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加纳青少年预防怀孕信息与服务的获取情况:一项基于社区的病例对照研究。

Access to Adolescent Pregnancy Prevention Information and Services in Ghana: A Community-Based Case-Control Study.

作者信息

Ahinkorah Bright Opoku, Hagan John Elvis, Seidu Abdul-Aziz, Budu Eugene, Hormenu Thomas, Mintah Joseph Kwame, Sambah Francis, Schack Thomas

机构信息

Faculty of Health, The Australian Centre for Public and Population Health Research (ACPPHR), University of Technology Sydney, Sydney, NSW, Australia.

Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana.

出版信息

Front Public Health. 2019 Dec 13;7:382. doi: 10.3389/fpubh.2019.00382. eCollection 2019.

Abstract

Pregnancy among girls 10-19 years remains a challenge that requires critical resolution all over the world. Despite this worrying sexual phenomenon, research pertaining to prevention information and related services in Sub-Saharan nations like Ghana is sparse. This study sought to determine the influence of access to pregnancy prevention information and services on adolescent pregnancy in the Komenda-Edina-Eguafo-Abrem Municipality in the Central Region of Ghana. Adopting a matched case-control research design with a 1:1 mapping, female adolescents aged between 15 and 19 years in the KEEA Municipality were selected using a facility based sampling technique. Results from both bivariate and multivariate analyses revealed that non-pregnant adolescents were about two times more likely to have access to pregnancy prevention information from health workers compared to pregnant adolescents [OR = 0.57, 95% CI = (0.33-0.96), = 0.036]. Likewise, pregnant adolescents were five times more likely to have access to pregnancy prevention information from media compared to non-pregnant adolescents [OR = 5.44, 95% CI = (2.64-11.23), = 0.000]. Additionally, non-pregnant adolescents were two times more likely to receive information on pregnancy prevention from school compared to pregnant adolescents [OR = 0.48, 95% CI = (0.28-0.81), = 0.006]. Sexuality and reproductive health (SRH) programme organizers should target specific intervention programmes that focus on training health workers and/or other analogous staff to enhance their awareness, attitudes, and skills to more effectively meet with the specific needs of adolescents. Specific health workers training and redesign of health facilities to foster more adolescent user friendly working environment (e.g., extension in operational times, reduction in fees of SRH services, transforming physical design to promote privacy or confidentiality) ought to be encouraged. Different media outreach programmes should also combine other community level events [e.g., informative methods through schools (e.g., focus group discussions, participatory learning), assisting connections to health services, community information network (e.g., use of sirens)] to provide well-tailored advocacy that would help modify SRH and sociocultural norms that hinder positive sexual behaviors among young people.

摘要

10至19岁女孩怀孕仍是一个全球性难题,亟待解决。尽管存在这一令人担忧的性现象,但在加纳等撒哈拉以南国家,有关预防信息和相关服务的研究却很匮乏。本研究旨在确定在加纳中部地区的科门达-埃迪纳-埃瓜福-阿布雷姆市,获取预防怀孕信息和服务对青少年怀孕的影响。采用1:1匹配的病例对照研究设计,运用基于机构的抽样技术,选取了该市15至19岁的女性青少年。双变量和多变量分析结果显示,与怀孕青少年相比,未怀孕青少年从医护人员处获取预防怀孕信息的可能性高出约两倍[比值比(OR)=0.57,95%置信区间(CI)=(0.33 - 0.96),P = 0.036]。同样,与未怀孕青少年相比,怀孕青少年从媒体获取预防怀孕信息的可能性高出五倍[OR = 5.44,95% CI = (2.64 - 11.23),P = 0.000]。此外,与怀孕青少年相比,未怀孕青少年从学校获取预防怀孕信息的可能性高出两倍[OR = 0.48,9 % CI = (0.28 - 0.81),P = 0.006]。性与生殖健康(SRH)项目组织者应针对特定的干预项目,重点培训医护人员和/或其他类似工作人员,以提高他们的意识、态度和技能,从而更有效地满足青少年的特殊需求。应鼓励对医护人员进行专门培训,并重新设计医疗机构,营造更适合青少年的友好工作环境(如延长营业时间、降低SRH服务费用、改变物理设计以增强隐私性或保密性)。不同的媒体宣传项目还应结合其他社区层面的活动[如通过学校开展信息传播方法(如焦点小组讨论、参与式学习)、协助联系医疗服务、社区信息网络(如使用警报器)],提供精心定制的宣传,以帮助改变阻碍年轻人积极性行为的SRH和社会文化规范。

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