Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review

Background Despite the global agreements on adolescents' sexual and reproductive health and rights, access to and utilisation of these services among the youth/adolescents remain unsatisfactory in low- and middle-income countries which are a significant barrier to progress in this area. This re...

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Bibliographic Details
Published in:Reproductive health 2021-06, Vol.18 (1), p.1-135, Article 135
Main Authors: Ninsiima, Lesley Rose, Chiumia, Isabel Kazanga, Ndejjo, Rawlance
Format: Article
Language:English
Subjects:
Adolescents
Africa
Barriers
Care and treatment
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Demographic aspects
Facilitators
Gender
Health aspects
Health services
Medical care
Qualitative research
Reproductive health
Review
Sexual behavior
Systematic review
Teenage girls
Teenagers
Utilization
Women's health services
Womens health
Young adults
Youth
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Summary:Background Despite the global agreements on adolescents' sexual and reproductive health and rights, access to and utilisation of these services among the youth/adolescents remain unsatisfactory in low- and middle-income countries which are a significant barrier to progress in this area. This review established factors influencing access and utilisation of youth-friendly sexual and reproductive health services (YFSRHS) among the youth in sub-Saharan Africa to inform programmatic interventions. Methodology A systematic review of studies published between January 2009 and April 2019 using PubMed, Web of Science, EMBASE, Medline, and Cochrane Library, and Google Scholar databases was conducted. Studies were screened based on the inclusion criteria of barriers and facilitators of implementation of YFSRHS, existing national policies on provision of YFSRHS, and youth's perspectives on these services. Findings A total of 23,400 studies were identified through database search and additional 5 studies from other sources. After the full-text screening, 20 studies from 7 countries met the inclusion criteria and were included in the final review. Structural barriers were the negative attitude of health workers and their being unskilled and individual barriers included lack of knowledge among youth regarding YFSRHS. Facilitators of utilisation of the services were mostly structural in nature which included community outreaches, health education, and policy recommendations to improve implementation of the quality of health services and clinics for adolescents/youth to fit their needs and preferences. Conclusion Stakeholder interventions focusing on implementing YFSRHS should aim at intensive training of health workers and put in place quality implementation standard guidelines in clinics to offer services according to youth's needs and preferences. In addition, educating the youth through community outreaches and health education programs for those in schools can facilitate utilisation and scale up of the service. Keywords: Adolescents, Barriers, Facilitators, Reproductive health, Youth, Africa
ISSN:1742-4755
1742-4755
DOI:10.1186/s12978-021-01183-y