Social and Behavioral Sciences, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA.
BMJ Glob Health. 2023 May;8(Suppl 2). doi: 10.1136/bmjgh-2022-011560.
Adolescent pregnancy is associated with increased risk of maternal and child morbidity and mortality globally. Access to safe, appropriate and affordable antenatal, childbirth and postnatal care (PNC) is essential in mitigating this risk. PNC is an often undervalued, underused, and understudied component of the continuum of maternal health services; however, it provides an important opportunity for adolescent girls to have access to health information and resources as they navigate the transition to motherhood and/or recovery from childbirth. This qualitative evidence synthesis seeks to highlight the experiences and perspectives of adolescent girls and their partners in accessing and using routine PNC.
Papers were selected from a primary review on PNC where a global search of databases was conducted to identify studies with qualitative data focused on PNC utilisation. Within this primary review, a subset of studies focused on adolescents was tagged for subanalysis. A data extraction form drawing on an a priori framework was used to extract data from each study. Review findings were grouped across studies and mapped onto relevant themes, which were then adapted, as appropriate, to best reflect emergent themes from included studies.
Of 662 papers identified for full text review, 15 were included in this review on adolescents' experiences. Fourteen review findings were mapped onto four themes including: resources and access, social norms, experiences of care, and tailored support needs.
Improving uptake of PNC by adolescent girls requires multipronged approaches in improving availability of and access to adolescent-sensitive maternal health services and reducing feelings of shame and stigma in the postpartum period. Much should be done to address structural barriers to access, but tangible steps to improving the quality and responsiveness of available services can be taken immediately.
CRD42019139183.
全球范围内，青少年妊娠与母婴发病率和死亡率升高相关。获得安全、适当且负担得起的产前、分娩和产后护理（PNC）对于降低这种风险至关重要。PNC 是孕产妇保健服务连续体中经常被低估、未充分利用和研究不足的部分；然而，它为青少年女孩提供了一个重要的机会，让她们在过渡到母亲身份和/或从分娩中恢复时获得健康信息和资源。本定性证据综合研究旨在强调青少年女孩及其伴侣在获得和使用常规 PNC 方面的经验和观点。
从一项关于 PNC 的主要综述中选择了论文，该综述对数据库进行了全球搜索，以确定侧重于 PNC 利用的定性数据的研究。在这个主要综述中，对关注青少年的一组研究进行了标记，以便进行子分析。使用一个预先制定的框架的数据提取表从每一项研究中提取数据。综述结果根据研究进行分组，并映射到相关主题上，然后根据需要进行调整，以最佳反映纳入研究中出现的主题。
在 662 篇全文审查的论文中，有 15 篇被纳入了这篇关于青少年经验的综述。14 项综述结果被映射到四个主题上，包括：资源和获取、社会规范、护理体验和个性化支持需求。
要提高青少年女孩对 PNC 的利用率，需要采取多种方法，包括改善青少年敏感的孕产妇保健服务的可及性和可用性，以及减少产后的羞耻感和污名化。在解决获取障碍方面还有很多工作要做，但可以立即采取切实措施来提高现有服务的质量和响应能力。
PROSPERO 注册号：CRD42019139183。
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