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Munakampe MN, Ngoma-Hazemba A, Sampa M, Jacobs CN. Understanding inequalities in the coverage of adolescent sexual and reproductive health services: a qualitative case study of the selected regions of Zambia. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1399289. [PMID: 39166176 PMCID: PMC11333446 DOI: 10.3389/frph.2024.1399289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/23/2024] [Indexed: 08/22/2024] Open
Abstract
Introduction Despite substantial investment in improving healthcare among adolescents in low- and middle-income countries, barriers to access and utilization of services persist, especially to sexual and reproductive health (SRH) services. In response to adolescents' health service needs due to their vulnerability, interventions aimed at improving access and utilization of sexual and reproductive health services have been implemented in specific regions of Zambia. To highlight progress in the access and the overall delivery of services in Zambia, in the wake of a system-level funding mechanism, this paper aims to understand the accessibility, availability, acceptability and quality (AAAQ) of health services provided to young people. Materials and methods In a qualitative case study, 48 discussions- 32 individual interviews with stakeholders and 16 focus group discussions, consisting of 128 male and female adolescents were conducted in six districts from Eastern, Southern and Muchinga provinces of Zambia. Interviews were audio-recorded, recordings transcribed verbatim, and transcripts were analysed using deductive thematic analysis, using the AAAQ framework and Atun's framework on integration, as a guide to reporting the findings. Results We found that adolescents knew of and had access to common commodities and services- male condoms, health education and HIV counselling and testing. However, availability was affected by access-related barriers such as frequent stock-outs and insufficiently trained healthcare providers. In addition, accessibility was more restricted during the COVID-19 pandemic lockdown and compounded by the low acceptability of SRH service among adolescents across all contexts. This led to the use of alternatives such as herbal medicine and maintained common myths and misconceptions. The overall quality was marred by the lack of dedicated spaces for adolescent health services and the lack of information, education and communication (IEC) materials in some spaces. Conclusion While it was noted that some services were available for adolescents in all the study sites, numerous barriers inhibited access to these services and had an impact on the quality-of-service provision. With the added restriction to SRH service asses for young people, due to the low acceptability of adolescent SRH service use, the overall integration of adolescent SRH interventions into routine service provision was low and can be improved by targeting contextual barriers and maintaining best practices.
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Affiliation(s)
- Margarate Nzala Munakampe
- Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia
- Yakini Health Research Institute, Lusaka, Zambia
- Women in Global Health, Zambia Chapter, Lusaka, Zambia
| | - Alice Ngoma-Hazemba
- Department of Community and Family Medicine, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Mutale Sampa
- Women in Global Health, Zambia Chapter, Lusaka, Zambia
- Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Choolwe N. Jacobs
- Women in Global Health, Zambia Chapter, Lusaka, Zambia
- Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia
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Mkhize SP, Buthelezi S, Mkhize AM, Tokwe L. Beyond the curriculum: A gay medical student's perceptions of health sciences education and healthcare access in KwaZulu-Natal. Health SA 2024; 29:2656. [PMID: 39114342 PMCID: PMC11304179 DOI: 10.4102/hsag.v29i0.2656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/29/2024] [Indexed: 08/10/2024] Open
Abstract
Background The prevailing social constructs of cis-heteronormativity and endosexism have structurally marginalised sexual and gender minorities, leading to their limited representation and inclusion in mainstream health systems and health sciences education. Aim The study aimed to explore a gay medical student's perceptions of the health sciences curriculum and their experiences in accessing and utilising healthcare services offered both by the university and externally. Setting At a university in KwaZulu-Natal, South Africa. Methods This study originates from a larger qualitative study conducted in 2018, involving 12 Lesbian, Gay, Bisexual, Transgender (LGBT)-identifying participants who were selected using purposive and snowball sampling techniques. The larger study used a case study approach to explore how healthcare services meet the sexual health needs of LGBT youth. Among the 12 sampled participants, one participant self-identified as 'gay' and was pursuing a Bachelor of Medicine and Bachelor of Surgery. This participant was specifically selected for analysis in this study because of their knowledge of health sciences education and pursuit of a career in healthcare. Results Three themes were identified in the participant's interview, including: (1) navigating healthcare services as a young gay man, (2) silenced voices: the impact of the limited Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, Asexual and + (LGBTIQA+) health education, and (3) challenging the silenced voices. Conclusion There is a need for a well-planned curriculum that includes LGBTIQA+ issues to equip healthcare professionals with the knowledge to provide high-quality care to all patients, regardless of their sex, gender, or sexuality. Contribution The study provides solid proposals for developing an inclusive healthcare curriculum that considers identities beyond binary going forward.
