Understanding sexual and reproductive health needs of young women living in Zika affected regions: a qualitative study in northeastern Brazil
Understanding sexual and reproductive health needs of young women living in Zika affected regions: a qualitative study in northeastern Brazil
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DOI：
10.1186/s12978-020-0869-4
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发表时间：
2020-02-06
影响因子：
3.4
通讯作者：
Brito, Luciana
中科院分区：
文献类型：
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作者：
Diniz, Debora;Ali, Moazzam;Brito, Luciana
背景2016年，由于寨卡病毒与小头畸形症和其他神经疾病有关，世界卫生组织宣布进入国际关注的公共卫生紧急状态。巴西是这一流行病的震中，受影响最严重的地区的人类发展指数最低，青少年怀孕率最高。尽管寨卡疫情已经结束，但巴西仍然是寨卡病毒的中心。这项研究调查了在受影响地区寻求性健康和生殖健康(SRH)护理服务的年轻妇女所面临的障碍，以及她们对性健康和生殖健康需求和现有服务的态度。方法对巴西东北部三个受寨卡病毒感染的城市的22名14-24岁的年轻女性进行个人半结构式访谈。本次定性研究采用主题分析的方法进行数据分析。结果近半数(n=10)的受试者在青春期(12-19岁)首次怀孕，均为意外。人们发现，缺乏信息和获得计划生育的障碍是导致避孕需求得不到满足的原因。参与者报告了关于避孕的知识差距。寨卡病毒并不被认为是一个健康问题，参与者也不知道寨卡病毒可能会通过性传播。结论青年妇女对其SRH需求的认识和态度突出了获得保健的障碍。它还意味着，全面、生物、心理、社会和政治理解是必要的，以便向这些人口充分提供性保健，并满足他们的需求。政府应将妇女放在应对影响育龄妇女的紧急情况的任何公共卫生措施的中心位置，并以符合文化和年龄的方式重点改善获得信息和计划生育服务的机会。
Background In 2016, the World Health Organization declared a Public Health Emergency of International Concern due to Zika's association with microcephaly and other neurological disorders. Brazil was the epicenter of this epidemic and the most affected region has the lowest Human Development Index and the highest rates of adolescent pregnancy. Despite the end of the epidemic, Brazil continues to be the epicenter of Zika illness. This study examined the barriers faced by young women who seek sexual and reproductive health (SRH) care services living in affected areas and their attitudes towards SRH needs and the available services. Methods Individual semi-structured interviews were conducted with 22 young women, aged 14-24 years in three Zika affected municipalities in the Brazilian Northeast. This qualitative research used thematic analysis for data analysis. Results Almost half (n = 10) of the participants had their first pregnancy during adolescence (from 12 to 19), all of which were unintended. Lack of information and barriers to access family planning were found to contribute to the unmet need for contraception. Participants reported knowledge gaps about contraception. Zika was not considered a health concern and participants were unaware of the possibility of Zika's sexual transmission. Conclusions The young women's knowledge and attitudes towards their SRH needs highlight the barriers to access care. It also implies that comprehensive, biopsychosocial and political, understanding is necessary in order to adequately provide SRH to this population and meet their needs. The government should place women at the center of any public health response to an emergency affecting women of reproductive age and focus on improving access to information and family planning services in a culturally and age appropriate manner.