Abstract
BackgroundSexual activity during adolescence is common in Vanuatu, however many adolescents lack access to sexual and reproductive health (SRH) services and subsequently suffer a disproportionate burden of poor SRH. There is limited peer-reviewed research describing adolescents’ SRH service delivery preferences in Vanuatu to inform policy and programs. The aim of this qualitative study was to explore the barriers preventing adolescents from accessing SRH services in Vanuatu and the features of a youth-friendly health service as defined by adolescents.MethodsSixty-six focus group discussions were conducted with 341 male and female adolescents aged 15–19 years in rural and urban communities. Additionally, 12 semi-structured interviews were undertaken with policymakers and service providers. Data were analysed using thematic analysis.ResultsSocio-cultural norms and taboos regarding adolescent sexual behaviour were the most significant factors preventing adolescents from accessing services. These contributed to adolescents’ own fear and shame, judgmental attitudes of service providers, and disapproval from parents and community gate-keepers. Lack of confidentiality and privacy, costs, and adolescents’ lack of SRH knowledge were also important barriers. Adolescents and service providers identified opportunities to make existing services more youth-friendly. The most important feature of a youth-friendly health service described by adolescents was a friendly service provider. Free or affordable services, reliable commodity supply, confidentiality and privacy were also key features. The need to address socio-cultural norms and community knowledge and attitudes was also highlighted.ConclusionsThere are significant demand and supply-side barriers contributing to low utilisation of SRH services by adolescents in Vanuatu. However, there are many opportunities to make existing SRH services more youth-friendly, such as improving service provider training. Investment is also required in strategies that aim to create a more supportive environment for adolescent SRH.
Highlights
Sexual activity during adolescence is common in Vanuatu, many adolescents lack access to sexual and reproductive health (SRH) services and subsequently suffer a disproportionate burden of poor SRH
More than 36% of ni-Vanuatu males and 14% of females aged 15–24 report ever being diagnosed with an Sexually transmitted infection (STI), with surveillance data indicating the highest rates of chlamydia occur among adolescents aged 15–19 [7,9]
Characteristics of adolescent focus group participants A total of 66 Focus group discussion (FGD) were conducted involving 341 participants, 49.0% of whom were from rural areas (Table 1)
Summary
Sexual activity during adolescence is common in Vanuatu, many adolescents lack access to sexual and reproductive health (SRH) services and subsequently suffer a disproportionate burden of poor SRH. There is limited peer-reviewed research describing adolescents’ SRH service delivery preferences in Vanuatu to inform policy and programs The aim of this qualitative study was to explore the barriers preventing adolescents from accessing SRH services in Vanuatu and the features of a youth-friendly health service as defined by adolescents. More than 36% of ni-Vanuatu males and 14% of females aged 15–24 report ever being diagnosed with an STI, with surveillance data indicating the highest rates of chlamydia occur among adolescents aged 15–19 [7,9].
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