Assessment of Structural and Process Factors in Delivering Quality Adolescent Sexual and Reproductive Health Services in Ghana

Overview

Journal Glob J Qual Saf Healthc

Date 2024 Feb 26

PMID 38406655

Authors

Augustine Kumah

Lawrencia Antoinette Aidoo

Vera Edem Amesawu

Abdul-Razak Issah

Hillary Selassi Nutakor

Affiliations

Soon will be listed here.

Abstract

Introduction: Sexual and reproductive health services are often underserved to adolescents in many societies. For many of these sexually active adolescents, reproductive health services such as the provision of contraception and treatment for sexually transmitted infections, either are not available or are provided in a way that makes adolescents feel unwelcome and embarrassed. This study assessed the structural and process factors available in delivering quality adolescent sexual and reproductive health (ASRH) services in health facilities across three regions in Ghana.

Methods: A facility-based descriptive cross-sectional study assessed the structural and process factors available for delivering quality adolescent sexual reproductive health services in 158 selected health facilities across three regions (Oti, Eastern, and Volta) of Ghana. A simple random sampling by balloting was used to select the health facilities and a total of 158 adolescents who used ASRH services in the selected facilities were sampled for an existing interview. The Donabedian model of quality assessment was adopted and modified into an assessment tool and a questionnaire to assess the selected health facilities and respondents. The Statistical Package for the Social Sciences (SPSS) version 20.0 was used to analyze the data collected and the findings presented in the tables.

Results: The study found some structural and process barriers that affected the delivery of quality ASRH services in Ghana. A proportion of 85 (53.50%) of the facilities assessed did not have separate spaces for delivering services for adolescents. All 158 health facilities had the National Health Insurance Scheme (NHIS) covering contraceptive/family planning services for adolescents. Most (128, 81.01%) facilities had available educational materials on ASRH but were not made available for take home by adolescents. The findings indicated that most respondents did not require parental, spouse, or guardian consent before using ASRH services. The average waiting time for adolescents to be attended to by service providers was ≤30 minutes.

Conclusions: The study found some structural and process barriers that affected the delivery of quality ASRH services in Ghana. ASRH services, particularly contraceptive/family planning services, were well integrated into NHIS to improve access and utilization by adolescents.

Citing Articles

Utilisation of Reproductive Health Services among Adolescents in Ghana: Analysis of the 2007 and 2017 Ghana Maternal Health Surveys.

Ehiawey J, Manu A, Modey E, Ogum D, Atuhaire E, Torpey K Int J Environ Res Public Health. 2024; 21(5).

PMID: 38791741 PMC: 11121036. DOI: 10.3390/ijerph21050526.

References

Bankole A, Biddlecom A, Guiella G, Singh S, Zulu E . Sexual behavior, knowledge and information sources of very young adolescents in four sub-Saharan African countries. Afr J Reprod Health. 2008; 11(3):28-43. PMC: 2367131. View

Campbell S, Roland M, Buetow S . Defining quality of care. Soc Sci Med. 2000; 51(11):1611-25. DOI: 10.1016/s0277-9536(00)00057-5. View

Onukwugha F, Hayter M, Magadi M . Views of Service Providers and Adolescents on Use of Sexual and Reproductive Health Services by Adolescents: A Systematic Review. Afr J Reprod Health. 2019; 23(2):134-147. DOI: 10.29063/ajrh2019/v23i2.13. View

Kleinert S, Horton R . Urban design: an important future force for health and wellbeing. Lancet. 2016; 388(10062):2848-2850. DOI: 10.1016/S0140-6736(16)31578-1. View

Renju J, Andrew B, Nyalali K, Kishamawe C, Kato C, Changalucha J . A process evaluation of the scale up of a youth-friendly health services initiative in northern Tanzania. J Int AIDS Soc. 2010; 13:32. PMC: 2944311. DOI: 10.1186/1758-2652-13-32. View

Nair M, Baltag V, Bose K, Boschi-Pinto C, Lambrechts T, Mathai M . Improving the Quality of Health Care Services for Adolescents, Globally: A Standards-Driven Approach. J Adolesc Health. 2015; 57(3):288-98. PMC: 4540599. DOI: 10.1016/j.jadohealth.2015.05.011. View

