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通过津巴布韦选定地区综合卫生系统促进青少年安全性行为的策略:一项混合方法研究方案。

Strategies to facilitate safe sexual practices in adolescents through integrated health systems in selected districts of Zimbabwe: a mixed method study protocol.

机构信息

Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa.

Department of Environmental Science and Health, Faculty of Applied Sciences, National University of Science and Technology, Bulawayo, Zimbabwe.

出版信息

Reprod Health. 2020 Jan 31;17(1):20. doi: 10.1186/s12978-020-0862-y.

Abstract

BACKGROUND

Zimbabwe has the highest teenage pregnancy rate in Sub Saharan Africa. Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) prevalence in adolescents that are from tribes that perform cultural initiations and subscribe to certain norms are higher than the national prevalence which is estimated at 12% (18 and 13.6% respectively) in Zimbabwe. Indigenous Health Systems (IHSs) and Modern Health Systems (MHSs) in Zimbabwe run parallel thereby introducing challenges in the management of adolescent sexual health due to conflicts. This study seeks to develop strategies that will facilitate the integration of IHSs and MHS in Mberengwa and Umguza districts.

METHODS

This research will be conducted in two phases. The first phase would utilise a concurrent triangulation mixed methods design with both qualitative and quantitative approaches. The findings from the qualitative and quantitative approaches would be merged through a comparison of findings side by side. The second phase would focus on the development and validation of strategies that would facilitate the integration of IHSs and MHSs. The Strength, Weakness, Opportunity and Threat (SWOT) analysis would be applied on interfaced findings from phase one. The Basic Logic and the Build, Overcome, Explore and Minimise (BOEM) models would then be used to develop strategies based on the SWOT findings. The developed strategies would be validated through the application of Delphi technique and administration of checklist to selected key stakeholders through organised workshops.

DISCUSSION

There have been no known studies found in the literature that explores the possibility and developed strategies of integrating IHSs and MHSs so as to promote safe sexual practices in adolescents. Most programs on sexual health have ignored the role of IHSs and MHSs in influencing safe sexual practices leading to them failing to attain desired goals. A lot of emphases has been targeted at minimising the spread of Sexually Transmitted Infections (STIs) through advocating for utilisation MHSs rather than focussing on an integrating systems that are meant to manage Adolescent Sexual Health (ASH) related issues. The study protocol was approved by the University of Venda Ethics Committee Registration (SHS/19/PH/17/2608) on the 26th of August 2019.

摘要

背景

津巴布韦是撒哈拉以南非洲青少年怀孕率最高的国家。在津巴布韦,那些来自进行文化启蒙并遵守某些规范的部落的青少年中,艾滋病毒(HIV)和获得性免疫缺陷综合征(AIDS)的患病率高于全国估计的 12%(分别为 18%和 13.6%)。津巴布韦的土著卫生系统(IHS)和现代卫生系统(MHS)并行运行,这给青少年性健康管理带来了挑战。本研究旨在制定策略,促进姆贝雷格瓦和乌姆古扎地区 IHS 和 MHS 的整合。

方法

本研究将分两个阶段进行。第一阶段将采用同时性三角混合方法设计,结合定性和定量方法。通过并排比较研究结果,将合并定性和定量方法的发现。第二阶段将专注于制定促进 IHS 和 MHS 整合的策略的发展和验证。将对第一阶段的接口结果应用优势、劣势、机会和威胁(SWOT)分析。然后,根据 SWOT 分析结果,利用基本逻辑和构建、克服、探索和最小化(BOEM)模型制定策略。通过向选定的关键利益相关者应用德尔菲技术和检查表,并通过组织研讨会进行管理,对制定的策略进行验证。

讨论

在文献中没有发现探索整合 IHS 和 MHS 以促进青少年安全性行为的可能性并制定策略的已知研究。大多数性健康方案都忽略了 IHS 和 MHS 对影响安全性行为的作用,导致它们未能达到预期目标。强调重点主要放在通过倡导利用 MHS 来减少性传播感染(STIs)的传播,而不是专注于整合旨在管理青少年性健康(ASH)相关问题的系统。该研究方案于 2019 年 8 月 26 日获得文达大学伦理委员会注册(SHS/19/PH/17/2608)的批准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d24f/6995095/2d40ea92954a/12978_2020_862_Fig1_HTML.jpg

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