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Affiliation(s)
- Sthembiso P Mkhize
- Gauteng City-Region Observatory, University of Johannesburg, Johannesburg, South Africa
- Gauteng City-Region Observatory, University of the Witwatersrand, Johannesburg, South Africa
| | - Sanele Buthelezi
- Department of Optometry, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Attah M Mkhize
- Department of Clinical Forensics and Medical Services, Bertha Gxowa Hospital Care Centre, Ekurhuleni, South Africa
| | - Lwandile Tokwe
- Department of Psychiatry and Mental Health, HIV Mental Health Research Unit, University of Cape Town, Cape Town, South Africa
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Ramalepa TN, Netangaheni TR. A scoping review of strategies for adolescents' sexual and reproductive health role modelling. S Afr Fam Pract (2004) 2024; 66:e1-e9. [PMID: 38708753 PMCID: PMC11151353 DOI: 10.4102/safp.v66i1.5859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/22/2023] [Accepted: 01/24/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Individuals strive to maintain their sexual and reproductive health (SRH) by being exposed to correct information, having access to contraceptives, and promoting safe sex practices. Adolescent SRH promotion efforts should consider the influence of role models. This review explored the availability and nature of strategies and programmes on adolescents' SRH role modelling and described them using a scoping review. METHODS Studies were retrieved from four databases and grey literature through a search of 223 studies. The databases included EBSCO-host, Medline, Sabinet, and Pubmed. Data extraction was guided by a data-extraction tool adapted from the JBI Manual for Evidence Synthesis. The characteristics of the selected studies were recorded in a Microsoft spreadsheet. Eleven studies published between 2014 and 2022 were included for the final review and analysed using thematic analysis. RESULTS Selected articles focused on adolescents' SRH; however, only two studies focused particularly on role modelling. Nonetheless, some aspects of the findings and recommendations presented could be extrapolated to adolescents' SRH role modelling. This includes adolescent-parent communication on SRH, community engagement, mentoring, positive role modelling, and information sharing through media campaigns. CONCLUSION There is a lack of literature on SRH role modelling because most studies did not focus on role modelling as an aspect of SRH. Therefore, research needs to be conducted on strategies and programmes focusing on SRH modelling.Contribution: The findings of this scoping review may encourage the development and implementation of strategies and programmes targeting adolescents' SRH throughout diverse communities to promote adolescent SRH.
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Affiliation(s)
- Tshiamo N Ramalepa
- Department of Nursing Science, School of Healthcare Sciences, Sefako Makgatho Health Sciences University, Tshwane.
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Fernandes D, Kemigisha E, Achen D, Akatukwasa C, Ruzaaza GN, Coene G, Delobelle P, Nyakato VN, Michielsen K. Process evaluation of a parent-child communication intervention for adolescent sexual and reproductive health in Uganda. BMC Public Health 2024; 24:319. [PMID: 38287314 PMCID: PMC10826092 DOI: 10.1186/s12889-023-17513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 12/18/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Previous initiatives concerning adolescent sexual and reproductive health (SRH) education in Low-or-Middle Income Countries (LMICs) have been limited by cultural norms and misinformation perpetuated within families. Responding to the paucity of research on the implementation of SRH interventions in LMICs and limited knowledge regarding their mechanisms, this study undertakes a process evaluation of a parent-focused intervention to promote parent-adolescent communication about SRH in Uganda. METHODS This paper explores the implementation, contextual factors and mechanisms of impact of the intervention, using the Medical Research Council (MRC) guidelines for process evaluations. Implementation was evaluated through indicators of dose, fidelity and adaptations, acceptability and feasibility. The contextual factors and mechanisms of impact were evaluated to refine the intervention's causal assumptions. Data was collected during April - October 2021 in South-Western Uganda using a mixed-methods approach, including document analysis, intervention observations, interviews, focus group discussions and most significant change stories. RESULTS The acceptability of the intervention was related to its community engagement, the strong rapport with delivery agents, and individual characteristics of participants. Five contextual factors influencing implementation were highlighted; (i) cultural norms, (ii) perceptions about youth SRH, (iii) poverty, (iv) Covid-19 pandemic, and (v) prior research projects in the community. When considering the intervention's mechanisms of impact, four causal pathways were identified; (i) Awareness of SRH needs helped parents overcome stigma, (ii) Parenting skills training improved SRH communication, (iii) Group learning stimulated shared parenting, and (iv) Group learning improved co-parenting. CONCLUSION The paper presented three key learnings and corresponding recommendations for future research. Firstly, implementation success was credited to meaningful community engagement which improved acceptability and uptake. Secondly, the complex influences of contextual factors highlighted the need for contextual analysis in research studies to inform intervention design. Finally, this evaluation recognised the interplay between mechanisms of impact and suggested further research consider such combined impacts when designing intervention content.
