PDF(Pubmed)
Abstract：
BACKGROUND: Despite advancements in family planning (FP) services, several barriers persist in the Occupied Palestinian territory (oPt), blocking women\'s access to suitable, high-quality and equitable FP services. The aim of this study was to understand how healthcare providers perceive their abilities, barriers and opportunities in providing good quality FP services. Furthermore, it seeks to explore knowledge and training regarding FP among healthcare providers engaged in providing FP services.
METHODS: A qualitative study was undertaken from August to September 2022 in seven Primary Health Care (PHC) clinics distributed in three governorates and operating under the Palestinian Ministry of Health (MoH) in the West Bank. Semi-structured, in-depth face-to-face interviews were conducted with 13 health providers (Physicians, midwives and nurses), using an interview guide in Arabic language. Transcripts were subsequently analyzed using the six phases of reflexive thematic analysis.
RESULTS: FP services face various challenges, including shortages in resources such as staff, supplies, infrastructures and FP methods. Midwives possess significant potentials to offer accessible, high-quality, efficient and equitable FP services, yet, their capacities remain underutilized, representing a missed opportunity for a country like Palestine. The study provided a current overview of FP services while illustrating the need for quality FP services and the need for an updated continuous education and training, updated standardized guidelines and protocols and supportive supervision are needed across all levels of healthcare providers. Finally, providers reported a wide range of structural barriers to FP services.
CONCLUSIONS: It is crucial to meticulously address both community-related and health system factors to enhance the fulfillment of FP needs and reduce unintended and closely spaced pregnancies. Policymakers should invest in the development of laws and regulations regarding FP services, promoting a comprehensive and holistic approach to FP services. This includes formulating supportive policies, capacity building of human resources and maintaining security of FP commodities.
METHODS: A qualitative study was undertaken from August to September 2022 in seven Primary Health Care (PHC) clinics distributed in three governorates and operating under the Palestinian Ministry of Health (MoH) in the West Bank. Semi-structured, in-depth face-to-face interviews were conducted with 13 health providers (Physicians, midwives and nurses), using an interview guide in Arabic language. Transcripts were subsequently analyzed using the six phases of reflexive thematic analysis.
RESULTS: FP services face various challenges, including shortages in resources such as staff, supplies, infrastructures and FP methods. Midwives possess significant potentials to offer accessible, high-quality, efficient and equitable FP services, yet, their capacities remain underutilized, representing a missed opportunity for a country like Palestine. The study provided a current overview of FP services while illustrating the need for quality FP services and the need for an updated continuous education and training, updated standardized guidelines and protocols and supportive supervision are needed across all levels of healthcare providers. Finally, providers reported a wide range of structural barriers to FP services.
CONCLUSIONS: It is crucial to meticulously address both community-related and health system factors to enhance the fulfillment of FP needs and reduce unintended and closely spaced pregnancies. Policymakers should invest in the development of laws and regulations regarding FP services, promoting a comprehensive and holistic approach to FP services. This includes formulating supportive policies, capacity building of human resources and maintaining security of FP commodities.
摘要：
背景：尽管计划生育（FP）服务取得了进展，在被占领的巴勒斯坦领土上仍然存在一些障碍，阻止女性接触合适的，高质量和公平的FP服务。这项研究的目的是了解医疗保健提供者如何看待他们的能力，提供优质FP服务的障碍和机会。此外，它旨在在从事提供FP服务的医疗保健提供者中探索有关FP的知识和培训。
方法：2022年8月至9月，在西岸三个省分布在巴勒斯坦卫生部（MoH）下的七个初级卫生保健（PHC）诊所进行了定性研究。半结构化,与13名医疗服务提供者进行了深入的面对面访谈(医师，助产士和护士)，使用阿拉伯语的采访指南。随后使用反身性专题分析的六个阶段对成绩单进行了分析。
结果：FP服务面临各种挑战，包括人员等资源短缺，用品,基础设施和FP方法。助产士具有提供无障碍服务的巨大潜力，高品质，高效和公平的FP服务，然而，他们的能力仍然没有得到充分利用，代表了像巴勒斯坦这样的国家错失的机会。该研究提供了FP服务的最新概述，同时说明了对高质量FP服务的需求以及对更新的持续教育和培训的需求，各级医疗保健提供者需要更新标准化指南和协议以及支持性监督.最后,提供商报告了FP服务存在广泛的结构性障碍。
结论：必须认真解决社区相关和卫生系统因素，以增强对FP需求的满足并减少意外和近距离妊娠。政策制定者应投资于制定有关FP服务的法律法规，促进对FP服务采取全面和整体的方法。包括制定扶持政策,人力资源能力建设和维护FP商品安全。
方法：2022年8月至9月，在西岸三个省分布在巴勒斯坦卫生部（MoH）下的七个初级卫生保健（PHC）诊所进行了定性研究。半结构化,与13名医疗服务提供者进行了深入的面对面访谈(医师，助产士和护士)，使用阿拉伯语的采访指南。随后使用反身性专题分析的六个阶段对成绩单进行了分析。
结果：FP服务面临各种挑战，包括人员等资源短缺，用品,基础设施和FP方法。助产士具有提供无障碍服务的巨大潜力，高品质，高效和公平的FP服务，然而，他们的能力仍然没有得到充分利用，代表了像巴勒斯坦这样的国家错失的机会。该研究提供了FP服务的最新概述，同时说明了对高质量FP服务的需求以及对更新的持续教育和培训的需求，各级医疗保健提供者需要更新标准化指南和协议以及支持性监督.最后,提供商报告了FP服务存在广泛的结构性障碍。
结论：必须认真解决社区相关和卫生系统因素，以增强对FP需求的满足并减少意外和近距离妊娠。政策制定者应投资于制定有关FP服务的法律法规，促进对FP服务采取全面和整体的方法。包括制定扶持政策,人力资源能力建设和维护FP商品安全。
