{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:45:21Z","timestamp":1792759521810,"version":"4.5.0"},"reference-count":46,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>COVID\u201019 pandemic disrupted adolescents' access to sexual and reproductive health (SRH) services for adolescents in Nepal. This study explored adolescents' and health care provider's perspectives on how the COVID\u201019 pandemic affected adolescents' SRH information and services, SRH\u2010related behaviours, and factors that strengthen care and service pathways during the pandemic in Nepal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used qualitative methods and adapted the social cognitive theory as an analytical framework to explore individual, social and environmental influences on adolescents' sexual and reproductive health (SRH) information and services pathways during the COVID\u201019 pandemic. A total of 86 participants were included in the study, including 64 adolescents (15\u201319 years) and 22 service providers. For this, total of six focus group discussions, 12 in\u2010depth interviews and 22 key informant interviews were conducted. Thematic analysis was conducted to identify, analyse and interpret the data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>The study findings showed that COVID\u201019 disrupted adolescents' SRH information and services pathways through interconnected environmental, social and individual factors. School closures reduced access to school\u2010based SRH information and opportunities to interact with teachers and peers, while interruptions in service delivery compromised adolescent's pathways to SRH information and services. Adolescents reported changes in sexual behaviours and mental health effects during pandemic. Strengthening adolescents' pathways to SRH information and service during crises requires provider's capacity strengthening, conducting virtual child club programmes for self\u2010help and social interaction, digital information and psychosocial services, and prioritising coordinated interventions among stakeholders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Maintaining adolescent SRH care during public health emergencies requires an ecosystem approach addressing individual, social and environmental factors together. Adolescents' SRH needs during public health emergencies extend beyond the availability of clinical services and include opportunities for emotional, social and trusted support. Strengthening adolescents' self\u2010efficacy, conducive social environments, and community\u2010based actors such as Female Community Health Volunteers (FCHVs) along with accessible, confidential and adolescent\u2010responsive services, helps maintain continuity of sexual and reproductive health and rights (SRHR) information and care during emergencies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>This manuscript is developed from the study done under the larger project that was designed to address sexual and reproductive health and rights (SRHR) of adolescents and women in the Sindhupalchowk district. The study adopted a participatory approach through active engagement with adolescents, community actors, health service providers, and local stakeholders throughout the research process. Different consultation meetings were held with these stakeholders to identify research priorities, refining research questions and development of study tools to ensure contextual relevance and responsiveness to community SRHR needs. The findings further emphasise the importance of community\u2010based SRHR approaches, strengthening local actors and volunteers and fostering adolescent self\u2010efficacy in supporting adolescent responsive services during public health emergencies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70931","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:45:56Z","timestamp":1792161956000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Qualitative Exploration of Need for Adolescent Sexual and Reproductive Health Care and Service Pathways Readiness During Pandemic in Nepal"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1398-0515","authenticated-orcid":false,"given":"Saki","family":"Thapa","sequence":"first","affiliation":[{"name":"Research Department Birat Nepal Medical Trust (BNMT) Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7218-6237","authenticated-orcid":false,"given":"Bikram","family":"Bucha","sequence":"additional","affiliation":[{"name":"Research Department Birat Nepal Medical Trust (BNMT) Kathmandu Nepal"},{"name":"Department of Global Public Health Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7291-538X","authenticated-orcid":false,"given":"Swastika","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Research Department Birat Nepal Medical Trust (BNMT) Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4491-6323","authenticated-orcid":false,"given":"Raghu","family":"Dhital","sequence":"additional","affiliation":[{"name":"Research Department Birat Nepal Medical Trust (BNMT) Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7957-8109","authenticated-orcid":false,"given":"Kritika","family":"Dixit","sequence":"additional","affiliation":[{"name":"Research Department Birat Nepal Medical Trust (BNMT) Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1106-0108","authenticated-orcid":false,"given":"Lal","family":"Rawal","sequence":"additional","affiliation":[{"name":"Public Health, School of Health Medical and Applied Science CQUniversity Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4465-7835","authenticated-orcid":false,"given":"Amit","family":"Timilsina","sequence":"additional","affiliation":[{"name":"Research and Community Development Center Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"World Health Organization. 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