Nurses' perceptions of adolescents accessing and utilizing sexual and reproductive healthcare services in Cape Town, South Africa: A qualitative study

Kim Jonas; Nicolette Roman; Priscilla Reddy; Anja Krumeich; Bart van den Borne; Rik Crutzen

doi:10.1016/j.ijnurstu.2019.05.008

Nurses' perceptions of adolescents accessing and utilizing sexual and reproductive healthcare services in Cape Town, South Africa: A qualitative study

Kim Jonas^*, Nicolette Roman, Priscilla Reddy, Anja Krumeich, Bart van den Borne, Rik Crutzen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: In Sub-Saharan Africa access to and utilization of sexual and reproductive healthcare is unsatisfactory. Consequently, rates of teenage pregnancy and unsafe abortions among adolescents in Sub-Saharan Africa, including in South Africa remain a public health challenge. The aim of this study was to explore nurses' views on and perceptions of adolescent girls' barriers and needs to accessing and utilizing sexual and reproductive healthcare services.

Methods: Twenty-four purposively selected healthcare workers from nine public healthcare facilities in Cape Town, South Africa participated in this qualitative descriptive study. Data were collected through nine group discussions, and audio-recorded with hand-written notes taken during the discussions. Data were analyzed using thematic analysis, following the Tesch's eight steps for coding and analysing qualitative data.

Results: Sexual and reproductive healthcare nurses are generally supportive of adolescents who ask for and use contraceptives. Non-compliance to family planning regimens and repeated requests for termination of pregnancies were perceived by nurses as irresponsible behaviours which are particularly frustrating to them and not in concordance with their personal values. The subsequent nurse-adolescent interactions sometimes appeared to hinder access to and utilization of sexual and reproductive healthcare services by adolescents.

Conclusions: Nurses perceive certain behaviours of adolescent girls as irresponsible and warrant their negative attitudes and reactions toward them. The negative attitudes and reactions of nurses potentially further compromises access to and utilization of sexual and reproductive healthcare services by adolescent girls in South Africa and requires urgent attention. Adolescent-friendly clinic hours together with youth-friendly nurses is likely to encourage adolescent girls to access sexual and reproductive healthcare services and improve the use thereof. (C) 2019 Published by Elsevier Ltd.

Original language	English
Pages (from-to)	84-93
Number of pages	10
Journal	International Journal of Nursing Studies
Volume	97
DOIs	https://doi.org/10.1016/j.ijnurstu.2019.05.008
Publication status	Published - Sept 2019

Keywords

Adolescents
Behaviours
Family planning
Healthcare workers
Compliance
Provider perspectives
Sexual and reproductive healthcare termination of pregnancy
BARRIERS

Access to Document

10.1016/j.ijnurstu.2019.05.008

Cite this

@article{38d15e097e6042e08e618946c2c615fb,

title = "Nurses' perceptions of adolescents accessing and utilizing sexual and reproductive healthcare services in Cape Town, South Africa: A qualitative study",

abstract = "Background: In Sub-Saharan Africa access to and utilization of sexual and reproductive healthcare is unsatisfactory. Consequently, rates of teenage pregnancy and unsafe abortions among adolescents in Sub-Saharan Africa, including in South Africa remain a public health challenge. The aim of this study was to explore nurses' views on and perceptions of adolescent girls' barriers and needs to accessing and utilizing sexual and reproductive healthcare services.Methods: Twenty-four purposively selected healthcare workers from nine public healthcare facilities in Cape Town, South Africa participated in this qualitative descriptive study. Data were collected through nine group discussions, and audio-recorded with hand-written notes taken during the discussions. Data were analyzed using thematic analysis, following the Tesch's eight steps for coding and analysing qualitative data.Results: Sexual and reproductive healthcare nurses are generally supportive of adolescents who ask for and use contraceptives. Non-compliance to family planning regimens and repeated requests for termination of pregnancies were perceived by nurses as irresponsible behaviours which are particularly frustrating to them and not in concordance with their personal values. The subsequent nurse-adolescent interactions sometimes appeared to hinder access to and utilization of sexual and reproductive healthcare services by adolescents.Conclusions: Nurses perceive certain behaviours of adolescent girls as irresponsible and warrant their negative attitudes and reactions toward them. The negative attitudes and reactions of nurses potentially further compromises access to and utilization of sexual and reproductive healthcare services by adolescent girls in South Africa and requires urgent attention. Adolescent-friendly clinic hours together with youth-friendly nurses is likely to encourage adolescent girls to access sexual and reproductive healthcare services and improve the use thereof. (C) 2019 Published by Elsevier Ltd.",

keywords = "Adolescents, Behaviours, Family planning, Healthcare workers, Compliance, Provider perspectives, Sexual and reproductive healthcare termination of pregnancy, BARRIERS",

author = "Kim Jonas and Nicolette Roman and Priscilla Reddy and Anja Krumeich and {van den Borne}, Bart and Rik Crutzen",

note = "Funding Information: This study was funded by the Netherlands Fellowship Program (NFP)/Nuffic. The financial support of the National Research Foundation (NRF) towards this research is also hereby acknowledged. Opinion expressed and conclusions arrived at, are those of the authors and are not necessarily to be attributed to the NRF. Funding Information: This study was funded by the Netherlands Fellowship Program (NFP)/Nuffic . The financial support of the National Research Foundation (NRF) towards this research is also hereby acknowledged. Opinion expressed and conclusions arrived at, are those of the authors and are not necessarily to be attributed to the NRF. Publisher Copyright: {\textcopyright} 2019",

year = "2019",

month = sep,

doi = "10.1016/j.ijnurstu.2019.05.008",

language = "English",

volume = "97",

pages = "84--93",

journal = "International Journal of Nursing Studies",

issn = "0020-7489",

publisher = "Elsevier Science",

}

TY - JOUR

T1 - Nurses' perceptions of adolescents accessing and utilizing sexual and reproductive healthcare services in Cape Town, South Africa

