"Not on the agenda": A qualitative study of influences on health services use among poor young women who use drugs in Cape Town, South Africa
"Not on the agenda": A qualitative study of influences on health services use among poor young women who use drugs in Cape Town, South Africa
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DOI：
10.1016/j.drugpo.2015.12.019
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发表时间：
2016-04-01
影响因子：
4.4
通讯作者：
Wechsberg, Wendee M.
中科院分区：
文献类型：
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作者：
Myers, Bronwyn;Carney, Tara;Wechsberg, Wendee M.
背景：南非开普敦使用酒精和其他药物 (AOD) 的贫困年轻女性需要获得卫生服务来预防艾滋病毒。关于影响服务启动的因素的信息有限，阻碍了将年轻女性与服务联系起来的努力。我们探讨了对影响贫穷使用 AOD 的年轻女性使用卫生服务的因素的看法。方法：我们对使用 AOD 的年轻女性（16-21 岁）进行了四个焦点小组研究，这些女性是从开普敦的两个乡镇社区招募的。我们还对健康和社会福利服务规划者和提供者进行了 14 次深度访谈。讨论主题包括年轻女性对健康服务的使用情况以及对服务使用的感知影响。使用框架方法对定性数据进行了分析。结果：研究结果强调了使用 AOD 的年轻女性对健康服务使用的结构性、背景性和系统性影响。首先，年轻女性缺席健康议程，这对妇女特定服务的提供产生了影响。考虑了资源限制和性别不平等其次，性别不平等和对使用 AOD 的年轻女性的耻辱导致她们被社会排斥在教育、就业机会和医疗保健之外。第三，社区贫困导致了不正当的社会资本和社会混乱，限制了对治疗的社会支持。第四，医疗保健系统对这些年轻女性的多种服务需求反应迟钝。结论：为了惠及使用 AOD 的年轻女性，干预措施需要认识到年轻女性的风险环境，卫生系统也需要适应。为了更好地满足他们的需求，必须将性别问题纳入政策议程 (C) 2016 Elsevier B.V. 保留所有权利。
Background: Poor young women who use alcohol and other drugs (AODs) in Cape Town, South Africa, need access to health services to prevent HIV. Efforts to link young women to services are hampered by limited information on what influences service initiation. We explored perceptions of factors that influence poor AOD-using young women's use of health services.Methods: We conducted four focus groups with young women (aged 16-21) who used AODs and were recruited from two township communities in Cape Town. We also conducted 14 in-depth interviews with" health and social welfare service planners and providers. Discussion topics included young women's use of health services and perceived influences on service use. Qualitative data were analysed using a framework approach.Results: The findings highlighted structural, contextual, and systemic influences on the use of health services by young women who use AODs. First, young women were absent from the health agenda, which had an impact on the provision of women-specific services. Resource constraints and gender inequality were thought to contribute to this absence. Second, gender inequality and stigma toward young women who used AODs led to their social exclusion from education and employment opportunities and health care. Third, community poverty resulted in the emergence of perverse social capital and social disorder that limited social support for treatment. Fourth, the health care system was unresponsive to the multiple service needs of these young women.Conclusion: To reach young women who use AODs, interventions need to take cognisance of young women's risk environment and health systems need to adapt to respond better to their needs. For these interventions to be effective, gender must be placed on the policy agenda. (C) 2016 Elsevier B.V. All rights reserved.