Primary Healthcare Nurse’s Barriers and Facilitators to Providing Sexual and Reproductive Healthcare Services of LGBTQI Individuals: A Qualitative Study

Abstract

In most cases, we only hear Lesbians, Gays, Bisexuals, Transgender, Queer, and Intersex (LGBTQI) patients complaining about nurses being the reason for not accessing and utilizing healthcare services; for example, studies reports on the different attitudes of healthcare providers including nurses against LGBTQI patients. However, factors influencing the behavior of South African Primary Healthcare (PHC) Nurses toward LGBTQI patients are rarely reported. The study aimed to explore how PHC nurses experienced and perceived sexual and reproductive health services for LGBTQI individuals in Tshwane, Gauteng Province, South Africa. The study followed qualitative research using an exploratory design approach. The sample included 27 PHC nurses from Tshwane, Gauteng Province, South Africa. In-depth face-to-face interviews were coded and analyzed using Thematic Content Analysis (TCA) which included five interrelated steps. The results revealed three main themes: barriers to the provision of LGBTQI-related SRHS, facilitators for the provision of SRHS to LGBTQI individuals, and strategies to improve LGBTQI individuals’ SRHS accessibility and availability. Common barriers were related to the institutions, PHC nurses, the general public, and LGBTQI patients themselves. Regardless of the challenges faced by PHC nurses, there were some enabling factors that pushed them to continue rendering SHRS to LGBTQI patients who came to their clinics. Almost all PHC nurses suggested the importance of awareness, transparency, collaboration, and the need for training related to LGBTQI healthcare issues.

The hurdles faced by individuals identifying as queer when seeking for and by healthcare professionals when providing sexual and reproductive healthcare services in South Africa.

“…Empathy from HCPs, while typically positive, may impede effective communication and service delivery to queer people, highlighting a need for increased education and cultural competence within healthcare institutions. Synthesizing the results from multiple studies, we can conclude that one of the most signi cant barriers to queer utilization and accessibility of healthcare services is a lack of education, understanding, and competence among HCPs regarding queer people's related health issues [10,13,34]. Our ndings are consistent with several studies that found an absence of awareness among HCPs about transgender-related health issues [20], a de ciency of HCP awareness and insensitivity to the unique needs of this community [21], and a lack of understanding of transgenderspeci c well-being issues by HCPs [15].…”

“…Furthermore, these SDGs, notably SDG 3.7, seek to provide universal access to sexual and reproductive healthcare services by 2030 [7]. Speci cally, in SA, queer people continue to face di cult and diverse social challenges such as prejudice, stigmatization, denial of healthcare services, and community rejection [8][9][10][11][12][13][14].…”