De la política a la práctica: acceso de las adolescentes y mujeres jóvenes a los servicios de salud sexual y reproductiva mediante la Política Integrada de Salud Escolar en KwaZulu-Natal, Sudáfrica
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Introducción: Las adolescentes y mujeres jóvenes (AMJ) de Sudáfrica siguen enfrentando resultados desfavorables en salud sexual y reproductiva (SSR), como embarazos tempranos y no intencionados e infecciones de transmisión sexual. La Política Integrada de Salud Escolar (PISE) busca mejorar la salud y el bienestar de las AMJ escolarizadas promoviendo la SSR y ofreciendo servicios. Este estudio examinó la implementación de servicios de SSR para adolescentes escolarizadas en KwaZulu-Natal, Sudáfrica.
Métodos: Se empleó un diseño cualitativo, recopilando datos triangulados de seis grupos focales (GFs) con AMJ escolarizadas (n=54); entrevistas a informantes clave (EIC) con agentes de apoyo al alumnado (n=3); un miembro del equipo de apoyo escolar; miembros de equipos de apoyo distrital (N=8); y actores del ISHP a nivel provincial (n=2). Todos los GFs y EIC fueron grabadas en audio, transcritas y analizadas temáticamente.
Resultados: Identificamos varios desafíos “aguas arriba” en la provisión de servicios de SSR para AMJ escolarizadas. El control del acceso por parte de los órganos de gobierno escolar y las dificultades para obtener consentimiento parental fueron obstáculos clave para promover la SSR y brindar anticoncepción. Además, se reportaron normas culturales que favorecen los embarazos tempranos como un reto central. El apoyo psicosocial sigue siendo insuficiente, especialmente para jóvenes que han sufrido violencia sexual y/o son madres adolescentes. Impartir educación sexual adecuada a la edad sigue siendo un desafío por las disparidades de edad dentro de un mismo grado.
Conclusiones: Las políticas y la provisión de servicios de SSR deben ser sensibles a normas culturales que pueden entrar en tensión con un enfoque de derechos. Es necesario involucrar de forma significativa a padres/madres y los órganos de gobierno escolar mediante sensibilización y educación sobre los beneficios, a corto y largo plazo, del apoyo en SSR para las y los estudiantes.
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