Improving the Quality of Health Care Services for Adolescents, Globally: A Standards-Driven Approach

Abstract

PurposeThe World Health Organization (WHO) undertook an extensive and elaborate process to develop eight Global Standards to improve quality of health care services for adolescents. The objectives of this article are to present the Global Standards and their method of development.MethodsThe Global Standards were developed through a four-stage process: (1) conducting needs assessment; (2) developing the Global Standards and their criteria; (3) expert consultations; and (4) assessing their usability. Needs assessment involved conducting a meta-review of systematic reviews and two online global surveys in 2013, one with primary health care providers and another with adolescents. The Global Standards were developed based on the needs assessment in conjunction with analysis of 26 national standards from 25 countries. The final document was reviewed by experts from the World Health Organization regional and country offices, governments, academia, nongovernmental organizations, and development partners. The standards were subsequently tested in Benin and in a regional expert consultation of Latin America and Caribbean countries for their usability.ResultsThe process resulted in the development of eight Global Standards and 79 criteria for measuring them: (1) adolescents' health literacy; (2) community support; (3) appropriate package of services; (4) providers' competencies; (5) facility characteristics; (6) equity and nondiscrimination; (7) data and quality improvement; and (8) adolescents' participation.ConclusionsThe eight standards are intended to act as benchmarks against which quality of health care provided to adolescents could be compared. Health care services can use the standards as part of their internal quality assurance mechanisms or as part of an external accreditation process.

Our future: a Lancet commission on adolescent health and wellbeing

“…233 Other elements within a multifaceted approach might include promotion of adolescents’ literacy about their own health, engagement of community leaders, an appropriate package of services, ensuring provider competencies, improving facilities, promoting equity and non-discrimination, collecting data for quality improvement, and engaging adolescents around practice policies. 234 In England, the You’re Welcome criteria provide guidelines to health services to more consistently provide quality care to adolescents. 235 …”

Improving adolescent maternal health

“…Healthcare providers need to use a counselling approach that is non-judgemental and develop skills and techniques that welcome adolescent clients to their clinics and encourage them to seek care. Health facilities management are encouraged to maintain the eight standards, developed by the WHO, to improve quality of healthcare services for adolescents [15] -services that are equitable, accessible, acceptable, appropriate and effective (Table 2). The health facility implements systems to ensure that adolescents are knowledgeable about their own health and know where and when to obtain health services…”

Utilization of quality assessments in improving adolescent reproductive and sexual health services in rural block of Maharashtra, India

“…[3][4][5][6][7][8] However, majority of these studies are hospital/clinic based and are at tertiary level or in urban areas. There are very few published studies reporting utilization of serial Quality assessments for improvement of adolescent or youth friendly health services.…”

“…The eight standards of WHO can be utilized by the health care services as part of their quality control mechanism to improve adolescent health services. 8 The present paper has utilized seven WHO QA standards to assess the quality of ARSH services and utilized them as a part of quality assurance mechanism to improve ARSH services in a block in Maharashtra. The present QA survey conducted for five years in a rural block of Maharashtra, India reveals that utilization of the QA findings was useful to improve ARSH services and in creating a platform to carry out a sustained ARSH program.…”