T2 - A qualitative study

AU - Jonas, Kim

AU - Roman, Nicolette

AU - Reddy, Priscilla

AU - Krumeich, Anja

AU - van den Borne, Bart

AU - Crutzen, Rik

N1 - Funding Information: This study was funded by the Netherlands Fellowship Program (NFP)/Nuffic. The financial support of the National Research Foundation (NRF) towards this research is also hereby acknowledged. Opinion expressed and conclusions arrived at, are those of the authors and are not necessarily to be attributed to the NRF. Funding Information: This study was funded by the Netherlands Fellowship Program (NFP)/Nuffic . The financial support of the National Research Foundation (NRF) towards this research is also hereby acknowledged. Opinion expressed and conclusions arrived at, are those of the authors and are not necessarily to be attributed to the NRF. Publisher Copyright: © 2019

PY - 2019/9

Y1 - 2019/9

N2 - Background: In Sub-Saharan Africa access to and utilization of sexual and reproductive healthcare is unsatisfactory. Consequently, rates of teenage pregnancy and unsafe abortions among adolescents in Sub-Saharan Africa, including in South Africa remain a public health challenge. The aim of this study was to explore nurses' views on and perceptions of adolescent girls' barriers and needs to accessing and utilizing sexual and reproductive healthcare services.Methods: Twenty-four purposively selected healthcare workers from nine public healthcare facilities in Cape Town, South Africa participated in this qualitative descriptive study. Data were collected through nine group discussions, and audio-recorded with hand-written notes taken during the discussions. Data were analyzed using thematic analysis, following the Tesch's eight steps for coding and analysing qualitative data.Results: Sexual and reproductive healthcare nurses are generally supportive of adolescents who ask for and use contraceptives. Non-compliance to family planning regimens and repeated requests for termination of pregnancies were perceived by nurses as irresponsible behaviours which are particularly frustrating to them and not in concordance with their personal values. The subsequent nurse-adolescent interactions sometimes appeared to hinder access to and utilization of sexual and reproductive healthcare services by adolescents.Conclusions: Nurses perceive certain behaviours of adolescent girls as irresponsible and warrant their negative attitudes and reactions toward them. The negative attitudes and reactions of nurses potentially further compromises access to and utilization of sexual and reproductive healthcare services by adolescent girls in South Africa and requires urgent attention. Adolescent-friendly clinic hours together with youth-friendly nurses is likely to encourage adolescent girls to access sexual and reproductive healthcare services and improve the use thereof. (C) 2019 Published by Elsevier Ltd.

AB - Background: In Sub-Saharan Africa access to and utilization of sexual and reproductive healthcare is unsatisfactory. Consequently, rates of teenage pregnancy and unsafe abortions among adolescents in Sub-Saharan Africa, including in South Africa remain a public health challenge. The aim of this study was to explore nurses' views on and perceptions of adolescent girls' barriers and needs to accessing and utilizing sexual and reproductive healthcare services.Methods: Twenty-four purposively selected healthcare workers from nine public healthcare facilities in Cape Town, South Africa participated in this qualitative descriptive study. Data were collected through nine group discussions, and audio-recorded with hand-written notes taken during the discussions. Data were analyzed using thematic analysis, following the Tesch's eight steps for coding and analysing qualitative data.Results: Sexual and reproductive healthcare nurses are generally supportive of adolescents who ask for and use contraceptives. Non-compliance to family planning regimens and repeated requests for termination of pregnancies were perceived by nurses as irresponsible behaviours which are particularly frustrating to them and not in concordance with their personal values. The subsequent nurse-adolescent interactions sometimes appeared to hinder access to and utilization of sexual and reproductive healthcare services by adolescents.Conclusions: Nurses perceive certain behaviours of adolescent girls as irresponsible and warrant their negative attitudes and reactions toward them. The negative attitudes and reactions of nurses potentially further compromises access to and utilization of sexual and reproductive healthcare services by adolescent girls in South Africa and requires urgent attention. Adolescent-friendly clinic hours together with youth-friendly nurses is likely to encourage adolescent girls to access sexual and reproductive healthcare services and improve the use thereof. (C) 2019 Published by Elsevier Ltd.

KW - Adolescents

KW - Behaviours

KW - Family planning

KW - Healthcare workers

KW - Compliance

KW - Provider perspectives

KW - Sexual and reproductive healthcare termination of pregnancy

KW - BARRIERS

U2 - 10.1016/j.ijnurstu.2019.05.008

DO - 10.1016/j.ijnurstu.2019.05.008

M3 - Article

C2 - 31200221

SN - 0020-7489

VL - 97

SP - 84

EP - 93

JO - International Journal of Nursing Studies

JF - International Journal of Nursing Studies

ER -