An assessment of reproductive health services in selected health facilities, Anambra State, Nigeria

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.

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The Linked Response: Lessons Emerging from Integration of HIV and Reproductive Health Services in Cambodia

AIDS Research and Treatment ◽

10.1155/2013/504792 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Joanna White ◽

Thérèse Delvaux ◽

Chhorvann Chhea ◽

Sarun Saramony ◽

Vichea Ouk ◽

...

Keyword(s):

Reproductive Health ◽

Health Services ◽

Hiv Testing ◽

Health Facilities ◽

Hiv Positive ◽

Health Staff ◽

Reproductive Health Services ◽

Community Based ◽

Hiv Positive Women

A qualitative assessment was made of service provider and user perceptions of the quality of integrated reproductive health services established through a pilot intervention in Cambodia. The intervention aimed to promote pregnant women's HIV testing and general utilization of reproductive health facilities as well as improve the follow-up of HIV-positive women and exposed infants through strengthened referral and operational linkages amongst health facilities/services and community-based support interventions for PLHIV. The study was conducted in one operational district where the intervention was piloted and for comparative purposes in a district where integrated services had yet to be implemented. Service providers in the pilot district reported improved collaboration and coordination of services, more effective referral, and the positive impact of improved proximity of HIV testing through integrated local level facilities. Community-based support teams for PLHIV embraced their expanded role, were valued by families receiving their assistance, and were understood to have had an important role in referral, PMTCT follow-up and countering PLHIV stigmatization; findings which underscore the potential role of community support in integrated service provision. Challenges identified included stigmatization of PLHIV by health staff at district hospital level and a lack of confidence amongst non-specialized health staff when managing deliveries by HIV-positive women, partly due to fear of HIV transmission.

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Young People\'s Perspective of Reproductive Health Services at Three levels of Health Care in Anambra State. Nigeria

Nigerian Medical Practitioner ◽

10.4314/nmp.v47i4.28755 ◽

2005 ◽

Vol 47 (4) ◽

Author(s):

AL Ilika ◽

IP Okonkwo

Keyword(s):

Health Care ◽

Young People ◽

Reproductive Health ◽

Health Services ◽

Reproductive Health Services ◽

Anambra State

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A ‘Mystery Client’ Evaluation of Adolescent Sexual and Reproductive Health services in Health Facilities from Two Regions in Tanzania

PLoS ONE ◽

10.1371/journal.pone.0120822 ◽

2015 ◽

Vol 10 (3) ◽

pp. e0120822 ◽

Cited By ~ 16

Author(s):

Zaina Mchome ◽

Esther Richards ◽

Soori Nnko ◽

John Dusabe ◽

Elizabeth Mapella ◽

...

Keyword(s):

Reproductive Health ◽

Health Services ◽

Sexual And Reproductive Health ◽

Health Facilities ◽

Reproductive Health Services

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Health Facilities' Readiness to Provide Friendly Reproductive Health Services to Young People Aged 10-24 Years

Global Journal of Reproductive Medicine ◽

10.19080/gjorm.2017.02.555588 ◽

2017 ◽

Vol 2 (3) ◽

Cited By ~ 1

Author(s):

Justine N Bukenya

Keyword(s):

Young People ◽

Reproductive Health ◽

Health Services ◽

Health Facilities ◽

Reproductive Health Services

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Understanding sexual and reproductive health needs of adolescents: Evidence formative study in three districts of lake regions in Tanzania

10.21203/rs.3.rs-1049780/v1 ◽

2021 ◽

Author(s):

mwifadhi mrisho ◽

Michaela Mantel ◽

Abdunoor M Kabanywanyi ◽

Bakar Fakih ◽

Manzi Fatuma ◽

...

Keyword(s):

Health Care ◽

Reproductive Health ◽

Health Services ◽

Adolescent Girls ◽

Health Care Services ◽

Sexual And Reproductive Health ◽

Health Facilities ◽

Reproductive Health Services ◽

Care Services ◽

To Receive

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.

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Availability, Accessibility, and Quality of Adolescent Sexual and Reproductive Health Services in Urban Health Facilities of Rwanda: A survey among social and healthcare providers

10.21203/rs.3.rs-17230/v2 ◽

2020 ◽

Author(s):

Pacifique Ndayishimiye ◽

Rosine Uwase ◽

Isabelle Kubwimana ◽

Jean de la Croix Niyonzima ◽

Roseline Dine Dzekem ◽

...

Keyword(s):

Reproductive Health ◽

Health Services ◽

Urban Health ◽

Sexual And Reproductive Health ◽

Health Facilities ◽

Reproductive Health Services ◽

Cross Sectional Survey ◽

Services Delivery ◽

Depth Interviews

Abstract 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 innovative methods to broaden access to services.

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Availability, Accessibility, and Quality of Adolescent Sexual and Reproductive Health Services in Urban Health Facilities of Rwanda: A survey among social and healthcare providers

10.21203/rs.3.rs-17230/v1 ◽

2020 ◽

Author(s):

Pacifique Ndayishimiye ◽

Rosine Uwase ◽

Isabelle Kubwimana ◽

Jean de la Croix Niyonzima ◽

Roseline Dine Dzekem ◽

...

Keyword(s):

Reproductive Health ◽

Health Services ◽

Urban Health ◽

Sexual And Reproductive Health ◽

Healthcare Providers ◽

Health Facilities ◽

Reproductive Health Services ◽

Services Delivery ◽

Depth Interviews

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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