Banerjee Ankush, Paul Bobby, Das Ranjan, Bandyopadhyay Lina, Bhattacharyya Madhumita
MBBS, MD, Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India. Email:
MBBS, DCH, MD (PSM), Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India.
Malays Fam Physician. 2023 Apr 14;18:26. doi: 10.51866/oa.224. eCollection 2023.
Despite policy actions and strategic efforts for improving the reproductive and sexual health of adolescents by promoting the uptake of adolescent reproductive and sexual health (ARSH) services, the utilisation rate remains significantly low, especially in rural areas of India. This study aimed to assess the utilisation of these services by adolescents in rural West Bengal and its associated determinants.
This mixed-method study was conducted from May to September 2021 in the Gosaba rural block of South 24 Parganas, West Bengal. Quantitative data were collected from 326 adolescents using a pre-tested structured questionnaire. Qualitative data were collected via four focus group discussions among 30 adolescents and key-informant interviews among six healthcare workers. Quantitative data were analysed using SPSS, while qualitative data were analysed thematically.
Ninety-six (29.4%) adolescents had utilised ARSH services at least once during adolescence. The factors associated with non-utilisation of ARSH services were younger age, female sex, increasing reproductive health stigma and decreasing parent-adolescent communication related to sexual health. Qualitative exploration revealed that unawareness regarding services, perceived lack of privacy and confidentiality at healthcare facilities and disruption of services post-emergence of the COVID-19 pandemic were some major barriers to ARSH service utilisation.
A multi-component strategy, including promotion of adolescent-friendly health clinics, community support interventions associated with motivation and counselling of parents regarding the importance of adolescent reproductive health, is needed to improve the utilisation of ARSH services. Necessary steps to correct the deficiencies at the facility level should also be prioritised.
尽管通过推动青少年生殖与性健康（ARSH）服务的使用，采取了政策行动并做出了战略努力来改善青少年的生殖与性健康，但利用率仍然显著较低，尤其是在印度农村地区。本研究旨在评估西孟加拉邦农村地区青少年对这些服务的使用情况及其相关决定因素。
这项混合方法研究于2021年5月至9月在西孟加拉邦南24帕加纳斯的戈萨巴农村地区进行。使用预先测试的结构化问卷从326名青少年中收集定量数据。通过30名青少年参加的四次焦点小组讨论和六名医护人员的关键信息访谈收集定性数据。使用SPSS分析定量数据，而定性数据则进行主题分析。
96名（29.4%）青少年在青春期期间至少使用过一次ARSH服务。与未使用ARSH服务相关的因素包括年龄较小、女性、生殖健康耻辱感增加以及与性健康相关的父母与青少年沟通减少。定性探索表明，对服务的不了解、在医疗机构中缺乏隐私和保密性的认知以及COVID-19大流行出现后服务的中断是ARSH服务利用的一些主要障碍。
需要采取多方面的策略，包括推广对青少年友好的健康诊所、与家长就青少年生殖健康的重要性进行激励和咨询相关的社区支持干预措施，以提高ARSH服务的利用率。还应优先采取必要措施纠正机构层面的缺陷。
