Healthcare workers’ behaviors and personal determinants associated with providing adequate sexual and reproductive healthcare services in sub-Saharan Africa: a systematic review

Abstract

BackgroundHealthcare workers may affect the utilization of sexual and reproductive healthcare (SRH) services, and quality of care thereof, for example by their behaviours or attitudes they hold. This can become a hindrance to accessing and utilizing SRH services, particularly by young people, and thus a better understanding of these behaviours and associated factors is needed to improve access to and utilization of SRH services.MethodsA systematic review of literature was conducted to identify studies focusing on healthcare workers’ behaviors and personal determinants associated with providing adequate SRH services in sub-Saharan Africa (January 1990 - October 2015). Five databases were searched until 30th October 2015, using a search strategy that was adapted based on the technical requirements of each specific database. Articles were independently screened for eligibility by two researchers. Of the 125-screened full-text articles, 35 studies met all the inclusion criteria.ResultsNegative behaviours and attitudes of healthcare workers, as well as other personal determinants, such as poor knowledge and skills of SRH services, and related factors, like availability of essential drugs and equipment are associated with provision of inadequate SRH services. Some healthcare workers still have negative attitudes towards young people using contraceptives and are more likely to limit access to and utilization of SRH by adolescents especially. Knowledge of and implementation of specific SRH components are below optimum levels according to the WHO recommended guidelines.ConclusionsHealthcare workers’ negative behaviours and attitudes are unlikely to encourage women in general to access and utilize SRH services, but more specifically young women. Knowledge of SRH services, including basic emergency obstetric care (EmOC) is insufficient among healthcare workers in SSA.Trial registrationA protocol for this systematic review was registered with PROSPERO and the registration number is: CRD42015017509.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1268-x) contains supplementary material, which is available to authorized users.

Perceived Adherence to Professional Ethics and Associated Factors Among Health Professionals in Bale Zone Public Hospitals, Oromia Regional State, South-East Ethiopia

“…In this regard, paternalistic attitude toward patient this study shows 47.8% of them disagreed for statement provider should do what is best for patient irrespective of patient opinion and about 52.7% disagreed to the view that patient wishes must always be adhered. The result is consistent with study conducted in India and sub-Saharan African countries (13,44,45).…”

Knowledge level and associated factors about sexual and reproductive health rights among University of Gondar students, Gondar Ethiopia

“…In a study conducted south Ethiopia 45.5% students lack knowledge about SRH rights [10], and 80% do not know the reproductive health services [11]. Knowledge about SRHRs and RH service are affected by negative behaviors and attitudes of healthcare workers [12], sex taboos [13,14] and SRH service related factors such as cost [13], providers attitude [15,16] and confi dentiality [17][18][19]. Moreover age, residence, school attended at elementary [10,20], studying fi elds [21], prior SRH education/lectures [19], parental occupation and education [13,17,22], discussion of sexual issues with others [10,23], and source of information [10,13,17,20,24].…”

‘We are the advocates for the babies’ - understanding interactions between patients and health care providers during the prevention of mother-to-child transmission of HIV in South Africa: a qualitative study

“…lack of essential equipment are associated with inadequate sexual and reproductive health care services [16]. Other studies on sexual and reproductive health have highlighted similar challenges reported by HCPs, secondary to a high work load, poor skills and inability to access young women to provide appropriate preventative messages to optimise their health [15].…”

“…Previous research in South Africa and Sub-Saharan Africa has demonstrated that access to maternity care is not only affected by barriers such as availability and affordability; interactions between health care providers (HCPs) and patients are also important factors [6][7][8][9][10][11][12][13][14][15][16]. Additionally, negative treatment by HCPs can be an important barrier to PMTCT adherence [9,11].…”