Views of contraceptive service delivery to young people in the UK: a systematic review and thematic synthesis

Abstract

Background and methodology Despite widespread availability of contraceptives and increasing service provision in the UK, rates of teenage pregnancy remain a concern. It has been suggested that young people face particular obstacles in accessing services, leading to a need for specialist provision. This systematic review examined the literature reporting views of service providers and young people. Data were synthesised in order to develop key themes to inform the development of contraceptive services for this population. Results A total of 59 papers reporting studies carried out within the UK were included. Fortyfi ve of these provided qualitative or mixed method data and 14 reported survey fi ndings. Seven key themes were identifi ed: perceptions of services; accessibility; embarrassment; anonymity and confi dentiality; the clinic environment; the consultation; and service organisation. Conclusions This review suggests that the most signifi cant concern for young people is the preservation of anonymity and confi dentiality. There seems to be a need for young people to be given greater assurances about this, with process and environmental changes suggested. The fear of staff being critical or unfriendly also presents a considerable obstacle to some young people. Issues of service accessibility -such as convenience of location and opening hours -are also highlighted, with lifestyle factors and restrictions on where under-18s can go suggested as important aspects. The review suggests that varying preferences among young people with regard to which service to access requires choice to be preserved and, where possible, extended. This requires services to work effectively together to consider provision across a locality.

Barriers and facilitators of access to first-trimester abortion services for women in the developed world: a systematic review

“…The review excludes women's reasons for abortion,22 23 abortion in adolescence,24 25 late-stage abortion,5 access issues in relation to safe abortion,20 women in developing countries3 26 or countries where abortion is legally restricted27 28 as the contextual social and legal access issues were likely to vary too much between settings.…”

The perceived impact of interprofessional information sharing on young people about their sexual healthcare

“…They concluded that the openness of young people in medical consultations could be improved were doctors to take the time stress the confidential nature of the encounter. Indeed a systematic review of contraceptive service delivery to young people in the UK based on 59 articles concluded that the most dominant concern for young people was that anonymity and confidentiality be maintained (Baxter, Blank, Guillaume, Squires, & Payne, 2011); these authors stressed the importance of young people being reassured about this. These studies, as indicated, related to young people in general and not those in state care, but the implications of information being shared between health professionals are greater for young people in care who interface with multiple professionals and who may well be deterred from availing of the sexual health services as required.…”

Sexual health promotion for young people delivered via digital media: a scoping review

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“…35 The convenience of clinic locations and opening hours is particularly important for young people, who may face restrictions on where they can go and when. 35 Sexual health promotion forms a core component of care in sexual health clinics (e.g. as a part of a health advisor role), but the quality and intensity of advice or support is variable.…”