Health workers' attitudes toward sexual and reproductive health services for unmarried adolescents in Ethiopia

Abstract

BackgroundAdolescents in developing countries face a range of sexual and reproductive health problems. Lack of health care service for reproductive health or difficulty in accessing them are among them. In this study we aimed to examine health care workers' attitudes toward sexual and reproductive health services to unmarried adolescents in Ethiopia.MethodsWe conducted a descriptive cross-sectional survey among 423 health care service providers working in eastern Ethiopia in 2010. A pre-tested structured questionnaire was used to collect data. Descriptive statistics, chi-square tests and logistic regression were performed to drive proportions and associations.ResultsThe majority of health workers had positive attitudes. However, nearly one third (30%) of health care workers had negative attitudes toward providing RH services to unmarried adolescents. Close to half (46.5%) of the respondents had unfavorable responses toward providing family planning to unmarried adolescents. About 13% of health workers agreed to setting up penal rules and regulations against adolescents that practice pre-marital sexual intercourse. The multivariate analysis indicated that being married (OR 2.15; 95% CI 1.44 - 3.06), lower education level (OR 1.45; 95% CI 1.04 - 1.99), being a health extension worker (OR 2.49; 95% CI 1.43 - 4.35), lack of training on reproductive health services (OR 5.27; 95% CI 1.51 - 5.89) to be significantly associated with negative attitudes toward provision of sexual and reproductive services to adolescents.ConclusionsThe majority of the health workers had generally positive attitudes toward sexual and reproductive health to adolescents. However, a minority has displayed negatives attitudes. Such negative attitudes will be barriers to service utilization by adolescents and hampers the efforts to reduce sexually transmitted infections and unwanted pregnancies among unmarried adolescents. We therefore call for a targeted effort toward alleviating negative attitudes toward adolescent-friendly reproductive health service and re-enforcing the positive ones.

Sexually Transmitted Diseases: Knowledge and Sexual Behavior of Adolescents

“…19 Hormonal, emotional and social changes occur at around nine to ten years of age, instigating the rediscovery of the body as a source of pleasure, with manifestations of interest appearing, affection and desire for people outside the family environment. 20 Such interest may stimulate the onset of sexual activity.…”

“…[28][29] Corroborating studies emphasize the need for the participation of health professionals 20 articulated with the school and with the family, 30 providing conversations groups, lectures and reflections that contemplate the themes of sexuality and reproductive health in the school environment.…”

Perceptions of Couples Who Use Jadelle Implant in Blantyre District, Malawi

“…In this study, a participant complained that she was denied the removal of Jadelle when she wanted it removed and this nearly put her marriage in jeopardy. It is necessary that family planning providers should demonstrate positive attitudes because their negative attitudes maybe a barrier to contraceptives utilization [33].…”

Sexual and reproductive health and rights in changing health systems

“…Snow et al (2014) documents persistent inequalities in access to SRHR causing harm especially to women in the lowest two wealth quintiles, with 'key services … in shockingly short supply'. Furthermore, indirect evidence on HIV-and abortion-related and maternal deaths of adolescents suggests widespread gaps in access to health care (Chopra, Daviaud, Pattinson, Fonn, & Lawn, 2009;Houweling, Ronsmans, Campbell, & Kunst, 2007;Rashid, Akram, & Standing, 2011;Tilahun, Mengistie, Egata, & Reda, 2012). Santhya and Jejeebhoy (2014) provide evidence on the persistence of inequalities and gaps in SRHR among adolescents, especially girls.…”

“…However, even when financial and geographic barriers have been removed, acceptability (Govender & Penn-Kekana, 2008;Tilahun et al, 2012;Tylee, Haller, Graham, Churchill, & Sanci, 2007) and quality-of-care (Ahmed & Khan, 2011;Limwattananon, Tangcharoensathien, & Sirilak, 2011;Nguyen, Snider, Ravishankar, & Magvanjav, 2011;Ravindran & Nair, 2012) challenges can persist. SRH services, particularly those that are contested, are often the site where quality-of-care remains a challenge (Wood & Jewkes, 2006).…”