Bukenya Justine N, Mulogo Edgar, Kibira Simon Peter S, Muhumuza Christine, Atuyambe Lynn M
Department of Community Health, Makerere University School of Public Health, Uganda.
Departments of Epidemiology and Biostatistics, Makerere University School of Public Health, Uganda.
Glob J Reprod Med. 2017 Sep;2(3). doi: 10.19080/GJORM.2017.02.555588. Epub 2017 Sep 25.
While adolescents aged 10-19 years make up to 23.3% of Uganda's population, health facilities offering adolescent sexual and reproductive health services are few and do not fully address young people's needs. There is a paucity of evidence on the extent to which Ugandan health facilities in rural and peri-urban settings offer these services. This study assessed the readiness of health facilities to provide friendly reproductive health services to young people in rural and peri-urban contexts in Uganda.
The data for this paper come from a cross-sectional study that used quantitative and qualitative approaches to capture information. The study was conducted in 2012 in 32 health facilities in Wakiso district. It involved reviewing health facility records to assess client load for reproductive health services in the three months preceding data collection as well as key informant interviews with health managers and providers to identify gaps in service provision for young people. Quantitative data were entered into Epi-data and analysed using STATA10, while qualitative data were analysed using content analysis.
Among the 32 facilities visited; 41% (13/32) young people had to walk a distance of more than 5kms to access them, only one health centre had a separate space for providing services for adolescent clients and all facilities visited lacked a waiting room exclusive for young people. On the other hand, only 29% (9/32) and 22% (7/32) of the health facilities reported sufficient supplies and equipment respectively that are necessary for providing services that meet the needs of young people. Deliveries within the facilities were very low representing just 23% (1843/7975) of the number of young people who sought antenatal care services. Moreover 19% (6/32) of the facilities were not routinely screening for STIs yet in facilities where screening was being done, individuals younger than 15 years were being diagnosed with STIs. In addition, most facilities 86% (27/32) provided restricted family planning services to young people. No facility reported providing services responding to gender based violence while most facilities indicated verbal referrals for these services.
The findings of this paper suggest the need for training and equipping health care workers in order to improve the provision of reproductive health services to young people.
10至19岁的青少年占乌干达人口的23.3%，但提供青少年性与生殖健康服务的医疗机构数量稀少，且无法充分满足年轻人的需求。关于乌干达农村和城市周边地区的医疗机构提供这些服务的程度，缺乏相关证据。本研究评估了乌干达农村和城市周边地区的医疗机构为年轻人提供友好生殖健康服务的准备情况。
本文的数据来自一项横断面研究，该研究采用定量和定性方法来获取信息。该研究于2012年在瓦基索区的32家医疗机构中进行。研究包括查阅医疗机构记录，以评估数据收集前三个月内生殖健康服务的客户量，以及与卫生管理人员和提供者进行关键信息访谈，以确定为年轻人提供服务方面的差距。定量数据录入Epi-data并使用STATA10进行分析，而定性数据则使用内容分析法进行分析。
在所走访的32家医疗机构中，41%（13/32）的年轻人需步行超过5公里才能到达这些机构；只有一家健康中心有单独的空间为青少年客户提供服务，且所有走访的机构都没有专为年轻人设立的候诊室。另一方面，分别只有29%（9/32）和22%（7/32）的医疗机构报告称有提供满足年轻人需求的服务所需的充足物资和设备。机构内的分娩率非常低，仅占寻求产前护理服务的年轻人数量的23%（1843/7975）。此外，19%（6/32）的机构没有定期筛查性传播感染，而在进行筛查的机构中，15岁以下的个体被诊断出患有性传播感染。此外，大多数机构86%（27/32）为年轻人提供有限的计划生育服务。没有机构报告提供应对基于性别的暴力行为服务，而大多数机构表示会口头转介此类服务。
本文的研究结果表明，需要对医护人员进行培训并配备设备，以改善为年轻人提供生殖健康服务的情况。
