Barriers to Utilization of Sexual Health Services among Young People in District Dang Nepal: A Qualitative Study

Abstract

Background: Sexual behavior of young people is becoming one of the important social and major publichealth concerns in recent years. Despite the large population of young people, their needs receive limited programmatic and policy attention. Youth-friendly sexual and reproductive health services are lacking despite the existence of national guidelines that call for youth-friendly services. The aim of this study was to determine the barriers to utilization of sexual health services among young people of Badi community of Nepal.Materials & Methods: This qualitative study included the young people, 15-24 years of age among the Badi community in district Dang Nepal. We conducted 22 in-depth interviews by using the interview guideline among the young people. Written and verbal informed consent was taken from each research participants before data collection.Results: Fourteen of the participants were males and eight were females. Participants were divided into two age groups: 15-19 and 20-24 and there were eight and fourteen participants from each group respectively. Rural participants were not satisfied with the services provided to them. We observed that discrimination, beliefs of society and feeling of shame towards family norms, lack of information about existing services, poor gender friendly services,lack of privacy and confidentiality and poor availability of the services pose the barriers to utilization of the sexual health services.Conclusions: Communities should be provided with educational programs on sexual health through community based organization and the establishment of youth friendly service centers with easy access to communities in urban as well as in rural areas would encourage young people to use sexual health services more frequently.J MEDICINE JUL 2018; 19 (2) : 79-83

Exploring the factors impacting on access and acceptance of sexual and reproductive health services provided by adolescent-friendly health services in Nepal

“…Adolescents face numerous challenges to access and utilization of SRH services globally [17–21]. Some of these challenges include inadequate SRH information arising from lack of access to SRH education [22, 23], early marriage and pregnancy associated with adolescents’ having minimal or no voice in decision making in SRH matters [24], and poor quality SRH services where concerns about privacy and confidentiality are related to health care provider and health facility infrastructure [20, 21, 25]. These challenges are largely associated with complex social, environmental, cultural, economic, and psycho-social factors [26].…”

Access and utilization of the youth-friendly sexual and reproductive health services in Nepal: What does literature show?

“…Adolescents were reluctant to visit health facilities because of the poor availability of SRH items and other regular medicine (Pandey, Seale & Razee, 2019). Despite the positive policy focus, young people are not satisfied with their service (Gautam et al, 2018;Regmi, Baral & Khanal, 2016).…”

“…Youth people felt the need for sexual and reproductive health services but failed to utilize them according to their needs. Multiple factors are contributing as barriers to the utilization of sexual and reproductive health, such as poor reproductive health knowledge, lack of information about available services, shyness, strict gender role in society, fear of stigmatization, poor youthfriendly health services, poor gender-friendly service, judgmental attitude of the service provider and fear of parents (Gautam, Soomro, Sapkota, Gautam, & Kasaju, 2018;Pandey, Seale, & Razee, 2019;Regmi, Baral, & Khanal, 2016;Shrestha, 2017). Likewise (Regmi et al, 2016) find out some supply-side barriers such as lack of equipment, lack of trained male and female health care providers, lack of privacy and confidentiality, distance to facility and service charge, youth do not have adequate access to appropriate information and service (Tamang et al, 2016).…”

Factors influencing men’s decisions whether or not to utilize sexual and reproductive health services in Low-Middle-Income countries: A narrative review

“…Four (8%) studies were published in Zimbabwe [47][48][49][50]. Three (6%) studies were conducted in Nigeria [51][52][53] and Nepal [54][55][56]. In Rwanda [57,58], there were two (4%) studies identi ed, whilst only one (2%) study each conducted in Swaziland [59]…”

“…The majority (86%) of studies targeted adults 26 years and above [21-39, 41-44, 46-51, 53, 57-66, 71]. Studies which targeted adolescents were excluded, however those targeting youth or young adults age between 15-25 years (14%) were included [40,45,52,[54][55][56][67][68][69][70].…”