Perceived, anticipated and experienced stigma: exploring manifestations and implications for young people's sexual and reproductive health and access to care in North-Western Tanzania
Perceived, anticipated and experienced stigma: exploring manifestations and implications for young people's sexual and reproductive health and access to care in North-Western Tanzania
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DOI：
10.1080/13691058.2017.1293844
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发表时间：
2017-01-01
影响因子：
2.2
通讯作者：
Wamoyi, Joyce
中科院分区：
文献类型：
--
作者：
Nyblade, Laura;Stockton, Melissa;Wamoyi, Joyce
青年--尤其是撒哈拉以南非洲的女孩和青年妇女--面临获得性健康和生殖健康信息和服务的重大挑战。这些挑战在一定程度上是由包括耻辱在内的社会文化因素塑造的。本文介绍了一项定性研究的结果，该研究探索了坦桑尼亚两个社区围绕年轻人性健康和生殖健康的耻辱的微观社会过程。受访者描述了一种围绕未婚年轻人的性健康和生殖健康普遍存在的耻辱环境。耻辱表现为多种形式，从口头骚扰和社会孤立到家庭、社区成员、同龄人和医疗保健提供者的体罚。答复者认为，耻辱是年轻人获得性健康和生殖健康服务的障碍，并认为过度提问、斥责和要求性伴侣或父母在保健机构接受服务是获得护理的障碍。在这两个研究界，围绕青年性健康和生殖健康的污名的普遍性和复杂性及其对健康的潜在后果表明，需要谨慎使用污名一词，并进一步研究将减少污名的战略纳入青年性健康和生殖健康方案的可行性。
Young people - particularly girls and young women in sub-Saharan Africa - face significant challenges accessing sexual and reproductive health information and services. These challenges are shaped in part by sociocultural factors, including stigma. This paper presents findings from a qualitative study that explored the micro-level social process of stigma surrounding young people's sexual and reproductive health in two communities in Tanzania. Respondents described an environment of pervasive stigma surrounding the sexual and reproductive health of unmarried young people. Stigma manifested itself in multiple forms, ranging from verbal harassment and social isolation to physical punishment by families, community members, peers and healthcare providers. Respondents perceived that stigma was a barrier to young people accessing sexual and reproductive health services and identified excessive questioning, scolding and requirements to bring sexual partners or parents to receive services at health facilities as obstacles to accessing care. The pervasiveness and complexities of stigma surrounding young people's sexual and reproductive health in the two study communities and its potential consequences for health suggest both a need for care in using the term stigma as well as further studies on the feasibility of incorporating stigma-reduction strategies into young people's sexual and reproductive health programmes.