Table 3 HCW perspectives on client reluctance to access SRH services, per sector
Overall N (%) | Public N (%) | Private N (%) | OR (95% CI)a | PNFP N (%) | OR (95% CI)a | |
|---|---|---|---|---|---|---|
Clients reluctant to access SRH services | ||||||
Yes | 381 (39.3) | 195 (36.7) | 108 (43.0) | 1.03 (0.72–1.49) | 78 (41.5) | 0.92 (0.64–1.31) |
Reasons for reluctance to access SRH services | ||||||
Fear of stigmatisation | 238 (63.0) | 115 (59.6) | 70 (65.4) | 0.69 (0.36–1.32) | 53 (68.0) | 0.83 (0.44–1.58) |
Patient lack of knowledge | 189 (50.0) | 100 (51.8) | 57 (53.3) | 0.96 (0.53–1.73) | 32 (41.0) | 0.64 (0.36–1.15) |
Myths or superstitions | 169 (44.7) | 95 (49.2) | 43 (40.2) | 0.86 (0.48–1.56) | 31 (39.7) | 0.83 (0.47–1.48) |
Religious beliefs | 148 (39.2) | 84 (43.5) | 33 (30.8) | 0.89 (0.47–1.67) | 31 (39.7) | 1.40 (0.76–2.59) |
Fear of side effects | 146 (38.6) | 71 (36.8) | 46 (43.0) | 1.45 (0.78–2.68) | 29 (37.2) | 0.88 (0.48–1.62) |
Low support - male partner | 78 (20.6) | 49 (25.4) | 20 (18.7) | 0.64 (0.31–1.33) | 9 (11.5) | 0.43* (0.19–0.97) |
Poverty/costs | 48 (12.7) | 13 (6.7) | 20 (18.7) | 2.14 (0.85–5.38) | 15 (19.2) | 2.46 (1.05–5.73)* |
Frequent stockouts at HF | 32 (8.5) | 23 (11.9) | 4 (3.7) | 0.31 (0.08–1.19) | 5 (6.4) | 0.58 (0.20–1.73) |
Distance to HF | 28 (7.4) | 18 (9.3) | 5 (4.7) | 1.24 (0.34–4.50) | 5 (6.4) | 0.68 (0.21–2.15) |
Low support - female partner | 21 (5.6) | 10 (5.2) | 7 (6.5) | 0.99 (0.28–3.52) | 4 (5.1) | 1.00 (0.27–3.72) |
Recommendations to tackle client reluctance | ||||||
Expand client education | 367 (97.4) | 189 (97.4) | 101 (97.1) | 0.78 (0.11–5.68) | 77 (97.5) | 1.39 (0.19–10.42) |
Create youth-friendly health corners | 135 (35.8) | 76 (39.2) | 35 (33.7) | 0.43* (0.21–0.84) | 24 (30.4) | 0.42* (0.22–0.82) |
Involve partners | 109 (28.9) | 67 (34.5) | 26 (25.0) | 0.56 (0.29–1.08) | 16 (20.3) | 0.46* (0.24–0.91) |
Staff training | 75 (19.9) | 45 (23.2) | 19 (18.3) | 0.46* (0.21–0.99) | 11 (13.9) | 0.43* (0.20–0.95) |
Improve HCW-patient relationship | 63 (16.7) | 33 (17.0) | 17 (16.4) | 0.84 (0.39–1.84) | 13 (16.5) | 0.77 (0.36–1.65) |
Improve stock availability | 57 (15.1) | 34 (17.5) | 15 (14.4) | 0.56 (0.23–1.33) | 8 (10.1) | 0.48 (0.20–1.15) |
Empower people economically | 51 (13.5) | 18 (9.3) | 22 (21.2) | 1.70 (0.69–4.18) | 11 (13.9) | 1.24 (0.52–2.96) |
Reduce costs for patients | 36 (9.6) | 5 (2.6) | 23 (22.1) | 6.97** (2.20-22.07) | 8 (10.1) | 3.47* (1.04–11.56) |
Provide free FP services | 32 (8.5) | 9 (4.6) | 11 (10.6) | 1.95 (0.66–5.77) | 12 (15.2) | 3.19* (1.18–8.60) |