尼日利亚埃努古州青少年性与生殖健康服务：一种混合方法研究
Sexual and reproductive health services (SRHS) for adolescents in Enugu state, Nigeria: a mixed methods approach.
作者信息
Odo Amelia Ngozi, Samuel Efiong Sunday, Nwagu Evelyn N, Nnamani Petra Obioma, Atama Chiemezie S
机构信息
Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, Enugu, 410001, Nigeria.
Department of Pharmaceutics, University of Nigeria, Nsukka, Nigeria.
出版信息
BMC Health Serv Res. 2018 Feb 8;18(1):92. doi: 10.1186/s12913-017-2779-x.
BACKGROUND
Availability and accessibility of sexual and reproductive health services for adolescents are very crucial for prevention and control of sexual and reproductive health problems. These services also play vital roles in the promotion of adolescents' sexual and reproductive health generally. The main purpose of the study was to determine the availability and accessibility (geographical and financial) of sexual and reproductive health services (SRHS) among adolescents in Enugu State, Nigeria.
METHODS
A mixed methods approach was adopted for the study. 192 health facilities were reached to check availability of SRH services. Randomly sampled 1447 adolescents (12-22 years) completed the questionnaire correctly. Twenty-seven interviews and 18 group discussions were conducted. Instruments for data collection consisted of a checklist, a questionnaire, a focus group discussion guide and an in-depth interview guide. All instruments were pre-tested. Quantitative data were analyzed using descriptive statistics and Chi-square tests. NVivo 11 Pro software was used to code and thematically analyze the qualitative data.
RESULTS
A total of 1447 adolescents (between 12 and 22 years) completed the questionnaire correctly. Among these adolescents, males constituted 42.9% while females were 57.1%. The majority (86.7%) of the adolescents reported availability of safe motherhood services, and 67.5% reported availability of services for prevention and management of STIs and HIV and AIDS. The majority reported that these services were geographically accessible but few were financially accessible to adolescents. However, qualitative data revealed that available services were not specifically provided for adolescents but for general use. Age (p = ≤ .05), education (p = ≤ .05) and income (p = ≤ .05) were found to be significantly associated with access to SRHS.
CONCLUSION
SRHS were generally physically available but not financially accessible to adolescents. Adolescents' clinics were not available and this could affect the access of SRHS by adolescents. Education and income were significantly associated with access to SRHS.
背景
青少年性与生殖健康服务的可获得性和可及性对于预防和控制性与生殖健康问题至关重要。这些服务在总体上促进青少年性与生殖健康方面也发挥着关键作用。该研究的主要目的是确定尼日利亚埃努古州青少年性与生殖健康服务（SRHS）的可获得性和可及性（地理和经济方面）。
方法
本研究采用混合方法。联系了192个卫生机构以检查性与生殖健康服务的可获得性。随机抽取1447名青少年（12 - 22岁）正确完成了问卷。进行了27次访谈和18次小组讨论。数据收集工具包括一份清单、一份问卷、一份焦点小组讨论指南和一份深入访谈指南。所有工具均经过预测试。定量数据采用描述性统计和卡方检验进行分析。NVivo 11 Pro软件用于对定性数据进行编码和主题分析。
结果
共有1447名青少年（12至22岁）正确完成了问卷。在这些青少年中，男性占42.9%，女性占57.1%。大多数（86.7%）青少年报告有安全孕产服务，67.5%报告有性传播感染、艾滋病毒和艾滋病预防与管理服务。大多数人报告这些服务在地理上可及，但很少有青少年在经济上能够获得。然而，定性数据显示现有服务并非专门为青少年提供，而是供一般使用。发现年龄（p≤0.05）、教育程度（p≤0.05）和收入（p≤0.05）与获得性与生殖健康服务显著相关。
结论
性与生殖健康服务在实际中总体上可获得，但青少年在经济上难以获得。青少年诊所不存在，这可能会影响青少年获得性与生殖健康服务。教育和收入与获得性与生殖健康服务显著相关。
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