Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa.
Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka 10101, Zambia.
Int J Environ Res Public Health. 2023 Feb 3;20(3):2744. doi: 10.3390/ijerph20032744.
This scoping review mapped and synthesised existing evidence on the influence of individual, parental, peer, and societal-related factors on adolescents' decisions to use contraception in sub-Saharan Africa (SSA). Peer-reviewed and review articles published before May 2022, targeting adolescents aged 10-19 years were searched in PubMed, MEDLINE with Full Text via EBSCOhost, PsychINFO via EBSCOhost, CINAHL with Full Text via EBSCOhost, Google Scholar, Science Direct, and Scopus databases. Seven studies were included and analysed using thematic analysis based on the social-ecological model (SEM) and reported using the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Individual (fear of side effects, fear of infertility), parental (parental disappointment and disapproval), peer (social stigma), partner (association with promiscuity and multiple sexual partners), societal and community (contraceptive use disapproval and stigma), and institutional and environmental factors (lack of privacy and confidentiality) influence contraceptive decisions among adolescents. These also include a lack of accurate information, social exclusion, negative health provider attitudes, and a lack of infrastructure that provides privacy and safe spaces. Identifying and addressing core issues within the context of local cultural practices that restrict contraceptive use is important. Holistic, inclusive approaches that promote the well-being of adolescents must be utilised to provide a conducive environment that ensures privacy, confidentiality, safety, and easy access to contraceptive services.
这篇范围界定综述绘制并综合了现有关于个体、父母、同伴和社会相关因素对撒哈拉以南非洲（SSA）青少年避孕决策影响的证据。在 PubMed、EBSCOhost 上的 MEDLINE with Full Text、EBSCOhost 上的 PsychINFO、EBSCOhost 上的 CINAHL with Full Text、Google Scholar、Science Direct 和 Scopus 数据库中搜索了 2022 年 5 月之前发表的针对 10-19 岁青少年的同行评议和综述文章。纳入了 7 项研究，并使用基于社会生态学模型（SEM）的主题分析进行分析，并使用系统评价和荟萃分析的首选报告项目（PRISMA）进行报告。个体因素（对副作用的恐惧、对不孕的恐惧）、父母因素（父母的失望和不赞成）、同伴因素（社会耻辱）、伴侣因素（与滥交和多个性伴侣的关联）、社会和社区因素（对避孕的不赞成和耻辱）以及机构和环境因素（缺乏隐私和保密性）都会影响青少年的避孕决策。这些因素还包括缺乏准确的信息、社会排斥、医疗服务提供者的消极态度以及缺乏提供隐私和安全空间的基础设施。在限制避孕使用的当地文化习俗背景下，确定和解决核心问题很重要。必须采用促进青少年福祉的全面、包容的方法，为他们提供一个确保隐私、保密性、安全性和方便获得避孕服务的有利环境。
