斯里兰卡青少年对生殖健康护理服务的认知
Adolescents perception of reproductive health care services in Sri Lanka.
作者信息
Agampodi Suneth B, Agampodi Thilini C, Ukd Piyaseeli
机构信息
Medical officers of Health, Beruwala, Sri Lanka.
出版信息
BMC Health Serv Res. 2008 May 3;8:98. doi: 10.1186/1472-6963-8-98.
BACKGROUND
Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery.
METHODS
This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17-19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done.
RESULTS
Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners.
CONCLUSIONS AND RECOMMENDATIONS
Adolescent health services are inadequate and available services are not being delivered in an acceptable manner. Proper training of health care providers on youth friendly service provision is essential. A National level integrated health care program is needed for the adolescents.
背景
青少年的健康需求、行为和期望独具特点，常规医疗保健服务难以很好地满足这些需求。本研究旨在探索斯里兰卡一组青少年所感知到的生殖健康问题、就医行为、对现有服务的了解以及获取服务的障碍，以改善生殖健康服务的提供。
方法
这项定性研究在斯里兰卡的一个半城市地区开展。从17至19岁的青少年中选取了32名作为便利样本，参与了四次焦点小组讨论。参与者来自四个助产士区域。使用经过预测试的焦点小组指南进行数据收集。男性和女性主持人分别与年轻男性和女性进行讨论。所有录音数据都被完整转录并进行了主题分析。
结果
报告称，因各种原因导致的心理困扰以及月经周期和手淫方面的问题是最常见的健康问题。对现有服务的了解非常匮乏，男孩们完全不知道通过公共卫生系统可获得的青少年健康服务。在生殖健康问题上，女孩主要向朋友寻求帮助，而男孩则不想与任何人讨论他们的问题。指出服务可及性不足是满足青少年需求的最重要障碍。缺乏获取生殖健康知识的途径是青少年在讨论这些问题时缺乏自信的一个重要原因。缺乏保密性、对青少年不友好以及现有服务难以获得也是讨论到的其他障碍。青少年乐于通过公共诊所和其他卫生基础设施接受现有服务，而不是通过其他组织。他们要求通过医生提供单独的青少年友好型服务。
结论与建议
青少年健康服务不足，现有服务的提供方式也不尽如人意。对医疗保健提供者进行关于提供青少年友好型服务的适当培训至关重要。需要为青少年制定一项国家级综合医疗保健计划。
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