Adolescent Friendly Health Services in Level Two Facilities among Public Secondary School Students in Mombasa County, Kenya
Amuko, Selpha Ongaya
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Adolescents’ health is a great determinant of a country’s development since adolescents contribute a large proportion of the population. Sexual and reproductive health problems have been identified in several studies to be a major cause of ill health and even death among young people. These problems demand specialized attention which can be achieved through unlocking access to sexual and reproductive health services to young people through adolescent friendly health services. Despite the adoption of the adolescent friendly health services in all government health facilities, there is still high incidences of teenage pregnancies and HIV infections among young persons aged 15-19 years. The main objective of this study was to assess the adolescent friendly health services in public primary care facilities to adolescents aged 13-17 years attending secondary schools in Kisauni Sub-County, Mombasa, Kenya. The study was conducted to assess the views of secondary school students on adolescent friendly health services in level 2 facilities in Kisauni SubCounty, Mombasa County, Kenya. The study looked at staff characteristics, facility characteristics, interpersonal relationships and their association with students’ perceptions on friendliness of services. A survey was conducted with 313 secondary school going students from two public schools in Kisauni Sub-County, Mombasa County Kenya. Students were selected using a simple random selection process and structured questionnaires used to collect data. Additionally, researchers assessed four public primary care facilities using an observational checklist and Key informant interviews conducted on facility in charges. Relationships between variables were assessed using Chi-Square at 95% confidence interval. Finite correction formula was used to determine the sample size for the study. Kisauni Sub-County was selected purposively. Four public primary health care facilities in the Sub-County were included. Stratified random sampling and simple random sampling methods was used to select participants. Statistical package for social sciences (SPSS) version 23 was used for the analysis of quantitative data. For qualitative data, content analysis was done for open- ended questions responses. Chi-square was used to test the association between the independent and dependent variables of the study. Bar graphs and pie charts were used to present information obtained. The association was deemed statistically significant when the p-value was less than 0.05 at 95% level of confidence. Of all the respondents (n=313), 42% reported the services to be friendly. More than half 65.5% (n 205) of all the respondents thought facilities had appropriate staff to provide adolescent and friendly health services (AFHS) whereas majority 98% of all the respondents reported to prefer staff of same sex and age to offer services to them since they could understand them easily. Media (radio, newspapers) and static advertisements significantly influenced AFHS p - values 0.017 and 0.004 respectively. Less than a half of those who reported friendly services mentioned being aware of services offered in other settings (43.2%(n=32) drop-in centers, 43.7%(n=44) community outreach and 39.2% (n=65) school health programs. Accessing facility by use of vehicle and walking on foot had significant influence on AFHS, p- values of 0.001 and 0.003 respectively. Involvement of other agencies in service review had a significant influence on the friendliness of services, p- value 0.003. The adolescent health services in Mombasa were concluded not friendly. More studies to be carried out on barriers to access. Policy makers and implementers in the health sector found these study findings useful in quality improvement of adolescent friendly health services.