Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana.
Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana.
Reprod Health. 2018 Jul 5;15(1):122. doi: 10.1186/s12978-018-0564-x.
Adolescent sexual and reproductive health is recognized as a key developmental issue of international concern. However, adolescents' access to sexual and reproductive health (SRH) information and services is largely inadequate in sub-Saharan Africa. With increasing enrollment in schools, this could be an avenue to reach adolescents with SRH information and services. This study was therefore conducted to assess the acceptability and stakeholders' perspectives on the feasibility of using health workers and trained psychologists to provide school-based SRH services in Ghana.
Fourteen (14) focus group discussions (N = 136) were conducted; 8 among adolescents aged 12-17 years (4 boys, 4 girls groups), 4 among parents (2 males, 2 females groups) and two among mixed teacher groups. We also conducted 18 in-depth interviews with teachers, managers of schools, health workers, clinical psychologists, as well as adolescent SRH program managers in the Ghana Health Service, Ghana Education Service, UNICEF, UNESCO and National Population Council, Ghana. We audio-recorded all interviews and took field notes. Interviews were transcribed and transcripts imported into NVivo 11 for analysis using grounded theory approach to qualitative data analysis.
Many respondents reported that it was challenging for parents and/or teachers to provide adolescents with SRH information. For this reason, they agreed that it was a good idea to have health workers and psychologists provide SRH information and services to adolescents in school. Although, there was general agreement about providing SRH services in school, many of the respondents disagreed with distribution of condoms in schools as they believed that availing condoms would encourage adolescents to experiment with sex. While majority of respondents thought it was acceptable to use psychologists and health workers to provide school-based sexual and reproductive health to adolescents, some teachers and education managers thought the implementation of such a program would oppose practical challenges. Key among the challenges were how to pay for the services that health workers and trained psychologists will render, and the availability of psychologists to cater for all schools.
Stakeholders believe it is feasible and acceptable to use trained psychologists and health workers to deliver school-based SRH information and services in the Ghanaian school context. However, provisions must be made to cater for financial and other logistical considerations in the implementation of school-based SRH programs.
青少年性与生殖健康是国际关注的一个关键发展问题。然而，撒哈拉以南非洲地区的青少年获取性与生殖健康（SRH）信息和服务的渠道还远远不够。随着学校入学率的提高，这可能是向青少年提供 SRH 信息和服务的一个途径。因此，本研究旨在评估在加纳使用卫生工作者和经过培训的心理学家提供基于学校的 SRH 服务的可接受性和利益相关者对其可行性的看法。
我们进行了 14 次焦点小组讨论（N=136）；其中 8 次是在 12-17 岁的青少年（4 个男孩组，4 个女孩组）中进行的，4 次是在家长（2 个男性组，2 个女性组）中进行的，2 次是在混合教师组中进行的。我们还对加纳卫生服务、加纳教育服务、联合国儿童基金会、联合国教科文组织和国家人口委员会、加纳的学校、卫生工作者、临床心理学家以及青少年 SRH 项目管理人员进行了 18 次深入访谈。我们对所有访谈进行了录音，并记录了实地笔记。访谈记录被转录，并输入到 NVivo 11 中，使用扎根理论方法对定性数据分析进行分析。
许多受访者报告说，父母和/或教师向青少年提供 SRH 信息具有挑战性。因此，他们同意让卫生工作者和心理学家在学校向青少年提供 SRH 信息和服务是一个好主意。尽管许多受访者普遍同意在学校提供 SRH 服务，但他们中的许多人不同意在学校发放避孕套，因为他们认为提供避孕套会鼓励青少年尝试性行为。虽然大多数受访者认为使用心理学家和卫生工作者向青少年提供基于学校的性和生殖健康是可以接受的，但一些教师和教育管理人员认为实施这样的方案将面临实际挑战。其中的主要挑战是如何支付卫生工作者和经过培训的心理学家提供的服务费用，以及心理学家是否能够满足所有学校的需求。
利益相关者认为，在加纳的学校环境中，使用经过培训的心理学家和卫生工作者提供基于学校的 SRH 信息和服务是可行和可接受的。然而，在实施基于学校的 SRH 方案时，必须考虑到资金和其他后勤方面的考虑因素。
