Perceived barriers in accessing sexual and reproductive health services for youth in Lao People’s Democratic Republic


Autoři: Souksamone Thongmixay aff001;  Dirk Rombout Essink aff002;  Tim de Greeuw aff002;  Viengnakhone Vongxay aff001;  Vanphanom Sychareun aff001;  Jacqueline E. W. Broerse aff002
Působiště autorů: University of Health Sciences, Vientiane, Lao PDR aff001;  Vrije Universiteit Amsterdam, De Boelelaan, the Netherlands aff002
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0218296

Souhrn

Background

Sexual activity during youth is common in Lao PDR. However, young people seldom utilize sexual and reproductive health services and subsequently suffer from poor sexual and reproductive health. The aim of this qualitative study was to explore the barriers perceived by youth that prevent their access to sexual and reproductive health services.

Methods

Twenty-nine semi-structured interviews were conducted with 22 participants aged 15–25 years, from urban and rural areas. A vignette was used during interviews with those who had no experience with sexual and reproductive health services. Additionally, seven semi-structured interviews were conducted with health providers from youth-friendly health clinics and from public sexual and reproductive health services. Data were analyzed using a thematic approach.

Results

The main barriers preventing young people from accessing sexual and reproductive health services were related to cognitive accessibility and psychosocial accessibility. The cognitive accessibility barriers were a lack of sexual knowledge and a lack of awareness of services. Perceived barriers in psychosocial accessibility were the feelings of shyness and shame caused by negative cultural attitudes to premarital sex, and the fear of parents finding out about visits to public sexual and reproductive health services, due to lack of confidentiality in the services and among health providers. In addition, the barriers of geographical accessibility, mainly insufficient availability of youth-friendly health clinics.

Conclusion

To improve access to services, a multi-component strategy is needed: promotion of youth-friendly health clinics; sexual education in schools; a formal referral system between schools and youth-friendly health clinics; and community support interventions. Prior to implementation, more research should be done on the applicability of these methods in the Laos context. Future research should try to determine the cost-effectiveness of youth-friendly health clinics integrated in a district hospital and stand-alone clinics, to provide insight into which form should be further developed.

Klíčová slova:

Adolescents – Culture – Female contraception – Health education and awareness – Health services research – Pregnancy – Schools – Lao people


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Článek vyšel v časopise

PLOS One


2019 Číslo 10