Predictors of education and utilization of adolescent-friendly health services among youth in Kumbungu district, Ghana

PurposeThis paper assessed factors affecting adolescent-friendly health services (AFHS), education and utilization among youth (10–19 years) in Kumbungu district, Ghana.Design/methodology/approachThe study used a cross-sectional design involving 416 adolescents from households using a random sampling technique. The authors collected data on sociodemographic characteristics, education and utilization of AFHS using a semi-structured questionnaire between June and September 2017. Logistic regression models were used to determine the factors associated with AFHS education and utilization.FindingsOf the 416 adolescents interviewed, 66% were between 15 and 19 years. Half (50%) of the adolescents received AFHS education, 54% utilized existing services and 85% knew about health challenges. Females (aOR = 0.64; p = 0.031) were less likely to receive AFHS education compared to males. Muslims (aOR = 0.21; p < 0.001) were less likely to utilize AFHS compared to Christians. Adolescents with primary (aOR = 6.65; p = 0.020), junor high school (JHS) (aOR = 10.66, p = 0.079) or senior high school (SHS) (aOR = 1.04; p = 0.954) education were more likely to utilize AFHSs compared to those with no education.Originality/valueThis study reports a moderate level of education and the utilization of adolescent health services. Sex, religion and education are the key predictors of AFHS education and utilization. This study contributes to the understanding of adolescent health services and the foundation for future studies. It may be used for the planning of adolescent health service programs in disadvantaged settings.

Parent–adolescent communication on sexual and reproductive health and the utilization of adolescent-friendly health services in Kailali, Nepal

Background Adolescents are vulnerable to various sexual and reproductive health (SRH) problems such as unintended pregnancy, HIV or other sexually transmitted infections (STIs), and unsafe abortion. Adolescent-friendly health services offer SRH services such as SRH counseling, contraceptive services, STI and HIV services, and abortion-related services, which may help prevent these risks. Parent–adolescent communication about SRH prevents adolescents from adopting unhealthy SRH practices. However, its association with the utilization of SRH services is less known. Therefore, this study examined the association between parent–adolescent communication on SRH issues and the utilization of adolescent-friendly health services in Nepal. Methods This was a school-based, cross-sectional study conducted in Kailali district, Nepal, among students aged 15–19 years in Grade 11 and 12 from seven schools. We used multivariable logistic regression analysis to examine the association between parent–adolescent communication and service utilization. Results We analyzed the data from 594 students. Students with a higher score of parent–adolescent communication on SRH were significantly more likely to use adolescent-friendly health services (adjusted odds ratio, AOR: 1.70, 95% Confidence Interval, CI: 1.29–2.23, p<0.001). Those who reported having engaged in sexual intercourse in the past year were more likely to use services than those who did not (AOR: 29.11, 95% CI: 13.65–62.08, p<0.001). Those who belonged to the Janajati ethnic group were more likely to use these services than those from the Brahmin/Chhetri ethnic group (AOR: 2.86, 95% CI: 1.28–6.42, p = 0.01). Those living alone were less likely to use services than those living with both parents (AOR: 0.12, 95% CI: 0.02–0.66, p = 0.01). Conclusion Students with a higher score on parent–adolescent communication on SRH were more likely to use adolescent-friendly health services. Thus, parental involvement in SRH communication could contribute to the use of adolescent-friendly health services and ultimately prevent negative SRH outcomes among students in late adolescence.

A Study of Quality and Proficiency of the Service Providers in Delivering the Adolescent and Youth Friendly Services under the Rashtriya Kishor Swasthya Karyakram Programme in Madhya Pradesh

Despite existing frameworks for the improvement of adolescent reproductive health, there is a lack in provision of the Adolescent Friendly Health Services (AFHS). The primary objective of this study was to assess the quality and proficiency of service providers to deliver Adolescent Friendly Health Services (AFHS) in central India. Data was gathered by visiting 30 secondary and tertiary level health facilities to assess their infrastructure and preparedness for providing AFHS using a pre-designed questionnaire based on WHO guidelines for assessing quality. Descriptive analysis was done using SPSS v21 and Microsoft Excel. Quality of AFHS services was found to be poor in non- RKSK facilities. However the knowledge level, training status and counseling skills of the service provider was found to be highly substandard in both RKSK and Non-RKSK facilities. The RKSK program has not been properly implemented and has failed to make an impact where it was required.

