Abu Hamad Bassam, Jones Nicola, Gercama Ingrid
Faculty of Public Health, Al-Quds University/ GAGE MENA Regional Director, 101, Tel El Hawa, Gaza, Palestine.
ODI Principal Research Fellow and Director of Gender and Adolescence: Global Evidence (GAGE), Overseas Development Institute, 203 Blackfriars Bridge Road, London, SE1 8NJ, UK.
Confl Health. 2021 May 21;15(1):40. doi: 10.1186/s13031-021-00379-0.
Enjoyment of physical and mental health is not only recognized as a human right but also as an integral part of development, as reflected in Sustainable Development Goal 3 - to ensure healthy lives and promote well-being for all at all ages. The rapid physical and psychosocial changes that take place during adolescence have a strong influence on the rest of a person's life course, so investments in adolescent health services constitute a unique opportunity to reap inter-generational dividends. Yet the evidence base on adolescents' access to health services, particularly in conflict-affected contexts, remains thin. This article explores adolescents' access to health services in the Gaza Strip, and their experiences and perceptions of those services.
The article draws on mixed methods research in the Gaza Strip conducted in 2016 and 2017 as part of the Gender and Adolescence: Global Evidence research programme. Data were collected from 240 male and female adolescents combining in-depth interviews, focus group discussions and a tablet-based survey. This study also draws on a participatory action pilot project engaging 12 boys and 23 adolescent girls aged 15-19 years old.
The findings underscore that gender norms-especially those pertaining to adolescent girls' sexual purity--shape adolescent health in multiple ways. Girls face increasing restrictions on their mobility, leaving them with limited opportunities for leisure or exercise, socializing with peers or seeking health services and information. Adolescent boys in Gaza do not face the same restrictions, but given the multiple political, economic and familial stressors, they are at high risk of substance abuse including smoking and involvement in peer violence. Moreover, our findings suggest that a range of socioeconomic, cultural and structural barriers prevent adolescents in Gaza from accessing quality and appropriate health care. Study participants cited the main challenges being an absence of preventive adolescent health initiatives and limited information on sexual and reproductive health, as well as drug shortages, high treatment costs, and inappropriate interactions with service providers.
The article highlights the importance of designing and implementing conflict-sensitive and age- and gender-appropriate adolescent services and information and promoting preventive services targeted at adolescents.
身心健康不仅被视为一项人权，也是发展不可或缺的一部分，这在可持续发展目标3中得到体现——确保所有人在所有年龄段都能过上健康的生活并促进福祉。青少年时期发生的快速生理和心理社会变化对一个人余下的人生轨迹有重大影响，因此对青少年健康服务的投资是收获代际红利的独特机会。然而，关于青少年获得健康服务的证据基础，尤其是在受冲突影响的背景下，仍然薄弱。本文探讨了加沙地带青少年获得健康服务的情况，以及他们对这些服务的体验和看法。
本文借鉴了2016年和2017年在加沙地带进行的混合方法研究，该研究是“性别与青少年：全球证据”研究项目的一部分。通过深入访谈、焦点小组讨论和基于平板电脑的调查，收集了240名青少年（包括男性和女性）的数据。本研究还借鉴了一个参与式行动试点项目，该项目涉及12名男孩和23名15至19岁的青少年女孩。
研究结果强调，性别规范——尤其是与少女贞操相关的规范——以多种方式塑造青少年健康。女孩的行动自由受到越来越多的限制，休闲或锻炼、与同龄人交往或寻求健康服务和信息的机会有限。加沙地带的青少年男孩没有面临同样的限制，但鉴于多重政治、经济和家庭压力源，他们有很高的药物滥用风险，包括吸烟和参与同伴暴力。此外，我们的研究结果表明，一系列社会经济、文化和结构性障碍阻碍了加沙地带的青少年获得优质和适当的医疗保健。研究参与者提到的主要挑战包括缺乏预防性青少年健康倡议、性健康和生殖健康信息有限，以及药品短缺、治疗费用高昂和与服务提供者的不当互动。
本文强调了设计和实施对冲突敏感、适合年龄和性别的青少年服务和信息，以及推广针对青少年的预防服务的重要性。
