Provisión de anticonceptivos a adolescentes en clínicas de atención primaria en Sudáfrica: Perspectivas de los profesionales de atención primaria
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Introducción: La provisión de anticonceptivos a adolescentes constituye una estrategia de salud pública esencial para prevenir los embarazos no planificados en este grupo etario y garantizar el acceso universal a la salud sexual y reproductiva. En el marco de las directrices políticas nacionales y provinciales de Sudáfrica, esta intervención se implementa en las clínicas de atención primaria. Este estudio se propuso explorar las barreras y los facilitadores que influyen en la provisión de anticonceptivos a adolescentes en dichas clínicas desde la perspectiva de los profesionales de la salud.
Métodos: Adoptamos un enfoque cualitativo para la investigación. A través de un muestreo intencionado, seleccionamos a directivos y enfermeras implicadas en programas de atención primaria y salud sexual y reproductiva en Sudáfrica. Realizamos entrevistas semiestructuradas a veintinueve participantes en contextos urbanos y rurales. Tras transcribir las entrevistas y verificar su precisión, empleamos el modelo de análisis temático de Braun y Clarke para organizar los datos siguiendo marcos teóricos de acceso a los servicios de salud. Identificamos cuatro temas principales, cada uno con subtemas que detallan tanto los facilitadores como las barreras en la provisión de anticonceptivos a los adolescentes.
Resultados: Los resultados indican que el conocimiento adecuado de las directrices políticas por parte de los profesionales sanitarios facilita la provisión efectiva de anticonceptivos a los adolescentes. No obstante, las discrepancias entre las políticas escritas y las limitaciones prácticas pueden obstaculizar la adecuada prestación de estos servicios. Entre otros impedimentos destacan las barreras lingüísticas entre los proveedores de salud y los adolescentes, las restricciones de tiempo y la falta de privacidad durante las consultas. Se observó que una formación robusta del personal de enfermería y la creación de un entorno acogedor para los adolescentes son factores que contribuyen significativamente a mejorar la provisión de anticonceptivos.
Conclusiones: Este estudio aporta una perspectiva valiosa sobre las barreras y facilitadores que enfrentan los profesionales de atención primaria en la provisión de anticonceptivos a adolescentes. Los hallazgos sugieren que las políticas futuras y las investigaciones deberían enfocarse en fortalecer la prestación de servicios anticonceptivos dirigidos a adolescentes, abordando tanto las barreras identificadas como las oportunidades de mejora.
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