Barreras y facilitadores para el acceso a la atención en salud sexual y reproductiva de adolescentes en programas de protección y justicia en Chile.

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Title:	Barreras y facilitadores para el acceso a la atención en salud sexual y reproductiva de adolescentes en programas de protección y justicia en Chile.
Alternate Title:	Barriers and facilitators to accessing sexual and reproductive health care for adolescents in protection and justice programs in Chile.
Authors:	Leal Fuentes, Ingrid^1,2 igleal@uchile.cl, González Aristegui, Daniela¹, Carstens Riveros, Carolina², Molina González, Temistocles¹
Source:	Andes Pediatrica. Feb2025, Vol. 96 Issue 2, p1-10. 10p.
Subjects:	REPRODUCTIVE health, TEENAGERS, SOCIAL support, GOVERNMENT policy, MEDICAL care, CHILEANS, HUMAN rights organizations
Geographic Terms:	CHILE
Abstract (English):	Sexual and reproductive health (SRH) of adolescents in Chile faces significant challenges. Despite progress, gaps in access to services persist, especially for groups whose rights have been violated, such as adolescents who attend protection and justice programs. Objective: To analyze the barriers and facilitators of access to sexual and reproductive health services in Primary Health Care for adolescent women who attend protection and justice programs in the Metropolitan Region of Chile. Subjects and Method: Qualitative and exploratory research with intentional sampling of adolescent women in protection and justice programs, and primary care professionals and those of the programs. Semi-structured qualitative interviews were conducted. The analysis was carried out using a constructivist thematic approach, establishing a categorization and coding system. Results: 16 adolescents and 24 professionals were interviewed. The adolescents identified the following barriers to accessing services: opening hours, the obligation to attend with an adult when they are minors, lack of knowledge about administrative procedures and long waiting times. The professionals pointed out difficulties such as insufficient implementation of adolescent health policies and programs, high staff turnover, work overload and problems in intersectoral coordination. They also highlighted the mutual mistrust, prejudices and lack of knowledge between the health, protection and justice systems, the stigmatization of adolescent users, and the perception of this population as “complicated” to care for. They also emphasized the lack of awareness of those working in health regarding problems of rights violations. Among the facilitators, the recognition of the status as a priority population, the relationship of trust with the teams, educational interventions on sexuality, legal regulations that guarantee confidentiality, and the role of the professional in charge of intersectoral coordination, were key elements to improve access to health services. Conclusions: There are institutional barriers that hinder access by adolescents from protection and justice programs to sexual and reproductive health services in primary care. Knowledge and effective implementation of public policies that prioritize this population represent a key facilitator. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	La salud sexual y reproductiva (SSR) de adolescentes en Chile enfrenta desafíos significativos. A pesar de avances, persisten brechas en el acceso a servicios, especialmente para grupos vulnerados en sus derechos como las adolescentes que asisten a programas de protección y justicia. Objetivo: Analizar las barreras y facilitadores de acceso a servicios de salud sexual y reproductiva en la Atención Primaria de Salud para las adolescentes mujeres que asisten a programas de protección y justicia en la Región Metropolitana de Chile. Sujetos y Método: Investigación cualitativa y exploratoria con muestreo intencional, incluyendo a adolescentes mujeres en programas de protección y justicia, y profesionales de atención primaria y de los programas. Se realizaron entrevistas cualitativas semi-estructuradas. El análisis se realizó mediante enfoque temático constructivista, estableciendo un sistema de categorización y codificación. Resultados: Se entrevistó a 16 adolescentes y 24 profesionales. Las adolescentes identificaron como barreras para acceder a los servicios los horarios de atención, la obligatoriedad de asistir con un adulto cuando son menores de edad, el desconocimiento sobre los procedimientos administrativos y los prolongados tiempos de espera. Los/as profesionales señalaron dificultades como la implementación insuficiente de las políticas y programas de salud adolescentes, la alta rotación del personal, la sobrecarga laboral y problemas en la coordinación, colaboración y comunicación intersectorial. También destacaron la desconfianza, prejuicios y desconocimiento mutuos entre los sistemas de salud, protección y justicia, la estigmatización de las adolescentes usuarias, y la percepción de esta población como “complicada” para la atención. Asimismo, enfatizaron la falta de sensibilización de quienes se desempeñan en salud respecto a problemáticas de vulneración de derechos. Entre los facilitadores se destacó el reconocimiento del estatus como población prioritaria, la relación de confianza con los equipos, las intervenciones educativas en sexualidad, normativas legales que garantizan la confidencialidad, y el rol del profesional encargado de la articulación intersectorial como elementos claves para mejorar el acceso a los servicios de salud. Conclusiones: Existen barreras institucionales que dificultan el acceso de adolescentes de programas de protección y justicia a servicios de salud sexual y reproductiva en la atención primaria. El conocimiento y aplicación efectiva de las políticas públicas que priorizan a esta población, representan un facilitador clave. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Sexual and reproductive health (SRH) of adolescents in Chile faces significant challenges. Despite progress, gaps in access to services persist, especially for groups whose rights have been violated, such as adolescents who attend protection and justice programs. Objective: To analyze the barriers and facilitators of access to sexual and reproductive health services in Primary Health Care for adolescent women who attend protection and justice programs in the Metropolitan Region of Chile. Subjects and Method: Qualitative and exploratory research with intentional sampling of adolescent women in protection and justice programs, and primary care professionals and those of the programs. Semi-structured qualitative interviews were conducted. The analysis was carried out using a constructivist thematic approach, establishing a categorization and coding system. Results: 16 adolescents and 24 professionals were interviewed. The adolescents identified the following barriers to accessing services: opening hours, the obligation to attend with an adult when they are minors, lack of knowledge about administrative procedures and long waiting times. The professionals pointed out difficulties such as insufficient implementation of adolescent health policies and programs, high staff turnover, work overload and problems in intersectoral coordination. They also highlighted the mutual mistrust, prejudices and lack of knowledge between the health, protection and justice systems, the stigmatization of adolescent users, and the perception of this population as “complicated” to care for. They also emphasized the lack of awareness of those working in health regarding problems of rights violations. Among the facilitators, the recognition of the status as a priority population, the relationship of trust with the teams, educational interventions on sexuality, legal regulations that guarantee confidentiality, and the role of the professional in charge of intersectoral coordination, were key elements to improve access to health services. Conclusions: There are institutional barriers that hinder access by adolescents from protection and justice programs to sexual and reproductive health services in primary care. Knowledge and effective implementation of public policies that prioritize this population represent a key facilitator. [ABSTRACT FROM AUTHOR]
ISSN:	24526045
DOI:	10.32641/andespediatr.v96i2.5425