10 research outputs found
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
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
Predictors of nurses’ and midwives’ intentions to provide maternal and child healthcare services to adolescents in South Africa
BACKGROUND: Adolescent mothers are at a much higher risk for maternal mortality compared to mothers aged
20 years and above. Newborns born to adolescent mothers are also more likely to have low birth weight, with the
risk of long-term effects such as early onset of adult diabetes than newborns of older mothers. Few studies have
investigated the determinants of adequate quality maternal and child healthcare services to pregnant adolescents.
This study was conducted to gain an understanding of nurses’ and midwives’ intentions to provide maternal and
child healthcare and family planning services to adolescents in South Africa.
METHODS: A total of 190 nurses and midwives completed a cross-sectional survey. The survey included components
on demographics, knowledge of maternal and child healthcare (MCH) and family planning (FP) services, attitude
towards family planning services, subjective norms regarding maternal and child healthcare and family planning
services, self-efficacy with maternal and child healthcare and family planning services, and intentions to provide
maternal and child healthcare and family planning services to adolescents. Pearson’s correlation analysis was
conducted to determine the association between knowledge, attitude, subjective norms, self-efficacy, and intention
variables for FP and MCH services. A 2-step linear regression analysis was then conducted for both FP and MCH
services to predict the intentions to provide FP and MCH services to adolescents.
RESULTS: Self-efficacy to conduct MCH services (β = 0.55, p < 0.01) and years of experience as a nurse- midwife
(β = 0.14, p < 0.05) were associated with stronger intentions to provide the services. Self-efficacy to provide FP
services (β = 0.30, p < 0.01) was associated with stronger intentions to provide FP services.
CONCLUSIONS: Self-efficacy has a strong and positive association with the intentions to provide both MCH and FP
services, while there is a moderate association with attitude and norms. There is a need to improve and strengthen
nurses’ and midwives’ self-efficacy in conducting both MCH and FP services in order to improve the quality and
utilization of the services by adolescents in South Africa.IS