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“这样的对话在家庭中是不会进行的”:一项关于卢旺达青少年获得性健康和生殖健康及权利信息的决定因素的定性研究。

"Such conversations are not had in the families": a qualitative study of the determinants of young adolescents' access to sexual and reproductive health and rights information in Rwanda.

机构信息

School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.

出版信息

BMC Public Health. 2022 Oct 7;22(1):1867. doi: 10.1186/s12889-022-14256-9.


DOI:10.1186/s12889-022-14256-9
PMID:36207718
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9541074/
Abstract

BACKGROUND: Access to sexual and reproductive health and rights (SRHR) information during adolescence has become a global concern. This study explored factors that enable or prevent young adolescents from accessing to SRHR information from the perspective of the key informants in Rwanda. METHODS: We conducted a qualitative study using semi-structured interviews with 16 purposively selected key informants from public and private institutions in Rwanda. This selection was based on their positions and expertise in delivering SRHR information to adolescents. The interview guide questions were designed based on the social-ecological theoretical framework of adolescent health. The interview transcripts were recorded, transcribed, translated and thematically analysed in Nvivo 11. RESULTS: The study reflected that multiple enablers and barriers at the individual, relationship, community and societal levels determined young adolescents' access to SRHR information. These determinants include information-seeking behaviour and age of starting sexuality education at the individual level; and parents' limited communication with young adolescents due to taboos, lack of skills, limited parental availability, beliefs, lack of appropriate language and peer norms at the relationships level. Enablers and barriers at the community level were the diversity of SRHR sources, the scope of sexuality education programmes, and cultural and religious beliefs. Finally, the perceived enablers and barriers at the societal level consisted of inadequate resources, inappropriate SRHR policy-making processes and unfriendly SRHR laws. CONCLUSION: Enabling access to SRHR information requires addressing multiple factors within the social-ecological environment of young adolescents. Addressing these factors may facilitate improved access to SRHR information for this age group.

摘要

背景:青春期获取性与生殖健康和权利(SRHR)信息已成为全球关注的问题。本研究从卢旺达关键信息提供者的角度探讨了使青少年能够或阻止其获取 SRHR 信息的因素。

方法:我们采用半结构式访谈,在卢旺达的公立和私立机构中,选择了 16 名具有代表性的关键信息提供者参与研究。选择标准是他们在向青少年提供 SRHR 信息方面的职位和专长。访谈指南问题基于青少年健康的社会生态学理论框架设计。访谈记录、转录、翻译和主题分析均在 Nvivo 11 中进行。

结果:研究反映了个人、关系、社区和社会各级的多种促进因素和障碍决定了青少年获取 SRHR 信息的情况。这些决定因素包括个人层面的信息搜索行为和开始性教育的年龄;以及由于禁忌、缺乏技能、父母可用性有限、信仰、缺乏适当语言和同伴规范等原因,父母与青少年的沟通有限。社区层面的促进因素和障碍包括 SRHR 信息来源的多样性、性教育计划的范围,以及文化和宗教信仰。最后,社会层面的感知促进因素和障碍包括资源不足、SRHR 决策过程不当以及对 SRHR 法律的不友好。

结论:为了使青少年能够获取 SRHR 信息,需要解决其社会生态环境中的多个因素。解决这些因素可能有助于改善该年龄段青少年获取 SRHR 信息的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08bf/9541074/06f98aadb6d7/12889_2022_14256_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08bf/9541074/06f98aadb6d7/12889_2022_14256_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08bf/9541074/06f98aadb6d7/12889_2022_14256_Fig1_HTML.jpg

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[2]
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[3]
"Sexuality education is a double edge-sword…": a qualitative study on perceptions of school teachers on sexual and reproductive health of adolescent girls in Eastern India.

Reprod Health. 2025-8-11

[4]
Adolescent-Parent Communication on Sexual and Reproductive Health Issues in Nyarugenge and Kamonyi Districts, Rwanda: A Qualitative Exploration of Adolescent Insights.

Rwanda J Med Health Sci. 2025-3-31

[5]
Adolescent awareness and experience of the pubertal changes: A qualitative study from Rwanda.

PLoS One. 2025-6-24

[6]
The importance of reproductive health education for elementary school children: Long-term benefits and challenges in implementation - A literature review.

J Educ Health Promot. 2025-4-30

[7]
Understanding Church-Led Adolescent and Youth Sexual Reproductive Health (AYSRH) Interventions Within the Framework of Church Beliefs and Practices in South Africa: A Qualitative Study.

Healthcare (Basel). 2025-4-15

[8]
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[9]
Factors influencing abortion care-seeking outside of formal healthcare settings: lived experiences from Rwandan young women.

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[10]
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本文引用的文献

[1]
Sexual wellbeing in early adolescence: a cross-sectional assessment among girls and boys in urban Indonesia.

Reprod Health. 2021-7-20

[2]
Stakeholders' perspectives of comprehensive sexuality education in Iranian male adolescences.

Reprod Health. 2021-2-2

[3]
Adolescent sexual and reproductive health research in sub-Saharan Africa: a scoping review of substantive focus, research volume, geographic distribution and Africa-led inquiry.

BMJ Glob Health. 2021-2

[4]
Examining determinants of gender attitudes: evidence among Tanzanian adolescents.

BMC Womens Health. 2020-9-10

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Breaking barriers in the prevention of adolescent pregnancies for in-school children in Kirehe district (Rwanda): a mixed-method study for the development of a peer education program on sexual and reproductive health.

Reprod Health. 2020-9-7

[6]
Availability, accessibility, and quality of adolescent Sexual and Reproductive Health (SRH) services in urban health facilities of Rwanda: a survey among social and healthcare providers.

BMC Health Serv Res. 2020-7-29

[7]
Achieving SDG related sexual and reproductive health targets in China: what are appropriate indicators and how we interpret them?

Reprod Health. 2020-6-1

[8]
Parent-child sexual and reproductive health communication among very young adolescents in Korogocho informal settlement in Nairobi, Kenya.

Reprod Health. 2020-6-1

[9]
Parent's Perception regarding the Delivery of Sexual and Reproductive Health (SRH) Education in Secondary Schools in Fiji: A Qualitative Study.

J Environ Public Health. 2020-1-9

[10]
Associations Between Agency and Sexual and Reproductive Health Communication in Early Adolescence: A Cross-cultural, Cross-sectional Study.

J Adolesc Health. 2020-9

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