Barreras de acceso a los servicios primarios de salud sexual y reproductiva en adolescentes, de una comunidad urbano marginal del Perú

Introducción: Las barreras de acceso a los servicios de salud primario conforman estructuras sociales que agravan la situación de salud de los adolescentes, impactando negativamente en el ejercicio pleno de la salud sexual reproductiva, situando a los adolescentes en una población de riesgo social. Objetivo: Determinar las barreras en el acceso a los servicios primarios de Salud Sexual y Reproductiva de atención diferenciada a los adolescentes del Centro de Salud I - 4 Pampa Grande Tumbes 2018. Metodología: Estudio analítico de caso control, se entrevistaron a 288 adolescentes del tercero, cuarto y quinto de secundaria de la institución educativa pública Túpac Amaru del centro poblado Pampa Grande de Tumbes en el año 2019, entre experimento y control con una razón de 1 a 1. Se aplicaron cuestionarios anónimos para evaluar las barreras de accesibilidad a los servicios primarios de salud. Se recogieron variables: características sociodemográficas y culturales que son consideradas, como barreras de acceso a los servicios de salud. Se realizó un análisis descriptivo e inferencial con el programa SPSS® v.23. Resultados: La edad, sexo e ingreso económico están directa y significativamente relacionadas con la accesibilidad a los servicios de salud sexual y reproductiva (p<0.01 IC 95 %); La disposición de recursos económicos para asumir los costos de traslado al centro de salud (OR = 4,23); la utilización del transporte público (OR = 1,58), el conocimiento de los servicios de salud sexual y reproductiva (OR = 1,15) incrementan la probabilidad de acceder a los servicios de salud sexual y reproductiva de los adolescentes. Discusión: Las barreras socioeconómicas a los servicios de salud sexual y reproductiva de los adolescentes son modificables y dependen de la gestión en salud pública.

Introduction: The barriers to access to primary health services make up social structures that aggravate the health situation of adolescents, negatively impacting the full exercise of reproductive sexual health, placing adolescents in a population at social risk. Objective: To determine the barriers in the access to the primary services of Sexual and Reproductive Health of differentiated attention to the adolescents of the Health Center I - 4 Pampa Grande Tumbes 2018. Methods: Analytical case control study, 288 adolescents from the third, fourth and fifth grade of secondary school of the public educational institution Túpac Amaru in the Pampa Grande de Tumbes town center were interviewed in 2019, between experiment and control with a ratio of 1 to 1. Anonymous questionnaires were applied to assess accessibility barriers to primary health services. Variables were collected: sociodemographic and cultural characteristics that are considered as barriers to access to health services. A descriptive and inferential analysis was carried out with the SPSS® v.23 program. Results: Age, sex and economic income are directly and significantly related to accessibility to sexual and reproductive health services (p<0.01 95% CI); The availability of economic resources to assume the costs of transportation to the health center (OR = 4.23); the use of public transport (OR = 1.58), knowledge of sexual and reproductive health services (OR = 1.15) increase the probability of accessing sexual and reproductive health services for adolescents. Discussion: Socioeconomic barriers to sexual and reproductive health services for adolescents are modifiable and depend on public health management.

Reproductive health education: a qualitative study of health seeking behaviour of in-school female adolescents

Introduction: adolescents in developing countries are often vulnerable to sexually transmitted diseases (STDs) and unplanned pregnancies. It is estimated that about 13 million adolescent girls have unplanned births each year in developing countries. This study examined the scope of the School Health Education Programme (SHEP) and health-seeking behaviours of female adolescents in Junior High School (JHS). Methods: this qualitative research used the narrative approach. Group discussions were conducted among 100 female adolescents aged 12-19 years. Interviews were conducted among five community health workers in five health centres that provide reproductive health services. The in-depth interviews and group discussions were documented, transcribed and analyzed using NVivo 11, whilst thematic analysis was used in analyzing data. Results: the mean age of adolescents was 15.5 years, with 74% reporting having knowledge of STDs. It was observed that the SHEP offers various information on health issues such as menstrual hygiene, STDs, personal hygiene, contraceptives, personal development and unsafe abortion practices. Adolescent reproductive health services were also available in the health centres but patronage was low as a result of perceived negative attitude of health workers and trust. Knowledge on issues of reproductive health is insufficient among JHS female adolescents, with many of them relying on the media and peers for reproductive health support. Conclusion: in this study, female adolescents are generally involved in risky sexual behaviour due to their low level of knowledge on reproductive issues and their unwillingness to patronize available reproductive health services because of the health system and cultural barriers.

