Fataar Kulthum, Zweigenthal Virginia, Harries Jane
Department of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Front Glob Womens Health. 2022 Sep 14;3:917881. doi: 10.3389/fgwh.2022.917881. eCollection 2022.
Health care providers can play a significant role in empowering women to make informed decisions when selecting suitable contraceptive methods during contraceptive counseling. This study explores primary care providers' perspectives and approaches to contraceptive service provision for women attending public sector clinics in South Africa, with the intention of ascertaining established practices and training needs.
Ten in-depth interviews were conducted at five primary health care facilities in urban areas in Cape Town, South Africa. Eligible participants included nurses providing contraceptive services and willing to participate in the study. The qualitative software package NVivo was used to sort and manage data. Data was analyzed using a thematic analysis approach.
Overall, providers emphasized supporting women in contraceptive decision-making. Sexual and reproductive health training increased providers confidence to deliver appropriate contraceptive services. Contraceptive prescribing practices were influenced by women's medical history and preferred bleeding patterns. Providers' concerns about adherence to methods for younger women and suspected adverse events for older women impacted on prescribing. Challenges experienced when providing contraceptive services included: contraceptive stockouts; time constraints of employed women accessing the service; and their work pressure due to providing other health services.
Health care providers play a critical role in facilitating women's right to access high quality contraceptive services. Providers saw themselves as negotiators during contraceptive counseling. They considered both women's preferences and their own recommendations for contraception, to provide information that would enable women to make informed contraceptive decisions. By reinforcing this approach to contraceptive counseling and focusing on shared decision-making, should encourage autonomy in method selection and limit the influence of provider's contraceptive method selection.
在避孕咨询过程中,医疗保健提供者在帮助女性做出明智的避孕方法选择决策方面可以发挥重要作用。本研究探讨了南非公共部门诊所的初级保健提供者对为女性提供避孕服务的看法和方法,旨在确定既定做法和培训需求。
在南非开普敦市区的五个初级卫生保健机构进行了十次深入访谈。符合条件的参与者包括提供避孕服务并愿意参与研究的护士。使用定性软件包NVivo对数据进行分类和管理。采用主题分析方法对数据进行分析。
总体而言,提供者强调在避孕决策方面支持女性。性健康和生殖健康培训增强了提供者提供适当避孕服务的信心。避孕处方做法受女性病史和偏好的出血模式影响。提供者对年轻女性避孕方法依从性的担忧以及对老年女性疑似不良事件的担忧影响了处方。提供避孕服务时遇到的挑战包括:避孕药具缺货;职业女性获取服务的时间限制;以及由于提供其他健康服务而带来的工作压力。
医疗保健提供者在促进女性获得高质量避孕服务的权利方面发挥着关键作用。提供者将自己视为避孕咨询过程中的协商者。他们既考虑女性的偏好,也考虑自己对避孕的建议,以提供能使女性做出明智避孕决策的信息。通过强化这种避孕咨询方法并注重共同决策,应鼓励在方法选择上的自主性,并限制提供者对避孕方法选择的影响。