Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
University of Minnesota, School of Public Health, 1300 S. 2nd St., Minneapolis, MN, 55454, USA.
BMC Public Health. 2021 Apr 7;21(1):676. doi: 10.1186/s12889-021-10696-x.
Health care providers across sub-Saharan Africa continue to face challenges while delivering sexual health care services. We explored the experiences, views and challenges of health care professionals and health students across different disciplines in Tanzania, towards delivery of sexual health services to men who have sex with men.
Utilizing a qualitative approach, we recruited 121 health care professionals (providers) and students from the fields of midwifery, nursing and medicine in Dar es Salaam, Tanzania. We conducted 18 focus groups discussions, stratified by profession and experience, to investigate clinical management and challenges while addressing a case of an adult male presenting with rectal gonorrhea.
Findings indicated this case as extremely sensitive, clinical management involved establishing rapport and consent, medical care from history taking to treatment, and referral to other specialties. However, the illegal status of homosexuality in Tanzania was a primary concern to participants, this triggered the clinical care of this case scenario as challenging. There were uncertainties whether or not that such a case should be reported to the authorities.
Findings from this study revealed a need for training health students in Tanzania to address sexual health issues including accurate information on homosexuality, reporting requirements and clinical management in the legal and socio-cultural context of the African continent.
撒哈拉以南非洲的医疗保健提供者在提供性保健服务时仍然面临挑战。我们探讨了坦桑尼亚不同学科的医疗保健专业人员和学生在向男男性行为者提供性保健服务方面的经验、观点和挑战。
利用定性方法，我们从达累斯萨拉姆招募了 121 名助产士、护理和医学专业的医疗保健专业人员和学生。我们进行了 18 次焦点小组讨论，按专业和经验进行分层，以调查在处理一名成年男性直肠淋病病例时的临床管理和挑战。
研究结果表明，这种情况极其敏感，临床管理涉及建立融洽关系和同意，从病史采集到治疗的医疗护理，以及转介给其他专业。然而，坦桑尼亚同性恋的非法地位是参与者的主要关注点，这使得这种病例的临床护理具有挑战性。对于这样的病例是否应该向当局报告存在不确定性。
这项研究的结果表明，坦桑尼亚需要培训医学生解决性健康问题，包括同性恋的准确信息、报告要求以及非洲大陆法律和社会文化背景下的临床管理。
