埃塞俄比亚卫生工作者对未婚青少年性与生殖健康服务的态度。
Health workers' attitudes toward sexual and reproductive health services for unmarried adolescents in Ethiopia.
机构信息
Population Studies and Training Center, Brown University, Providence, RI, USA.
出版信息
Reprod Health. 2012 Sep 3;9:19. doi: 10.1186/1742-4755-9-19.
BACKGROUND
Adolescents in developing countries face a range of sexual and reproductive health problems. Lack of health care service for reproductive health or difficulty in accessing them are among them. In this study we aimed to examine health care workers' attitudes toward sexual and reproductive health services to unmarried adolescents in Ethiopia.
METHODS
We conducted a descriptive cross-sectional survey among 423 health care service providers working in eastern Ethiopia in 2010. A pre-tested structured questionnaire was used to collect data. Descriptive statistics, chi-square tests and logistic regression were performed to drive proportions and associations.
RESULTS
The majority of health workers had positive attitudes. However, nearly one third (30%) of health care workers had negative attitudes toward providing RH services to unmarried adolescents. Close to half (46.5%) of the respondents had unfavorable responses toward providing family planning to unmarried adolescents. About 13% of health workers agreed to setting up penal rules and regulations against adolescents that practice pre-marital sexual intercourse. The multivariate analysis indicated that being married (OR 2.15; 95% CI 1.44 - 3.06), lower education level (OR 1.45; 95% CI 1.04 - 1.99), being a health extension worker (OR 2.49; 95% CI 1.43 - 4.35), lack of training on reproductive health services (OR 5.27; 95% CI 1.51 - 5.89) to be significantly associated with negative attitudes toward provision of sexual and reproductive services to adolescents.
CONCLUSIONS
The majority of the health workers had generally positive attitudes toward sexual and reproductive health to adolescents. However, a minority has displayed negatives attitudes. Such negative attitudes will be barriers to service utilization by adolescents and hampers the efforts to reduce sexually transmitted infections and unwanted pregnancies among unmarried adolescents. We therefore call for a targeted effort toward alleviating negative attitudes toward adolescent-friendly reproductive health service and re-enforcing the positive ones.
背景
发展中国家的青少年面临一系列性健康和生殖健康问题。其中包括缺乏生殖健康医疗服务或难以获得这些服务。在这项研究中，我们旨在探讨埃塞俄比亚卫生保健工作者对未婚青少年性健康和生殖健康服务的态度。
方法
我们于 2010 年在埃塞俄比亚东部对 423 名卫生保健服务提供者进行了一项描述性横断面调查。使用经过预测试的结构化问卷收集数据。采用描述性统计、卡方检验和逻辑回归分析来驱动比例和关联。
结果
大多数卫生工作者持有积极的态度。然而，近三分之一（30%）的卫生保健工作者对向未婚青少年提供生殖健康服务持消极态度。近一半（46.5%）的受访者对向未婚青少年提供计划生育服务持不利反应。约 13%的卫生工作者同意对婚前性行为的青少年制定惩罚性法规和条例。多变量分析表明，已婚（OR 2.15；95%CI 1.44-3.06）、教育程度较低（OR 1.45；95%CI 1.04-1.99）、作为卫生推广工作者（OR 2.49；95%CI 1.43-4.35）、缺乏生殖健康服务培训（OR 5.27；95%CI 1.51-5.89）与对向青少年提供性健康和生殖健康服务的消极态度显著相关。
结论
大多数卫生工作者对青少年的性健康和生殖健康普遍持积极态度。然而，少数人表现出消极的态度。这种消极态度将成为青少年利用服务的障碍，并阻碍减少未婚青少年中的性传播感染和意外怀孕的努力。因此，我们呼吁有针对性地努力减轻对青少年友好型生殖健康服务的负面态度，并加强对青少年友好型生殖健康服务的正面态度。
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