Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden.
St. Francis Hospital Nsambya, Kampala, Uganda.
PLoS One. 2020 Jun 25;15(6):e0234658. doi: 10.1371/journal.pone.0234658. eCollection 2020.
Although progress has been made to improve access to sexual and reproductive health services globally in the past two decades, in many low-income countries, improvements have been slow. Discrimination against vulnerable groups and failure to address health inequities openly and comprehensively play a role in this stagnation. Healthcare practitioners are important actors who, often alone, decide who accesses services and how. This study explores how health care practitioners perceive sexual and reproductive health and rights (SRHR) and how background factors influence them during service delivery. Participants were a purposefully selected sample of health practitioners from five low income countries attending a training in at Lund University, Sweden. Semi-structured interviews and qualitative content analysis were used. Three themes emerged. The first theme, "one-size doesn't fit all' in SRHR" reflects health practitioners' perception of SRHR. Although they perceived rights as fundamental to sexual and reproductive health, exercising of these rights was perceived to be context-specific. The second theme, "aligning a pathway to service delivery", illustrates a reflective balancing act between their personal values and societal norms in service delivery, while the third theme, "health practitioners acting as gatekeepers", describes how this balancing act oscillates between enabling and blocking behaviours. The findings suggest that, even though health care practitioners perceive SRHR as fundamental rights, their preparedness to ensure that these rights were upheld in service delivery is influenced by personal values and society norms. This could lead to actions that enable or block service delivery.
尽管在过去的二十年中，全球范围内在改善获得性和生殖健康服务方面取得了进展，但在许多低收入国家，进展缓慢。在这种停滞不前的情况下，弱势群体受到歧视，以及未能公开和全面解决健康不平等问题，都起到了一定的作用。医疗保健从业者是重要的参与者，他们往往独自决定谁可以获得服务以及如何获得服务。本研究探讨了医疗保健从业者如何看待性和生殖健康及权利（SRHR），以及背景因素如何在服务提供过程中影响他们。参与者是来自五个低收入国家的医疗保健从业者，他们是在瑞典隆德大学参加培训的有目的选择的样本。使用了半结构化访谈和定性内容分析。出现了三个主题。第一个主题是“一刀切不适合所有人”，反映了医疗保健从业者对 SRHR 的看法。尽管他们认为权利是性和生殖健康的基础，但行使这些权利被认为是具体情况具体分析的。第二个主题是“调整服务提供的途径”，说明了在服务提供过程中，他们的个人价值观和社会规范之间的反思性平衡行为，而第三个主题是“医疗保健从业者充当把关人”，描述了这种平衡行为如何在促进和阻碍行为之间波动。研究结果表明，尽管医疗保健从业者认为 SRHR 是基本权利，但他们准备在服务提供中确保这些权利得到维护的意愿受到个人价值观和社会规范的影响。这可能导致促进或阻碍服务提供的行为。
