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首页> 外文期刊>Reproductive Health >Realising sexual and reproductive health and rights of adolescent girls and young women living in slums in Uganda: a qualitative study
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Realising sexual and reproductive health and rights of adolescent girls and young women living in slums in Uganda: a qualitative study

机译：实现乌干达贫民窟贫民窟的性和生殖健康和权利：一个定性研究

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摘要

Sexual and reproductive health and rights are critical entitlements best supported through human rights-based approaches empowering rights-holders to claim their rights and duty bearers to fulfil their obligations. Implementing these requires information on the current needs and challenges faced by those seeking to claim their sexual and reproductive health and rights. We aimed to identify the underlying factors influencing the realisation of sexual and reproductive health and rights for adolescent girls and young women living Ugandan slums by: (1) exploring the role of relevant service providers and stakeholders; and (2) uncovering knowledge and gaps in protecting adolescent girls’ and young women’s sexual and reproductive health and rights. Qualitative data were collected through focus groups and interviews focused on current knowledge, behaviours and attitudes towards sexual and reproductive health and rights among adolescent girls and young women, service providers and stakeholders. Data were analysed thematically using NVivo software. Ten in-depth interviews were conducted with key informants; two focus groups were held with adolescent girls and young women living in two slums in Uganda (21 participants in total); and three focus groups were held with community leaders, service providers, teachers and parents (30 participants in total). Adolescent girls and young women lacked information regarding their sexual health, services available, and redress mechanisms for rights violations. Formal sources of information were frequently inaccessible. Family members were sometimes the source of rights violations, and informal methods of redressing rights were often sought. Stigma and fear were common features both in healthcare and in the pursuit of formal justice, with duty-bearers habitually breaking confidentiality. Education and training were the predominant suggestions offered for change. Adolescent girls and young women continue to face obstacles in achieving their full sexual and reproductive health and rights. Targeted interventions for the realisation of adolescent girls’ and young women’s sexual and reproductive health and rights can address underlying causes and positively shift attitudes to promote health. Every woman is entitled to good sexual and reproductive health. This involves being free from sexually transmitted infections, gender-based violence and maternal mortality, and able to access essential health services. In low and middle-income countries, adolescents comprise a fifth of the population, yet their sexual and reproductive health needs are often overlooked. Adolescent girls and young women are more likely to experience gender-based violence, sexually transmitted infections and poor access to sexual and reproductive health services. Those living in slums have even worse outcomes, but little evidence exists regarding the opportunities and barriers to improving sexual and reproductive health among adolescent girls and young women in a slum setting. In this study, we conducted focus groups and interviews with 21 adolescent girls and young women living in two Ugandan slums, 10 individuals with an essential role, for example, at state level, as well as 30 other stakeholders including healthcare workers, teachers, parents, district leaders and community support officers working with adolescent girls and young women. Results indicate that adolescent girls and young women lack information regarding their sexual health, what services are available and who and where to go if they experience violations such as sexual assault. In instances of sexual assault, fear and stigma prevented adolescent girls and young women from going to the police, and instead disputes were handled informally between families. Participants in our focus groups and interviews felt that education and training were needed, and that health services need to improve. Interventions are necessary to improve adolescent girls’ and young women’s sexual and reproductive health in this setting.
机译：性和生殖健康和权利是通过基于人权的方法支持的重要权利，赋予权利持有人申请权利和责任承担履行义务的权利。实施这些要求有关寻求申请性和生殖健康和权利的当前需求和挑战的信息。我们旨在确定影响性健康和生育健康和乌干达贫民窟的年轻女性权利和副妇女的权利的潜在因素：（1）探索相关服务提供者和利益攸关方的作用; （2）揭示保护青少年女童的知识和差距和年轻妇女的性与生殖健康和权利。通过焦点小组和面试收集的定性数据，专注于当前知识，行为和对青少年女孩和年轻女性，服务提供商和利益相关者的性健康和生殖健康和权利的态度。使用NVivo软件进行主题分析数据。有十个深入的访谈与关键信息人进行;两个焦点小组被乌干达的两个贫民窟的青少年女孩和年轻女性举行（总共21名参与者）;三个焦点小组与社区领导，服务提供商，教师和家长（共有30名参与者）举行。青春期女孩和年轻女性缺乏有关其性健康，可用服务的信息，以及侵犯职权的补救机制。正式的信息来源经常无法进入。家庭成员有时是侵犯权利的来源，往往寻求非正式的纠正权利方法。耻辱和恐惧是医疗保健和追求正式的正义的常见特征，惯常承载者习惯性地违反保密性。教育和培训是改变的主要建议。青春期女孩和年轻女性继续面临障碍，实现完全性和生殖健康和权利。有针对性的干预措施来实现青春期女童和年轻妇女的性和生殖健康和权利可以解决潜在的原因和积极转变促进健康的态度。每个女人都有权享受良好的性和生殖健康。这涉及免于性传播的感染，基于性别的暴力和孕产妇死亡，并且能够获得基本健康服务。在中低收入国家，青少年包括人口的五分之一，但他们的性和生殖健康需求往往被忽视。青春期女孩和年轻女性更有可能体验基于性别的暴力，性传播感染和对性和生殖健康服务的差。生活在贫民窟的人甚至更糟糕的结果，但有人有关于改善青少年女孩和年轻女性在贫民窟环境中的性能和生殖健康的机会和障碍的缺点。在这项研究中，我们用居住在两个乌干达贫民窟的21名青少年女孩和年轻女性的焦点小组和访谈进行了焦点，例如，具有重要作用，例如，在国家级，以及其他30个其他利益攸关方，包括医疗保健工作者，教师，父母，地区领导和社区支持人员与青春期女孩和年轻女性合作。结果表明，青少年女孩和年轻女性缺乏有关其性健康的信息，可提供哪些服务，如果他们遭受性侵犯等违规行为。在性侵犯的情况下，恐惧和耻辱阻碍了青少年女孩和年轻女性去警察，而是家庭之间非正式处理的争议。我们的重点小组和访谈中的参与者认为需要教育和培训，并且卫生服务需要改进。干预措施是在这种环境中改善青少年女孩和年轻女性的性和生殖健康。

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