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Affiliation(s)
- Danielle Fernandes
- International Center for Reproductive Health, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium.
- Centre of Expertise on Gender, Diversity and Intersectionality, Vrije Universiteit Brussels, Brussels, 1090, Belgium.
| | - Elizabeth Kemigisha
- Faculty of Interdisciplinary Studies, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
- African Population and Health Research Center, P.O Box 10787-00100, Nairobi, Kenya
| | - Dorcus Achen
- Centre of Expertise on Gender, Diversity and Intersectionality, Vrije Universiteit Brussels, Brussels, 1090, Belgium
| | - Cecilia Akatukwasa
- International Center for Reproductive Health, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium
| | - Gad Ndaruhutse Ruzaaza
- Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Gily Coene
- Centre of Expertise on Gender, Diversity and Intersectionality, Vrije Universiteit Brussels, Brussels, 1090, Belgium
| | - Peter Delobelle
- Department of Public Health, Vrije Universiteit Brussels, Brussels, 1090, Belgium
- Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Observatory, Cape Town, 7925, South Africa
| | - Viola N Nyakato
- Faculty of Interdisciplinary Studies, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Kristien Michielsen
- International Center for Reproductive Health, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium
- Institute for Family and Sexuality Studies, Dept. of Neurosciences, Fac. of Medicine, KU Leuven, Leuven, Belgium
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Sidamo NB, Kerbo AA, Gidebo KD, Wado YD. Socio-Ecological Analysis of Barriers to Access and Utilization of Adolescent Sexual and Reproductive Health Services in Sub-Saharan Africa: A Qualitative Systematic Review. Open Access J Contracept 2023; 14:103-118. [PMID: 37398897 PMCID: PMC10312343 DOI: 10.2147/oajc.s411924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/19/2023] [Indexed: 07/04/2023] Open
Abstract
Background In sub-Saharan African countries (SSA), despite the efforts to enable adolescents to access sexual and reproductive health (SRH) services, there are limited systematic review studies that comprehensively synthesize barriers to accessing services using a social-ecological model. Therefore, this review was conducted to fill this gap. Methods This study protocol was registered in the PROSPERO database (CRD42022259095). We followed PRISMA guideline to conduct this review. PubMed, Google Scholar, Embase and African Journal Online databases were used. Two authors individually screened articles. Only qualitative articles published in the English in last 10 years were included in this review. Results From the total of 4890 studies, 23 qualitative studies fulfilled the eligibility criteria. Those studies were from 11 SSA countries. This review finding revealed that inadequate information about the services, the incorrect perception about services, low self-esteem, fear of being noticed by family members, and financial constraints are barriers at the intrapersonal level. Unsupportive families and lack of open communication between adolescent-parent about sexuality issues were interpersonal barriers to access. Lack of provider competency, provider attitude, an unsupportive environment, physical inaccessibility of services, and shortage of medicine, and supplies were identified as institutional-level barriers. Moreover, community-level barriers like community stigma, social, religious, and gender norms within the society were identified as the main barriers to accessing services for adolescents. Conclusion This review finding reveals that the main barriers to access SRH services for adolescents living in SSA are misperception about services, low self-esteem to access services, financial constraints, unsupportive families, community stigma and social norms, unsupportive environments in health facilities, healthcare provider behavior, poor competency, being judgmental attitude, and breaking privacy and confidentiality. This study finding calls for new approach like a multi-pronged that works with service providers, with community, with families, and with adolescent to improve SRH services utilization of adolescent.
