Sexual and reproductive health knowledge, attitudes and service uptake barriers among Zambian in-school adolescents: a mixed methods study

Namukonda, Edith S.; Rosen, Joseph G.; Simataa, Melody N.; Chibuye, Mwelwa; Mbizvo, Michael T.; Kangale, Chabu

doi:10.1080/14681811.2020.1832458

Cited by 5 publications

(9 citation statements)

References 19 publications

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“…They reported parents or guardians as the most preferred sources for SRH information, though they reported being afraid of discussing sexuality topics except menstruation with their parents. Namukonda, Rosen [ 60 ]; 2021 Zambia To assess school adolescents’ SRH knowledge, attitudes and service utilisation experiences in the context of CSE implementation Cross-sectional; mixed approach School; 1,612 in-school young people aged 12–24 years; randomly surveyed Questionnaire; FGD guide Only less than half of sexually experienced adolescents reported accessing SRH services in spite of having moderate SRH knowledge and acceptability to SRH services. Factors influencing SRH service uptake, include low perceived benefits of the services, unsupportive parental and community environments, and unfriendly environment or interactions with healthcare providers.…”

Section: Study Selection and Data Extraction Presentation And Analysismentioning

confidence: 99%

“…Of the 24 eligible studies, 20 studies measured SRH knowledge of participants. Of these 20 studies, 13 studies were concerned with young people in schools, and seven of these studies [ 44 , 50–52 , 55 , 58 , 60 ] found that the majority of respondents had inadequate SRH knowledge, while the remaining six studies [ 39 , 40 , 45 , 47 , 48 , 57 ] reported that more than half of respondents had good knowledge of some aspects of SRH. For instance, Barchi et al [ 39 ] found that 90% of respondents were aware of one or more forms of contraception, although only 67% could name a method for which they knew a source, and Obarisiagbon et al [ 48 ] reported that 61.6% of study participants had good knowledge of HIV/AIDS.…”

Section: Srh Knowledge Among Young Peoplementioning

confidence: 99%

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Sexual and reproductive health literacy among young people in Sub-Saharan Africa: evidence synthesis and implications

Amanu,

Birhanu,

Godesso

2023

Global Health Action

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Background Sexual and reproductive health literacy is a key to attaining and maintaining sexual and reproductive health, especially among young people in low-income countries, such as sub-Saharan Africa. While the importance of sexual and reproductive health literacy is gaining wider recognition, studies on the topic have been mainly concentrated in high-income (developed) countries. Objective The aim of this study was to provide a coherent summary and synthesis of the available evidence on sexual and reproductive health literacy among young people in sub-Saharan Africa, with implications for policy, interventions, and research. Methods The review was conducted using the Joanna Briggs Institute’s methodology for reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline to enhance the clarity and transparency of the reporting process. PubMed, CINAHL, AJOL, AIM, and Google Scholar were searched for evidence from 18 March to 20 May 2022. Results The search provided 2,682 articles in total, of which only 24 met the eligibility criteria and were included in this review. The findings revealed persistent sexual and reproductive health information/knowledge gaps, poor sexual and reproductive health-related knowledge and practices, lack of exercising sexual and reproductive health knowledge, and multiple determinants of sexual and reproductive health literacy among young people, ranging from personal to larger structural conditions. Conclusion The review found that sexual and reproductive health literacy among young people in sub-Saharan Africa is concerning and has not been fully researched. A deeper understanding of the issue is essential for designing and implementing effective interventions to improve sexual and reproductive health literacy and health outcomes among young people.

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Section: Study Selection and Data Extraction Presentation And Analysismentioning

confidence: 99%

Section: Srh Knowledge Among Young Peoplementioning

confidence: 99%

Sexual and reproductive health literacy among young people in Sub-Saharan Africa: evidence synthesis and implications

Amanu,

Birhanu,

Godesso

2023

Global Health Action

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“…Patient lack of knowledge about SRH and SRH services, raised as a main challenge by HCWs across the sectors, is an often-raised barrier to accessing SRH services [ 24 – 27 ]. Related to this, HCWs believed that clients’ reluctance to access SRH services was caused for a large part by their lack of knowledge, as well as myths or superstitions, and fear of side effects.…”

Section: Discussionmentioning

confidence: 99%

“…This because many misunderstandings persist, including that contraceptives cause infertility [ 14 , 28 , 29 ]. However, research has shown that only tackling client knowledge may only have a limited effect on health-seeking behaviour [ 24 , 25 ]. A multi-pronged approach is thus needed, tackling the other factors which also influence access to SRH services.…”

Section: Discussionmentioning

confidence: 99%

Healthcare workers’ perspectives on access to sexual and reproductive health services in the public, private and private not-for-profit sectors: insights from Kenya, Tanzania, Uganda and Zambia

