乌干达向年轻人提供避孕服务的限制因素和前景：提供者的观点。
Constraints and prospects for contraceptive service provision to young people in Uganda: providers' perspectives.
机构信息
Department of Nursing, School of Health Sciences, Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda.
出版信息
BMC Health Serv Res. 2011 Sep 17;11:220. doi: 10.1186/1472-6963-11-220.
BACKGROUND
Unintended pregnancies lead to unsafe abortions, which are a leading cause of preventable maternal mortality among young women in Uganda. There is a discrepancy between the desire to prevent pregnancy and actual contraceptive use. Health care providers' perspectives on factors influencing contraceptive use and service provision to young people aged 15-24 in two rural districts in Uganda were explored.
METHODS
Semi-structured questionnaires were used for face- to-face interviews with 102 providers of contraceptive service at public, private not-for-profit, and private for-profit health facilities in two rural districts in Uganda. Descriptive and inferential statistics were used in the analysis of data.
RESULTS
Providers identified service delivery, provider-focused, structural, and client-specific factors that influence contraceptive use among young people. Contraceptive use and provision to young people were constrained by sporadic contraceptive stocks, poor service organization, and the limited number of trained personnel, high costs, and unfriendly service. Most providers were not competent enough to provide long-acting methods. There were significant differences in providers' self-rated competence by facility type; private for-profit providers' competence was limited for most contraceptives. Providers had misconceptions about contraceptives, they had negative attitudes towards the provision of contraceptives to young people, and they imposed non-evidence-based age restrictions and consent requirements. Thus, most providers were not prepared or were hesitant to give young people contraceptives. Short-acting methods were, however, considered acceptable for young married women and those with children.
CONCLUSION
Provider, client, and health system factors restricted contraceptive provision and use for young people. Their contraceptive use prospects are dependent on provider behavior and health system improvements.
背景
意外怀孕会导致不安全的堕胎，这是乌干达年轻女性可预防死亡的主要原因之一。人们希望避免怀孕，但实际使用的避孕措施却存在差异。本研究旨在探讨乌干达两个农村地区的卫生保健提供者对影响 15-24 岁年轻人使用避孕措施和提供服务的因素的看法。
方法
采用半结构式问卷，对乌干达两个农村地区的公共、非营利性私立和营利性私立卫生设施中 102 名避孕服务提供者进行了面对面访谈。对数据进行了描述性和推断性统计分析。
结果
提供者确定了影响年轻人使用避孕措施的服务提供、提供者为中心、结构和客户特定因素。避孕措施的使用和向年轻人提供受到间歇性的避孕库存、服务组织不善以及培训人员数量有限、成本高和服务不友好的限制。大多数提供者没有足够的能力提供长效方法。提供者的自我评估能力因设施类型而异，营利性私立提供者的能力有限，大多数避孕措施都无法提供。提供者对避孕药具存在误解，对向年轻人提供避孕药具持负面态度，并且对年轻人施加了无证据支持的年龄限制和同意要求。因此，大多数提供者没有准备好或不愿意为年轻人提供避孕药具。然而，短效方法被认为是年轻已婚妇女和有孩子的妇女可以接受的。
结论
提供者、客户和卫生系统因素限制了年轻人的避孕措施的提供和使用。他们的避孕措施使用前景取决于提供者的行为和卫生系统的改善。
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