Barriers to reproductive health services utilization among adolescents

Background Adolescents' access to quality reproductive health services is crucial for their psychosocial and physical wellbeing. Yet, adolescents encounter various barriers while utilizing reproductive health services, globally. Adolescent-friendly health services (AFHS) is an evidence-based intervention to meet the reproductive health needs inclusively of all adolescents. The study aimed to explore adolescents' experiences while seeking reproductive health services in primary healthcare facilities (PHCF) in Armenia. Methods We conducted a qualitative cross-sectional study using in-depth interviews, focus group discussions and observations of PHCFs. The study participants included adolescents (aged 18-19 years) (n = 17), PHC providers (PHP) (n = 29), managers of PHCFs (n = 7) and experts in the field of adolescent health (n = 5) from the two largest cities in Armenia. The Global standards for quality healthcare services for adolescents guided the instrument development process and deductive content analysis. Results Barriers to the utilization of reproductive health services by adolescents at PHCFs were related to various personal, cultural, and social factors. PHPs and experts blamed adolescents' insufficient knowledge of reproductive health and related services for being a major barrier. However, adolescents' reported a different set of important barriers to reproductive health services: PHPs' judgmental attitude, lack of efforts to protect privacy and confidentiality (due to lack of PHP competencies to provide AFHS and inadequate PHCF infrastructure), negative public opinion and lack of community support. Conclusions The study findings shed light on different perspectives related to various challenges adolescents come across in PHCFs. Addressing identified barriers have the potential of positively influencing adolescents' experiences while utilizing reproductive health services in PHCFs. Key messages Adolescents’ insufficient knowledge, PHPs’ judgmental attitude, lack of privacy and confidentiality, and negative public opinion are among the main barriers to the reproductive health services. Further enforcement of adolescent-friendly health services in primary healthcare facilities is needed to ensure accessibility of quality reproductive health services for all adolescents.

Utilization of adolescent friendly health services and its associated factors in Dang district of Nepal

Background: Adolescence is a period of transition from childhood to adulthood. It is very crucial for adolescents to use the adolescent friendly health services in order to meet sexual and reproductive health needs. This study aimed to assess the factors associated with utilization of adolescent friendly health services in Dang district of Nepal.Methods: A community based analytical cross-sectional study was conducted in Dang district of Nepal. Five adolescent friendly health facilities were randomly selected and proportionate sampling was done to fulfill the required sample size. The adolescents were selected conveniently from the areas. Verbal informed consent was taken from the participants and their parents in case of age below 16 years. Approval was taken from Institutional Review Committee of Chitwan Medical College. Bivariate analysis was performed to detect the factors associated with utilization of adolescent friendly health services.Results: Nearly half (48.7%) of the adolescents had utilized adolescent friendly health services. Different socio-demographic factors like age of the participants, current educational status, mother’s education, ethnicity was significantly associated with utilization of adolescent friendly health services. Other factors like awareness about were services, convenient opening days and hour of health facilities and shyness to utilize the services were significantly associated with the utilization of the services.Conclusions: The utilization of the adolescent friendly services was found to be low among the adolescents of Dang district. In order to increase awareness among the adolescent regarding utilization of the services, there is need of coordination between schools, health institutions, communities etc. to conduct various awareness related program.

Adolescent Friendly Services: quality assessment with simulated users

OBJECTIVE: To assess the quality of adolescent friendly health services. METHODS: Qualitative assessment using the simulated user technique in first level clinics of Health Services of Morelos, Mexico, during 2018. Ten out of 17 facilities with non-exclusive adolescent friendly services were randomly selected. An additional facility with exclusive adolescent friendly services was included as an intensive subsample. Four adolescents served as simulated users interpreting different cases in the clinics. The total of 43 semi-structured exit interviews were conducted, and two nominal groups were made to assess the perceived quality from the adolescents’ perception of friendliness and experience. Thematic analysis of the data obtained was performed. RESULTS: Staff attitude was highlighted as a key element in the adolescents’ experience. Failures were found, such as the existence of bureaucratic barriers to access, lack of signage in clinics, lack of privacy and confidentiality, failure of physical examination during the appointment and lack of monitoring of the reasons for appointment. The exclusive clinic for adolescents offered more appropriate friendly services compared with nonexclusive clinics. CONCLUSION: Although the service is accessible in most of the clinics visited, it is still far from being friendly according to international recommendations. The exclusive clinic for adolescents stood out for having better structured mechanisms that can be implemented in nonexclusive clinics to improve the care process.

Making Health Services Adolescent-Friendly in Northeastern Peninsular Malaysia: A Mixed-Methods Study

A mixed-methods study was conducted in a Malaysian state beginning with a cross-sectional quantitative study to determine the relationship between clinic characteristics and clinic score of adolescent-friendliness. Subsequently, perceptions of healthcare providers on the facilitating factors for the provision of adolescent-friendly health services were explored qualitatively to support the quantitative findings. Availability of trained healthcare providers, adequate privacy, dedicated adolescent health services team, and adolescent health promotional activities were the clinic characteristics that significantly (p < 0.05) related with clinics’ scores of adolescent-friendliness. The facilitating factors required for adolescent-friendly health services were (1) healthcare providers’ commitment and prioritization towards adolescent-friendly health services; (2) organizational supports; (3) appropriate clinic settings; and (4) external supports for adolescent health promotional activities. The qualitative findings reaffirmed those of the quantitative study on the significant clinic characteristics required for adolescent-friendly health services. This study provides valuable insight for the Ministry of Health to elicit the required facilitating factors to further improve the quality of adolescent health services in Malaysia.