237. Healthcare Workers' Attitudes Toward Adolescent Reproductive Healthcare ∼The Case of Cebu City, The Philippines∼

Abstract

In reproductive healthcare, negative attitudes among healthcare workers sometimes appear toward adolescent clients who have premarital sex, who use contraceptives, and who are sexually active. Such attitudes influence the quality of the services that adolescents can receive. Past studies have found that ideas based on culture, religion, lack of knowledge, and personal values created negative attitudes among healthcare workers. In the Philippines, only a few studies on healthcare workers’ performance have been done and none focus on healthcare workers’ attitudes in adolescent reproductive healthcare. The purpose of this research is to identify healthcare workers’ attitudes toward adolescent reproductive healthcare in Cebu City, the Philippines, factors causing negative attitudes among healthcare workers, and to suggest how to improve the negative attitudes. This research consists of a mix of quantitative and qualitative methods with a concurrent design. As a quantitative method, 65 self-administered questionnaires were distributed (64 were submitted) to healthcare workers who are engaged in maternal and family planning services in barangay health centers (local district health centers). As a qualitative method, semi-structured interviews were conducted with a staff member who works at the city government level and 6 healthcare workers who work for barangay health centers in Cebu City. All the respondents were selected using non-probability purposive sampling. The quantitative data was analyzed by binominal test and correlation analysis using SPSS. The qualitative data was analyzed using thematic analysis. Almost all the healthcare workers surveyed in Cebu City, the Philippines, have positive attitudes toward the overall idea and the practice of promoting adolescent reproductive rights. On the other hand, most of them are hesitant to discuss sexual issues and concerns with adolescent clients and have negative impressions toward adolescents who have sexual experience. This result implies that healthcare workers are fulfilling their responsibilities based on the manual or professional guidelines. However, the actual quality of the services given to adolescents might be failing to provide youth-friendly services, to look at clients on an individual level, or to satisfy the real needs of adolescent clients. From the qualitative analysis, the factors causing the negative attitudes were divided into 2 types: internal factors brought by healthcare workers’ individual issues and external factors in the environment surrounding the healthcare workers. Internal factors include inadequate knowledge of adolescent sexual behavior, lack of interpersonal relations with adolescent clients, and a fear of encouraging adolescents to engage in premarital sex. External factors include ignorance of adolescent clients, parental consent required for minors’ reproductive healthcare, and pressure from the Church. In addition to healthcare workers' knowledge and communication skills, mandatory parental consent for minors and pressure from the Church discourage healthcare workers from providing youth-friendly services.