Attitude of Health Care Providers towards Adolescent Sexual and Reproductive Health Services in Developing Countries: A Systematic Review

Abstract

The aim of the review was to synthesise the best available evidence regarding attitude of health care providers towards adolescent sexual and reproductive health services in developing countries. The review was conducted following qualitative research method. An online search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), British Nursing Index (BNI), EMBASE and MEDLINE databases was conducted to identify relevant studies for the review. There were nine studies that met the inclusion criteria and these were critically assessed by two independent reviewers using the standardised Joanna Briggs Institute (JBI) critical appraisal forms. Data were extracted using the standardised JBI data extraction forms. A narrative synthesis was done on the findings. Key findings from the review indicate that unprofessional attitude of health care professionals and lack of youth friendly reproductive health services, inhibit adolescents from gaining access to sexual and reproductive health services in developing countries. It is recommended that youth friendly reproductive health services be provided to increase uptake of reproductive health services by adolescents.

Intersectoral strategies between health and education for preventing adolescent pregnancy in Chile: Findings from a qualitative study

“…Chile's predominant framework of sexual and reproductive health has been characterized as (a) being strongly heteronormative and biologicist, (b) reinforcing a risk approach, (c) being focused mainly on girls, thus excluding boys and young men as recipients of sexual and reproductive health care and (d) failing to promote adolescents’ participation and rights . These findings are similar to those from research in other regions of the world …”

“…While both strategies bring sexual and reproductive health services closer to adolescents, the findings suggest that the school‐based strategy responds better to adolescents’ sexual and reproductive health‐related needs, with access to contraception being fundamental, as suggested by literature . This strategy is overcoming many of the reported barriers to preventing adolescent pregnancy because adolescents are able to continuously access information and care for sexual and reproductive health issues in their daily lives (school in this case), and they develop affectionate and trustworthy relations with care providers. This does not mean that care in the health centres lacks affection or trust, but it usually lacks the quality time and frequency needed to nurture caring relationships.…”

Targeting factors for change: contraceptive counselling and care of female adolescents

“…[67] Service settings should therefore be welcoming and staffed by professionals who do not judge or moralise, but instead treat adolescents with respect, strengthen their self-esteem, and encourage them to value and protect their body and sexuality. [36] Such focus needs to be achieved whilst respecting and granting autonomy in the decision-making process.…”

“…Staff should be specially trained to meet adolescent reproductive health care needs and refrain from seeing adolescents as 'children', as these attitudes can cause a shift from their professional role to that of a 'parent'. [67] Where availability of qualified staff is an issue, task-shifting strategies can allow trained nurses, in collaboration with community pharmacists, to counsel and start healthy women on hormonal contraception for a six-month period without a medical consultation. [68] The prohibitive cost of contraceptive services and methods in some countries and the potential need for parental financial assistance can limit access as well as compromise maintenance of confidentiality in some countries.…”

Support of adolescents to resist peer pressure and coercion to sexual activity

“…Continuous professional development programmes for nurses who work with adolescent patients should focus on ways to enhance interaction between them and their adolescent patients. Nurses should be trained in the special needs of adolescents and also how to show respect for their dignity and not to alienate them from clinics and as a result deprive them from opportunities to learn how to resist peer pressure and coercion to sexual activity (Chilinda et al 2014). They need to develop skills regarding responsible decision-making to resist peer pressure and risk behaviour (Kerpelman et al 2016).…”