Would you offer contraception to a 14-year-old girl? Perspectives of health students and professionals in Dar es Salaam, Tanzania.
Would you offer contraception to a 14-year-old girl? Perspectives of health students and professionals in Dar es Salaam, Tanzania.
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DOI：
10.1186/s12978-021-01294-6
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发表时间：
2021-12-11
影响因子：
3.4
通讯作者：
Rosser BRS
中科院分区：
文献类型：
--
作者：
Mwakawanga DL;Mkonyi E;Mushy SE;Trent M;Bonilla Z;Massae AF;Lukumay GG;Mgopa LR;Mohammed I;Wadley J;Ross MW;Leshabari S;Rosser BRS
在包括坦桑尼亚在内的撒哈拉以南非洲国家，青少年意外怀孕和不安全人工流产的比率非常高。尽管现代计划生育方法很容易获得，但据报道青少年对其利用严重不足。这项研究是一项更广泛研究的一部分，旨在通过调查坦桑尼亚卫生服务提供者和学生的性健康培训需求来开发用于培训卫生专业人员的课程。这项研究描述了卫生专业人员和学生对向青少年提供避孕药具的看法。定性形成性评估类型的研究是由卫生专业人员和学生（助产士、护士和医生）组成的 18 个焦点小组进行分层的。研究参与者看到了一名 14 岁女孩在计划生育诊所寻求避孕服务的理论场景。这个理论场景被用来确定卫生专业人员和学生将如何处理该病例。专题分析指导数据结果的检查和确定。数据中出现了三个主题，包括（1）有关向青少年提供避孕药具的知识，（2）对青少年避孕药具使用权的看法，以及（3）向青少年提供避孕药具的障碍。参与者表示，对青少年避孕服务及其获得避孕药具的权利有基本了解将促使他们做出提供避孕药具的决定。另一方面，在理论上，由于不了解青少年的生殖健康权利，服务提供者的判断行为以及宗教和文化动态都被发现是服务提供者向 14 岁少女提供避孕服务的主要障碍。这些发现支持坦桑尼亚卫生专业培训计划中全面性健康教育的必要性。在坦桑尼亚，青少年怀孕在文化上是不受欢迎的，堕胎仍然是非法的，但青少年对计划生育服务的利用率仍然很低。社区对避孕药具副作用的神话和误解、医疗保健提供者的态度以及医疗保健系统内的障碍阻碍了青少年利用计划生育服务。有效利用计划生育方法将防止使用不安全的人工流产，从而降低年轻妇女的发病率和死亡率。只有医疗保健提供者具备解决坦桑尼亚青少年性健康和生殖健康挑战的知识和技能，这才有可能实现。因此，在这项研究中，我们决定探讨卫生专业人员和学生对向青少年提供避孕措施的看法。我们针对卫生专业人员和学生（助产士、护士、医生）进行了 18 个焦点小组分层。向参与者提供了一个理论场景，其中一名 14 岁女孩前往计划生育诊所寻求避孕服务，以确定卫生专业人员和学生将如何处理该案例。我们发现，提供者关于提供避孕措施的决定在很大程度上取决于对青少年的权利和避孕服务的基本了解。被认为是服务提供者不提供避孕服务的一些障碍包括缺乏对青少年生殖健康权利的认识、判断行为（服务提供者之间隐性和显性的偏见）以及宗教和文化动态。参与者还承认，提供者的指导方针和适当的培训可能会避免侵犯青少年获得性健康和生殖健康服务的权利。总之，这些发现支持坦桑尼亚卫生专业培训计划中全面性健康教育的必要性。
Rates of unplanned adolescent pregnancy and unsafe induced abortions are very high in Sub-Saharan African countries including Tanzania. Despite their availability and accessibility, modern family planning methods are reported to be critically underutilized by adolescents. This study is part of a broader study that aims to develop a curriculum that will be used in training health professionals by investigating the sexual health training needs of health providers and students in Tanzania. This study describes the perceptions of health professionals and students on the provision of contraceptives to adolescents. Qualitative formative assessment type of research was conducted using 18 focus groups stratified among health professionals and students (midwives, nurses, and medical doctors). Study participants were presented with the theoretical scenario of a 14-year-old girl who sought contraceptive services at a family planning clinic. This theoretical scenario was used to determine how health professionals and students would handle the case. Thematic analysis guided the examination and determination of data results. Three main themes emerged from the data, including (1) knowledge about the provision of contraceptives to adolescents, (2) perception of the adolescents’ right to contraceptive use, and (3) barriers to the provision of contraceptives to adolescents. Participants stated that having a baseline knowledge of contraceptive services for adolescents and their rights to contraceptives would trigger their decision on offering the contraceptive. On the other