SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2025
Understanding access to sexual and reproductive health in general practice using an adapted Candidacy Framework: a systematic review and qualitative evidence synthesis.
Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Influences on Transmasculine People's Experiences of Contraceptive Methods and Services in the UK: One-on-One Interviews and a Focus Group.Healthcare (Basel, Switzerland) · 2026Article
- Men's involvement in contraception: a qualitative study exploring the perceptions and practices of general practitioners in France.Preventive medicine reports · 2026Article
- Using the Candidacy Framework to Explore Access to NHS Healthcare for Street Sex Workers in Sheffield: An Ethnography and Art-Based Research Project.Healthcare (Basel, Switzerland) · 2026Article
- Telehealth for Sexual and Reproductive Healthcare: Evidence Map of Effectiveness, Patient and Provider Experiences and Preferences, and Patient Engagement Strategies.Clinics and practice · 2026Review
- Perceived barriers and facilitators of accessing statutory and non-statutory services, in disadvantaged communities, in England: a co-produced qualitative review.Public health reviews · 2026Review
- "I would walk through fire to get this vaccine": a mixed-methods study examining attitudes and perceptions of a gonorrhoea vaccine programme among UK sexual health service users.BMJ public health · 2026Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGeneral practice has a key role in reducing inequity in access to care relating to sexual and reproductive health (SRH). Unplanned pregnancy, abortion, and sexually transmitted infections are increasing and disproportionately affect deprived communities and minoritised ethnic groups. The Candidacy Framework is a practical and theoretical framework for understanding the complex interactional processes of access to SRH care in general practice.
aimTo use the Candidacy Framework to explore access to SRH care in general practice. The seven interaction stages are: identification of need; navigation of services; permeability of services; appearing and asserting need; adjudication by healthcare professional (HCP); offers or resistance of offer; and the local operating conditions or local production of candidacy. DESIGN &
settingSystematic review with qualitative evidence synthesis using a framework approach.
methodA systematic search of MEDLINE, Embase, PubMed, and the Web of Science was conducted to identify primary qualitative research exploring access to SRH care in general practice from practitioner, public, and patient perspectives in countries with universal health care. The Candidacy Framework was used to synthesise the findings.
resultsAnalysis of 42 studies revealed the impact of stigma, shame, and embarrassment among individuals, communities, and HCPs. Findings showed limited inclusion of demographics, such as ethnicity and socioeconomic status. Barriers to access were more evident for those from lower socioeconomic communities, minoritised ethnic groups, and the LGBTQ+ community. There are multiple barriers, which include the behaviours of HCPs, who have a crucial role in recognising an individual's SRH need.
conclusionGeneral practice offers a cradle-to-grave healthcare service that should have SRH as a priority area of provision. Further understanding is needed about the impact of historic harms by medicine and health care on racialised individuals and minoritised genders.
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