Mulaudzi M, Dlamini B, Coetzee J, Sikkema K, Gray G, Dietrich J . Perceptions of counsellors and youth-serving professionals about sexual and reproductive health services for adolescents in Soweto, South Africa. Reprod Health. 2018; 15(1):21. PMC: 5801675. DOI: 10.1186/s12978-018-0455-1. View

Ayehu A, Kassaw T, Hailu G . Young people's parental discussion about sexual and reproductive health issues and its associated factors in Awabel woreda, Northwest Ethiopia. Reprod Health. 2016; 13:19. PMC: 4782353. DOI: 10.1186/s12978-016-0143-y. View

Geary R, Gomez-Olive F, Kahn K, Tollman S, Norris S . Barriers to and facilitators of the provision of a youth-friendly health services programme in rural South Africa. BMC Health Serv Res. 2014; 14:259. PMC: 4067688. DOI: 10.1186/1472-6963-14-259. View

10.

Self A, Chipokosa S, Misomali A, Aung T, Harvey S, Chimchere M . Youth accessing reproductive health services in Malawi: drivers, barriers, and suggestions from the perspectives of youth and parents. Reprod Health. 2018; 15(1):108. PMC: 6008927. DOI: 10.1186/s12978-018-0549-9. View

11.

Rukundo G, Abaasa C, Natukunda P, Ashabahebwa B, Allain D . Antenatal services for pregnant teenagers in Mbarara Municipality, Southwestern Uganda: health workers and community leaders' views. BMC Pregnancy Childbirth. 2015; 15:351. PMC: 4688948. DOI: 10.1186/s12884-015-0772-0. View

12.

Atuyambe L, Kibira S, Bukenya J, Muhumuza C, Apolot R, Mulogo E . Understanding sexual and reproductive health needs of adolescents: evidence from a formative evaluation in Wakiso district, Uganda. Reprod Health. 2015; 12:35. PMC: 4416389. DOI: 10.1186/s12978-015-0026-7. View

13.

Budisavljevic S, Arnarsson A, Hamrik Z, Roberts C, Godeau E, Molcho M . Improving Adolescent Health: Translating Health Behaviour in School-aged Children Evidence Into Policy. J Adolesc Health. 2020; 66(6S):S9-S11. DOI: 10.1016/j.jadohealth.2020.03.010. View

14.

Dida N, Darega B, Takele A . Reproductive health services utilization and its associated factors among Madawalabu University students, Southeast Ethiopia: cross-sectional study. BMC Res Notes. 2015; 8:8. PMC: 4304627. DOI: 10.1186/s13104-015-0975-5. View

15.

Wakjira D, Habedi D . Barriers to access and utilisation of sexual and reproductive health services among adolescents in Ethiopia: a sequential mixed-methods study. BMJ Open. 2022; 12(11):e063294. PMC: 9670917. DOI: 10.1136/bmjopen-2022-063294. View

16.

Motuma A, Syre T, Egata G, Kenay A . Utilization of youth friendly services and associated factors among youth in Harar town, east Ethiopia: a mixed method study. BMC Health Serv Res. 2016; 16:272. PMC: 4947516. DOI: 10.1186/s12913-016-1513-4. View

17.

Blumenthal D . Part 1: Quality of care--what is it?. N Engl J Med. 1996; 335(12):891-4. DOI: 10.1056/NEJM199609193351213. View

18.

Mulugeta B, Girma M, Kejela G, Meskel F, Andarge E, Zerihun E . Assessment of Youth-Friendly Service Quality and Associated Factors at Public Health Facilities in Southern Ethiopia: A Facility-Based Cross-Sectional Study. Biomed Res Int. 2019; 2019:9696278. PMC: 6556297. DOI: 10.1155/2019/9696278. View

19.

Pustil R . Global AIDS. AIDS. 2004; 17 Suppl 4:S3-11. View

20.

Chidwick H, Baumann A, Ogba P, Banfield L, DiLiberto D . Exploring adolescent engagement in sexual and reproductive health research in Kenya, Rwanda, Tanzania, and Uganda: A scoping review. PLOS Glob Public Health. 2023; 2(10):e0000208. PMC: 10022240. DOI: 10.1371/journal.pgph.0000208. View