Mainstreaming youth-friendly health services into existing primary health care facilities: experiences from South-South Nigeria

Abstract

Background Youth friendly services, an evidence based approach to overcome the barriers experienced by youths in accessing care, is poorly implemented. The Medical Women's Association of Nigeria (MWAN) Rivers State chapter, was supported by Ford Foundation to mainstream youth-friendly health services (YFHS) into existing primary health care facilities in two hard-to-reach communities. This paper presents the interventions, findings, challenges and recommendations. Methods This study project was implemented in stages: design, baseline survey, interventions and evaluation, between 2014 and 2016. Interventions included facility modifications, health worker capacity building, school and community outreaches, peer group activities, and interpersonal communication. Pre-and-post-intervention surveys were carried out among in- and out-of-school youths to determine the effects of the interventions. Results The most commonly stated barriers to uptake of youth friendly health services included: unavailability of services (154; 33.1%), unavailability of health care workers (167; 38.9%), unaffordability of services (108; 45.8%) and difficulty in communicating with health workers (85; 36.0%). Post-intervention, utilization improved across all services while the perception of barriers to utilization of services reduced (p < 0.05). The interventions implemented increased the odds of youths utilizing YFHS 1.81 times (95% CI = 1.39-2.37). Conclusion Facility modifications, capacity building of health workers, school and community outreaches, peer group activities, and interpersonal communication improved utilization across all services while the perception of barriers to utilization of services reduced. Implementation of YFHS is impacted by external factors often beyond the control of project implementers. Innovative solutions outside of routine health care delivery systems are critical for success. Further evaluation to explore the effect of these interventions is needed. Strengthening of health systems remains a vital strategy for scale-up of YFHS.

The perception of parents of high school students about adolescent sexual and reproductive needs in Nigeria: A qualitative study

“…This is similar to a study conducted in 2018 by Ogu et al. [ 13 ]which revealed that the implementation of youth friendly health services remains minimal and are yet to be rolled out across all primary health centers in Nigeria.…”

Implementation Strategies to Enhance Youth-Friendly Sexual and Reproductive Health Services in Sub-Saharan Africa: A Systematic Review

“…Eight studies supported clinicians by employing peer navigators that work in tandem with youth-friendly clinic providers to support referral and linkage to the YFHSs, recruiting new clinic staff, and establishing new roles within the clinics (40,44,51,(54)(55)(56)(57)59). One study also implemented an adolescent HIV risk screening tool to help clinicians identify and prioritize high-risk patients (44).…”

“…(3) to deliver SRH services in ways that respond to the special needs of youths; (4) to appropriately provide STI diagnosis and treatment regimen for youths; and (5) to orient select youth to be advocates and change agents in their communities (i.e., peer educators). Ten studies reported the duration of the trainings and/or number of training sessions conducted, ranging from 1-5 days (38,(54)(55)(56)60)…”

Adolescents as our future and the pattern of violence against women and girls: experiences of the Rivers State observatory

“…Implementing youth-friendly health services in schools and communities may assist in enabling reporting; the odds of youths utilizing health facilities increased when the services are youth friendly. 25 In this study, 76.2% of perpetrators were known or trusted by the survivor or the survivor's family. This finding is truly traumatic and impacts the willingness of survivors to report an incident.…”