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Mainstreaming youth-friendly health services into existing primary health care facilities: experiences from South-South Nigeria

  • Rosemary Ogu EMAIL logo , Omosivie Maduka , Folusho Alamina , Obelebra Adebiyi , Vetty Agala , Gracia Eke , Ibimonye Porbeni , Nnesochi Offor , Claribel Abam , Alice Nte and Friday Okonofua

Abstract

Background

Youth friendly services, an evidence based approach to overcome the barriers experienced by youths in accessing care, is poorly implemented. The Medical Women’s Association of Nigeria (MWAN) Rivers State chapter, was supported by Ford Foundation to mainstream youth-friendly health services (YFHS) into existing primary health care facilities in two hard-to-reach communities. This paper presents the interventions, findings, challenges and recommendations.

Methods

This study project was implemented in stages: design, baseline survey, interventions and evaluation, between 2014 and 2016. Interventions included facility modifications, health worker capacity building, school and community outreaches, peer group activities, and interpersonal communication. Pre-and-post-intervention surveys were carried out among in- and out-of-school youths to determine the effects of the interventions.

Results

The most commonly stated barriers to uptake of youth friendly health services included: unavailability of services (154; 33.1%), unavailability of health care workers (167; 38.9%), unaffordability of services (108; 45.8%) and difficulty in communicating with health workers (85; 36.0%). Post-intervention, utilization improved across all services while the perception of barriers to utilization of services reduced (p < 0.05). The interventions implemented increased the odds of youths utilizing YFHS 1.81 times (95% CI = 1.39–2.37).

Conclusion

Facility modifications, capacity building of health workers, school and community outreaches, peer group activities, and interpersonal communication improved utilization across all services while the perception of barriers to utilization of services reduced. Implementation of YFHS is impacted by external factors often beyond the control of project implementers. Innovative solutions outside of routine health care delivery systems are critical for success. Further evaluation to explore the effect of these interventions is needed. Strengthening of health systems remains a vital strategy for scale-up of YFHS.

Funding source: Ford Foundation

Award Identifier / Grant number: 0145 1297

Funding statement: Ford Foundation grant number 0145 1297.

Acknowledgements

The Ford Foundation for their support with grant number 0145 1297 especially Dabesaki Mac-Ikemejima, Joy E. Ehinor and Afishetu Aliu at her office of West Africa, Lagos, Nigeria. The Rivers State Primary Health Care Management Board Especially Dr. Agiriye Harry, Dr. Clement Edet, Dr. Mina Whyte, Dr. Theophilus T. Dagogo and all the staff of Ataba and Unyeada model Primary Health Centres. The partnership of the technical working groups and Community Development Committees at Ataba and Unyeada is also appreciated.

  1. Disclosure statement: None of the authors have any competing interest.

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Supplemental Material

The online version of this article offers supplementary material (https://doi.org/10.1515/ijamh-2017-0151).


Received: 2017-09-02
Accepted: 2017-11-26
Published Online: 2018-01-25

©2018 Walter de Gruyter GmbH, Berlin/Boston

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