Barriers and facilitators to women's access to sexual and reproductive health services in rural Australia: a systematic review.

Access Barriers and facilitators Delivery of healthcare Health equity Health service Rural health Sexual and reproductive health Systematic review Women’s health

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
11 Oct 2024
Historique:
received: 19 06 2024
accepted: 04 10 2024
medline: 12 10 2024
pubmed: 12 10 2024
entrez: 11 10 2024
Statut: epublish

Résumé

Accessing sexual and reproductive health (SRH) services in rural Australia presents complex challenges that negatively impact women's health and exacerbate health inequities across the life course. This systematic review synthesises evidence on the barriers and facilitators to women's access to SRH services in rural Australia, considering both supply and demand dimensions. We systematically searched peer-reviewed literature published between 2013 and 2023. Search terms were derived from three major topics: (1) women living in rural Australia; (2) spatial or aspatial access to SRH services; and (3) barriers or facilitators. We adopted the "best fit" approach to framework synthesis using the patient-centred access to healthcare model. Database searches retrieved 1,024 unique records, with 50 studies meeting the inclusion criteria. Most studies analysed access to primary care services (n = 29; 58%), followed by hospital services (n = 14; 28%), health promotion and prevention (n = 5; 10%), and specialist care (n = 2; 4%). The type of care accessed was mostly maternity care (n = 21; 42%), followed by abortion services (n = 11; 22%), screening and testing (n = 8; 16%), other women's health services (n = 6; 12%), and family planning (n = 4; 8%). There were numerous barriers and facilitators in access from supply and demand dimensions. Supply barriers included fragmented healthcare pathways, negative provider attitudes, limited availability of services and providers, and high costs. Demand barriers encompassed limited awareness, travel challenges, and financial burdens. Supply facilitators included health system improvements, inclusive practices, enhanced local services, and patient-centred care. Demand facilitators involved knowledge and awareness, care preferences, and telehealth accessibility. This review highlights the urgent need for targeted interventions to address SRH service access disparities in rural Australia. Understanding the barriers and facilitators women face in accessing SRH services within the rural context is necessary to develop comprehensive healthcare policies and interventions informed by a nuanced understanding of rural women's diverse needs.

Sections du résumé

BACKGROUND BACKGROUND
Accessing sexual and reproductive health (SRH) services in rural Australia presents complex challenges that negatively impact women's health and exacerbate health inequities across the life course. This systematic review synthesises evidence on the barriers and facilitators to women's access to SRH services in rural Australia, considering both supply and demand dimensions.
METHODS METHODS
We systematically searched peer-reviewed literature published between 2013 and 2023. Search terms were derived from three major topics: (1) women living in rural Australia; (2) spatial or aspatial access to SRH services; and (3) barriers or facilitators. We adopted the "best fit" approach to framework synthesis using the patient-centred access to healthcare model.
RESULTS RESULTS
Database searches retrieved 1,024 unique records, with 50 studies meeting the inclusion criteria. Most studies analysed access to primary care services (n = 29; 58%), followed by hospital services (n = 14; 28%), health promotion and prevention (n = 5; 10%), and specialist care (n = 2; 4%). The type of care accessed was mostly maternity care (n = 21; 42%), followed by abortion services (n = 11; 22%), screening and testing (n = 8; 16%), other women's health services (n = 6; 12%), and family planning (n = 4; 8%). There were numerous barriers and facilitators in access from supply and demand dimensions. Supply barriers included fragmented healthcare pathways, negative provider attitudes, limited availability of services and providers, and high costs. Demand barriers encompassed limited awareness, travel challenges, and financial burdens. Supply facilitators included health system improvements, inclusive practices, enhanced local services, and patient-centred care. Demand facilitators involved knowledge and awareness, care preferences, and telehealth accessibility.
CONCLUSION CONCLUSIONS
This review highlights the urgent need for targeted interventions to address SRH service access disparities in rural Australia. Understanding the barriers and facilitators women face in accessing SRH services within the rural context is necessary to develop comprehensive healthcare policies and interventions informed by a nuanced understanding of rural women's diverse needs.

Identifiants

pubmed: 39394094
doi: 10.1186/s12913-024-11710-9
pii: 10.1186/s12913-024-11710-9
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1221

Informations de copyright

© 2024. The Author(s).

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Auteurs

Sarah M Wood (SM)

Deakin Rural Health, Deakin University, School of Medicine, Faculty of Health, Warrnambool Campus, PO Box 423, Warrnambool, VIC, 3280, Australia. woodsar@deakin.edu.au.
Centre for Australian Research into Access, Deakin University, Warrnambool, VIC, Australia. woodsar@deakin.edu.au.

Laura Alston (L)

Deakin Rural Health, Deakin University, School of Medicine, Faculty of Health, Warrnambool Campus, PO Box 423, Warrnambool, VIC, 3280, Australia.
Research Unit, Colac Area Health, Colac, VIC, Australia.

Anna Chapman (A)

Institute for Health Transformation, Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, VIC, Australia.

Jacinta Lenehan (J)

Women's Health and Wellbeing Barwon South West, Warrnambool, VIC, Australia.

Vincent L Versace (VL)

Deakin Rural Health, Deakin University, School of Medicine, Faculty of Health, Warrnambool Campus, PO Box 423, Warrnambool, VIC, 3280, Australia.
Centre for Australian Research into Access, Deakin University, Warrnambool, VIC, Australia.

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