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