Measuring adolescent friendly health services in India: A scoping review of evaluations

Abstract

BackgroundInitiatives to promote adolescent friendly health services (AFHS) have been taking place in India and many low- and middle-income countries for nearly two decades. Evaluations of these initiatives have been placed in the public arena from time to time, but little is known about what they say about the overall situation on AFHS in India. This study aimed to describe how efforts to provide AFHS in India have been evaluated, how well they have been evaluated, and what their findings and implications are.MethodsWe conducted a scoping review of evaluations of AFHS initiatives in India from 2000 to 2014. An electronic search was carried out in Medline and EMBASE. A manual search of grey literature was also performed, and experts were contacted in order to obtain additional manuscripts and reports.ResultsThirty evaluation reports were identified representing a broad geographic distribution. Evaluations have focused on government-sponsored AFHS programmes or independent non-governmental organization (NGO) initiatives to strengthen government services. The evaluations primarily measured programme outputs (e.g. quality and service utilization) and health behavioural outcomes (e.g. condom use). Study designs were commonly descriptive or quasi-experimental. Most evaluations found improvement in quality and utilization of services, and some demonstrated an increase in adolescent knowledge or health behaviours. Few measured positive project/programme results such as older age at first pregnancy. Strengths of evaluations were clear objectives, frequent use of multiple data sources, and assessment of programmatic outputs as well as health outcomes. Weaknesses were lack of consistency and quality.ConclusionsOur findings confirm that a number of evaluations of AFHS initiatives in India have been carried out. They point to service quality and in behavioural improvements in adolescents. However, their lack of consistency hinders comparison across sites, and their uneven quality means that their findings need to be interpreted with caution. Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-016-0251-8) contains supplementary material, which is available to authorized users.

Exploring the factors impacting on access and acceptance of sexual and reproductive health services provided by adolescent-friendly health services in Nepal

“…In other words, these are health care services that don’t restrict adolescents but do guarantee confidentiality, treat adolescents with respect and without judgment, and are within easy reach of and affordable for adolescents [33]. To deliver adolescent-friendly health services, many countries have made efforts to incorporate these features into their health care services with the aim of improving the arrangement, provision, and quality of SRH services for adolescents [34–38]. AFHSs are meant to be attractive to young people and thereby increase adolescent uptake of SRH services [32, 33].…”

Improving adolescent health: Learnings from an interventional study in Gujarat, India

“…These young people face a number of problems including sexual and reproductive health (SRH) problems, including HIV. [23] Empirical evidence shows that more than 33% of the disease burden and almost 60% of premature deaths among adults can be associated with behavior or conditions that began or occurred during adolescence. [45]…”

Knowledge deficit on health promotion activities during pregnancy: the case for adolescent pregnant women at Chiladzulu District, Malawi

“…In most cases in Malawi, antenatal care does not specifically have services that would target the needs of pregnant teenagers as indicated in an exploratory study on pregnant adolescents’ perceptions of the antenatal care received at a health centre in Blantyre, Malawi which found that the care was inadequate, as it did not meet the adolescents’ expected standards and needs [ 12 ]. Similarly, a study done in India highlighted that there were persistent unmet quality standards like provision of equipment and supplies to address the needs of adolescent mothers [ 40 ]. On the other hand, services that are more adolescent friendly resulted in increased knowledge about reproductive health services to young people [ 40 ].…”

“…Similarly, a study done in India highlighted that there were persistent unmet quality standards like provision of equipment and supplies to address the needs of adolescent mothers [ 40 ]. On the other hand, services that are more adolescent friendly resulted in increased knowledge about reproductive health services to young people [ 40 ]. Banke- Thomas et al, further added that there is poor utilization of maternal health services by adolescents compared to older mothers and concluded that education and male involvement in maternal health care would improve utilisation of the services [ 41 ].…”