Agu Ifunanya C, Agu Chibuike, Mbachu Chinyere O, Ekwueme Chinazom N, Nwankpa Ozioma, Ezumah Nkoli, Onwujekwe Obinna
Health Policy Research Group, University of Nigeria Nsukka, Enugu, Nigeria.
Institute of Public Health, University of Nigeria Nsukka, Enugu, Nigeria.
Afr J Reprod Health. 2025 Jun 20;29(6s):89-105. doi: 10.29063/ajrh2025/v29i6s.7.
This study describes the adoption of an action learning (AL) approach to (i) identify challenges that primary healthcare workers face in delivering gender-transformative sexual and reproductive health and rights (SRHR) services to young people, and (ii) recommend feasible solutions to resolve these challenges. This study implemented in Ebonyi State, Nigeria, included three AL structured sessions with healthcare workers, community members, and researchers. AL participants formed six groups, each representing one of the six selected local government areas. Data on potential challenges in providing youth-friendly gender-equitable and inclusive SRHR services and strategies for addressing them were synthesized through consultations with the stakeholders using the modified Delphi technique. The key challenges that health workers faced were: (i) provider-related issues such as personal values and beliefs regarding providing contraceptives to young unmarried people; (ii) community/client-related issues such as lack of male, parents/guardians, and community support; and (iii) negative perceptions regarding health seeking for SRHR services. Proposed strategies include reaching young men and boys with SRHR services outside Primary Health Care settings; facilitating dialogue to support female partners; and promoting community advocacy. AL has shown promise in understanding young people's SRHR challenges and in developing strategies to advance gender-transformative youth-friendly SRHR services in Nigeria.
本研究描述了采用行动学习（AL）方法来：（i）识别初级医疗保健工作者在为年轻人提供具有性别变革性的性健康和生殖健康及权利（SRHR）服务时所面临的挑战，以及（ii）推荐可行的解决方案来应对这些挑战。这项在尼日利亚埃邦伊州开展的研究，包括与医疗工作者、社区成员和研究人员进行的三次结构化行动学习会议。行动学习参与者分成六个小组，每个小组代表六个选定地方政府区域中的一个。通过使用改良德尔菲技术与利益相关者进行磋商，综合得出了在提供对青年友好、性别平等且包容的性健康和生殖健康及权利服务方面的潜在挑战数据，以及应对这些挑战的策略。卫生工作者面临的主要挑战包括：（i）与提供者相关的问题，例如在为未婚年轻人提供避孕药具方面的个人价值观和信念；（ii）与社区/服务对象相关的问题，例如缺乏男性、父母/监护人以及社区的支持；以及（iii）对寻求性健康和生殖健康及权利服务的负面看法。提议的策略包括在初级卫生保健机构之外为年轻男性提供性健康和生殖健康及权利服务；促进对话以支持女性伴侣；以及推动社区宣传。行动学习在理解年轻人的性健康和生殖健康及权利挑战以及制定策略以推进尼日利亚具有性别变革性、对青年友好的性健康和生殖健康及权利服务方面已显示出前景。
