An analysis on the roles and involvements of different stakeholders in the provision of adolescent sexual and reproductive health services in Southeast Nigeria

Abstract

Introduction Sexual and reproductive health of young people involve a lot of stakeholders, traverse different sectors, and cut across all levels of government. For a clearer understanding of the activities of these stakeholders in adolescent sexual and reproductive health (ASRH) services, this paper was designed to explore the positions, attitudes and involvements of government/public institutions and non-governmental organizations (NGOs) in ASRH policy-making processes and implementations in Ebonyi State, Nigeria. Methods The evidence was generated from a cross-sectional qualitative study, with data collected through in-depth interviews and focus group discussions from 81 and 59 stakeholders in adolescent sexual and reproductive health, respectively. A mapping tool was used for the stakeholder analysis. Results The State Ministry of Health (MOH) was identified as playing a major role in ASRH policy development and so was categorized as a ‘savior’. However, out of nine public institutions, four were categorized as ‘trip wire’ because they had non-supportive attitudes, weak powers and passive interests in ASRH policies and programs. All the NGOs were categorized as ‘friend’, because of their weak, but favorable disposition to ASRH policy-making processes. Regarding the implementation of ASRH programs, most public institutions were categorized as ‘savior’. Similarly, most of the institutions were classified as ‘trip wire’ at the local government level, in relation to ASRH policy development. Only, the offices of traditional rulers/village heads and local government administrative secretaries were regarded as ‘friend’, while the public schools were classified as an ‘acquaintance’. Concerning the implementation of ASRH programs at this level, public secondary schools, the offices of local government administrative secretaries and local government focal persons on ASRH were categorized as ‘savior’, while town union/ward development chairmen were considered ‘friend’. Few stakeholders, including, religious leaders were classified as ‘savior’ regarding engagement with local authorities on ASRH matters. Conclusion Although key stakeholders appear to play supportive roles in the implementation of ASRH programs in Ebonyi State, many of the relevant government and non-government institutions are not involved in the policy-making process. There is a need for more intentional and active involvement of relevant stakeholders in policy-making for better ownership and sustainability of ASRH interventions.

Disparities in access to Dolutegravir in West African children, adolescents and young adults aged 0-24 years living with HIV. A IeDEA Pediatric West African cohort analysis

“…Since most sites had begun DTG roll-out before WHO recommended DTG to all, we hypothesise our observation is mostly related to the challenges in DTG access when tied to contraceptive use [3]. Indeed, contraceptive uptake among adolescent girls and young women in Sub-Saharan Africa is low [19,20] and healthcare providers lack education or face bias [21,22]. There is an urgent need to integrate sexual and reproductive health, including contraception and pregnancy planning into adolescent HIV care.…”

Assessing interprofessional and integrated care in providing sexual and reproductive health services to adolescents at primary healthcare level in Nigeria

“…Over six million people reside in Ebonyi state, with about 40% tagged as adolescents (Agu et al ., 2022; Ebonyi State Government, 2023). A survey analysis of Ebonyi State reported that sexual debut among adolescents in Ebonyi state occur between 13 and 15 years (Mbachu et al ., 2020b), and of adolescents who are sexually active, about 10% of adolescent females have begun child bearing, with over 35% of them facing mortality incidents (Agu et al ., 2022; Ajah et al ., 2015). This led the Government of Ebonyi State to map specific local government areas (LGAs) in high need for SRH interventions (Mbachu et al ., 2020a).…”

A qualitative assessment of the impact of a community-embedded intervention on beneficiaries' attitudes and beliefs about adolescent sexual reproductive health in Ebonyi State, Southeast, Nigeria

“…It has been reported that the state has a high maternal mortality rate (602 per 100,000 population), and 39.7% of these mortalities occur among adolescent girls aged 15–19 years. Further description of the study area can be found in our previously published papers [ 10 , 29 – 31 ].…”