"It is just a lot to deal with": A qualitative study exploring the sexual and reproductive health needs of a sample of female sex workers in six locations in Southern Africa

The sexual and reproductive health of female sex workers in Southern Africa is particularly important, given the high prevalence of HIV among this population. This paper presents the results of a rapid assessment study conducted prior to the implementation of the "SRHR-HIV Knows No Borders" project in six Southern African countries. Trained interviewers interviewed 20 sex workers across 10 high migration communities. Data were analysed thematically. Participants were well informed about and were able toaccess preventive methods for STIs and pregnancy, although reports of condom failures were common. While sex workers found SRH services easily accessible, many reported experiences of stigma and discrimination when accessing them. Physical and sexual violence were common occurrences among participants, both from their clients and the police. In addition to addressing stigma within the healthcare and broader community, interventions could provide opportunities for those looking to exit the industry by providing skills training and microfinance support. (Afr J Reprod Health 2022; 26[5]: 72-80).

El modelo de la adaptación ante la infertilidad de la pareja / The model of adaptation to the infertility of the couple

Introducción: los modelos conceptuales constituyen un marco de referencia para la práctica de enfermería y para tratar a la pareja infértil, el modelo de la adaptación de Sor Callixta Roy permite que los profesionales utilicen como herramienta el "Proceso de Atención de Enfermería" para ofrecer un cuidado de excelencia. OBJETIVO: diseñar la propuesta de actuación de enfermería ante parejas infértiles a través del modelo de la adaptación de Sor Callixta Roy. MÉTODOS: estudio descriptivo y retrospectivo con las parejas tratadas en el "Centro territorial de atención a la pareja infértil" de la provincia de Cienfuegos tributarias de fertilización invitro. La muestra fue de 92 mujeres. RESULTADOS: predominó el grupo de mujeres de 36 a 40 años (35,9 por ciento), en cuanto a la edad en que iniciaron las relaciones sexuales el 39,1 por ciento lo hizo antes de los 14 años, aunque predominó el grupo entre 15 y 19 años. El grupo de 36 a 40 años fue el que refirió mayor número de parejas sexuales. El 52,2 por ciento se realizó al menos una interrupción provocada, el grupo entre 36 y 40 años fue el que más incurrió con 18,5 por ciento y hubo algunas que utilizaron este proceder tres veces o más como método anticonceptivo. El 16,3 por ciento de las mujeres nunca logró un embarazo en su vida reproductiva; el 78,2 por ciento, entre 1 y 3. En el 18,4 por ciento fue diagnosticada la clamidia y en el 23,9 por ciento otras infecciones. Solo el 6,5 por ciento de las mujeres no tenían dificultades para la reproducción por lo que el problema era de causa masculina. CONCLUSIONES: predominaron los factores de riesgo para las infecciones de transmisión sexual, así como un gran número de abortos provocados(AU)

INTRODUCTION: the conceptual models constitute a reference mark for the nursery practice and to treat the infertile couple. The model of adaptation of Sor Callixta Roy allows that the professionals use the "Process of nursery Care" as a tool to offer an excellence care. OBJECTIVE: to design the proposal of Nursery Care to infertile couples through the model of the adaptation of Sor Callixta Roy. METHOD: descriptive and retrospective study with the couples tried in the territorial "Center of Care to the infertile couple" of Cienfuegos tributaries to fertilization invitro; from a universe of 251 couples was selected a sample of 92 (36.6 percent) histories charts with the aleatory simple method whose were taken to a form the necessary variables. The datas were processed with SPSS version 15.0 and the results are shown in charts. RESULTS: the risk factors prevail for the infections of sexual transmission as well as the carrying out of great number of induced miscarriages which constitute causes of infertility. Other factors are evidence that allow to confirm that many cases can be avoided and the great mayority can solve their situation. CONCLUSIONS: the risk factors prevail for the infections of sexual transmission as well as the carrying out of great number of induced miscarriages which constitute causes of infertility(AU)