Logie Carmen H, Abela Heather, Turk Tarek, Parker Samantha, Gholbzouri Karima
Factor Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street, Toronto, ON, M5S 1V4, Canada.
Women's College Research Institute, Women's College Hospital, Toronto, Canada.
Health Res Policy Syst. 2021 Apr 21;19(Suppl 1):57. doi: 10.1186/s12961-020-00659-w.
Self-care strategies for sexual and reproductive health (SRH) include practices, tools, and strategies for people to manage their health. Access to SRH services has increased in the Eastern Mediterranean Region (EMR) in the past decade. The objective of this manuscript is to provide a preliminary assessment of self-care SRH interventions focusing on access, knowledge, perceived challenges, and recommendations for the future. We aim to contribute to the evidence base on knowledge and uptake of self-care SRH strategies in the EMR.
We conducted an online cross-sectional Global Values and Preferences Survey (GVPS) to inform WHO guideline development on self-care interventions for SRH. Recruitment was web-based and included hosting the survey on the WHO Department of Reproductive Health and Research website, and sharing the survey link to diverse SRH websites. Analyses included the subsample of respondents living in EMR countries. We first conducted descriptive statistics of sociodemographic and self-care intervention responses. We then conducted bivariate analyses to examine statistically significant differences in knowledge for each intervention between EMR and non-EMR regions. We extracted open-text responses and applied thematic analysis techniques.
There were 53 respondents from the EMR spanning 14 countries, including16 health care providers (HCP) and 37 laypersons. Qualitative responses (n = 16) suggest that (a) perceived benefits of self-care SRH strategies include enhanced SRH access, knowledge, and improved SRH outcomes; (b) perceived concerns include misuse and safety; (c) linkage to care following self-care SRH interventions can consider mobile phone apps, hotlines, health care liaisons, and community outreach; (d) HCP want additional training on strengthening therapeutic alliances with patients and practical information on interventions; and (e) future research can focus on reproductive health, condom use, service barriers, and implementation. EMR respondents reported lower knowledge levels than non-EMR respondents on the following strategies: diaphragm/cervical cap, contraceptive patch, web-based SRH information, post-exposure prophylaxis, re-exposure prophylaxis, and HIV treatment.
Knowledge of self-care SRH strategies varies by intervention type in the EMR. Future research with larger and more representative samples can inform regional self-care SRH implementation. Knowledge dissemination, stigma reduction, accessibility, and training of health care professionals are key domains for advancing access to self-care SRH strategies in the EMR.
性与生殖健康（SRH）的自我保健策略包括个人管理自身健康的实践、工具和策略。在过去十年中，东地中海区域（EMR）获得SRH服务的机会有所增加。本论文的目的是对自我保健SRH干预措施进行初步评估，重点关注可及性、知识、感知到的挑战以及对未来的建议。我们旨在为东地中海区域自我保健SRH策略的知识和应用的证据基础做出贡献。
我们开展了一项在线横断面全球价值观与偏好调查（GVPS），以为世卫组织关于SRH自我保健干预措施的指南制定提供信息。招募通过网络进行，包括在世卫组织生殖健康与研究司网站上发布调查，以及将调查链接分享到各种SRH网站。分析包括居住在东地中海区域国家的受访者子样本。我们首先对社会人口统计学和自我保健干预措施的回答进行描述性统计。然后进行双变量分析，以检验东地中海区域和非东地中海区域在每种干预措施的知识方面的统计学显著差异。我们提取了开放式回答并应用了主题分析技术。
来自东地中海区域14个国家的53名受访者参与了调查，其中包括16名医疗保健提供者（HCP）和37名非专业人员。定性回答（n = 16）表明：（a）自我保健SRH策略的感知益处包括增加SRH服务可及性、知识以及改善SRH结果；（b）感知到的担忧包括误用和安全问题；（c）自我保健SRH干预措施后的护理联系可考虑手机应用程序、热线、医疗保健联络人和社区外展；（d）医疗保健提供者希望获得关于加强与患者治疗联盟的额外培训以及干预措施的实用信息；（e）未来研究可侧重于生殖健康、避孕套使用、服务障碍和实施。在以下策略方面，东地中海区域的受访者报告的知识水平低于非东地中海区域的受访者：隔膜/宫颈帽、避孕贴片、基于网络的SRH信息、暴露后预防、再次暴露预防和艾滋病毒治疗。
在东地中海区域，自我保健SRH策略的知识因干预类型而异。未来采用更大规模和更具代表性样本的研究可为区域自我保健SRH的实施提供信息。知识传播、减少耻辱感、可及性以及医疗保健专业人员的培训是促进东地中海区域获得自我保健SRH策略的关键领域。
