Barriers of Adolescents' Access to Reproductive and Sexual Health Services in Iran: A Systematic Review

Authors

1 Ph.D Student of Reproductive Health, Student Research Committee, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Professor, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Ph.D Candidate of Reproductive Health, Student Research Committee, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 MSc of Legal Medical Midwife, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Background: Adolescence is an important period in human life and the low-level access of adolescents to reproductive and sexual health services is a concern because preventive, diagnostic and therapeutic services are needed for healthy sexual and reproductive behaviors. This study was conducted with the aim of considering the barriers against adolescent access to reproductive and sexual health services in Iran.
Materials and Methods: All Iranian qualitative and quantitative studies which were published without time limit were entered in this systematic review article. The investigation was performed in the international databases such as Scopus, Medline, ProQuest, and Cochrane Library and national databases such as Magiran, SID, IranDoc, and Barakat Knowledge Network System. Keywords were selected based on the Mesh and include: "Youth", "Teenager", "Adolescent health service", and "Iran", combined with the Boolean OR and AND operators. Ultimately, two researchers reviewed articles for the quality appraisal (Newcastle-Ottawa tool for observational studies and JBI-QARI tool for qualitative studies), and extracted their main findings, independently.  
Results: Finally, 10 articles (with 1,933 population) that comprised including criteria were selected. Articles were quantitative (n=8), and qualitative (n=2) types and their year of publication varied from 2009 to 2018. Barriers against adolescent access to reproductive and sexual health services were classified into four main categories (individual barriers, structural barriers, social barriers, and policy barriers).
Conclusion: Based on the results, the barriers of adolescent access to reproductive and sexual health services include individual, structural, social, and policy barriers. Because the development of adolescents’ demands is crucial for all societies, through identification and removal of these barriers, we can promote the access of the youth to adolescent health services.

Keywords