Sexual and Reproductive Health Services: experiences and views of young adults and providers in Soshanguve

dc.contributor.advisorHeunis, Christoen_ZA
dc.contributor.advisorKigozi-Male, Gladysen_ZA
dc.contributor.authorMaeko, Naum Mahlatseen_ZA
dc.date.accessioned2025-01-03T12:25:57Z
dc.date.available2025-01-03T12:25:57Z
dc.date.issued2024en_ZA
dc.descriptionDissertation (M.Soc.Sc.(Health Systems Studies))--University of the Free State, 2024en_ZA
dc.description.abstract๐—•๐—ฎ๐—ฐ๐—ธ๐—ด๐—ฟ๐—ผ๐˜‚๐—ป๐—ฑ: Despite efforts to educate young people about healthy sexual behaviours and the availability of sexual and reproductive health (SRH) services, risky sexual behaviour (RSB) outcomes such as unplanned pregnancies, unsafe abortions, and sexually transmitted infections (STIs) among youth in South Africa persist. Efforts have been made to implement SRH interventions aimed at addressing RSB outcomes through targeted clinic SRH services tailored for young people. However, implementation discrepancies continue, necessitating improvements in service delivery strategies and policy guidelines. These discrepancies stem from various barriers such as insufficient knowledge, education gaps, myths, misconceptions, family dynamics, socio-cultural elements, and systemic health issues. To comprehensively analyse these challenges, this study adopted the Socio-Ecological Model (SEM) proposed by McLeroy et al. (1988). The SEM framework acknowledges the multi-layered influences on human behaviour; that is, the ๐˜ช๐˜ฏ๐˜ฅ๐˜ช๐˜ท๐˜ช๐˜ฅ๐˜ถ๐˜ข๐˜ญ, ๐˜ช๐˜ฏ๐˜ต๐˜ฆ๐˜ณ๐˜ฑ๐˜ฆ๐˜ณ๐˜ด๐˜ฐ๐˜ฏ๐˜ข๐˜ญ, ๐˜ค๐˜ฐ๐˜ฎ๐˜ฎ๐˜ถ๐˜ฏ๐˜ช๐˜ต๐˜บ, ๐˜ช๐˜ฏ๐˜ด๐˜ต๐˜ช๐˜ต๐˜ถ๐˜ต๐˜ช๐˜ฐ๐˜ฏ๐˜ข๐˜ญ ๐˜ข๐˜ฏ๐˜ฅ ๐˜ฑ๐˜ฐ๐˜ญ๐˜ช๐˜ค๐˜บ-๐˜ญ๐˜ฆ๐˜ท๐˜ฆ๐˜ญ ๐˜ง๐˜ข๐˜ค๐˜ต๐˜ฐ๐˜ณ๐˜ด. ๐— ๐—ฎ๐—ถ๐—ป ๐—ฟ๐—ฒ๐˜€๐—ฒ๐—ฎ๐—ฟ๐—ฐ๐—ต ๐—พ๐˜‚๐—ฒ๐˜€๐˜๐—ถ๐—ผ๐—ป: How do socio-ecological factors influence young adults and SRH providersโ€™ experiences and views regarding SRH services in Soshanguve, South Africa? ๐—”๐—ถ๐—บ: The aim of the study was to explore how socio-ecological factors influence the experiences and views of young adults and SRH providers regarding SRH services in Soshanguve. ๐— ๐—ฒ๐˜๐—ต๐—ผ๐—ฑ๐—ผ๐—น๐—ผ๐—ด๐˜†: The research project utilised an interpretive paradigm. A qualitative approach was employed by using an exploratory research design to explore the personal views and experiences of young adults and SRH providers regarding SRH services at clinics. The study was conducted in three purposively selected local clinics in Soshanguve. The sample consisted of fifteen young adults, comprising of seven females and eight males, selected through convenience sampling. Five SRH providers were selected through purposive sampling. They were collected through in-depth interviews (IDIs) with young adult participants, in addition to key informant interviews (KIIs) with SRH provider-participants. All interviews were audio-recorded and