Adolescents Sexual and Reproductive Health Services | OAJC

Barriers to Accessing Sexual and Reproductive Health Services for Adolescents in Sub-Saharan Africa: A Systematic Review

Introduction

The World Health Organization (WHO) defines adolescence as the period between 10 and 19 years of age, during which individuals become sexually active and develop behavioral patterns that can impact their future health. Access to sexual and reproductive health (SRH) services is a priority in sub-Saharan Africa (SSA) and is aligned with the Sustainable Development Goals (SDGs). However, adolescents face various barriers to accessing these services, including attitudes of healthcare providers, lack of confidentiality, cultural and religious norms, and inadequate information. This systematic review aims to comprehensively synthesize the barriers reported by adolescents to accessing SRH services in SSA.

Methods

This systematic review followed the PRISMA guidelines and included qualitative studies published in English within the last 10 years. The studies were selected based on their relevance to the research question and objectives. Data extraction was performed using a standardized tool, and quality appraisal was conducted using the JBI checklist for qualitative research. The findings were synthesized using a socio-ecological model (SEM) to identify barriers at the intrapersonal, interpersonal, institutional, and community levels.

Results

A total of 23 qualitative studies were included in the final review. The barriers identified at the intrapersonal level included lack of information about SRH services, low self-esteem, and financial constraints. At the interpersonal level, lack of parental support and poor parent-to-adolescent communication were identified as barriers. Institutional level barriers included physical inaccessibility of services, shortage of medicines and supplies, and an unsupportive environment. Provider-related barriers included healthcare provider behaviors, poor provider competency, and lack of privacy and confidentiality. Community level barriers included stigma, social and religious norms, and gender norms.

Discussion

The findings of this review highlight the complex and interacting barriers that adolescents face in accessing SRH services in SSA. These barriers operate at multiple levels and require a multi-pronged approach to address them. Interventions should focus on empowering adolescents, engaging parents and communities, improving the quality of healthcare services, and addressing social and cultural norms. The findings of this review can inform policy and practice to improve the access and utilization of SRH services for adolescents in SSA.

SDGs, Targets, and Indicators:

1. SDG 3: Good Health and Well-being

– Target 3.7: By 2030, ensure universal access to sexual and reproductive healthcare services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.

– Indicator: Access to sexual and reproductive healthcare services for adolescents in sub-Saharan Africa.

2. SDG 5: Gender Equality

– Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Program of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.

– Indicator: Access to sexual and reproductive health services for adolescent girls in sub-Saharan Africa.

3. SDG 10: Reduced Inequalities

– Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion, or economic or other status.

– Indicator: Reduction in barriers to accessing sexual and reproductive health services for adolescents in sub-Saharan Africa.

Table:

| SDGs | Targets | Indicators |

|——|———|————|

| SDG 3 | Target 3.7 | Indicator: Access to sexual and reproductive healthcare services for adolescents in sub-Saharan Africa |

| SDG 5 | Target 5.6 | Indicator: Access to sexual and reproductive health services for adolescent girls in sub-Saharan Africa |

| SDG 10 | Target 10.2 | Indicator: Reduction in barriers to accessing sexual and reproductive health services for adolescents in sub-Saharan Africa |

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