Ooms

Oirschot

Okemo³

et al. 2022

BMC Health Serv Res

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Background Access to sexual and reproductive health services remains a challenge for many in Kenya, Tanzania, Uganda and Zambia. Health service delivery in the four countries is decentralised and provided by the public, private and private not-for-profit sectors. When accessing sexual and reproductive health services, clients encounter numerous challenges, which might differ per sector. Healthcare workers have first-hand insight into what impediments to access exist at their health facility. The aim of this study was to identify differences and commonalities in barriers to access to sexual and reproductive health services across the public, private and private not-for-profit sectors. Methods A cross-sectional survey was conducted among healthcare workers working in health facilities offering sexual and reproductive health services in Kenya (n = 212), Tanzania (n = 371), Uganda (n = 145) and Zambia (n = 243). Data were collected in July 2019. Descriptive statistics were used to describe the data, while binary logistic regression analyses were used to test for significant differences in access barriers and recommendations between sectors. Results According to healthcare workers, the most common barrier to accessing sexual and reproductive health services was poor patient knowledge (37.1%). Following, issues with supply of commodities (42.5%) and frequent stockouts (36.0%) were most often raised in the public sector; in the other sectors these were also raised as an issue. Patient costs were a more significant barrier in the private (33.3%) and private not-for-profit sectors (21.1%) compared to the public sector (4.6%), and religious beliefs were a significant barrier in the private not-for-profit sector compared to the public sector (odds ratio = 2.46, 95% confidence interval = 1.69–3.56). In all sectors delays in the delivery of supplies (37.4-63.9%) was given as main stockout cause. Healthcare workers further believed that it was common that clients were reluctant to access sexual and reproductive health services, due to fear of stigmatisation, their lack of knowledge, myths/superstitions, religious beliefs, and fear of side effects. Healthcare workers recommended client education to tackle this. Conclusions Demand and supply side barriers were manifold across the public, private and private not-for-profit sectors, with some sector-specific, but mostly cross-cutting barriers. To improve access to sexual and reproductive health services, a multi-pronged approach is needed, targeting client knowledge, the weak supply chain system, high costs in the private and private not-for-profit sectors, and religious beliefs.

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“…Qualitative studies have explored how misunderstandings of age-of-consent requirements or inconsistencies in their implementation constrain HIV testing accessibility for adolescents. [10][11][12][13] To our knowledge, only one study has quantitatively examined the relationship between parental consent policies with adolescent HIV testing, finding that less restrictive age-of-consent requirements were associated with higher rates of adolescent HIV testing. 14 However, this study was restricted to sub-Saharan African countries-the results of which may not be generalized to other low-and middle-income countries with different HIV epidemic profiles.…”

Section: Introductionmentioning

confidence: 99%

Age-of-consent requirements and adolescent HIV testing in low-and middle-income countries: multinational insights from 51 population-based surveys

Rosen

Mbizvo

2022

Int J STD AIDS

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Background Pervasive social and structural barriers—including national policies—inhibit HIV testing uptake among priority populations, including adolescents. We assessed the relationship between age-of-consent policies for HIV testing and adolescent HIV testing coverage in 51 low- and middle-income countries. Methods We pooled data from household surveys (2010–2020) and calculated the weighted country-level prevalence of lifetime HIV testing separately for adolescent girls and boys (ages 15–19). We then abstracted age-of-consent requirements for HIV testing across countries. Using multivariable linear regression, we estimated the average difference in national HIV testing coverage estimates for adolescent girls and boys by age-of-consent restrictions for HIV testing. Results National HIV testing coverage estimates ranged from 0.7% to 72.5% among girls (median: 18.0%) and 0% to 73.2% among boys (median: 7.5%) in Pakistan and Lesotho, respectively. In adjusted models, HIV testing coverage in countries requiring parental consent for individuals <18 years was, on average, 9.4 percentage-points (pp) lower (95% confidence interval [95%CI] −17.9pp to −0.9pp) among girls and 9.3pp lower (95%CI: −17.3pp to −1.2pp) among boys, relative to countries with less restrictive policies (age-of-consent: ≤16 years). Compared to countries with less restrictive (age-of-consent: ≤14 years) policies, HIV testing prevalence was significantly lower among girls ( β −10.5pp, 95%CI: −19.7pp to −1.3pp) and boys ( β −10.5pp, 95%CI –19.2pp to −1.8pp) in countries with more restrictive (age-of-consent: 18 years) parental consent requirements. Conclusions Age-of-consent policies are persistent obstacles to adolescent HIV testing. Repealing parental consent requirements for HIV testing is needed to expand coverage and accelerate progress towards global HIV treatment and prevention targets.

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Sexual and reproductive health knowledge, attitudes and service uptake barriers among Zambian in-school adolescents: a mixed methods study

Cited by 5 publications

References 19 publications

Sexual and reproductive health literacy among young people in Sub-Saharan Africa: evidence synthesis and implications

Sexual and reproductive health literacy among young people in Sub-Saharan Africa: evidence synthesis and implications

Healthcare workers’ perspectives on access to sexual and reproductive health services in the public, private and private not-for-profit sectors: insights from Kenya, Tanzania, Uganda and Zambia

Age-of-consent requirements and adolescent HIV testing in low-and middle-income countries: multinational insights from 51 population-based surveys

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