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. 2018 Feb 13;18(1):109.
doi: 10.1186/s12913-018-2917-0.

Healthcare workers' beliefs, motivations and behaviours affecting adequate provision of sexual and reproductive healthcare services to adolescents in Cape Town, South Africa: a qualitative study

Kim Jonas  1   2 , Rik Crutzen  3 , Anja Krumeich  4 , Nicolette Roman  5 , Bart van den Borne  3 , Priscilla Reddy  5   6
Affiliations

Healthcare workers' beliefs, motivations and behaviours affecting adequate provision of sexual and reproductive healthcare services to adolescents in Cape Town, South Africa: a qualitative study

Kim Jonas et al. BMC Health Serv Res. .

Abstract

Background: Adolescents' sexual and reproductive healthcare (SRH) needs have been prioritized globally, and they have the rights to access and utilize SRH services for their needs. However, adolescents under-utilize SRH services, especially in sub-Saharan Africa. Many factors play a role in the under-utilization of SRH services by adolescents, such as the attitude and behaviour of healthcare workers. The aim of this study therefore, was to explore and gain an in-depth understanding of healthcare workers' beliefs, motivations and behaviours affecting adequate provision of these services to adolescents in South Africa.

Methods: Twenty-four healthcare workers in public SRH services in Cape Town, South Africa participated in this qualitative study through focus group discussions. To fulfill the aims of this study, nine focus group discussions were conducted among the SRH nurses.

Results: SRH nurses indicated that they are experiencing challenges with the concept and practice of termination of pregnancy. They explained that this practice contradicted their opposing beliefs and values. Some nurses felt that they had insufficient SRH skills, which hinder their provision of adequate SRH services to adolescents, while others described constraints within the health system such as not enough time to provide the necessary care. They also explained having limited access to schools where they can provide SRH education and pregnancy prevention services in the surrounding area.

Conclusions: Nurses are faced with numerous challenges when providing SRH services to adolescents. Providing the nurses with training programmes that emphasize value clarification may help them to separate their personal beliefs and norms from the workplace practice. This may help them to focus on the needs of the adolescent in a way that is beneficial to them. At the health systems level, issues such as clinic operating hours need to be structured such that the time pressure and constraints upon the nurse is relieved.

Keywords: Adolescents; Beliefs; Cape Town; Motivations; Sexual and Reproductive Healthcare; South Africa.

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Conflict of interest statement

Ethics approval and consent to participate

Permission to conduct the study was obtained from the the University of the Western Cape Research and Ethics Committee (Ethics Reference Number: HS/16/3/49). Signed informed consent was obtained from each participant before they participated in the focus group discussons. Participants were informed of their rights to withdraw from the study at any time. Anonymity of participants was maintained and assurance given that all information would be treated in absolute confidence. Participants were also provided with written information sheet on the study and their rights regarding participation and the option of withdrawing at any time. All data collected was safely stored and the anonymity of the participants maintained throughout the process. Data was safely secured and only authorized personnel and research coordinators have access to the data.

Consent for publication

Not applicable.

Competing interests

All authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Overall themes. Key: ASRH = Adolescents Sexual and Reproductive Healthcare, TOP = Termination of Pregnancy, FP = Family Planning
See this image and copyright information in PMC

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