Primary healthcare providers’ views on improving sexual and reproductive healthcare for adolescents in Bolivia, Ecuador, and Nicaragua

Abstract

ObjectivesTo elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicaragua on how adolescent sexual and reproductive health (ASRH) care in their communities can be improved.MethodsOverall, 126 healthcare providers (46 from Bolivia, 39 from Ecuador, and 41 from Nicaragua) took part in this qualitative study. During a series of moderated discussions, they provided written opinions about the accessibility and appropriateness of ASRH services and suggestions for its improvement. The data were analyzed by employing a content analysis methodology.ResultsStudy participants emphasized managerial issues such as the prioritization of adolescents as a patient group and increased healthcare providers’ awareness about adolescent-friendly approaches. They noted that such an approach needs to be extended beyond primary healthcare centers. Schools, parents, and the community in general should be encouraged to integrate issues related to ASRH in the everyday life of adolescents and become ‘gate-openers’ to ASRH services. To ensure the success of such measures, action at the policy level would be required. For example, decision-makers could call for developing clinical guidelines for this population group and coordinate multisectoral efforts.ConclusionsTo improve ASRH services within primary healthcare institutions in three Latin American countries, primary healthcare providers call for focusing on improving the youth-friendliness of health settings. To facilitate this, they suggested engaging with key stakeholders, such as parents, schools, and decision-makers at the policy level.

Processos organizacionais na Estratégia Saúde da Família: uma análise pelos enfermeiros

“…The incipient results regarding adolescents suggests greater involvement of the school and parents in order to optimize care. (17) The incipient result of the welcoming and the non-implementation of the Manchester protocol, indicate the need to move forward with the humanization of care. Welcoming with risk classification prioritize patients who need immediate treatment or acute conditions, reinforcing the principle of equity in the FHS, however the scientific production in Brazil is scarce.…”

Attention on Contraception by Family Health Teams: Convergence of Educational and Investigational Practices

“…This can also be verified through the results of a study that points out that the health professionals perceive information; the provision of contraceptive methods; the effectiveness of the method; the prompt delivery of the male condom; counseling on the repercussions of an unplanned pregnancy; sexuality detached from pregnancy; the inclusion of the sexual partner in family planning decisions; and conducting group orientation for adolescents, women and couples, as important factors for the quality of contraceptive care, but point out that the FH units are not a place for training the health professionals on issues related to sexual and reproductive health. 15 In addition to these factors, other studies add that the perceptions and knowledge of the health workers, especially the knowledge deficits of PHC workers regarding the theme of contraception, [16][17][18][19][20] by far determine the quality of care offered, example: there is the non-prescription of Emergency Contraception (EC) by some professionals, with the simple justification that the use of EC will not become a routine. 20 Also, considering the note that PHC workers make the precariousness of sexual and reproductive health care to adolescents and men, and the latter, in particular, are said to be clients who hardly seek PHC to address sexual and reproductive health issues, and the biggest perceived obstacles are misconceptions and preconceptions, especially those related to vasectomy.…”

“…7 Several studies indicate that the care for adolescents, in the context of sexual and reproductive health, is precarious and not specific, 26 some also consider that the way the professionals perceive teenage pregnancy is what will influence their attitude toward prescribing contraceptive methods for adolescents; 27 others believe that increasing adolescents' access to the health services requires a reduction in formalities, besides perceiving promoting characteristics for health actions in the school. 19 For the outcome of the scenes, there was the insertion of the proposed action chosen. With slight variations, it was observed that the efforts of the FHts to effectively perform and improve contraceptive care were aimed at ensuring the users' access to the health services.…”

“…To ensure the users' access to the health services, especially in the context of contraceptive care, the improvement of the services offered, the improvement of communication, the promotion of contraceptive methods, the implementation of actions at the managerial and network level, are encouraged, especially with schools. 19,24,29 Some researchers are making efforts to study the differential of the CHA in contraceptive care, as well as the potential of the CHA to broaden the users' access to sexual and reproductive health services. 18,30 It is also observed that, for the most part, this is not very sophisticated: simple interventions can make a difference in the quality of the contraceptive care offered.…”

Clarifying the criteria for reproductive health counselling for adolescent girls by service providers: A qualitative study

“…In our study, providers stated that counsellors should have the ability to communicate with adolescent in order to provide appropriate counselling services, so the counselling skills of midwives should be increased. In the study of Jarosowens too, care providers agreed with the additional training of the staff of health centers and believed that education would improve service providing and communication skills with adolescents [33].…”