Department of Health Systems and Policy, College of Medicine, School of Public Health and Family Medicine, University of Malawi, Chichiri, Private Bag 360, Blantyre, Malawi.
College of Medicine, African Centre of Excellence in Public Health and Herbal Medicine (ACEPHEM), University of Malawi, Blantyre, Malawi.
Reprod Health. 2021 Jan 20;18(1):15. doi: 10.1186/s12978-020-01065-9.
Despite documented benefits of contraceptives, uptake among young people aged 20-24 years is high compared to adolescents aged 15-19 years in Malawi. As the world's population of 15-19-year-olds continues to grow the need to meet the increasing demand for contraceptive services and information that address adolescent-specific needs cannot be underestimated. To inform Sexual and Reproductive health services for the youth, we explored strategies for optimizing uptake of contraceptives among this age group.
An exploratory qualitative cross-sectional study was conducted at Nsanje District Hospital and Nyamadzere Community Day Secondary School guided by Social-Ecological Framework to understand strategies that may optimize the uptake of contraceptives among adolescents aged 15-19. Nsanje district was purposively selected based on the reason that it is the second district in Malawi with the highest rate of adolescent childbearing of girls aged 15-19 years. We conducted a Focus Group Discussion (FGD) with 9 traditional leaders, 11 Key Informant Interviews (KIIs) with health workers, 20 In-depth Interviews (IDIs) with 12 adolescents, 4 teachers, and 4 parents. All data were digitally recorded, transcribed verbatim into English. The data was analyzed and managed using deductive thematic analysis guided by Social-Ecological Framework.
Adolescents suggested accessing contraceptives from local drug stores, pharmacies and hospitals at a health system level and through Youth Centres, clubs, and corners at a Community level. There is a need to ensure a continuous supply of various kinds of contraceptives and the presence of youth-friendly health care workers in the specified areas.
There is no one way of delivering contraceptives to adolescents. Multiple avenues existent at the health facility and community could be leveraged to optimize delivery and uptake of contraceptives in a manner that is not intimidating to an adolescent while involving key stakeholders.
尽管避孕药具已被证实具有益处，但与 15-19 岁青少年相比，马拉维 20-24 岁年轻人的避孕药具使用率仍然较高。随着世界 15-19 岁人口的持续增长，满足青少年对避孕服务和信息日益增长的需求不容忽视。为了为年轻人提供性健康和生殖健康服务，我们探讨了优化该年龄段人群避孕药具使用率的策略。
本研究在 Nsanje 区医院和 Nyamadzere 社区日中学开展了一项探索性定性横断面研究，该研究以社会生态框架为指导，以了解可能优化 15-19 岁青少年使用避孕药具的策略。Nsanje 区之所以被选择是基于它是马拉维第二个少女生育比例最高的区，在该地区女孩 15-19 岁的生育率为 2 。我们与 9 名传统领袖进行了焦点小组讨论（FGD），与 11 名卫生工作者进行了 11 次关键知情者访谈（KII），与 12 名青少年、4 名教师和 4 名家长进行了 20 次深入访谈（IDI）。所有数据均进行了数字记录，并逐字转录为英文。数据使用社会生态框架指导的演绎主题分析进行分析和管理。
青少年建议在卫生系统层面从当地药店、药房和医院获取避孕药具，在社区层面通过青年中心、俱乐部和角落获取避孕药具。需要确保在指定区域持续供应各种避孕药具，并配备对青少年友好的卫生保健工作者。
向青少年提供避孕药具的方式不止一种。可以利用现有的多种途径，包括卫生保健机构和社区，以一种不令青少年感到畏惧的方式优化避孕药具的提供和使用，同时涉及到关键利益攸关方。
