Youth underrepresentation as a barrier to sexual and reproductive healthcare access in Kasulu district, Tanzania: A qualitative thematic analysis
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
International journal of public health
Abstract
Representation of the key groups in community-level healthcare decisions is a prerequisite for accountable and
responsive primary healthcare systems. However, meaningful representation requires both the presence of individuals who
represent the key community groups and their capacity to influence the key healthcare plans and decisions. Our study
explored how the underrepresentation of the youth in health facility committees, the decentralized community- and facilitylevel
healthcare decision-making forums affects youth access to sexual and reproductive health services.
Methods A multisite case study involving focus group discussions, interviews, and meeting observation was conducted in
eight primary healthcare facilities in Kasulu, a rural district in Tanzania. Inductive thematic analysis was used to identify
the key emerging themes.
Results Five major themes were identified in connection with youth underrepresentation and limited access to sexual
reproductive health as a ‘taboo’ phenomenon in the communities. These were: numbers do not matter, passive representation,
sociopolitical gerontocracy, economic vulnerability, and mistrust and suspicion.
Conclusions Gradual emancipatory and transformative efforts are needed to normalize the representation of the youth and
their concerns in formal community-level decision-making institutions.
Description
Keywords
Youth representation, Sexual and reproductive health, Health facility committees, Healthcare access
Citation
Damian, R. S., Zakumumpa, H., & Fonn, S. (2020). Youth underrepresentation as a barrier to sexual and reproductive healthcare access in Kasulu district, Tanzania: a qualitative thematic analysis. International journal of public health, 65, 391-398. https://doi.org/10.1007/s00038-020-01367-6(0123456789().,-volV)(0123456789,-().volV)