PDF(Pubmed)
Abstract：
BACKGROUND: Adolescents and young women in low-middle-income countries face obstacles to accessing HIV, Sexual and Reproductive Health (SRH), and related Gender-Based Violence (GBV) services. This paper presents facilitators, opportunities, and barriers to enhance uptake of HIV, GBV, and SRH services among Adolescent Girls and Young Women (AGYW) in selected districts in Zambia.
METHODS: This study was conducted in Chongwe, Mazabuka, and Mongu Districts among adolescent girls and young women in Zambia. Key informants (n = 29) and in and out-of-school adolescents and young people (n = 25) were interviewed. Purposive sampling was used to select and recruit the study participants. Interviews were transcribed verbatim, and a content analysis approach was used for analysis.
RESULTS: The facilitators that were used to enhance the uptake of services included having access to health education information on comprehensive adolescent HIV and gender-based violence services. Non-governmental organisations (NGOs) were the main source of this information. The opportunities bordered on the availability of integrated approaches to service delivery and strengthened community and health center linkages with referrals for specialised services. However, the researchers noted some barriers at individual, community, and health system levels. Refusal or delay to seek the services, fear of side effects associated with contraceptives, and long distance to the health facility affected the uptake of services. Social stigma and cultural beliefs also influenced the understanding and use of the available services in the community. Health systems barriers were; inadequate infrastructure, low staffing levels, limited capacity of staff to provide all the services, age and gender of providers, and lack of commodities and specialised services.
CONCLUSIONS: The researchers acknowledge facilitators and opportunities that enhance the uptake of HIV, GBV, and SRH services. However, failure to address barriers at the individual and health systems level always negatively impacts the uptake of known and effective interventions. They propose that programme managers exploit the identified opportunities to enhance uptake of these services for the young population.
METHODS: This study was conducted in Chongwe, Mazabuka, and Mongu Districts among adolescent girls and young women in Zambia. Key informants (n = 29) and in and out-of-school adolescents and young people (n = 25) were interviewed. Purposive sampling was used to select and recruit the study participants. Interviews were transcribed verbatim, and a content analysis approach was used for analysis.
RESULTS: The facilitators that were used to enhance the uptake of services included having access to health education information on comprehensive adolescent HIV and gender-based violence services. Non-governmental organisations (NGOs) were the main source of this information. The opportunities bordered on the availability of integrated approaches to service delivery and strengthened community and health center linkages with referrals for specialised services. However, the researchers noted some barriers at individual, community, and health system levels. Refusal or delay to seek the services, fear of side effects associated with contraceptives, and long distance to the health facility affected the uptake of services. Social stigma and cultural beliefs also influenced the understanding and use of the available services in the community. Health systems barriers were; inadequate infrastructure, low staffing levels, limited capacity of staff to provide all the services, age and gender of providers, and lack of commodities and specialised services.
CONCLUSIONS: The researchers acknowledge facilitators and opportunities that enhance the uptake of HIV, GBV, and SRH services. However, failure to address barriers at the individual and health systems level always negatively impacts the uptake of known and effective interventions. They propose that programme managers exploit the identified opportunities to enhance uptake of these services for the young population.
摘要：
背景：中低收入国家的青少年和年轻妇女在接触艾滋病毒方面面临障碍，性健康和生殖健康（SRH）和相关的基于性别的暴力（GBV）服务。本文介绍了主持人，机遇,以及增加艾滋病毒吸收的障碍，GBV,赞比亚某些地区的少女和年轻妇女（AGYW）中的SRH服务。
方法：本研究在崇高进行，Mazabuka,赞比亚少女和年轻妇女中的蒙古区。采访了主要线人（n=29）以及校内和校外青少年和年轻人（n=25）。目的抽样用于选择和招募研究参与者。访谈被逐字转录，并采用内容分析法进行分析。
结果：用于加强服务的促进者包括获得关于青少年艾滋病毒和基于性别的暴力综合服务的健康教育信息。非政府组织是这一信息的主要来源。这些机会与提供服务的综合方法的可用性以及加强社区和卫生中心与转介专业服务的联系有关。然而,研究人员注意到个人的一些障碍，社区,和卫生系统水平。拒绝或延迟寻求服务，担心与避孕药相关的副作用，到医疗机构的长距离影响了服务的使用。社会耻辱和文化信仰也影响了社区对可用服务的理解和使用。卫生系统的障碍是；基础设施不足，人员配备水平低，工作人员提供所有服务的能力有限，提供者的年龄和性别，缺乏商品和专业服务。
结论：研究人员承认促进和机会，提高艾滋病毒的吸收，GBV,SRH服务。然而,未能解决个人和卫生系统层面的障碍总是对已知和有效干预措施的采用产生负面影响。他们建议方案管理人员利用已查明的机会，加强为年轻人提供这些服务。
方法：本研究在崇高进行，Mazabuka,赞比亚少女和年轻妇女中的蒙古区。采访了主要线人（n=29）以及校内和校外青少年和年轻人（n=25）。目的抽样用于选择和招募研究参与者。访谈被逐字转录，并采用内容分析法进行分析。
结果：用于加强服务的促进者包括获得关于青少年艾滋病毒和基于性别的暴力综合服务的健康教育信息。非政府组织是这一信息的主要来源。这些机会与提供服务的综合方法的可用性以及加强社区和卫生中心与转介专业服务的联系有关。然而,研究人员注意到个人的一些障碍，社区,和卫生系统水平。拒绝或延迟寻求服务，担心与避孕药相关的副作用，到医疗机构的长距离影响了服务的使用。社会耻辱和文化信仰也影响了社区对可用服务的理解和使用。卫生系统的障碍是；基础设施不足，人员配备水平低，工作人员提供所有服务的能力有限，提供者的年龄和性别，缺乏商品和专业服务。
结论：研究人员承认促进和机会，提高艾滋病毒的吸收，GBV,SRH服务。然而,未能解决个人和卫生系统层面的障碍总是对已知和有效干预措施的采用产生负面影响。他们建议方案管理人员利用已查明的机会，加强为年轻人提供这些服务。
