Kim Jonas1, Nicolette Roman2, Priscilla Reddy3, Anja Krumeich4, Bart van den Borne5, Rik Crutzen6. 1. School of Public Health and Primary Care (CAPHRI), Department of Health Promotion, Faculty of Heath, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands; Health Systems Research Unit (HSRU), South African Medical Research Council (SA-MRC), Cape Town, South Africa; Division of Child and Adolescent Psychiatry, Adolescent Health Research Unit, University of Cape Town, Rondebosch, Cape Town, South Africa. Electronic address: kim.jonas@mrc.ac.za. 2. Faculty of Community and Health Science, University of the Western Cape, South Africa. Electronic address: nroman@uwc.ac.za. 3. Faculty of Community and Health Science, University of the Western Cape, South Africa; Human Sciences Research Council (HSRC), Population Health, Health Systems and Innovation Unit, Cape Town, South Africa. Electronic address: preddy@hsrc.ac.za. 4. Department of Health, Ethics and Society/Global Health, Faculty of Heath, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. Electronic address: a.krumeich@maastrichtuniversity.nl. 5. School of Public Health and Primary Care (CAPHRI), Department of Health Promotion, Faculty of Heath, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands. Electronic address: b.vdborne@maastrichtuniversity.nl. 6. School of Public Health and Primary Care (CAPHRI), Department of Health Promotion, Faculty of Heath, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands. Electronic address: rik.crutzen@maastrichtuniversity.nl.
Abstract
BACKGROUND: In Sub-Saharan Africa access to and utilization of sexual and reproductive healthcare is unsatisfactory. Consequently, rates of teenage pregnancy and unsafe abortions among adolescents in Sub-Saharan Africa, including in South Africa remain a public health challenge. The aim of this study was to explore nurses' views on and perceptions of adolescent girls' barriers and needs to accessing and utilizing sexual and reproductive healthcare services. METHODS: Twenty-four purposively selected healthcare workers from nine public healthcare facilities in Cape Town, South Africa participated in this qualitative descriptive study. Data were collected through nine group discussions, and audio-recorded with hand-written notes taken during the discussions. Data were analyzed using thematic analysis, following the Tesch's eight steps for coding and analysing qualitative data. RESULTS: Sexual and reproductive healthcare nurses are generally supportive of adolescents who ask for and use contraceptives. Non-compliance to family planning regimens and repeated requests for termination of pregnancies were perceived by nurses as irresponsible behaviours which are particularly frustrating to them and not in concordance with their personal values. The subsequent nurse-adolescent interactions sometimes appeared to hinder access to and utilization of sexual and reproductive healthcare services by adolescents. CONCLUSIONS: Nurses perceive certain behaviours of adolescent girls as irresponsible and warrant their negative attitudes and reactions toward them. The negative attitudes and reactions of nurses potentially further compromises access to and utilization of sexual and reproductive healthcare services by adolescent girls in South Africa and requires urgent attention. Adolescent-friendly clinic hours together with youth-friendly nurses is likely to encourage adolescent girls to access sexual and reproductive healthcare services and improve the use thereof.
BACKGROUND: In Sub-Saharan Africa access to and utilization of sexual and reproductive healthcare is unsatisfactory. Consequently, rates of teenage pregnancy and unsafe abortions among adolescents in Sub-Saharan Africa, including in South Africa remain a public health challenge. The aim of this study was to explore nurses' views on and perceptions of adolescent girls' barriers and needs to accessing and utilizing sexual and reproductive healthcare services. METHODS: Twenty-four purposively selected healthcare workers from nine public healthcare facilities in Cape Town, South Africa participated in this qualitative descriptive study. Data were collected through nine group discussions, and audio-recorded with hand-written notes taken during the discussions. Data were analyzed using thematic analysis, following the Tesch's eight steps for coding and analysing qualitative data. RESULTS: Sexual and reproductive healthcare nurses are generally supportive of adolescents who ask for and use contraceptives. Non-compliance to family planning regimens and repeated requests for termination of pregnancies were perceived by nurses as irresponsible behaviours which are particularly frustrating to them and not in concordance with their personal values. The subsequent nurse-adolescent interactions sometimes appeared to hinder access to and utilization of sexual and reproductive healthcare services by adolescents. CONCLUSIONS: Nurses perceive certain behaviours of adolescent girls as irresponsible and warrant their negative attitudes and reactions toward them. The negative attitudes and reactions of nurses potentially further compromises access to and utilization of sexual and reproductive healthcare services by adolescent girls in South Africa and requires urgent attention. Adolescent-friendly clinic hours together with youth-friendly nurses is likely to encourage adolescent girls to access sexual and reproductive healthcare services and improve the use thereof.
Keywords:
Adolescents; Behaviours; Compliance; Family planning; Healthcare workers; Provider perspectives; Sexual and reproductive healthcare termination of pregnancy