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南非低收入社区中校内避孕诊所的可接受性与可行性

Acceptability and feasibility of a school-based contraceptive clinic in a low-income community in South Africa.

作者信息

Khoza Nondumiso, Zulu Phindile, Shung-King Maylene

机构信息

Ukwanda Center for Rural Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

出版信息

Prim Health Care Res Dev. 2019 Mar 20;20:e22. doi: 10.1017/S1463423618000762.

Abstract

AIM

To investigate how acceptable and feasible a school-based contraceptive clinic (SBCC) would be in a low-income South African community.

BACKGROUND

Teenage pregnancy is an important issue in South Africa, with significant health and social consequences. Issues regarding lack of confidentiality in an intimate community, unwelcoming health workers, long distances to clinics and perceptions of contraceptive side effects may all inhibit contraceptive use by adolescents. Although SBCC has been initiated and investigated in other countries, this approach is inadequately researched in South Africa.

METHODS

A mixed method study was conducted to assess the attitudes of one community towards establishment of an SBCC in their area. Methods of data collection included: focus group discussions (FGDs) with teenage girls from a local high school; a key informant interview with the school principal; a structured survey, including open-ended questionnaires with randomly selected parents of teenage girls from the same community; and a documentary analysis to explore relevant legal and policy considerations.

FINDINGS

Teenage girls, the school principal and parents with teenage daughters largely supported the idea of an SBCC, but with concerns about confidentiality, the possibility of increased promiscuity and contraceptive side effects. While legal statutes and policies in South Africa do not pose any barriers to the establishment of an SBCC, some logistical barriers remain.

摘要

目的

调查在南非一个低收入社区设立校内避孕诊所(SBCC)的可接受性和可行性。

背景

青少年怀孕在南非是一个重要问题,会带来重大的健康和社会后果。在亲密社区中缺乏保密性、医护人员态度不友好、到诊所路途遥远以及对避孕副作用的认知等问题,都可能抑制青少年使用避孕药具。尽管其他国家已经启动并研究了校内避孕诊所,但南非对这种方法的研究还不够充分。

方法

采用混合方法研究来评估一个社区对在其所在地区设立校内避孕诊所的态度。数据收集方法包括:与当地一所高中的少女进行焦点小组讨论(FGD);对学校校长进行关键 informant 访谈;进行结构化调查,包括对来自同一社区的随机挑选的少女家长进行开放式问卷调查;以及进行文献分析以探讨相关的法律和政策考量。

结果

少女、学校校长和有十几岁女儿的家长大多支持设立校内避孕诊所的想法,但对保密性、滥交增加的可能性和避孕副作用表示担忧。虽然南非的法律法规和政策对设立校内避孕诊所没有任何障碍,但仍存在一些后勤障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/868f/6476342/d432056cd17a/S1463423618000762_fig1.jpg

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