College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia.
College of Medicine and Dentistry, Anton Breinl Research Centre for Health Systems Strengthening, James Cook University, Townsville, Queensland, Australia.
PLoS One. 2023 Jan 26;18(1):e0280667. doi: 10.1371/journal.pone.0280667. eCollection 2023.
The number of young people utilising sexual and reproductive health services in Pacific Island Countries and Territories remains poor despite the availability and the existence of the fundamental rights to access these services. Adolescents and youth need accurate information and timely access to contraceptives to prevent adverse consequences associated with unintended pregnancies, abortion, childbirth and untreated sexually transmitted infections. This scoping review identifies and analyses factors contributing to young people's low access to sexual and reproductive health information and services in this region.
Guided by the PRISMA Scoping review guidelines, we searched three databases (Medline Ovid, Scopus and CINAHL Complete) for peer-reviewed articles published between 1st January 2000 and 31st August 2020 that reported on factors, including barriers and enablers, affecting access to sexual and reproductive health information and services by young people living in Pacific Island Countries and Territories. We assessed the quality of each study according to the study designs, methods of data collection, data analysis and ethical considerations. All information was sorted and organised using an Excel Spreadsheet. Text data from published articles were charted inductively using thematic analysis with no predetermined codes and themes.
Five hundred eighty-nine articles were screened, and only eight met the inclusion criteria outlined in this scoping review protocol. These eight articles reported studies conducted in four Pacific Island Countries and Territories: Cook Islands, Fiji, Papua New Guinea, and Vanuatu. Factors such as lack of accurate sexual and reproductive health knowledge and social stigma were the leading causes of young people's limited access to sexual and reproductive health services. Cultural and religious beliefs also invoked stigmatising behaviours in some family and community members.
This scoping review revealed that social stigma and judgemental attitudes imposed by family and community members, including healthcare providers, hinder young unmarried individuals in Pacific Island Countries and Territories from accessing sexual and reproductive health information and contraceptives. Alternatively, a non-judgmental healthcare provider is perceived as an enabler in accessing sexual and reproductive health information and services. Moreover, given that only a few studies have actually focused on young people's sexual and reproductive health needs in the region, more research is required to fully understand the health-seeking behaviours of young people in their specific contexts.
尽管太平洋岛国和地区拥有获得这些服务的基本权利，但年轻人利用性健康和生殖健康服务的人数仍然很少。青少年和青年需要准确的信息和及时获得避孕药具，以防止意外怀孕、堕胎、分娩和未经治疗的性传播感染带来的不良后果。本范围界定审查旨在确定并分析导致该地区年轻人难以获得性健康和生殖健康信息和服务的因素。
本研究遵循 PRISMA 范围界定审查指南，在 2000 年 1 月 1 日至 2020 年 8 月 31 日期间，在 Medline Ovid、Scopus 和 CINAHL Complete 三个数据库中搜索了同行评议文章，报告了影响生活在太平洋岛国和地区的年轻人获得性健康和生殖健康信息和服务的因素，包括障碍和促进因素。我们根据研究设计、数据收集方法、数据分析和伦理考虑对每项研究的质量进行了评估。使用 Excel 电子表格对所有信息进行了分类和组织。使用无预定代码和主题的归纳主题分析对来自已发表文章的文本数据进行了图表绘制。
筛选出 589 篇文章，只有 8 篇符合本范围界定审查方案中概述的纳入标准。这 8 篇文章报告了在四个太平洋岛国和地区进行的研究：库克群岛、斐济、巴布亚新几内亚和瓦努阿图。缺乏准确的性健康和生殖健康知识以及社会污名化等因素是年轻人获得性健康服务有限的主要原因。文化和宗教信仰也引起了一些家庭和社区成员的污名化行为。
本范围界定审查显示，家庭和社区成员（包括医疗保健提供者）施加的社会污名和评判态度阻碍了太平洋岛国和地区的未婚年轻人获得性健康和生殖健康信息和避孕药具。相反，不评判的医疗保健提供者被视为获取性健康和生殖健康信息和服务的促进因素。此外，由于该地区实际上只有少数研究真正关注年轻人的性健康和生殖健康需求，因此需要进行更多的研究，以充分了解年轻人在特定背景下的健康寻求行为。
