能力建设干预对尼日利亚东南部医疗保健提供者提供青少年性与生殖健康服务的看法和认知的影响:一项横断面定性研究。
Impact of a capacity-building intervention on views and perceptions of healthcare providers towards the provision of adolescent sexual and reproductive health services in southeast Nigeria: a cross-sectional qualitative study.
机构信息
Health Policy Research Group, College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
Health Policy Research Group, College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria.
出版信息
BMJ Open. 2023 Nov 24;13(11):e073586. doi: 10.1136/bmjopen-2023-073586.
OBJECTIVES
Negative views of healthcare providers towards adolescent sexual and reproductive health (SRH) services deter adolescents from seeking vital SRH services. This paper assessed the impact of an intervention on the views and perceptions of healthcare providers towards the provision of adolescent SRH services.
DESIGN AND SETTING
A descriptive, cross-sectional, qualitative study was conducted between 14 October and 19 November 2021 in six local government areas (LGAs) in Ebonyi state, southeast Nigeria, after the implementation of an intervention comprising of training and supportive supervision.
PARTICIPANTS AND DATA COLLECTION
Data were collected through: (1) two in-depth interviews (IDIs) with LGA healthcare managers; (2) six IDIs with LGA adolescent health programme managers; (3) two focus group discussions (FGDs) with 15 primary healthcare facility managers; (4) two FGDs with 20 patent medicine vendors and (5) two FGDs with 17 community health volunteers. A total of six FGDs were held with 52 healthcare providers. The interviews were conducted using pretested interview guides. Transcripts were coded in NVivo (V.12) and themes were identified through inductive analysis.
RESULTS
As a result of the intervention, most healthcare providers started recognising the rights of adolescents to obtain contraceptive services and no longer deny them access to contraceptive services. The providers also became friendlier and were no longer harsh in their interactions with adolescents. There were some unique findings relative to whether the providers were formal or informal healthcare providers. It was found that the informal healthcare providers were bolder and more comfortable delivering SRH services to adolescents and reported improved patronage by the adolescents. The formal healthcare providers made their facilities more conducive for adolescents by creating safe spaces and introducing extracurricular activities.
CONCLUSION
These findings highlight the importance of the constant capacity building of both formal and informal healthcare providers, which can address healthcare providers' biases, views and perceptions of delivering SRH services to adolescents.
目的
医疗保健提供者对青少年性健康和生殖健康(SRH)服务的负面看法阻碍了青少年寻求重要的 SRH 服务。本文评估了一项干预措施对医疗保健提供者提供青少年 SRH 服务的看法和看法的影响。
设计和设置
2021 年 10 月 14 日至 11 月 19 日,在尼日利亚东南部埃邦伊州的六个地方政府区(LGAs)进行了一项描述性、横断面、定性研究,此前实施了一项干预措施,包括培训和支持性监督。
参与者和数据收集
通过以下方式收集数据:(1)与 LGA 医疗保健经理进行两次深入访谈(IDIs);(2)与 LGA 青少年健康计划经理进行六次 IDI;(3)与 15 名初级保健设施经理进行两次焦点小组讨论(FGD);(4)与 20 名专利药品供应商进行两次 FGD 和(5)与 17 名社区卫生志愿者进行两次 FGD。总共进行了六次 FGD,共有 52 名医疗保健提供者参加。访谈使用了预先测试的访谈指南。使用 NVivo(V.12)对转录本进行编码,并通过归纳分析确定主题。
结果
由于干预措施,大多数医疗保健提供者开始认识到青少年获得避孕服务的权利,并不再拒绝他们获得避孕服务的机会。提供者也变得更加友好,不再在与青少年的互动中苛刻。关于提供者是正式还是非正式医疗保健提供者,存在一些独特的发现。结果发现,非正式医疗保健提供者更大胆,更愿意为青少年提供 SRH 服务,并报告青少年的光顾率有所提高。正式医疗保健提供者通过创建安全空间和引入课外活动,使他们的设施更适合青少年。
结论
这些发现强调了不断对正式和非正式医疗保健提供者进行能力建设的重要性,这可以解决医疗保健提供者对向青少年提供 SRH 服务的偏见、看法和看法。