Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Sciences, Infectious Medicine, Uppsala University, Uppsala, Sweden.
BMC Health Serv Res. 2022 May 18;22(1):668. doi: 10.1186/s12913-022-07945-z.
Sexual and reproductive health and rights (SRHR) is an important aspect for young people. In Sweden, young migrants often encounter barriers to accessing and using sexual and reproductive health (SRH) services, despite that these services are free of charge for young people (ages 15-25). Healthcare providers' views and best practices are of great importance for improving the utilisation of existing SRH services, particularly for young people. This study aims to understand healthcare providers' experiences and perspectives on barriers to SRHR among young migrants and their suggestions for strategies to improve the provision of SRH services to this group.
Midwives, counsellors and nurses with at least five years of professional experience within SRHR were reached through a purposeful sample at primary care clinics, specialised clinics and youth-friendly clinics, which provide SRH services to migrant youths in Stockholm. Twelve interviews were conducted from May 2018 to February 2020. Qualitative content analysis was performed.
The analysis identified one theme: Improving the fragmentation in the SRH services, and four sub-themes: 1. Being unaware of SRHR; 2. Creating trust and responsive interactions; 3. Communicating in the same language; and 4. Collaborating to build bridges. The barriers included distrust in the healthcare system, socio-cultural norms surrounding SRHR, incomplete translations, and a need for long-lasting collaboration with SRH services and other range of services for migrants. The strategies for improvement as suggested by participants included involving existing cultural groups and organisations to enable trust, consistent and dependable interpreters, a streamline of SRH services with other healthcare staff and health facilities, and collaborations with homes designated for young migrants and language schools for a direct linkage to service providers.
Findings indicate that there are fragmentations in SRH services, and these include lack of knowledge about SRHR among migrant youth, language and communication barriers, and a lack of structure needed to build dependable services that go beyond one-time interventions. While initiatives and strategies from healthcare providers for improvement of SRH services exist, the implementation of some strategies may also require involving the regional and national decision-makers and multi-stakeholders like communities, civil society and young migrants themselves.
性与生殖健康和权利（SRHR）是年轻人的一个重要方面。在瑞典，年轻移民在获得和使用性与生殖健康（SRH）服务方面经常遇到障碍，尽管这些服务对 15-25 岁的年轻人是免费的。医疗保健提供者的观点和最佳实践对于改善现有 SRH 服务的利用至关重要，特别是对于年轻人而言。本研究旨在了解医疗保健提供者对年轻移民的 SRHR 障碍的经验和看法，以及他们对改善向这一群体提供 SRH 服务的策略的建议。
通过在初级保健诊所、专门诊所和青年友好诊所的有针对性的抽样，接触了至少有五年 SRHR 专业经验的助产士、顾问和护士，这些诊所为斯德哥尔摩的移民青年提供 SRH 服务。2018 年 5 月至 2020 年 2 月期间进行了 12 次访谈。采用定性内容分析法进行分析。
分析确定了一个主题：改善 SRH 服务的碎片化，以及四个子主题：1. 不了解 SRHR；2. 建立信任和响应性互动；3. 用同一种语言交流；4. 合作以建立桥梁。障碍包括对医疗保健系统的不信任、SRHR 周围的社会文化规范、不完整的翻译，以及对与 SRH 服务和其他移民服务范围的长期合作的需求。参与者提出的改进策略包括：让现有文化群体和组织参与以建立信任、提供一致和可靠的口译员、将 SRH 服务与其他医疗保健人员和卫生设施整合、与青年移民的指定住所和语言学校合作，以直接与服务提供者建立联系。
研究结果表明，SRH 服务存在碎片化，包括移民青年对 SRHR 的知识缺乏、语言和沟通障碍，以及缺乏建立可靠服务所需的结构，这些服务不仅限于一次性干预。虽然医疗保健提供者已经提出了改进 SRH 服务的倡议和策略，但一些策略的实施也可能需要涉及区域和国家决策者以及多利益相关者，如社区、民间社会和青年移民本身。