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Affiliation(s)
- Negussie Boti Sidamo
- School of Public Health, College of Health and Medicine Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Amene Abebe Kerbo
- School of Public Health, College of Health and Medicine Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kassa Daka Gidebo
- School of Public Health, College of Health and Medicine Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Manet H, Doucet MH, Bangoura C, Dioubaté N, El Ayadi AM, Sidibé S, Millimouno TM, Delamou A. Factors facilitating the use of contraceptive methods among urban adolescents and youth in Guinea: a qualitative study. Reprod Health 2023; 20:89. [PMID: 37312141 DOI: 10.1186/s12978-023-01621-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/11/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND The use of modern contraceptive methods among adolescents and youth is a public health priority to prevent unintended pregnancies. To our knowledge, no study has ever explored and documented factors promoting contraceptive use among urban adolescents and youth in Guinea. The objective of this study was to explore the factors that promote the use of contraceptive methods at the personal, interpersonal, community, and health system levels among urban adolescents and youth in Guinea. METHODS We conducted a qualitative research study including twenty-six individual in-depth interviews among adolescents and youth, and 10 group interviews with an additional eighty individuals, for a total of 106 participants. The socio-ecological model was used to orient both data collection and analysis. Data were collected from June to October 2019. Both individual and group interviews were audio-recorded, and transcribed verbatims afterwards. Data was analyzed thematically, using deductive codes. RESULTS The individual factors favoring contraceptive use among adolescents and youth pertained to perceived benefits of the methods (e.g., discretion, absence of side effects, duration of action, ease of use), knowledge of the family planning service channels, and means to afford the cost of the method. The interpersonal factors were spouse/sexual partner approval, and peer suggestions about contraceptive methods. The community factors included socio-cultural beliefs about the methods, and community expectation not to get pregnant before marriage. The health system factors included access to free contraceptive methods, availability of methods, clinical competence and attitude of the health care provider to advise or administer methods, and proximity of family planning services to users' place of residence. CONCLUSIONS This qualitative research shows that many adolescents and youth living in Conakry use a variety of contraceptive methods, whether modern, traditional Access to free or affordable methods, discretion of method use, proximity and availability of methods, and suggestions of methods by peers are factors that motivate adolescents and youth to use contraception. In order to optimally facilitate the use of modern contraception among adolescent and young urban Guineans, we recommend that: (1) adolescents and youth have access to public health strategies enabling them to learn about, obtain, and use methods in a way that allows them to remain discreet; (2) the use of modern contraceptive methods be promoted by peers; and (3) health care providers and peers be adequately trained to have accurate and up-to-date knowledge about the different contraceptive methods available, demonstrate clinical skills for teaching and for method placement (if applicable), and show appropriate attitudes toward this population. This knowledge can inform policies and programs to improve the use of effective contraceptive methods by adolescents and youth living in urban Guinea.
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Affiliation(s)
- Hawa Manet
- Maferinyah National Training and Research Center in Rural Health (CNFRSR), Forécariah, Guinea.
| | - Marie-Hélène Doucet
- National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, University of Bordeaux, Bordeaux, France
| | - Charlotte Bangoura
- Maferinyah National Training and Research Center in Rural Health (CNFRSR), Forécariah, Guinea
| | - Nafissatou Dioubaté
- Maferinyah National Training and Research Center in Rural Health (CNFRSR), Forécariah, Guinea
| | - Alison M El Ayadi
- Department of Obstetrics Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, USA
| | - Sidikiba Sidibé
- Maferinyah National Training and Research Center in Rural Health (CNFRSR), Forécariah, Guinea
| | - Tamba Mina Millimouno
- Maferinyah National Training and Research Center in Rural Health (CNFRSR), Forécariah, Guinea
| | - Alexandre Delamou
- Maferinyah National Training and Research Center in Rural Health (CNFRSR), Forécariah, Guinea
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, University of Conakry, Conakry, Guinea
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Abdurahman C, Oljira L, Hailu S, Mengesha MM. Sexual and reproductive health services utilization and associated factors among adolescents attending secondary schools. Reprod Health 2022; 19:161. [PMID: 35840973 PMCID: PMC9287868 DOI: 10.1186/s12978-022-01468-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 06/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Sexual and reproductive health (SRH) is referring to physical and emotional wellbeing and includes the ability to be free from unwanted pregnancy, unsafe abortion, sexually transmitted infections including HIV/AIDS, and all forms of sexual violence and coercion. SRH is the main services packages that prevent and reduce adolescent reproductive health risks and problems. While the government of Ethiopia has undertaken several measures to improve SRH services, there was limited data on utilization among adolescents and associated factors. Objective To assess utilization of SRH services and associated factors among adolescents attending secondary schools in Haramaya District, Eastern Ethiopia. Methods A school-based cross-sectional study was conducted among adolescent students aged 15–19 years. A total of 692 adolescents were selected using a multi-stage sampling from two randomly selected secondary schools, each from rural and