scholarly journals Adolescent and Young People's Utilization of HIV/Sexual and Reproductive Health Services: Comparing Health Facilities and Mobile Community Outreach Centers

Author(s):  
Ikenna J. Nwakamma ◽  
Carol S. Talla ◽  
Stephanie E. Kei ◽  
Genevieve C. Okoro ◽  
Godwin Asuquo ◽  
...  

Background/Objectives: Demand creation for uptake of HIV and sexual reproductive health (HIV/SRH) services among adolescents and young people (AYP) in Nigeria is challenging. This study compares the reach, and utilization patterns, and factors that drive the patterns of utilization of HIV/SRH services by AYP in mobile outreach service centers and health care facilities in Nigeria's capital city. Methods: Data were obtained from service exit surveys and HIV/SRH service utilization records in selected health facilities and mobile testing outreaches from January to April 2018. The service providers were provided a checklist to capture key information during their interaction with their AYP clients. Data were captured with Microsoft Excel, imported to and analysed with Statistical Package for Social Sciences, version 16. Results: Community-based mobile outreaches reached a significantly higher proportion of participants, with 88% of them from the community HIV testing points. Among the participants in the SRH service utilization assessment, 20 (15%) and 142 (19%) voluntarily asked for SRH-related information in the health facility and mobile outreach respectively; 53 (40%), and 224 (30%) accepted offer of SRH counselling in the health facility and mobile outreach respectively. There were significant differences in the waiting time for testing and waiting time for result collection at the mobile testing posts and the health facilities. Conclusion and Implications for Translation: AYP friendly mobile community outreach model shows more promise in terms of reach and also seems to encourage voluntary request for HIV/SRH services among AYP. The costs and waiting times favor the mobile outreach model; however, the quality in terms of personnel and environment was an issue of concern. Hospitals are not providing friendly environments that encourage voluntary uptake of HIV/SRH services by AYPs. A model for AYPs should prioritize community based and friendly services with well-trained personnel in order to build the confidence of AYPs for improved SRH seeking behaviors. Key words: • HIV • Sexual and reproductive Health • Adolescents and Young People • Preferences • Mobile outreaches services • Health facility testing • Abuja Nigeria   Copyright © 2019 Nwakamma et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.affect economic and health promotion.

2019 ◽  
Author(s):  
Ifunanya Agu ◽  
Chinyere Mbachu ◽  
Uchenna Ezenwaka ◽  
Chinyere Okeke ◽  
Irene Eze ◽  
...  

Abstract [EXSCINDED] Abstract Background Adolescents’ sexual and reproductive health have an important influence on a country’s long-term national growth. There is high level of burden due to poor adolescent sexual and reproductive health (ASRH) in Nigeria, especially Ebonyi state. Evidence shows that in Sub-Saharan Africa region, most adolescents experience poor access to information and other services relating to their sexual and reproductive health. Many cultures in Africa see matters around sex and sexuality as social taboos. This study aimed to access variations in utilization of health facilities for sexual and reproductive health information and services among adolescents in Ebonyi State, Nigeria. This will inform the design of interventions to improve ASRH.Methods A total of 1057 in-school and out-of-school adolescents aged 13 to18 years were selected using cluster sampling of households from the 6 selected LGAs in this cross sectional survey. Structured questionnaires were used to collect data. Descriptive statistics was performed alongside stratification analysis. Tabulation, bivariate and multivariate logistic regression analysis were undertaken. A household wealth index was calculated using the total household consumption calculated divided by the number of people in the households (per capital household consumption). The per capita household consumption was used to categorize households into socio-economic quintiles. The variable was used to differentiate where key variables into socio-economic quintile equity analysis.Results Majority of respondents had never visited any type of health facility to receive either SRH information (90.2%) or services (97.1%). Utilization rate of health facilities for SRH information was 9.8% while for other SRH services was 2.8%. Patent medicine vendor (PMV) was the most visited type of facility for SRH information and other services. Schooling is a strong predictor of health facilities’ utilization for SRH information (P<0.01) and other services (P<0.01).Conclusion Utilization of health facilities for information and services among adolescents in Ebonyi State is very low and favourable towards informal service providers such as PMVs. Establishment and strengthening of the existing youth friendly centres, school clinics and occasional outreach programs designed specifically to target adolescents would perhaps improve adolescents’ access to adequate information and health facility utilization for sexual reproductive and health services.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melvin Simuyaba ◽  
Bernadette Hensen ◽  
Mwelwa Phiri ◽  
Chisanga Mwansa ◽  
Lawrence Mwenge ◽  
...  

Abstract Background Meeting the sexual and reproductive health (SRH) needs of adolescents and young people (AYP) requires their meaningful engagement in intervention design. We describe an iterative process of engaging AYP to finalise the design of a community-based, peer-led and incentivised SRH intervention for AYP aged 15–24 in Lusaka and the lessons learnt. Methods Between November 2018 and March 2019, 18 focus group discussions, eight in-depth interviews and six observations were conducted to assess AYP’s knowledge of HIV/SRH services, factors influencing AYP’s sexual behaviour and elicit views on core elements of a proposed intervention, including: community-based spaces (hubs) for service delivery, type of service providers and incentivising service use through prevention points cards (PPC; “loyalty” cards to gain points for accessing services and redeem these for rewards). A total of 230 AYP (15 participated twice in different research activities) and 21 adults (only participated in the community mapping discussions) participated in the research. Participants were purposively selected based on age, sex, where they lived and their roles in the study communities. Data were analysed thematically. Results Alcohol and drug abuse, peer pressure, poverty, unemployment and limited recreation facilities influenced AYP’s sexual behaviours. Adolescent boys and young men lacked knowledge of contraceptive services and all AYP of pre and post exposure prophylaxis for HIV prevention. AYP stated a preference for accessing services at “hubs” located in the community rather than the health facility. AYP considered the age, sex and training of the providers when choosing whom they were comfortable accessing services from. PPCs were acceptable among AYP despite the loyalty card concept being new to them. AYP suggested financial and school support, electronic devices, clothing and food supplies as rewards. Conclusions Engaging AYP in the design of an SRH intervention was feasible, informative and considered responsive to their needs. Although AYP’s suggestions were diverse, the iterative process of AYP engagement facilitated the design of an intervention that is informed by AYP and implementable. Trial registration This formative study informed the design of this trial: ClinicalTrials.gov, NCT04060420. Registered 19 August, 2019.


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