Adolescent Friendly Health Services in Level Two Facilities among Public Secondary School Students in Mombasa County, Kenya
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Date
2020
Authors
Amuko, Selpha Ongaya
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
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.
Description
A Research Project Submitted in Partial Fulfilment of
the Requirements for the Award of the Degree of Master
of Science in Public Health Systems Management And
Application in the School of Public Health and Applied
Human Sciences of Kenyatta University
Keywords
Adolescent Friendly Health Services, Public Secondary School Students, Mombasa County, Kenya