Adolescent Friendly Services: quality assessment with simulated users

Abstract

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.

Changes over time in HIV testing and counselling uptake and associated factors among youth in Zambia: a cross-sectional analysis of demographic and health surveys from 2007 to 2018

“…The development of gender-sensitive HTC services and less coercive strategies to sustain the gain in testing uptake among men in a union are also important to consider. Finally, the warning about barriers associated with the access to sexual health and HIV services through YFS in a recent study from Brazil [ 79 ], and the scarcity of evidence supporting the progress made since their introduction in Zambia, suggest that more research will help to demonstrate their contribution and yield.…”

Changes over time in HIV testing and counselling uptake and associated factors among youth in Zambia: A cross-sectional analysis of Demographic and Health Surveys from 2007 to 2018

“…The development of gender-sensitive HTC services and less coercive strategies to sustain the gain in testing uptake among men in a union are also important to consider. Finally, the warning about barriers associated with the access to sexual health and HIV services through YFS in a recent study from Brazil (77), and the scarcity of evidence supporting the progress made since their introduction in Zambia, suggest that more research will help to demonstrate their contribution and yield.…”

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“…En el diseño de los servicios destinados a las adolescentes, tener una visión integral favorece que los espacios disponibles respondan a las demandas específicas de esta población. Ello es relevante en la concepción de servicios amigables para adolescentes 32 , lo cual resulta importante para quebrar el paradigma adultocéntrico que, en ocasiones, permea los servicios de salud 33 .…”