当前位置: X-MOL 学术Sexual and Reproductive Health Matters › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Challenges and facilitators to the provision of sexual, reproductive health and rights services in Ghana
Sexual and Reproductive Health Matters ( IF 5.732 ) Pub Date : 2020-11-20 , DOI: 10.1080/26410397.2020.1846247
James Akazili 1 , Edmund Wedam Kanmiki 2 , Dominic Anaseba 3 , Veloshnee Govender 4 , Georges Danhoundo 4 , Augustina Koduah 5
Affiliation  

Abstract

Expanding access to sexual and reproductive health (SRH) services is one of the key targets of the Sustainable Development Goals. The extent to which sexual and reproductive health and rights (SRHR) targets will be achieved largely depends on how well they are integrated within Universal Health Coverage (UHC) initiatives. This paper examines challenges and facilitators to the effective provision of three SRHR services (maternal health, gender-based violence (GBV) and safe abortion/post-abortion care) in Ghana. The analysis triangulates evidence from document review with in-depth qualitative stakeholder interviews and adopts the Donabedian framework in evaluating provision of these services. Critical among the challenges identified are inadequate funding, non-inclusion of some SRHR services including family planning and abortion/post-abortion services within the health benefits package and hidden charges for maternal services. Other issues are poor supervision, maldistribution of logistics and health personnel, fragmentation of support services for GBV victims across agencies, and socio-cultural and religious beliefs and practices affecting service delivery and utilisation. Facilitators that hold promise for effective SRH service delivery include stakeholder collaboration and support, health system structure that supports continuum of care, availability of data for monitoring progress and setting priorities, and an effective process for sharing lessons and accountability through frequent review meetings. We propose the development of a national master plan for SRHR integration within UHC initiatives in the country. Addressing the financial, logistical and health worker shortages and maldistribution will go a long way to propel Ghana’s efforts to expand population coverage, service coverage and financial risk protection in accessing essential SRH services.



中文翻译:

在加纳提供性、生殖健康和权利服务的挑战和促进因素

摘要

扩大获得性与生殖健康 (SRH) 服务的机会是可持续发展目标的主要目标之一。性与生殖健康与权利 (SRHR) 目标的实现程度在很大程度上取决于它们在全民健康覆盖 (UHC) 计划中的整合程度。本文探讨了在加纳有效提供三项 SRHR 服务(孕产妇健康、基于性别的暴力 (GBV) 和安全堕胎/堕胎后护理)的挑战和促进因素。该分析通过深入的定性利益相关者访谈对来自文件审查的证据进行三角测量,并在评估这些服务的提供时采用 Donabedian 框架。已确定的挑战中的关键是资金不足,不包括一些 SRHR 服务,包括计划生育和堕胎/堕胎后服务,以及孕产妇服务的隐性收费。其他问题包括监管不力、后勤和卫生人员分配不当、跨机构为 GBV 受害者提供的支持服务分散,以及影响服务提供和使用的社会文化和宗教信仰和做法。承诺有效提供 SRH 服务的促进者包括利益相关者的合作和支持、支持连续护理的卫生系统结构、用于监测进展和确定优先事项的数据的可用性,以及通过频繁的审查会议分享经验教训和问责制的有效过程。我们建议制定一项国家总体规划,将 SRHR 整合到该国的全民健康覆盖计划中。解决财务、后勤和卫生工作者短缺和分配不均问题将大大有助于推动加纳努力扩大人口覆盖面、服务覆盖面和获得基本 SRH 服务的财务风险保护。

更新日期:2021-01-22
down
wechat
bug