Abstract

This paper focuses on rural aspects of sexual and reproductive health and sexuality. Disadvantage of access to practitioners with expertise in sexual and reproductive health and sexuality is compounded for rural residents. Retaining and supporting the rural sexual and reproductive health workforce is important in addressing sexual health inequities and promoting the sexual and reproductive rights of rural residents. However, little is known about the role-related challenges encountered by rurally-based sexual and reproductive health practitioners. We draw on 15 qualitative interviews with general practitioners and nurses with recognised expertise in sexual and reproductive health working in three rural regions of Victoria, Australia. Findings highlight the precarious state of sexual and reproductive health delivery in rural contexts and draw attention to the unsustainability of current systems for providing access to care in rural settings. Problems stem from cultural processes and assumptions within the health sector. Adapting organisational cultures and how sexual and reproductive health is structured within the health system are critical to improving access for rural residents. Our findings have relevance for other high-income, Eurocentric and metrocentric countries with public health systems and similar geographies.

摘要

本文侧重于农村方面的性健康和生殖健康以及性行为。对于农村居民来说，接触具有性与生殖健康和性方面专业知识的从业者的不利因素更加严重。留住和支持农村性与生殖健康劳动力对于解决性健康不平等问题和促进农村居民的性与生殖权利具有重要意义。然而，对于农村性健康和生殖健康从业者所遇到的与角色相关的挑战知之甚少。我们对在澳大利亚维多利亚州三个农村地区工作的具有公认的性健康和生殖健康专业知识的全科医生和护士进行了 15 次定性访谈。调查结果突出了农村环境中性健康和生殖健康提供的不稳定状态，并提请注意当前在农村环境中提供医疗服务的系统的不可持续性。问题源于卫生部门的文化过程和假设。适应组织文化以及如何在卫生系统内构建性健康和生殖健康对于改善农村居民的可及性至关重要。我们的研究结果与其他具有公共卫生系统和类似地理位置的高收入、以欧洲为中心和以都市为中心的国家相关。适应组织文化以及如何在卫生系统内构建性健康和生殖健康对于改善农村居民的可及性至关重要。我们的研究结果与其他具有公共卫生系统和类似地理位置的高收入、以欧洲为中心和以都市为中心的国家相关。适应组织文化以及如何在卫生系统内构建性健康和生殖健康对于改善农村居民的可及性至关重要。我们的研究结果与其他具有公共卫生系统和类似地理位置的高收入、以欧洲为中心和以都市为中心的国家相关。