Standardizing and scaling up quality adolescent friendly health services in Tanzania

Abstract

BackgroundAdolescents in Tanzania require health services that respond to their sexual and reproductive health – and other – needs and are delivered in a friendly and nonjudgemental manner. Systematizing and expanding the reach of quality adolescent friendly health service provision is part of the Tanzanian Ministry of Health and Social Welfare's (MOHSW) multi-component strategy to promote and safeguard the health of adolescents.ObjectiveWe set out to identify the progress made by the MOHSW in achieving the objective it had set in its National Adolescent Health and Development Strategy: 2002–2006, to systematize and extend the reach of Adolescent Friendly Health Services (AFHS) in the country.MethodsWe reviewed plans and reports from the MOHSW and journal articles on AFHS. This was supplemented with several of the authors’ experiences of working to make health services in Tanzania adolescent friendly.ResultsThe MOHSW identified four key problems with what was being done to make health services adolescent friendly in the country – firstly, it was not fully aware of the various efforts under way; secondly, there was no standardized definition of AFHS; thirdly, it had received reports that the quality of the AFHS being provided by some organizations was poor; and fourthly, only small numbers of adolescents were being reached by the efforts that were under way. The MOHSW responded to these problems by mapping existing services, developing a standardized definition of AFHS, charting out what needed to be done to improve their quality and expand their coverage, and integrating AFHS within wider policy and strategy documents and programmatic measurement instruments. It has also taken important preparatory steps to stimulate and support implementation.ConclusionThe MOHSW is aware that the focus of the effort must now shift from the national to the regional, council and local levels. The onus is on regional and council health management teams as well as health facility managers to take the steps needed to ensure that all adolescents in the country obtain the sexual and reproductive health (SRH) services they need, delivered in a friendly and non-judgemental manner. But they cannot do this without substantial and ongoing support.

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

“…The study indicates that the development and implementation of quality standards is a useful means of ensuring efforts to make health services adolescent friendly. 6 Similar observations are noted in the present study in which the utilization of QA survey findings provided gaps which were addressed to improve the ARSH services. In the present study the QA tools were developed based on the seven WHO standards which are almost similar to the standards developed by Tanzania.…”

“…[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.…”

Adolescent Sexual and Reproductive Health Services and Implications for the Provision of Voluntary Medical Male Circumcision: Results of a Systematic Literature Review

“…Program implementers can rapidly conduct this research as part of program development. Where standards based on global guidance for implementing adolescent-friendly SRH services are implemented, they have shown some impactful results if grounded in wider public health work at the national and community level [ 45 ]. Thus, integration of age and culturally appropriate VMMC programming and other SRH services for adolescents are necessary.…”

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

“…Many countries to date have moved toward a standards-driven approach to improve the quality of care for adolescents [5,32–36] . Standards are developed to be applied across the broad range of services such as primary care, general practice and community-based services, government and nongovernment services, and those in the private sector [15–17,31,37] .…”