transcribed for analysis by applying Thompsonโ€™s (2022) eight-step abductive analysis, which allowed the blending of inductive and deductive reasoning. Data from young adults and SRH providers was triangulated. Ethical considerations focused on informed consent, confidentiality, privacy, and respect throughout the research. ๐—™๐—ถ๐—ป๐—ฑ๐—ถ๐—ป๐—ด๐˜€: Both young adults and SRH providers identified key challenges across the SEM that affected their views and experiences of clinic SRH service in Soshanguve. At the ๐˜ช๐˜ฏ๐˜ฅ๐˜ช๐˜ท๐˜ช๐˜ฅ๐˜ถ๐˜ข๐˜ญ ๐˜ญ๐˜ฆ๐˜ท๐˜ฆ๐˜ญ, knowledge, attitudes and beliefs about SRH were crucial determinants. At the ๐˜ช๐˜ฏ๐˜ต๐˜ฆ๐˜ณ๐˜ฑ๐˜ฆ๐˜ณ๐˜ด๐˜ฐ๐˜ฏ๐˜ข๐˜ญ ๐˜ญ๐˜ฆ๐˜ท๐˜ฆ๐˜ญ, both groups perceived parent-child and peer communication as the critical factors influencing young adults' knowledge, attitudes, and behaviours towards SRH. ๐˜Š๐˜ฐ๐˜ฎ๐˜ฎ๐˜ถ๐˜ฏ๐˜ช๐˜ต๐˜บ-๐˜ณ๐˜ฆ๐˜ญ๐˜ข๐˜ต๐˜ฆ๐˜ฅ factors hindering and facilitating young adultsโ€™ access to and utilisation of clinic SRH services such as societal attitudes, religious beliefs, and cultural norms emerged as significant barriers contributing to stigma and discrimination for both groups. Both groups perceived similar ๐˜ช๐˜ฏ๐˜ด๐˜ต๐˜ช๐˜ต๐˜ถ๐˜ต๐˜ช๐˜ฐ๐˜ฏ๐˜ข๐˜ญ-๐˜ณ๐˜ฆ๐˜ญ๐˜ข๐˜ต๐˜ฆ๐˜ฅ barriers and facilitators such as limited clinic operating hours, overcrowding, and lack of confidentiality. However, young adults expressed greater concerns about SRH providersโ€™ judgemental and gender-bias attitudes, while SRH providers were concerned with the impact of the clinic booking system, especially for the abortions. At the ๐˜ฑ๐˜ฐ๐˜ญ๐˜ช๐˜ค๐˜บ ๐˜ญ๐˜ฆ๐˜ท๐˜ฆ๐˜ญ, both groups emphasised the need for guidelines that could support comprehensive education, youth-friendly services, and mobile SRH services to address systemic issues and enhance access for young adults. ๐—–๐—ผ๐—ป๐—ฐ๐—น๐˜‚๐˜€๐—ถ๐—ผ๐—ป: The findings revealed the views and experiences of both young adults and SRH providers regarding young adultsโ€™ access to and utilisation of clinic SRH services in Soshanguve, thus underscoring the necessity for a multi-layered SEM approach. Addressing the identified SEM factors through targeted interventions and policies can assist in bridging the gaps in service delivery and the utilisation of resources to promote better SRH outcomes among young adults.en_ZA
dc.identifier.urihttp://hdl.handle.net/11660/12903
dc.language.isoen
dc.publisherUniversity of the Free Stateen_ZA
dc.rights.holderUniversity of the Free Stateen_ZA
dc.subjectSexual and reproductive health servicesen_ZA
dc.subjectRisky sexual behaviouren_ZA
dc.subjectSocio-ecological modelen_ZA
dc.subjectYoung adultsen_ZA
dc.subjectSRH providersen_ZA
dc.titleSexual and Reproductive Health Services: experiences and views of young adults and providers in Soshanguveen_ZA
dc.typeDissertation
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