Mbachu Chinyere Ojiugo, Eze Irene Ifeyinwa, Onwujekwe Obinna
Health Policy Research Group, University of Nigeria Enugu Campus, Enugu, Nigeria.
Community Medicine Department, College of Medicine, Alex Ekwueme Federal University Ndufu-Alike Ikwo, Abakaliki, Nigeria.
Reprod Health. 2025 May 31;22(Suppl 1):74. doi: 10.1186/s12978-025-01994-3.
Adolescent sexual and reproductive health (ASRH) is a critical global health concern, demanding multifaceted approaches for effective intervention. This paper presents a qualitative exploration of an innovative community-embedded intervention aimed at enhancing intersectoral collaboration to improve ASRH outcomes.
A qualitative study design was employed to explore the types, processes, and factors that enabled or constrained intersectoral collaborations in implementing a community-embedded intervention for ASRH in Ebonyi State, Nigeria. Thirty in-depth interviews and 18 focus group discussions were conducted with policymakers, health service providers, teachers, community gatekeepers, parents, and adolescents. The interview transcripts were coded in NVivo 12. The outputs of the coded transcripts were analyzed using thematic analysis and presented as narratives.
Key findings highlight the emergence of three predominant collaboration models: horizontal integration between healthcare and education sectors, horizontal integration across various governmental agencies (formal providers) and non-governmental organizations (informal providers), and diagonal integration bridging gaps between community stakeholders and service providers. The processes underpinning these collaborations emphasize the significance of trust-building, shared goals, and clear communication. The study identifies the pivotal role of champions and intermediaries in facilitating collaboration, along with the necessity for a supportive institutional framework. The enabling factors include robust leadership commitment, dedicated funding mechanisms, and a favorable policy environment. Conversely, challenges stemming from resource constraints, conflicting interests, and organizational silos hindered collaboration efforts.
This research underscores the potential of community-embedded interventions to strengthen intersectoral collaboration for the acceptability and adoption of ASRH strategies. It offers a valuable resource for policymakers, healthcare professionals, and stakeholders seeking to enhance ASRH outcomes through collaborative efforts.
青少年性与生殖健康（ASRH）是全球关键的健康问题，需要多方面的方法进行有效干预。本文对一项创新的社区嵌入式干预措施进行了定性探索，该干预旨在加强部门间合作以改善青少年性与生殖健康成果。
采用定性研究设计，以探索在尼日利亚埃邦伊州实施一项针对青少年性与生殖健康的社区嵌入式干预措施过程中，促成或制约部门间合作的类型、过程及因素。对政策制定者、医疗服务提供者、教师、社区守门人、家长和青少年进行了30次深入访谈和18次焦点小组讨论。访谈记录在NVivo 12中进行编码。使用主题分析法对编码后的记录输出进行分析，并以叙述形式呈现。
主要研究结果突出了三种主要合作模式的出现：医疗保健与教育部门之间的横向整合、各政府机构（正规提供者）与非政府组织（非正规提供者）之间的横向整合，以及弥合社区利益相关者与服务提供者之间差距的对角整合。这些合作的过程强调了建立信任、共享目标和清晰沟通的重要性。该研究确定了倡导者和中介在促进合作方面的关键作用，以及支持性制度框架的必要性。促成因素包括强有力的领导承诺、专门的资金机制和有利的政策环境。相反，资源限制、利益冲突和组织孤岛带来的挑战阻碍了合作努力。
本研究强调了社区嵌入式干预措施在加强部门间合作以促进青少年性与生殖健康战略的可接受性和采用方面的潜力。它为寻求通过合作努力改善青少年性与生殖健康成果的政策制定者、医疗专业人员和利益相关者提供了宝贵资源。
