Exploring challenges to the uptake of sexual and reproductive health services among lesbian and bisexual women in Bulawayo, Zimbabwe: a qualitative enquiry.

IF 3.1 Q1 OBSTETRICS & GYNECOLOGY Therapeutic advances in reproductive health Pub Date : 2024-10-17 eCollection Date: 2024-01-01 DOI:10.1177/26334941241289553
Methembe Yotamu Khozah, Wilfred Njabulo Nunu
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Abstract

Background: Reproductive healthcare is essential for all people, including lesbian and bisexual women. However, lesbians and bisexual women are among society's most marginalised and excluded members.

Objective: This study aimed to explore the challenges faced by lesbian and bisexual women in accessing Sexual and Reproductive Health (SRH) Services in Bulawayo, Zimbabwe.

Design: An exploratory, descriptive qualitative study was conducted on two populations that included eight participants identified through the Voice of the Voiceless organisation in Bulawayo and 10 key informants and probed the challenges faced by lesbians and bisexual women when accessing SRH services.

Methods: Data were gathered through 10 key informant interviews and 1 focus group discussion (FGD; with 8 participants). The interviews and FGDs were recorded, transcribed verbatim, coded and thematically analysed.

Results: The themes that emerged included the uptake of SRH services among lesbians and bisexual women, the challenges faced by lesbians and bisexual women when accessing SRH services, and strategies to aid the uptake of SRH services by lesbians and bisexual women. The findings showed that the uptake of SRH services was generally low and was influenced by factors such as clinical settings. The challenges mentioned included stigma and the unavailability of specific lesbian and bisexual women's services. By contrast, the most frequent strategies included affirmative training for healthcare providers and improved clinical settings to become friendly and inclusive.

Conclusion: There is an imperative for targeted SRH services that address the distinct needs of lesbians and bisexual women, in line with the 95-95-95 strategy and Sustainable Development Goals target 3.7. The observed low uptake of these services can be attributed to several systemic barriers, including inadequate training of health providers, negative attitudes and lack of inclusive policies. Enhancing the sensitivity of health facilities, strengthening links to sexual health education and implementing supportive legal frameworks are essential steps to improve SRH outcomes in this population. These findings elucidate critical gaps within the current healthcare system and present significant opportunities for policymakers to formulate evidence-based strategies to ensure equitable access to SRH services, thereby advancing public health objectives.

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探索津巴布韦布拉瓦约女同性恋和双性恋妇女接受性健康和生殖健康服务所面临的挑战:定性调查。
背景:生殖保健对所有人都至关重要,包括女同性恋者和双性恋妇女。然而,女同性恋者和双性恋妇女是社会中最边缘化和最受排斥的成员:本研究旨在探讨津巴布韦布拉瓦约的女同性恋者和双性恋妇女在获得性与生殖健康(SRH)服务时所面临的挑战:对两个人群进行了探索性、描述性定性研究,其中包括通过布拉瓦约 "无声者之声 "组织确认的 8 名参与者和 10 名关键信息提供者,并探讨了女同性恋者和双性恋妇女在获得性与生殖健康服务时面临的挑战:通过 10 次关键信息提供者访谈和 1 次焦点小组讨论(FGD,8 人参加)收集数据。对访谈和 FGD 进行了录音、逐字记录、编码和主题分析:出现的主题包括女同性恋者和双性恋妇女对性健康和生殖健康服务的接受情况、女同性恋者和双性恋妇女在获得性健康和生殖健康服务时面临的挑战以及帮助女同性恋者和双性恋妇女接受性健康和生殖健康服务的策略。研究结果表明,性健康和生殖健康服务的接受率普遍较低,并受到临床环境等因素的影响。提到的挑战包括污名化以及没有专门针对女同性恋和双性恋妇女的服务。与此相反,最常见的策略包括对医疗服务提供者进行平权培训,以及改善临床环境,使其变得友好和具有包容性:根据 "95-95-95 "战略和可持续发展目标的具体目标 3.7,有必要提供有针对性的性健康和生殖健康服务,以满足女同性恋者和双性恋妇女的独特需求。所观察到的对这些服务的低接受率可归因于几个系统性障碍,包括对医疗服务提供者的培训不足、消极态度和缺乏包容性政策。提高医疗机构的敏感性、加强与性健康教育的联系以及实施支持性法律框架,是改善这一人群性健康和生殖健康成果的必要步骤。这些研究结果阐明了当前医疗保健系统中存在的关键差距,并为政策制定者提供了制定循证战略的重要机会,以确保公平获得性健康和生殖健康服务,从而推进公共卫生目标的实现。
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