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Exploring the views and experiences of primary healthcare professionals who deliver Sexual and Reproductive Health services to unmarried adolescents in Malaysia

Abdul Hamid, Siti Hazariah binti

[Thesis]. Manchester, UK: The University of Manchester; 2019.

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Abstract

Background: In Malaysia, information about contraception and safe sexual practices is still not delivered formally to young people in health clinics. Concurrently, unintended teenage pregnancies and the practice of â€˜baby dumpingâ€™ are serious public health issues in Malaysia, particularly among young unmarried women. Research in other countries has highlighted several factors that influence the effectiveness of the provision of sexual and reproductive health (SRH) services to adolescents, including comprehensive sex education, friendly services and the use of contraception. Little is known about the provision of sexual healthcare for this group since it has not been examined in depth in a Malaysian context. Aims: This study set out to explore the views and experiences of primary healthcare professionals (HCPs) who deliver SRH services to unmarried adolescents in primary healthcare settings in Malaysia, with a view to identifying the factors that influence the provision of SRH services to unmarried adolescents. A further aim is to consider how the cultural and religious beliefs of HCPs might impact upon the SRH services they provide. Methods: A qualitative study informed by a pragmatic approach was utilised. Thirty-one HCPs were interviewed to understand their experiences of dealing with adolescents and also their views on current SRH services provision. The interviews were conducted over a period of seven months between October 2014 and April 2015, and the data were analysed using thematic analysis. I also critiqued the SRH educational material that intended to be used by HCPs when working with adolescents. The initial critique of the SRH educational material was carried out using a technique broadly informed by critical discourse analysis. Findings and discussion: The findings highlight that SRH services for adolescents are generally a low priority in Malaysia and that formal educational materials do little to address the issue of safe sex or unintended pregnancy. Furthermore the cultural and religious context creates tension for HCPâ€™s who provide SRH information and treatment to sexually active unmarried adolescents. Conclusion: The findings can contribute to a better understanding of SRH services provision for unmarried adolescents in Malaysia with a view to addressing more effectively the issues of unintended pregnancies in this group. The evidence from this study can be used in the development of strategies to improve the quality of care and facilitate changes in the provision of SRH services to adolescents in Malaysia.