Alemu Melaku Birhanu, Norman Richard, Dantas Jaya, Belay Daniel Gashaneh, Haile Tsegaye G, Pereira Gavin, Tessema Gizachew A
PhD Candidate, Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Bentley, Australia; Lecturer, Department of Health Systems and Policy, Institute of Public Health, University of Gondar, Gondar, Ethiopia. Correspondence:
Professor, Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Bentley, Australia.
Sex Reprod Health Matters. 2025 Dec;33(1):2520682. doi: 10.1080/26410397.2025.2520682. Epub 2025 Aug 1.
Adolescents and young adults (AYAs) constitute approximately 30% of the African population and face significant challenges in accessing sexual and reproductive health (SRH) services. Low service uptake, despite availability, may indicate service provision misalignment with AYAs' preferences. This reflects the health sector gap and will partly compromise AYAs' rights. This study synthesised stated preference studies on SRH services among AYAs in Africa, following the PRISMA 2020 guidelines. Searches were conducted across six databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus and Global Health) and Google Scholar for grey literature on 24 April 2024. The attributes used to measure SRH preferences were classified based on the Donabedian quality of healthcare framework. A risk of bias assessment was conducted to evaluate the quality of included studies. The review was registered in PROSPERO (CRD42023386944). From 8,329 identified records, 16 studies with 8,005 participants from six countries were included in the final analysis. The attributes used were related to the structural (44.3%), process (41.7%) and outcome-related (13.9%) dimensions. The most important attributes were the cost of services, effectiveness of treatment and treatment frequency. Conversely, the least important attributes were treatment side effects, treatment and medical test sample collection characteristics, provider characteristics (age, gender and profession), and incentive type and recipient. In conclusion, AYAs' preferences were mainly influenced by cost, treatment effectiveness and incentive distribution methods. Policymakers need to develop affordable and effective SRH programmes with tailored incentives to align with AYAs' preferences to improve service uptake. However, these insights reflect data from a limited range of African countries.
青少年和青年（AYAs）约占非洲人口的30%，在获得性与生殖健康（SRH）服务方面面临重大挑战。尽管有服务提供，但服务利用率低可能表明服务提供与AYAs的偏好不一致。这反映了卫生部门的差距，并将部分损害AYAs的权利。本研究遵循PRISMA 2020指南，综合了非洲AYAs对SRH服务的陈述性偏好研究。于2024年4月24日在六个数据库（MEDLINE、EMBASE、PsycINFO、CINAHL、Scopus和全球卫生）以及谷歌学术上进行搜索，以查找灰色文献。用于衡量SRH偏好的属性根据多纳贝迪安医疗保健质量框架进行分类。进行了偏倚风险评估以评估纳入研究的质量。该综述已在PROSPERO（CRD42023386944）中注册。从8329条已识别记录中，最终分析纳入了来自六个国家的16项研究，共8005名参与者。所使用的属性与结构维度（44.3%）、过程维度（41.7%）和结果相关维度（13.9%）有关。最重要的属性是服务成本、治疗效果和治疗频率。相反，最不重要的属性是治疗副作用、治疗和医学检验样本采集特征、提供者特征（年龄、性别和职业）以及激励类型和接受者。总之，AYAs的偏好主要受成本、治疗效果和激励分配方式的影响。政策制定者需要制定经济实惠且有效的SRH计划，并提供量身定制的激励措施，以符合AYAs的偏好，从而提高服务利用率。然而，这些见解反映的是来自有限数量非洲国家的数据。
