conclusion: Healthcare providers need to learn about their legal obligations surrounding adolescent sexual and reproductive health services.

scholarly journals Looking ahead in the COVID-19 pandemic: emerging lessons learned for sexual and reproductive health services in low- and middle-income countries

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Aduragbemi Banke-Thomas ◽  
Sanni Yaya
Keyword(s):  
Reproductive Health ◽  
Service Provision ◽  
Sexual And Reproductive Health ◽  
Lessons Learned ◽  
Safe Abortion ◽  
Middle Income ◽  
Health Service Provision ◽  
Middle Income Countries ◽  
Published Evidence ◽  
Low And Middle Income

AbstractThe COVID-19 pandemic has caused widespread disruption to essential health service provision globally, including in low- and middle-income countries (LMICs). Recognising the criticality of sexual and reproductive health (SRH) services, we review the actual reported impact of the COVID-19 pandemic on SRH service provision and evidence of adaptations that have been implemented to date. Across LMICs, the available data suggests that there was a reduction in access to SRH services, including family planning (FP) counselling and contraception access, and safe abortion during the early phase of the pandemic, especially when movement restrictions were in place. However, services were quickly restored, or alternatives to service provision (adaptations) were explored in many LMICs. Cases of gender-based violence (GBV) increased, with one in two women reporting that they have or know a woman who has experienced violence since the beginning of the pandemic. As per available evidence, many adaptations that have been implemented to date have been digitised, focused on getting SRH services closer to women. Through the pandemic, several LMIC governments have provided guidelines to support SRH service delivery. In addition, non-governmental organisations working in SRH programming have played significant roles in ensuring SRH services have been sustained by implementing several interventions at different levels of scale and to varying success. Most adaptations have focused on FP, with limited attention placed on GBV. Many adaptations have been implemented based on guidance and best practices and, in many cases, leveraged evidence-based interventions. However, some adaptations appear to have simply been the sensible thing to do. Where evaluations have been carried out, many have highlighted increased outputs and efficiency following the implementation of various adaptations. However, there is limited published evidence on their effectiveness, cost, value for money, acceptability, feasibility, and sustainability. In addition, the pandemic has been viewed as a homogenous event without recognising its troughs and waves or disentangling effects of response measures such as lockdowns from the pandemic itself. As the pandemic continues, neglected SRH services like those targeting GBV need to be urgently scaled up, and those being implemented with any adaptations should be rigorously tested.

scholarly journals The experiences of clients and healthcare providers regarding the provision of reproductive health services including the prevention of HIV and AIDS in an informal settlement in Tshwane

2016 ◽  
Vol 21 ◽  
pp. 67-76
Author(s):  
M. L.S. Mataboge ◽  
S. Beukes ◽  
A. G.W. Nolte
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Primary Healthcare ◽  
Informal Settlement ◽  
Healthcare Providers ◽  
Hiv And Aids ◽  
Reproductive Health Services ◽  
Healthcare Provision ◽  
Reproductive Healthcare ◽  
Prevention Of Hiv

Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV) and to acquired immunodeficiency syndrome (AIDS) than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.

scholarly journals Guidelines and best practice recommendations on reproductive health services provision amid COVID-19 pandemic: Scoping review.

2020 ◽  
Author(s):  
Lemi Belay Tolu ◽  
Wondimu Gudu Jeldu
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Service Provision ◽  
Postnatal Care ◽  
Sexual And Reproductive Health ◽  
Data Extraction ◽  
Reproductive Health Services ◽  
Safe Abortion ◽  
Practice Recommendations ◽  
Consensus Statements

Abstract Introduction: During pandemics, there is uncertainty and information overload. Policymakers and health professionals prefer to use summarized evidence of practice recommendations. The aim of this scoping review is therefore to identify available guidelines, consensus statements, the standard of practice and practice recommendations on reproductive health service provision during the COVID-19 pandemics.Methods: We searched guideline databases and websites of professional associations and international organizations working on sexual and reproductive health. We looked for guidelines, protocols, consensus statements and practice recommendations on sexual reproductive health services (SRH) during COVID-19 pandemics. Additionally, we searched: MEDLINE, EMBASE and Google Scholar. Data extraction was done by two independent reviewers using a customized tool that was developed to record the key information of the source that’s relevant to the review question. The difference between the two authors on data extraction was resolved by discussion.Results: A total of 20 records were included in the review. Identified recommendations were classified into thematic areas. The records addressed approaches to the antenatal care, labour and delivery, postnatal care, safe abortion, contraception, gender-based violence and artificial reproduction. We haven’t employed any of the quality assessment tools as the pandemic is new clinical entity and evidences are based on expert opinion and limited clinical evidence.Conclusions: There were consistent consensus statements and recommendations that there should be access to sexual and reproductive health services like antenatal care(ANC), postnatal care(PNC), contraception service, safe abortion care and clinical management of rape survivors during the COVID-19 pandemics with the concerted effort of service re-organization. The practice recommendations focus on innovative ways of service provision to minimize patient and staff exposure to COVID-19 as well as alleviate the burden on the health care system. These include utilizing telemedicine or digital health and community/home-based care or self-care.

scholarly journals Self-care and remote care during pregnancy: a new paradigm?

