Nearly half of the world’s population comprise youths. However, addressing their Sexual and Reproductive Health (SRH) remains a challenge. Globally countries are mandated to continually provide Youth Friendly Sexual ...Nearly half of the world’s population comprise youths. However, addressing their Sexual and Reproductive Health (SRH) remains a challenge. Globally countries are mandated to continually provide Youth Friendly Sexual and Reproductive Health services (YFSRHs) to the youth. The objective of this study was to assess and describe youth’s perspectives on a sustainable model for the provision of YFSRHs in Kenya. Data was collected among 400 youths aged 18 - 24 years in Embu and Kirinyaga counties, Kenya. A structured questionnaire was utilized as the data collection tool. Collected data was analyzed using SAS statistical software version 9.4. Statistical threshold of P ≤ 0.05 was used. Overall the mean age of the study participants was ±standard deviation (SD) 21.2 ± 1.86 years. Majority of the participants’ perspective on the health care system sustainability was that the waiting time at the facility should be less than an hour, accessible geographically (less than a kilometre), affordable (≤20 Ksh.), and convenient working hours (weekday and weekends ratio 1:1). Advocacy was on health care provider’s attributes of politeness, welcoming, confidential and non-judgmental. The most preferred locations for the youth friendly centres by the participants were community and school based locations. Similarly, parental and community support was reported to highly contribute to sustained utilization and provision of the YFSRHs (P < 0.001). Unlike popular belief, 99.8% did not see the need for recreational facilities at the youth centres to ensure sustainability of the model. To ensure a sustainable model for the provision of YFSRHs, there is need for a multi-sectoral and stakeholder involvement that is;youth, health care system structure, health care service providers, parents and community. Further research is needed on parents and health care service provider’s perspectives on how to sustain the provision of YFSRH services.展开更多
An attempt has been made to assess the Youth Friendly Health Services (YFHS) from the clients’ perspectives and the role of outreach community-based approach (Youth Information Center, YIC) in improving access to ser...An attempt has been made to assess the Youth Friendly Health Services (YFHS) from the clients’ perspectives and the role of outreach community-based approach (Youth Information Center, YIC) in improving access to services. A cross- sectional study was undertaken in Arajiline and Hoskote blocks in Varanasi and Bangalore districts respectively using primarily a quantitative technique. A consecutive sample of 120 clients from 4 selected clinics was interviewed after seeking services from YFHS. Additionally, facility assessment of clinics and 8 FGDs were conducted among community members and the young people in the community. Majority of the clients (90.8%) are aware that YFHS provide services to young males and females separately on specific day and time. Nearly 66% clients visited YFHS to sought treatment for three key health problems i.e. menstruation problems (25.4%) followed by general illness (22.8%) and swelling/itching of private parts (21.1%). In Hos- akote privacy was maintained during the con- sultation with the doctor, however, situation was relatively not better in Arajiline. Out of those clients who had visited YIC atleast once, 49 out of 53 in Arajiline and 51 out of 60 in Hasokote reported that the YIC staff/activities had motivated them to sought services at YFHS. Study concludes that while majority of the clients were satisfied with the services at YFHS, there is a need for strengthening the existing “package” of the services. At facility level, reassurance about the privacy and confidentially and alternative ways to promote access and utilization of services by active involvement of young people is recommended. On the other hand, at outreach level, new technologies should be introduced to generate demand, intensive focus on adults in the community and integration of YIC with local governance and school environment is suggested so as to protect young people against poor health outcomes.展开更多
Background: Ministry of Health, Government of India developed the Adolescent Reproductive and Sexual Health (ARSH) strategy and operationalized adolescent health services up to district and sub-district hospital level...Background: Ministry of Health, Government of India developed the Adolescent Reproductive and Sexual Health (ARSH) strategy and operationalized adolescent health services up to district and sub-district hospital level. Objectives: To operationalize adolescent health services at primary health care level in a block of Maharashtra;assess impact of need based interventions on quality of services;and understand potential for scalability in the state. Methods: Adolescent and Youth friendly centers were established at primary health care settings and interventions such as health system strengthening, sensitizing gatekeepers, involving Accredited Social Health Activist (ASHAs), developing inter and intra-sectoral linkages, improving monitoring and evaluation were tested. Results: Over a period of 2009-2014, there was a steady increase in the number of clients attending the Adolescent and Youth Friendly Health Centers (A&YFHCs). Attitude of providers to address adolescents’ needs improved significantly. Successful interventions were networking with schools, colleges and Non Government Organization (NGOs), linkages with HIV program and Integrated Child Development Services (ICDS), and involvement of ASHAs. Conclusions: The study demonstrates that although health system has the primary responsibility of addressing health issues among adolescents;it has limitations in terms of its reach to adolescents and generating demand for services. There is a need to network with education sector, ICDS, NGOs working for adolescent health and development to work as a team and address the multifaceted needs of the adolescents. Such a strategy will be crucial while implementing the recently launched Rashtriya Kishor Swasthya Karyakram— the new national adolescent health programme in India.展开更多
