Jonas Kim, Crutzen Rik, van den Borne Bart, Reddy Priscilla
Department of Health Promotion, School of Public Health and Primary Care (CAPHRI), Faculty of Heath, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Faculty of Community and Health Science, University of the Western Cape, Cape Town, South Africa.
BMC Pregnancy Childbirth. 2017 Mar 13;17(1):86. doi: 10.1186/s12884-017-1268-x.
Healthcare workers may affect the utilization of sexual and reproductive healthcare (SRH) services, and quality of care thereof, for example by their behaviours or attitudes they hold. This can become a hindrance to accessing and utilizing SRH services, particularly by young people, and thus a better understanding of these behaviours and associated factors is needed to improve access to and utilization of SRH services.
A systematic review of literature was conducted to identify studies focusing on healthcare workers' behaviors and personal determinants associated with providing adequate SRH services in sub-Saharan Africa (January 1990 - October 2015). Five databases were searched until 30th October 2015, using a search strategy that was adapted based on the technical requirements of each specific database. Articles were independently screened for eligibility by two researchers. Of the 125-screened full-text articles, 35 studies met all the inclusion criteria.
Negative behaviours and attitudes of healthcare workers, as well as other personal determinants, such as poor knowledge and skills of SRH services, and related factors, like availability of essential drugs and equipment are associated with provision of inadequate SRH services. Some healthcare workers still have negative attitudes towards young people using contraceptives and are more likely to limit access to and utilization of SRH by adolescents especially. Knowledge of and implementation of specific SRH components are below optimum levels according to the WHO recommended guidelines.
Healthcare workers' negative behaviours and attitudes are unlikely to encourage women in general to access and utilize SRH services, but more specifically young women. Knowledge of SRH services, including basic emergency obstetric care (EmOC) is insufficient among healthcare workers in SSA.
A protocol for this systematic review was registered with PROSPERO and the registration number is: CRD42015017509 .
医护人员可能会影响性与生殖健康保健（SRH）服务的利用及其护理质量，例如通过他们的行为或所持态度。这可能会成为获取和利用SRH服务的障碍，尤其是对年轻人而言，因此需要更好地了解这些行为及相关因素，以改善SRH服务的获取和利用情况。
对文献进行系统综述，以识别聚焦于撒哈拉以南非洲地区（1990年1月至2015年10月）医护人员与提供充分SRH服务相关的行为及个人决定因素的研究。截至2015年10月30日，对五个数据库进行了检索，使用的检索策略是根据每个特定数据库的技术要求进行调整的。由两名研究人员独立筛选文章以确定其是否符合资格。在125篇经过筛选的全文文章中，有35项研究符合所有纳入标准。
医护人员的消极行为和态度，以及其他个人决定因素，如对SRH服务的知识和技能不足，以及相关因素，如基本药物和设备的可获得性，都与提供不充分的SRH服务有关。一些医护人员对年轻人使用避孕药具仍持消极态度，尤其更有可能限制青少年获取和利用SRH服务。根据世界卫生组织推荐的指南，对特定SRH组成部分的知识和实施情况低于最佳水平。
医护人员的消极行为和态度不太可能鼓励一般女性获取和利用SRH服务，尤其是年轻女性。撒哈拉以南非洲地区的医护人员对SRH服务，包括基本的产科急诊护理（EmOC）的了解不足。
该系统综述的方案已在国际系统评价前瞻性注册库（PROSPERO）注册，注册号为：CRD42015017509 。
