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津巴布韦翁古扎和姆贝伦瓜区的本土卫生系统与青少年性健康:社区关键利益相关者的观点

Indigenous Health Systems and Adolescent Sexual Health in Umguza and Mberengwa Districts of Zimbabwe: Community Key Stakeholders' Perspectives.

作者信息

Nunu Wilfred Njabulo, Makhado Lufuno, Mabunda Jabu Tsakani, Lebese Rachel Tsakani

机构信息

Department of Public Health, School of Health Sciences, University of Venda, Thohoyandou, South Africa.

Department of Environmental Science and Health, Faculty of Applied Sciences, National University of Science and Technology, Bulawayo, Zimbabwe.

出版信息

Health Serv Insights. 2021 Apr 30;14:11786329211013553. doi: 10.1177/11786329211013553. eCollection 2021.

Abstract

Different stakeholders play varying roles in shaping up adolescent sexual behaviours that, in turn, influence their sexual experiences. In Zimbabwe, it has been reported that adolescents from cultural districts exhibit poor sexual health outcomes as compared to other districts. Therefore, this study sought to explore the role of different key community stakeholders in the indigenous health system and how it impacts on adolescent sexual health issues. The study further explored how the indigenous health system could be integrated into the modern health system. A qualitative cross-sectional survey was conducted on purposively and snowballed respondents in Umguza and Mberengwa districts. Interviews and focus group discussions were used to gather and record data from participants. The recorded data were transcribed verbatim, translated to English, coded and thematically analysed on MAXQDA Analytics Pro 2020. Four superordinate and 12 subordinate themes emerged from the data during analysis. Stakeholders play varied roles in adolescents' upbringing and support though there are contradicting teachings from the indigenous health system and modern health system. It is possible to integrate these two systems though there were foreseen logistical challenges and clashes in the values and belief systems. Participants made suggestions on how these challenges could be overcome. There is a window of opportunity to pursue the suggested ways of integrating indigenous health systems and modern health systems for improved adolescent sexual health outcomes.

摘要

不同的利益相关者在塑造青少年性行为方面发挥着不同的作用,而青少年性行为又会反过来影响他们的性经历。在津巴布韦,据报道,与其他地区相比,来自文化地区的青少年性健康状况较差。因此,本研究旨在探讨本土卫生系统中不同关键社区利益相关者的作用,以及它如何影响青少年性健康问题。该研究还进一步探讨了本土卫生系统如何能够融入现代卫生系统。在翁古扎和姆贝伦瓜地区,对有目的选取和通过滚雪球方式确定的受访者进行了定性横断面调查。通过访谈和焦点小组讨论来收集和记录参与者的数据。记录的数据被逐字转录,翻译成英文,编码并在MAXQDA Analytics Pro 2020上进行主题分析。分析过程中从数据中得出了四个上位主题和12个下位主题。尽管本土卫生系统和现代卫生系统的教义相互矛盾,但利益相关者在青少年的成长和支持方面发挥着不同的作用。整合这两个系统是有可能的,尽管预计会在后勤方面面临挑战,以及在价值观和信仰体系方面存在冲突。参与者就如何克服这些挑战提出了建议。存在一个机会窗口,可以采用所建议的方式整合本土卫生系统和现代卫生系统,以改善青少年的性健康状况。

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