sexual and reproductive health services;
adolescence;
disability;
Tanzania;
access to health care;
inequality;
SRHR;
INTELLECTUAL DISABILITY;
PEOPLE;
RIGHTS;
WOMEN;
PERCEPTIONS;
QUALITY;
ABUSE;
CARE;
INTERVENTIONS;
EXPLOITATION;
D O I:
10.3390/ijerph18041657
中图分类号:
X [环境科学、安全科学];
学科分类号:
08 ;
0830 ;
摘要:
Despite at times having greater needs for sexual and reproductive health (SRH) services, adolescents with disabilities often face challenges when trying to access them. This inaccessibility is further exacerbated during female adolescence. The qualitative study examines how SRH services respond to the characteristics of Tanzanian adolescent females with disabilities. We used the method of empathy-based stories to investigate the perceptions of 136 adolescent females with disabilities of their access to SRH services in Tanzania. The study used thematic content analysis and the Levesque model of health care access was applied as an analytical framework. The results demonstrate that discrimination affects access at different phases of care-seeking, that affectionate behaviour of providers is a central enabler of access, and that for this population access relies on a collective effort. We propose that affection, as an enabler of access, is as an additional provider dimension of access to SRH services for adolescents with disabilities, serving as a "reasonable accommodation" to the health care systems in southern contexts and beyond.
机构:
Brandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
NIH, Clin Res Ctr, Dept Rehabil Med, Bldg 10, Bethesda, MD 20892 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Gulley, Stephen P.
Rasch, Elizabeth K.
论文数: 0引用数: 0
h-index: 0
机构:
NIH, Clin Res Ctr, Dept Rehabil Med, Bldg 10, Bethesda, MD 20892 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Rasch, Elizabeth K.
Bethell, Christina D.
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Bethell, Christina D.
Carle, Adam C.
论文数: 0引用数: 0
h-index: 0
机构:
Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Carle, Adam C.
Druss, Benjamin G.
论文数: 0引用数: 0
h-index: 0
机构:
Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Druss, Benjamin G.
Houtrow, Amy J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Pittsburgh, Sch Med, Pittsburgh, PA USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Houtrow, Amy J.
Reichard, Amanda
论文数: 0引用数: 0
h-index: 0
机构:
Univ Kansas, Lawrence, KS 66045 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Reichard, Amanda
Chan, Leighton
论文数: 0引用数: 0
h-index: 0
机构:
NIH, Clin Res Ctr, Dept Rehabil Med, Bldg 10, Bethesda, MD 20892 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
机构:
Ifakara Hlth Inst, Dept Hlth Syst Impact Evaluat & Policy, POB 78373, Dar Es Salaam, TanzaniaIfakara Hlth Inst, Dept Hlth Syst Impact Evaluat & Policy, POB 78373, Dar Es Salaam, Tanzania
Binyaruka, Peter
Borghi, Josephine
论文数: 0引用数: 0
h-index: 0
机构:
London Sch Hyg & Trop Med, Dept Global Hlth & Dev, 15-17 Tavistock Pl, London WC1H 9SH, EnglandIfakara Hlth Inst, Dept Hlth Syst Impact Evaluat & Policy, POB 78373, Dar Es Salaam, Tanzania
机构:
Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
Univ Calif San Francisco, Philip R Lee Inst Hlth Policy Studies, San Francisco, CA 94143 USA
Univ Calif San Francisco, Bixby Ctr Global Reprod Hlth, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
Decker, Martha J.
Zarate, Catherine Gilmore
论文数: 0引用数: 0
h-index: 0
机构:
Calif Dept Publ Hlth, Maternal Child & Adolescent Hlth Div, Sacramento, CA USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
Zarate, Catherine Gilmore
Atyam, Tara, V
论文数: 0引用数: 0
h-index: 0
机构:
Calif Dept Publ Hlth, Maternal Child & Adolescent Hlth Div, Sacramento, CA USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
Atyam, Tara, V
Saphir, Melissa
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Francisco, Philip R Lee Inst Hlth Policy Studies, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
机构:
Brandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
NIH, Clin Res Ctr, Dept Rehabil Med, Bldg 10, Bethesda, MD 20892 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Gulley, Stephen P.
Rasch, Elizabeth K.
论文数: 0引用数: 0
h-index: 0
机构:
NIH, Clin Res Ctr, Dept Rehabil Med, Bldg 10, Bethesda, MD 20892 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Rasch, Elizabeth K.
Bethell, Christina D.
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Bethell, Christina D.
Carle, Adam C.
论文数: 0引用数: 0
h-index: 0
机构:
Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Carle, Adam C.
Druss, Benjamin G.
论文数: 0引用数: 0
h-index: 0
机构:
Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Druss, Benjamin G.
Houtrow, Amy J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Pittsburgh, Sch Med, Pittsburgh, PA USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Houtrow, Amy J.
Reichard, Amanda
论文数: 0引用数: 0
h-index: 0
机构:
Univ Kansas, Lawrence, KS 66045 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
Reichard, Amanda
Chan, Leighton
论文数: 0引用数: 0
h-index: 0
机构:
NIH, Clin Res Ctr, Dept Rehabil Med, Bldg 10, Bethesda, MD 20892 USABrandeis Univ, Heller Sch Social Policy & Management, Waltham, MA USA
机构:
Ifakara Hlth Inst, Dept Hlth Syst Impact Evaluat & Policy, POB 78373, Dar Es Salaam, TanzaniaIfakara Hlth Inst, Dept Hlth Syst Impact Evaluat & Policy, POB 78373, Dar Es Salaam, Tanzania
Binyaruka, Peter
Borghi, Josephine
论文数: 0引用数: 0
h-index: 0
机构:
London Sch Hyg & Trop Med, Dept Global Hlth & Dev, 15-17 Tavistock Pl, London WC1H 9SH, EnglandIfakara Hlth Inst, Dept Hlth Syst Impact Evaluat & Policy, POB 78373, Dar Es Salaam, Tanzania
机构:
Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
Univ Calif San Francisco, Philip R Lee Inst Hlth Policy Studies, San Francisco, CA 94143 USA
Univ Calif San Francisco, Bixby Ctr Global Reprod Hlth, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
Decker, Martha J.
Zarate, Catherine Gilmore
论文数: 0引用数: 0
h-index: 0
机构:
Calif Dept Publ Hlth, Maternal Child & Adolescent Hlth Div, Sacramento, CA USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
Zarate, Catherine Gilmore
Atyam, Tara, V
论文数: 0引用数: 0
h-index: 0
机构:
Calif Dept Publ Hlth, Maternal Child & Adolescent Hlth Div, Sacramento, CA USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA
Atyam, Tara, V
Saphir, Melissa
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif San Francisco, Philip R Lee Inst Hlth Policy Studies, San Francisco, CA 94143 USAUniv Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA