RT Journal Article
SR Electronic
T1 Implementing Quality Improvement Initiatives to Improve the Use of Adolescent- and Youth-Friendly Health Services in Zou, Benin
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP e2200223
DO 10.9745/GHSP-D-22-00223
VO 12
IS Supplement 2
A1 Avocè, Josephat
A1 Kandji, Mamadou
A1 Mitchell, Vanessa
A1 Mensah, Koami Maurice
A1 Gnahoui, Hugues
A1 Talla, Hawa
A1 Nakoulma, René Jean Firmin
A1 Diop, Cheikh Ibrahima
A1 Faye, Moussa
A1 Sow, Fatimata
A1 Bose, Krishna
YR 2024
UL http://www.ghspjournal.org/content/12/Supplement_2/e2200223.abstract
AB Key FindingsTo assess the quality of adolescent- and youth-friendly health services (AYFHS) at 65 service delivery points in Zou, Benin, a 15-item quality assessment (QA) checklist was implemented to measure adherence to AYFHS standards.Quality improvement initiatives and supportive supervision were implemented to address service delivery, contraceptive availability, and provider bias and proved to be effective mechanisms in boosting the quality of AYFHS after the first QA cycle and the use of contraceptive services.Due to the COVID-19 pandemic that occurred between the second and third QA cycles as well as internal factors, many service delivery points regressed in scores.Key ImplicationsLocal governments can adapt the QA tool and institutionalize it within their supportive supervision systems.National stakeholders should invest in quality improvement strategies to increase the potential use of sexual and reproductive health services among adolescents and youth.Program managers need to anticipate possible internal or external factors that could influence the quality of services and uptake of contraception and put in place plans to mitigate them.Introduction:In Benin, the unmet need for family planning services is especially high for adolescent girls and youth aged 15–24 years. The Challenge Initiative (TCI) supported the health system to assess and improve the quality of adolescent and youth sexual reproductive health services and enhance contraceptive uptake in 65 service delivery points (SDPs) of the Zou department.Program Description:Between June 2019 and March 2021, TCI supported the health districts in Zou to train an assessment team to complete 3 cycles of quality assessments (QAs) using a QA checklist adapted to the local context. Based on assessment scores, the SDPs were categorized into poor, moderate, or good to excellent quality. The SDP managers developed remedial action plans after each cycle and for each SDP and followed up with supportive supervision.Results:The first QA cycle showed that 52% of assessed SDPs achieved a good to excellent classification; by the second QA cycle, this reached 74%. However, the quality of adolescent- and youth-friendly health services regressed during the third QA cycle (during COVID-19 pandemic disruptions), when only 40% of SDPs achieved the good to excellent category. Between the first and second QA cycles, contraceptive uptake for adolescents and youth improved in the SDPs that had good or excellent quality of services, compared to the ones that were of lower quality (established significance level of 5% with a P value of .031).Conclusion:Further assessments could deepen our understanding of the internal and external factors that can affect service quality. The findings reinforce the importance of investing in quality improvement strategies to maximize the use of sexual and reproductive health services among adolescents and youth. They also underscore the need for a contextual and nuanced approach to ensure enduring results.