Improving young people's access to reproductive health care in rural Zimbabwe.

The aim of this study was to explore ways to improve the accessibility of clinics for young people with reproductive health problems in rural Zimbabwe. This study, which took place in rural Masvingo, was part of a project to develop a comprehensive adolescent reproductive health intervention for Zimbabwean youth. Six focus group discussions were held with secondary school pupils aged 16-19; four focus group discussions were held with nurses. Additionally, 16 community meetings with parents of adolescents were observed. The data were analyzed using the principles of grounded theory: three main categories and several sub-categories emerged from the data. The accessibility of existing services for young people was poor, partly because nurses were reluctant to provide such services due to lack of clarity in legislation and also through fear of condoning adolescent sexual activity. Although the clinical acumen of staff was recognized as sound, service delivery was perceived to be judgemental and lacking in confidentiality and privacy. This reflects the cultural context in which services are delivered. Culturally, adolescents are deemed to be children and as such to have few rights. There is a widely held belief that teaching young people about sex will promote sexual activity. Our findings suggested that staff training should focus on attitudinal rather than medical issues.