文摘Nearly half of the world’s population comprise youths. However, addressing their Sexual and Reproductive Health (SRH) remains a challenge. Globally countries are mandated to continually provide Youth Friendly Sexual and Reproductive Health services (YFSRHs) to the youth. The objective of this study was to assess and describe youth’s perspectives on a sustainable model for the provision of YFSRHs in Kenya. Data was collected among 400 youths aged 18 - 24 years in Embu and Kirinyaga counties, Kenya. A structured questionnaire was utilized as the data collection tool. Collected data was analyzed using SAS statistical software version 9.4. Statistical threshold of P ≤ 0.05 was used. Overall the mean age of the study participants was ±standard deviation (SD) 21.2 ± 1.86 years. Majority of the participants’ perspective on the health care system sustainability was that the waiting time at the facility should be less than an hour, accessible geographically (less than a kilometre), affordable (≤20 Ksh.), and convenient working hours (weekday and weekends ratio 1:1). Advocacy was on health care provider’s attributes of politeness, welcoming, confidential and non-judgmental. The most preferred locations for the youth friendly centres by the participants were community and school based locations. Similarly, parental and community support was reported to highly contribute to sustained utilization and provision of the YFSRHs (P < 0.001). Unlike popular belief, 99.8% did not see the need for recreational facilities at the youth centres to ensure sustainability of the model. To ensure a sustainable model for the provision of YFSRHs, there is need for a multi-sectoral and stakeholder involvement that is;youth, health care system structure, health care service providers, parents and community. Further research is needed on parents and health care service provider’s perspectives on how to sustain the provision of YFSRH services.
文摘An attempt has been made to assess the Youth Friendly Health Services (YFHS) from the clients’ perspectives and the role of outreach community-based approach (Youth Information Center, YIC) in improving access to services. A cross- sectional study was undertaken in Arajiline and Hoskote blocks in Varanasi and Bangalore districts respectively using primarily a quantitative technique. A consecutive sample of 120 clients from 4 selected clinics was interviewed after seeking services from YFHS. Additionally, facility assessment of clinics and 8 FGDs were conducted among community members and the young people in the community. Majority of the clients (90.8%) are aware that YFHS provide services to young males and females separately on specific day and time. Nearly 66% clients visited YFHS to sought treatment for three key health problems i.e. menstruation problems (25.4%) followed by general illness (22.8%) and swelling/itching of private parts (21.1%). In Hos- akote privacy was maintained during the con- sultation with the doctor, however, situation was relatively not better in Arajiline. Out of those clients who had visited YIC atleast once, 49 out of 53 in Arajiline and 51 out of 60 in Hasokote reported that the YIC staff/activities had motivated them to sought services at YFHS. Study concludes that while majority of the clients were satisfied with the services at YFHS, there is a need for strengthening the existing “package” of the services. At facility level, reassurance about the privacy and confidentially and alternative ways to promote access and utilization of services by active involvement of young people is recommended. On the other hand, at outreach level, new technologies should be introduced to generate demand, intensive focus on adults in the community and integration of YIC with local governance and school environment is suggested so as to protect young people against poor health outcomes.
文摘Background: Ministry of Health, Government of India developed the Adolescent Reproductive and Sexual Health (ARSH) strategy and operationalized adolescent health services up to district and sub-district hospital level. Objectives: To operationalize adolescent health services at primary health care level in a block of Maharashtra;assess impact of need based interventions on quality of services;and understand potential for scalability in the state. Methods: Adolescent and Youth friendly centers were established at primary health care settings and interventions such as health system strengthening, sensitizing gatekeepers, involving Accredited Social Health Activist (ASHAs), developing inter and intra-sectoral linkages, improving monitoring and evaluation were tested. Results: Over a period of 2009-2014, there was a steady increase in the number of clients attending the Adolescent and Youth Friendly Health Centers (A&YFHCs). Attitude of providers to address adolescents’ needs improved significantly. Successful interventions were networking with schools, colleges and Non Government Organization (NGOs), linkages with HIV program and Integrated Child Development Services (ICDS), and involvement of ASHAs. Conclusions: The study demonstrates that although health system has the primary responsibility of addressing health issues among adolescents;it has limitations in terms of its reach to adolescents and generating demand for services. There is a need to network with education sector, ICDS, NGOs working for adolescent health and development to work as a team and address the multifaceted needs of the adolescents. Such a strategy will be crucial while implementing the recently launched Rashtriya Kishor Swasthya Karyakram— the new national adolescent health programme in India.