Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?

Abstract

BackgroundResearchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents.MethodsWe gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services.ResultsGovernments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents.ConclusionsWith support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.

Challenges and strategies for sustaining youth-friendly health services — a qualitative study from the perspective of professionals at youth clinics in northern Sweden

“…The other axes of inequity mentioned in this study — gender identity, sexual orientation, ethnic background and disability — deserve further exploration. Other studies have pointed out that the domain of equity is the one that is usually less developed when YFHSs are implemented [2, 42, 56]. …”

“…Health-care services can provide information on health-related issues, treat youths who are ill, and reach those who are in vulnerable situations [2, 4–6, 11]. However, for health-care services to be beneficial for youths, it is important that they are youth-friendly, or, as defined by the World Health Organization (WHO): accessible, acceptable, equitable, appropriate and effective for different youth subpopulations [5, 12].…”

“…In order to be sustained, YFHSs have to be considered part of public health policies, programmes and systems and not organized as isolated initiatives dependent on external support [2, 4, 5, 17]. In fact, the WHO has recently highlighted the need to move forward from YFHSs into youth-responsive health systems [18].…”

“…In fact, the WHO has recently highlighted the need to move forward from YFHSs into youth-responsive health systems [18]. However, progress has been slow, despite the fact that the literature shows that implementing YFHSs is a cost-effective intervention that could contribute to better health among young people [2, 17, 19, 20]. Even in countries where public health systems perform well, health care for young people is usually a neglected area that lacks clear guidelines and political will.…”

Strengthening Youth Friendly Health Services through Expanding Method Choice to include Long-Acting Reversible Contraceptives for Ethiopian Youth

“…Helping young persons and especially adolescents avoid unintended pregnancies reduces the adverse consequences of early childbearing (maternal, infant and child mortality and severe morbidity); with concomitant savings in maternal and child health care; enhances young women's education and economic opportunities; and reduces gender inequality and poverty 9 . While concerted national efforts to provide adolescent friendly services in several low and middle income countries have evolved in the recent past with measurable though uneven improvements in health service utilization 10 . However, much still needs to be done to respond to the unmet need for all sexually active young people 11 .…”