Exploring Providers’ Perception Towards Provision of Sexual and Reproductive Health Services for Unmarried Adolescents in Gamo Zone, Southern Ethiopia: A Phenomenological Study

Abstract

Background Healthcare providers play a critical role in the provision of sexual and reproductive health services for adolescents. In Ethiopia, due to different reasons, including healthcare providers associated reasons, most unmarried adolescents are not accessing the services. However, little is known about healthcare providers’ perception towards the provision of SRH services for unmarried adolescents. This study aimed to explore healthcare provider perception towards the provision of SRH services to unmarried adolescents in Gamo zone, Southern Ethiopia. Methods A qualitative phenomenological research design was used in May 2021. Fifteen healthcare providers (HCPs) working in adolescent and youth sexual and reproductive health centers were involved in this study. A purposive sampling technique was used to select healthcare providers assuming they are “information-rich” regarding the phenomenon of interest. Inclusion of the study participants was continued until data saturation is reached. To analyze the data, we used inductive thematic analysis, method, and main themes, which captured the diverse views and feelings of the participants. To maintain the trustworthiness of the data, we used dependability, transferability, conformability, and credibility. Results In this study, individual-level attributes such as healthcare provider’s personal belief, attitude, and motivation; community-level influences like socio-cultural norms, religious reasons, and lack of parental support; and health system setbacks like shortage of essential medical supplies and lack of training are identified as major obstacles in the provision of sexual and reproductive health services for unmarried adolescents. Conclusion Provision of sexual and reproductive health services for unmarried adolescents is constrained by the interplay of factors acting at an individual level, community level, and health system level. The Ministry of Health (MOH), program planners and policymakers are recommended to give due attention to fulfill the necessary inputs, improving healthcare provider’s attitude and skill and engagement of religious and community leaders to create a safe and supportive environment for providing sexual and reproductive health services to unmarried adolescents.

Disparities in Sexual and Reproductive Health Service Utilization and Associated Factors among Agrarian and Pastoralist Adolescents in South Omo Zone, Ethiopia: A Community-Based Comparative Cross-Sectional Study

“…The ndings revealed that overall sexual and reproductive health service utilization was 27.4% (95%CI: 26.9, 27.8). This nding was higher than studies conducted in Gamo Gofa (16.9%) 15 Philippines (13.8%) 16 , Indonesia (24.3%) 17 East Gojam, Ethiopia (21.5%) 18 and Ethiopia 19.18%) 19 . However, lower than the study conducted in Jima Ethiopia, 41.1% 20 ; Eastern Ethiopia, 39.3% 21 ; Wolaita, Southern Ethiopia (49.8%) 22 and Kenya 36%) 23 .…”

Restrictions on contraceptive services for unmarried youth: a qualitative study of providers’ beliefs and attitudes in India

“…Similar findings were reported in studies from Senegal, Nigeria and Ethiopia, where healthcare providers tended to promote abstinence rather than providing contraceptive services to unmarried young populations. 14–16 Many studies have recognised provider bias: that is, providers’ self-imposed restrictions in order that young, unmarried people should not indulge in premarital sex. 26 These restrictions from providers do not comply with medical eligibility and are certainly against the clients’ rights.…”

“…Due to prevailing social norms for premarital sex, healthcare providers often feel uncomfortable discussing sexual issues with unmarried young people. 14 A study in Senegal reported that even when there were no legal restrictions, providers were reluctant to provide oral contraceptive pills to unmarried young women and advised them against premarital sex. 15 In Nigeria, healthcare providers perceived the provision of contraceptives for unmarried adolescents as promoting sexual promiscuity.…”

Sexuality of adolescent girls born with HIV in Senegal: an anthropological analysis

“…These situations are common to numerous African countries. In Ethiopia, Sidamo et al 30 observe the influence of sociocultural and religious norms on health workers' attitudes toward unmarried adolescents, which compromises SRH services delivery, already undermined by the health system's shortcomings in terms of essential medical supplies and training.…”