Barriers faced by Ugandan university students in seeking medical care and sexual health counselling: a cross-sectional study

BMC Public Health

Anette Agardh³  Benedict O Asamoah²  Farhad Ali Khan¹  Andualem Tadesse Boltena² 

[1] Swedish Institute for Communicable Disease Control, Stockholm, Sweden;Social Medicine and Global Health, Department of Clinical Sciences Malmo, Lund University, Lund, Sweden;Centre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, University of Melbourne, Melbourne, VIC, Australia

关键词: Uganda;    Youth-friendly;    Self-rated health;    Sexual health counselling need;    Unmet medical care need;    Availability;    Accessibility;    Acceptability;   

Others  :  1162831
DOI  :  10.1186/1471-2458-12-986

 received in 2012-05-21, accepted in 2012-11-13,  发布年份 2012

【 摘 要 】

Background

Meeting the medical and sexual health care needs of young people is crucial for sustainable development. In Uganda, youth are faced with a number of challenges related to accessing medical care and sexual health counselling services. This study sought to investigate the barriers faced by Ugandan university students in seeking medical care and sexual health counselling.

Methods

This study is part of a cross-sectional survey conducted in 2005 among 980 students at Mbarara University of Science and Technology. Data was collected by means of a self-administered 11-page questionnaire. The barriers encountered by respondents in seeking medical care and sexual health counselling were classified into three categories reflecting the acceptability, accessibility, or availability of services.

Results

Two out of five students reported unmet medical care needs, and one out of five reported unmet sexual health counselling needs. Acceptability of services was the main barrier faced by students for seeking medical care (70.4%) as well as for student in need of sexual health counselling (72.2%), regardless of age, gender, self-rated health, and rural/peri-urban or urban residence status. However, barriers differed within the various strata. There was a significant difference (p-value 0.01) in barriers faced by students originally from rural versus peri-urban/urban areas in seeking medical care (acceptability: 64.8%/74.5%, accessibility: 22.0% /12.6%, availability 13.2%/12.9%, respectively). Students who reported poor self-rated health encountered barriers in seeking both medical care and sexual health counselling that were significantly different from their other counterparts (p-value 0.001 and 0.007 respectively).

Conclusions

Barriers faced by students in seeking medical and sexual health care should be reduced by interventions aimed at boosting confidence in health care services, encouraging young people to seek early treatment, and increasing awareness of where they can turn for services. The availability of medical services should be increased and waiting times and cost reduced for vulnerable groups.

【 授权许可】

   
2012 Boltena et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]United Nations: United Nations world Youth Report. In Youth and Climate Change. New York: United Nations; 2010.
• [2]Musacchio NS, Forcier M: Adolescent Health. International Encyclopedia of Public Health 2008, 1:33-48.
• [3]Sukarieh M, Tannock S: The Positivity Imperative: A Critical Look at the "New" Youth Development Movement. Journal of Youth Studies 2011, 14(6):675-691.
• [4]Senderowitz J, Hainsworth G, Calthy S: A Rapid Assessment of Youth Friendly Reproductive Health Services. Watertown: Pathfinder International; 2003.
• [5]Nelson CH, Park J: The nature and correlates of unmet health care needs in Ontario, Canada. Social Science & Medicine 2006, 62(9):2291-2300.
• [6]Blum RW: Young people: not as healthy as they seem. Lancet 2009, 374(9693):853-854.
• [7]Narevic E, Garrity TF, Schoenberg NE, Hiller ML, Webster JM, Leukefeld CG, Staton Tindall M: Factors predicting unmet health services needs among incarcerated substance users. Substance use & misuse 2006, 41(8):1077-1094.
• [8]Perruccio AV, Badley EM, Hogg-Johnson S, Davis AM: Characterizing self-rated health during a period of changing health status. Social science & medicine 2010, 71(9):1636-1643.
• [9]Diaz A, Neal WP, Nucci AT, Ludmer P, Bitterman J, Edwards S: Legal and ethical issues facing adolescent health care professionals. Mt Sinai J Med 2004, 71(3):181-185.
• [10]Kleinert S: Adolescent health: an opportunity not to be missed. Lancet 2007, 369(9567):1057-1058.
• [11]Meuwissen LE, Gorter AC, Segura Z, Kester AD, Knottnerus JA: Uncovering and responding to needs for sexual and reproductive health care among poor urban female adolescents in Nicaragua. Tropical medicine & international health: TM & IH 2006, 11(12):1858-1867.
• [12]Hesketh T, Ding QJ, Tomkins AM: Health and health care-seeking behavior of adolescents in urban and rural China. The Journal of adolescent health: official publication of the Society for Adolescent Medicine 2003, 33(4):271-274.
• [13]Ensign J, Panke A: Barriers and bridges to care: voices of homeless female adolescent youth in Seattle, Washington, USA. J Adv Nurs 2002, 37(2):166-172.
• [14]Ali M, de Muynck A: Illness incidence and health seeking behaviour among street children in Rawalpindi and Islamabad, Pakistan – a qualitative study. Child: Care, Health & Development 2005, 31(5):525-532.
• [15]Agampodi SB, Agampodi TC, Ukd P: Adolescents perception of reproductive health care services in Sri Lanka. BMC Heal Serv Res 2008, 8:98.
• [16]Mollaab ME, Berhaned M, Lindtjørna Y: Readiness of youth in rural Ethiopia to seek health services for sexually transmitted infections. African Journal of AIDS Research 2009, 8(2):135-146.
• [17]Pathfinder International: Integrating Youth-Friendly Sexual and Reproductive Health Services in Public Health Facilities: A Success Story and Lessons Learned in Tanzania. Tanzania: Pathfinder International; 2005.
• [18]Obare FB, H. Kavuma L: Barriers to Sexual and Reproductive Health Programming for Adolescents Living with HIV in Uganda. Population Research and Policy Review 2010, 30(1):151-163.
• [19]van der Kwaak A, Ferris K, van Kats J, Dieleman M: Performances of sexuality counselling: a framework for provider-client encounters. Patient education and counseling 2010, 81(3):338-342.
• [20]Agardh A, Emmelin M, Muriisa R, Ostergren PO: Social capital and sexual behavior among Ugandan university students. Glob Health Action 2010., 3(5432)
• [21]Sibley LM, Glazier RH: Reasons for self-reported unmet healthcare needs in Canada: a population-based provincial comparison. Healthcare policy = Politiques de sante Healthcare policy = Politiques de sante 2009, 5(1):87-101.
• [22]Chen J, Hou F: Unmet needs for health care. Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé 2002, 13(2):23.
• [23]Bryant T, Leaver C, Dunn J: Unmet healthcare need, gender, and health inequalities in Canada. Health policy 2009, 91(1):24-32.