urban settings, in Haramaya district where 642 provided complete data and included in the analysis. A structured, pretested, and self-administered questionnaire was used to collect data. Data entry was conducted using Epi Data version 3.1 and exported to STATA version 16 for analysis. Bivariable and multivariable binary logistic regression were used to identify factors associated with school adolescents’ utilization of SRH. Statistically significant associations are declared at P-value < 0.05. Result A total of 642 completed the survey questionnaire, constituting a response rate of 92.7% (642/692). Male adolescents accounted 63.7% and the mean age of respondents was 17.71 years. Among those who completed the survey, 23.5% (95% CI: 20–26.8) utilized SRH services. Adolescents who were exposed to SRH information (adjusted odds ratio (AOR) = 2.11, 95% CI: 1.22–3.6), aware of SRH service providing facility (AOR = 1.83, 95% CI: 1.12–3.0) and SRH service components (AOR = 2.76, 95%, CI: 1.53–4.97), and distance from SRH facilities (AOR = 2.28, 95%, CI: 1.13–4.62) were significantly associated with the utilization of SRH services. Conclusion Nearly one-in-four secondary school adolescents (23.5%) utilized SRH services. Targeted promotion of SRH providing facilities and SRH service components aimed at awareness creation could improve adolescents’ utilization of SRH services. Improved SRH services utilization among adolescents who were far from SRH services providing facilities needs further investigation. Background Sexual and reproductive health (SRH) refers to physical and emotional wellbeing and includes the ability to be free from unwanted pregnancy, unsafe abortion, sexually transmitted infections including HIV/AIDS, and all forms of sexual violence and coercion. Components of the SRH services are important to reduce adolescent reproductive health risks and problems. This paper reports on the frequency of in-school adolescents who utilized SRH services and the factors that determined it. Methods we collected data from 642 in-school secondary school adolescents, aged 15–19 years, in Haramaya district, East Ethiopia. The data were collected from two schools, one from rural and the other from urban areas, using lottery method from the available schools in the district. A face-to-face interview was conducted to obtain data from the adolescents in the selected secondary schools. Result Out of 642 in-school adolescents, 23.5% utilized SRH services in Haramaya District. Adolescents who previously received SRH information, who knew SRH services providing facility, aware of SRH service components, and those who live not close to the SRH facilities were utilized the SRH services more often compared to their friends. Conclusion Nearly one-in-four secondary school adolescents (23.5%) utilized SRH services. Targeted promotion of SRH providing facilities and SRH service components aimed at awareness creation could improve adolescents’ utilization of SRH services.
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Affiliation(s)
- Chaltu Abdurahman
- College of Health and Medical Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Saba Hailu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Melkamu Merid Mengesha
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
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Thiongo M, Gichangi P, Macho PK, Byrne ME, Kimani P, Waithaka M, Radloff S, Anglewicz P, Decker MR. Implementation of respondent driven sampling in Nairobi, Kenya, for tracking key family planning indicators among adolescents and youth: lessons learnt. BMC Res Notes 2022; 15:200. [PMID: 35672785 PMCID: PMC9171948 DOI: 10.1186/s13104-022-06038-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 04/12/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Adolescents and youth constitute a significant proportion of the population in developing nations. Conventional survey methods risk missing adolescents/youth because their family planning/contraception (FP/C) behavior is hidden. Respondent-driven sampling (RDS), a modified chain-referral recruitment sampling approach, was used to reach unmarried adolescents/youth aged 15-24 in Nairobi, Kenya to measure key FP/C indicators. Seeds were selected and issued with three coupons which they used to invite their peers, male or female, to participate in the study. Referred participants were also given coupons to invite others till sample size was achieved. We report on key implementation parameters following standard RDS reporting recommendations. RESULTS A total of 1674 coupons were issued to generate a sample size of 1354. Coupon return rate was 82.7%. Study participants self-administered most survey questions and missing data was low. Differential enrolment by gender was seen with 56.0% of females recruiting females while 44.0% of males recruited males. In about two months, it was possible to reach the desired sample size using RDS methodology. Implementation challenges included presentation of expired coupons, recruitment of ineligible participants and difficulty recruiting seeds and recruits from affluent neighborhoods. Challenges were consistent with RDS implementation in other settings and populations. RDS can complement standard surveillance/survey approaches, particularly for mobile populations like adolescents/youth.
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Affiliation(s)
- Mary Thiongo
- International Centre for Reproductive Health, Mombasa, Kenya
| | - Peter Gichangi
- International Centre for Reproductive Health, Mombasa, Kenya
- Technical University of Mombasa, Mombasa, Kenya
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Present Address: P.O. Box, Nairobi, 2631-00202 Kenya
| | - Patrick K. Macho
- School of Public Health, College of Health Sciences, Moi University, Eldoret, Kenya
| | - Meagan E. Byrne
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Peter Kimani
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Michael Waithaka
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Scott Radloff
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Philip Anglewicz
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Michele R. Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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