Availability, accessibility, and quality of adolescent Sexual and Reproductive Health (SRH) services in urban health facilities of Rwanda: a survey among social and healthcare providers
Availability, accessibility, and quality of adolescent Sexual and Reproductive Health (SRH) services in urban health facilities of Rwanda: a survey among social and healthcare providers
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DOI：
10.1186/s12913-020-05556-0
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发表时间：
2020-07-29
影响因子：
2.8
通讯作者：
Ntokamunda Kadima, Justin
中科院分区：
文献类型：
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作者：
Ndayishimiye, Pacifique;Uwase, Rosine;Ntokamunda Kadima, Justin
在卢旺达和其他地方一样，青少年仍然怀孕和感染人类免疫缺陷病毒（HIV）和性传播感染（STI）。为青少年提供优质和全面的性健康和生殖健康服务和信息，对青少年的福祉十分重要。这项研究旨在了解SRH服务提供者的观点，在选定的城市Rwander.MethodThe研究是一个描述性的横断面调查，在2018年5月和2019年5月之间进行的六个选定的城市卢旺达使用混合方法的方法提供给青少年的SRH服务的可及性，可用性和质量。使用一份核对表从159个方便选择的性健康和生殖健康服务提供者收集数据。调查工具得到验证。SPSS 20版被用来描述定量数据和ATLAS TI版本5.2被用来编码和分析的定性数据thematically. ResultsQualcomm，卫生保健提供者报告说，青少年SRHS的可用性是令人满意的获得准确的性健康和生殖健康信息，避孕方法，预防和管理性传播疾病和艾滋病毒的服务，咨询。然而，获得某些服务的机会仍然有限。据答复者称，有些产品，如女用避孕套，需求较少，往往在分发之前就过期了。一位护士澄清说，如果青少年有医疗保险，他们会以低廉的价格提供服务。宗教领袖和家庭成员可能会通过提倡禁欲和阻止使用保护性手段来阻碍青少年寻求健康的行为。从数量上看，我们发现94.3%的卫生设施向青少年提供了关于可获得的性健康和生殖健康服务的信息，51.6%的卫生设施确认以低成本提供服务。只有57.2%的受访者提到，青少年参与设计的反馈机制，在他们的facility.ConclusionSRH服务在卢旺达提供给一般人群，并不是专门为青少年设计的。这些性健康和生殖健康服务似乎对青少年来说是相当容易获得的，但质量不够，因为青少年本身并没有充分参与世界卫生组织（世卫组织）所述的高质量性健康和生殖健康服务的其他方面。因此，有必要提高这些服务的现有质量，以满足城市环境中青少年的需求。
BackgroundAdolescents are still getting pregnant and contracting Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs) in Rwanda as elsewhere. Quality and comprehensive SRH services and information for adolescents is valuable for adolescents' wellbeing. This study aimed at understanding SRH services providers' viewpoints on accessibility, availability, and quality of SRH services provided to adolescents in selected cities of Rwanda.MethodThe 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. A checklist was used to collect data from 159 conveniently selected SRH services providers. The survey tool was validated. SPSS version 20 was used to describe quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically.ResultsQualitatively, health care providers reported that the availability of adolescent SRHS are satisfactory with access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV services, 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. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Religious leaders and family members may hinder adolescents from health-seeking behavior by promoting abstinence and discouraging use of protective means. Quantitatively, we found that 94.3% of health facilities provide information to adolescents on SRH services that were available and 51.6% affirmed delivering services at a low cost. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities.ConclusionSRH services in Rwanda are available for the general population and are not specifically designed for adolescents. These SRH services seem to be fairly accessible to adolescents with insufficient quality as adolescents themselves do not get to be fully involved in service provision among other aspects of quality SRH as stated by the World Health Organization (WHO). Therefore, there is a need to improve the present quality of these services to meet adolescents' needs in an urban setting.