hand, being unaware of the reproductive health rights for adolescents, judgmental behavior of providers, as well as religious and cultural dynamics were all found to be major barriers for providers to offer contraceptive services to the 14-year-old adolescent girl in the theoretical scenario. These findings support the need for comprehensive sexual health education in Tanzanian health professional training programs. In Tanzania, adolescent pregnancies are culturally unwanted, abortion remains illegal and yet the utilization of family planning services among adolescents is still low. The community myths and misconceptions about the side effects of contraceptives, healthcare providers’ attitudes, and barriers within the healthcare system hinder adolescents’ utilization of family planning services. The effective use of family planning methods will prevent the use of unsafe induced abortions and hence reduce morbidity and mortality among young women. This will be possible only if healthcare providers are equipped with the knowledge and skills to address these sexual and reproductive health challenges among adolescents in Tanzania. Therefore, in this study, we decided to explore the perceptions of health professionals and students on the provision of contraception to adolescents. We conducted 18 focus groups stratified among health professionals and students (midwives, nurses, medical doctors). Participants were supplied with a theoretical scenario wherein a 14-year-old girl presented to a family planning clinic seeking contraceptive services to determine how health professionals and students would handle the case. We found that the decision of providers with regards to offering contraception is highly dependent on having a baseline knowledge of the rights and contraceptive services available to adolescents. Some barriers identified as reasons for providers not to offer contraceptive services include a lack of awareness of the reproductive health rights for adolescents, judgmental behavior (implicit and explicit biases among providers), as well as religious and cultural dynamics. Participants also acknowledged that the presence of guidelines and proper training among providers might avoid the infringement of adolescents’ rights to sexual and reproductive health services. In conclusion, these findings support the need for comprehensive sexual health education in Tanzanian health professional training programs.
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影响因子：
3.6
作者：
Hokororo A;Kihunrwa A;Hoekstra P;Kalluvya SE;Changalucha JM;Fitzgerald DW;Downs JA
通讯作者：
Downs JA
影响因子：
11.1
作者：
Kuruvilla S;Bustreo F;Kuo T;Mishra CK;Taylor K;Fogstad H;Gupta GR;Gilmore K;Temmerman M;Thomas J;Rasanathan K;Chaiban T;Mohan A;Gruending A;Schweitzer J;Dini HS;Borrazzo J;Fassil H;Gronseth L;Khosla R;Cheeseman R;Gorna R;McDougall L;Toure K;Rogers K;Dodson K;Sharma A;Seoane M;Costello A
通讯作者：
Costello A
影响因子：
2.8
作者：
Godia PM;Olenja JM;Lavussa JA;Quinney D;Hofman JJ;van den Broek N
通讯作者：
van den Broek N
影响因子：
5.2
作者：
Michaud, Pierre-Andre;Visser, Annemieke;Jansen, Danielle
通讯作者：
Jansen, Danielle
DOI：
10.1016/j.ijgo.2015.10.001
发表时间：
2016-01-01
影响因子：
3.8
作者：
Kangaude, Godfrey
通讯作者：
Kangaude, Godfrey