Do European Union countries adequately address the healthcare needs of adolescents in the area of sexual reproductive health and rights?
Do European Union countries adequately address the healthcare needs of adolescents in the area of sexual reproductive health and rights?
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DOI：
10.1136/archdischild-2019-317073
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发表时间：
2020-01-01
影响因子：
5.2
通讯作者：
Jansen, Danielle
中科院分区：
文献类型：
--
作者：
Michaud, Pierre-Andre;Visser, Annemieke;Jansen, Danielle
背景和目标青少年的性健康和生殖健康及权利具有特别重要的意义，因为它们可能对健康产生短期或长期影响。这项研究评估了31个欧洲国家在这一领域获得护理的建议和政策（欧洲联盟（EU）加上冰岛、挪威和瑞士）。方法作为欧盟资助的儿童健康模型评估项目的一部分，数据收集使用43-向每个国家负责收集信息的专家发送了项目调查表。结果10个国家尚未制定任何正式的政策或建议保证尊重保密性和在父母不知情的情况下咨询医生的可能性。近一半的国家没有专门从事青少年保健、处理综合健康问题或专门关注性健康和生殖健康的中心。在大多数国家，获得紧急避孕药具和怀孕信息，包括检测，都很容易。然而，只有10个国家免费提供口服避孕药。23个国家在提供基于政策的怀孕护理方面没有达到目前的标准，只有13个国家为怀孕少女制定了特别方案。只有七个国家的青少年可以肯定有他们的怀孕终止没有他们的父母知道（在另外七个国家在选定的situations）。结论提供和可用性友好的性健康和生殖健康及权利护理是远远不够的，在大约一半的调查国家。这些结果需要审查和实施政策、专业医疗中心和初级保健提供者的培训计划。
Background and objectives Adolescent sexual and reproductive health and rights (SRHR) are of particular relevance given their potential short-term or long-term health consequences. This study evaluates recommendations and policies regarding access to care in this area in 31 European countries (European Union (EU) plus Iceland, Norway and Switzerland).Methods As part of the EU funded Models of Child Health Appraised project, data were gathered using a 43-item questionnaire sent to experts responsible for collecting information in each country.Results Ten countries have not developed any formal policy or recommendation that guarantee the respect of confidentiality and the possibility of consulting a physician without parents knowing. Nearly half of the countries do not have centres specialised in adolescent healthcare, tackling comprehensive health issues or focusing specifically on SRH. Access to emergency contraception and information regarding pregnancy, including testing, is easy in most countries. However, oral contraception is delivered free of charge in only 10 countries. Twenty-three countries do not meet current standards in terms of providing policy-based pregnancy care, and only 13 have set up special programmes for pregnant adolescents. In only seven countries can adolescents definitely have their pregnancy terminated without their parents knowing (and in another seven countries in selected situations).Conclusion The provision and availability of adolescent-friendly SRHR care are far from optimal in around half of the surveyed countries. These results call for the review and implementation of policies, specialised healthcare centres and training initiatives for primary care providers.