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
A. Metin Gülmezoglu ◽  
Anne Ammerdorffer ◽  
Manjulaa Narasimhan ◽  
Alyce N. Wilson ◽  
Joshua P. Vogel ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Healthcare Providers ◽  
Self Care ◽  
Reproductive Health Services ◽  
New Paradigm ◽  
Remote Care

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.

scholarly journals What do service providers in Southern Ethiopia say about barriers to using youth-friendly sexual and reproductive health services for adolescents?: Qualitative study

2021 ◽  
Author(s):  
Yitagesu Habtu ◽  
Mirgissa Kaba ◽  
Hussen Mekonnen
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Healthcare System ◽  
Sexual And Reproductive Health ◽  
Service Providers ◽  
Healthcare Providers ◽  
System Level ◽  
Southern Ethiopia ◽  
Reproductive Health Services ◽  
Youth Friendly

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.

scholarly journals What do service providers in Southern Ethiopia say about barriers to using youth-friendly sexual and reproductive health services for adolescents?: Qualitative study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yitagesu Habtu ◽  
Mirgissa Kaba ◽  
Hussein Mekonnen
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Healthcare System ◽  
Sexual And Reproductive Health ◽  
Service Providers ◽  
Healthcare Providers ◽  
System Level ◽  
Southern Ethiopia ◽  
Reproductive Health Services ◽  
Youth Friendly

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.

scholarly journals Guidelines and best practice recommendations on reproductive health services provision amid COVID-19 pandemic: scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lemi Belay Tolu ◽  
Garumma Tolu Feyissa ◽  
Wondimu Gudu Jeldu
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Service Provision ◽  
Postnatal Care ◽  
Sexual And Reproductive Health ◽  
Data Extraction ◽  
Reproductive Health Services ◽  
Safe Abortion ◽  
Practice Recommendations ◽  
Consensus Statements

Abstract Background Policymakers and health professionals prefer to use summarized evidence of practice recommendations. The aim of this scoping review is therefore to identify available guidelines, consensus statements, the standard of practice, and practice recommendations on reproductive health service provision during the COVID-19 pandemics. Methods We searched guideline databases and websites of professional associations and international organizations working on sexual and reproductive health. We looked for practice recommendations on sexual reproductive health services (SRH) during COVID-19 pandemics. Additionally, we searched: MEDLINE, EMBASE, and Google Scholar. Data extraction was done by two independent reviewers using a customized tool that was developed to record the key information of the source that’s relevant to the review question. The difference between the two authors on data extraction was resolved by discussion. Results A total of 21 records were included in the review. Identified recommendations were classified into thematic areas. The records addressed approaches to antenatal care, labour and delivery, postnatal care, safe abortion, contraception, gender-based violence, and artificial reproduction. Conclusions There were consistent consensus statements and recommendations that there should be access to sexual and reproductive health services like antenatal care (ANC), postnatal care (PNC), contraception service, safe abortion care, and clinical management of rape survivors during the COVID-19 pandemics with the concerted effort of service re-organization. The practice recommendations focus on innovative ways of service provision to minimize patient and staff exposure to COVID-19 as well as alleviate the burden on the health care system. These include utilizing telemedicine and community/home-based care or self-care.

scholarly journals What do Service Providers in Southern Ethiopia Think About Barriers to using Youth-Friendly Sexual and Reproductive Health Services for Adolescents?: Qualitative Study

2020 ◽  
Author(s):  
Yitagesu Habtu ◽  
Mirgissa Kaba ◽  
Hussen Mekonnen
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Service Providers ◽  
Healthcare Providers ◽  
System Level ◽  
Southern Ethiopia ◽  
Reproductive Health Services ◽  
African Countries ◽  
Youth Friendly

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.

scholarly journals What do service providers in Southern Ethiopia say about barriers to using youth-friendly sexual and reproductive health services for adolescents?: Qualitative study 

2021 ◽  
Author(s):  
Yitagesu Habtu ◽  
Mirgissa Kaba ◽  
Hussen Mekonnen
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Service Providers ◽  
Healthcare Providers ◽  
System Level ◽  
Southern Ethiopia ◽  
Reproductive Health Services ◽  
African Countries ◽  
Youth Friendly

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.

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