The role of community-based health planning and services strategy in involving males in the provision of family planning services: a qualitative study in Southern Ghana
The role of community-based health planning and services strategy in involving males in the provision of family planning services: a qualitative study in Southern Ghana
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DOI：
10.1186/1742-4755-10-36
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发表时间：
2013-07-26
影响因子：
3.4
通讯作者：
Akweongo, Patricia
中科院分区：
文献类型：
--
作者：
Adongo, Philip Baba;Tapsoba, Placide;Akweongo, Patricia
背景资料：生殖健康和计划生育服务受到全球关注，特别是在生育率高的发展中国家。传统上，计划生育服务总是针对女性，很少或根本不关注男性。为确保公平分配保健服务，加纳卫生部通过了“社区保健规划和服务”，作为一项全国性的保健政策，目的是减少获得保健服务（包括计划生育服务）的实际和地理障碍。然而，关于这项政策在多大程度上促进了男性参与计划生育服务，人们知之甚少。因此，本定性描述性研究旨在探讨男性参与计划生育服务的社区运作良好的CHPS和那些较少或没有运作CHPS结构。该研究进一步征求意见的社区上的健康状况的children.Methods：这是一个定性的描述性研究，并适应设计正在进行的研究，以评估男性参与FP被称为Navrongo实验在加纳北方的影响。与男性和女性社区成员举行了12次焦点小组讨论，其中6次在有功能性社区保健和医疗服务的社区，6次在功能性社区保健和医疗服务较少/没有功能的社区。此外，还与地区和区域一级的社区卫生官员、社区卫生志愿者和卫生管理人员进行了五十九（59）次深入访谈。访谈和讨论录音数字化，转录并进入QSR Nvivo 10（c）进行分析。结果：结果显示，在过去十年中，社区儿童的健康状况得到了改善，这是一个普遍的高感知。这些改善归功于儿童免疫接种、纯母乳喂养、向母亲提供育儿保健教育、儿童成长监测和可获得的保健。尽管在儿童健康方面取得了这些成就，但与会者报告说，社区中营养不良现象仍然很普遍。调查结果还显示，在妇女使用避孕药具方面，配偶的同意仍然是重要的;然而，母系制度似乎在决策方面给予妇女更多的自主权。人们认为，社区卫生和保健服务战略在社区充分参与各级执行进程的情况下非常有用。男性更多地参与计划生育服务的社区与功能CHPS比那些没有功能CHPS。结论：CHPS战略增加了获得计划生育服务，但配偶的同意是非常重要的计划生育服务的使用。让男性参与生殖健康问题，包括计划生育，对于实现生殖健康目标十分重要。
Background: Reproductive health and Family Planning (FP) services have been of global concern especially in developing countries where fertility rates are high. Traditionally FP services had always targeted females with little or no attention given to males. To ensure equitable distribution of health services, Ministry of Health (MOH), Ghana adopted the Community-Based Health Planning and Services (CHPS) as a nationwide health policy with the aim of reducing obstacles to physical and geographical access to health care delivery including FP services. However, not much is known about the extent to which this policy has contributed to male involvement in FP services. This qualitative descriptive study was therefore designed to explore male involvement in FP services in communities with well functioning CHPS and those with less or no functioning CHPS structures. The study further solicited views of the community on the health status of children.Methods: This was a qualitative descriptive study and adapted the design of an ongoing study to assess the impact of male involvement in FP referred to as the Navrongo experiment in Northern Ghana. Twelve focus group discussions were held with both male and female community members, six in communities with functional CHPS and six for communities with less/no-functional CHPS. In addition, fifty- nine (59) in-depth interviews were held with Community Health Officers (CHOs), Community Health Volunteers (CHVs) and Health Managers at both the districts and regional levels. The interviews and discussions were tape recorded digitally, transcribed and entered into QSR Nvivo 10 (c) for analysis.Results: The results revealed a general high perception of an improved health status of children in the last ten years in the communities. These improvements were attributed to immunization of children, exclusive breastfeeding, health education given to mothers on childcare, growth monitoring of children and accessible health care. Despite these achievements in the health of children, participants reported that malnutrition was still rife in the community. The results also revealed that spousal approval was still relevant for women in the use of contraceptives; however, the matrilineal system appears to give more autonomy to women in decision-making. The CHPS strategy was perceived as very helpful with full community participation at all levels of the implementation process. Males were more involved in FP services in communities with functioning CHPS than those without functioning CHPS.Conclusion: The CHPS strategy has increased access to FP services but spousal consent was very important in the use of FP services. Involving males in reproductive health issues including FP is important to attain reproductive health targets.