Understanding barriers to young people’s utilisation of sexual and reproductive health services in Asia-Pacific countries: a qualitative systematic review and thematic synthesis
Introduction Based on the United Nations’ sustainable development goals, universal access to sexual and reproductive health (SRH) services should be attained by 2030. Yet, large inequalities in adolescent SRH knowledge and service use still exist both within and between countries. The goal of this s...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Public Health |
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| author | Daniel Mackay Benjamin Gregory Evi Germeni Watcharakorn Riabroi |
| author_facet | Daniel Mackay Benjamin Gregory Evi Germeni Watcharakorn Riabroi |
| author_sort | Daniel Mackay |
| collection | DOAJ |
| description | Introduction Based on the United Nations’ sustainable development goals, universal access to sexual and reproductive health (SRH) services should be attained by 2030. Yet, large inequalities in adolescent SRH knowledge and service use still exist both within and between countries. The goal of this study was to identify and synthesise published qualitative research on factors affecting young people’s utilisation of SRH services in Asia-Pacific countries.Methods We systematically searched five electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science) for qualitative studies reporting the experiences, attitudes and views of young people (aged 10–24 years) regarding the utilisation of SRH services in Asia-Pacific countries. We assessed the quality of identified studies using the Critical Appraisal Skills Programme qualitative checklist and employed a thematic synthesis approach for the data analysis.Results We included 31 articles that reported the experiences of over 1800 young people from 15 different countries. Thematic synthesis identified six descriptive themes that captured factors influencing SRH service utilisation: (1) navigating puberty; (2) knowledge and beliefs about SRH; (3) embarrassment and confidentiality concerns; (4) low decision-making autonomy; (5) traditional practices and religious beliefs; and (6) social and gender norms. Based on these, we developed an overarching analytical theme, ‘trapped in a legacy of shame’, which highlights the role of shame as a key emotion associated with young people’s utilisation of SRH services.Conclusion Our findings point towards the necessity of integrating shame-sensitive approaches and a social norms perspective in interventions aiming to improve young people’s SRH outcomes in Asia-Pacific countries.PROSPERO registration number CRD42023389653. |
| format | Article |
| id | doaj-art-4b2179c59857475b94bc36bc12298a42 |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Public Health |
| spelling | doaj-art-4b2179c59857475b94bc36bc12298a422025-01-20T05:25:09ZengBMJ Publishing GroupBMJ Public Health2753-42942025-01-013110.1136/bmjph-2024-001504Understanding barriers to young people’s utilisation of sexual and reproductive health services in Asia-Pacific countries: a qualitative systematic review and thematic synthesisDaniel Mackay0Benjamin Gregory1Evi Germeni2Watcharakorn Riabroi3Healthy Working Lives Group, University of Glasgow, Glasgow, UK1Department of Infection, Immunity and Cardiovascular Disease, University of SheffieldHealth Economics and Health Technology Assessment (HEHTA), University of Glasgow, Glasgow, UKSchool of Health and Wellbeing, University of Glasgow, Glasgow, UKIntroduction Based on the United Nations’ sustainable development goals, universal access to sexual and reproductive health (SRH) services should be attained by 2030. Yet, large inequalities in adolescent SRH knowledge and service use still exist both within and between countries. The goal of this study was to identify and synthesise published qualitative research on factors affecting young people’s utilisation of SRH services in Asia-Pacific countries.Methods We systematically searched five electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science) for qualitative studies reporting the experiences, attitudes and views of young people (aged 10–24 years) regarding the utilisation of SRH services in Asia-Pacific countries. We assessed the quality of identified studies using the Critical Appraisal Skills Programme qualitative checklist and employed a thematic synthesis approach for the data analysis.Results We included 31 articles that reported the experiences of over 1800 young people from 15 different countries. Thematic synthesis identified six descriptive themes that captured factors influencing SRH service utilisation: (1) navigating puberty; (2) knowledge and beliefs about SRH; (3) embarrassment and confidentiality concerns; (4) low decision-making autonomy; (5) traditional practices and religious beliefs; and (6) social and gender norms. Based on these, we developed an overarching analytical theme, ‘trapped in a legacy of shame’, which highlights the role of shame as a key emotion associated with young people’s utilisation of SRH services.Conclusion Our findings point towards the necessity of integrating shame-sensitive approaches and a social norms perspective in interventions aiming to improve young people’s SRH outcomes in Asia-Pacific countries.PROSPERO registration number CRD42023389653.https://bmjpublichealth.bmj.com/content/3/1/e001504.full |
| spellingShingle | Daniel Mackay Benjamin Gregory Evi Germeni Watcharakorn Riabroi Understanding barriers to young people’s utilisation of sexual and reproductive health services in Asia-Pacific countries: a qualitative systematic review and thematic synthesis BMJ Public Health |
| title | Understanding barriers to young people’s utilisation of sexual and reproductive health services in Asia-Pacific countries: a qualitative systematic review and thematic synthesis |
| title_full | Understanding barriers to young people’s utilisation of sexual and reproductive health services in Asia-Pacific countries: a qualitative systematic review and thematic synthesis |
| title_fullStr | Understanding barriers to young people’s utilisation of sexual and reproductive health services in Asia-Pacific countries: a qualitative systematic review and thematic synthesis |
| title_full_unstemmed | Understanding barriers to young people’s utilisation of sexual and reproductive health services in Asia-Pacific countries: a qualitative systematic review and thematic synthesis |
| title_short | Understanding barriers to young people’s utilisation of sexual and reproductive health services in Asia-Pacific countries: a qualitative systematic review and thematic synthesis |
| title_sort | understanding barriers to young people s utilisation of sexual and reproductive health services in asia pacific countries a qualitative systematic review and thematic synthesis |
| url | https://bmjpublichealth.bmj.com/content/3/1/e001504.full |
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