PT  - JOURNAL ARTICLE
AU  - Akila, Dorcas
AU  - Oluwasegun, Akinola
AU  - Bose, Krishna
AU  - Omotoso, Olukunle
AU  - Adefila, Adewale
AU  - Mwaikambo, Lisa
TI  - Improving the Quality of Adolescent and Youth-Friendly Health Services Through Integrated Supportive Supervision in Four Nigerian States
AID  - 10.9745/GHSP-D-22-00169
DP  - 2024 May 21
TA  - Global Health: Science and Practice
PG  - e2200169
VI  - 12
IP  - Supplement 2
4099  - http://www.ghspjournal.org/content/12/Supplement_2/e2200169.short
4100  - http://www.ghspjournal.org/content/12/Supplement_2/e2200169.full
SO  - GLOB HEALTH SCI PRACT2024 May 21; 12
AB  - Key FindingsAdapting a regional adolescent- and youth-friendly family planning supportive supervision tool within an existing government health supportive supervision system, accompanied by provider capacity strengthening and coaching, can help improve the quality of adolescent- and youth-friendly health services (AYFHS) provided.This facility-level AYFHS intervention, combined with community-level demand-generating activities and youth social mobilization efforts, can facilitate an increased demand and uptake of modern contraceptive services by adolescents and youth.Key ImplicationsEffective policy-level support at the national, state, and facility levels is critical to improving AYFHS quality and contraceptive uptake among adolescents and youth.Application of the supportive supervision tool and its accompanying processes should be built into existing supportive supervision systems to ensure ongoing behavior change among providers and system-level improvements to ensure adolescent-responsive contraceptive services that are available long term.Background:Although the unique sexual and reproductive health needs of adolescents and youth (AY) are widely recognized, the challenge remains how to integrate adolescent- and youth-friendly health services (AYFHS) effectively within a systems-based approach that is both feasible and scalable. This article provides preliminary evidence from 4 Nigerian states that sought to overcome this challenge by implementing capacity-strengthening approaches centered around a shortened quality assurance (QA) tool that has become part of the state health system’s routine supportive supervision process and follow-up quality improvement (QI) activities.Methods:A shortened QA tool was administered to assess and track the performance of 130 high-volume health facilities across 5 domains to serve its AY population with quality contraceptive services. Facility-based providers (N=198) received training on adolescent and youth sexual and reproductive health, AYFHS, and long-acting reversible contraceptive methods. To corroborate checklist findings, we conducted exit interviews with 754 clients (aged 15–24 years) who accessed contraceptive services from the facilities that met the World Health Organization’s minimum standards for quality AYFHS.Results:In the 4 states, the QA tool was applied at baseline and 2 rounds, accompanied by QI capacity strengthening after each round. At baseline, only 12% of the 130 facilities in the 4 states scored met the minimum quality standards for AYFHS. After 2 rounds, 88% of the facilities met the minimum standards. AY client volume increased over this same period. All 4 states showed great improvements; however, the achievements varied by state. The exit interview feedback supported client satisfaction with the services provided to AY.Conclusion:Integrating QA followed by QI within Nigeria’s family planning supportive supervision system is not only feasible but also impacts the quality of AYFHS and contraceptive uptake by clients aged 15–24 years.