Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal

Autor: A Amatya, Sudip Ale Magar, Bhup Raj Dhakal, Rashmi Paudel, Barsha Thapa, Krishtee Napit, K B Shrestha
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Adolescent
Service delivery framework
Health
Toxicology and Mutagenesis
Sexual and reproductive health
Qualitative property
Adolescent-friendly services
Health Services Accessibility
Young Adult
03 medical and health sciences
0302 clinical medicine
Nepal
Surveys and Questionnaires
Environmental health
medicine
Humans
030212 general & internal medicine
lcsh:RC620-627
Qualitative Research
Reproductive health
Service (business)
business.industry
030503 health policy & services
Public health
lcsh:Public aspects of medicine
Public Health
Environmental and Occupational Health
lcsh:RA1-1270
Focus Groups
Patient Acceptance of Health Care
Service provider
Focus group
Utilization
lcsh:Nutritional diseases. Deficiency diseases
Cross-Sectional Studies
Bhaktapur
Adolescent Behavior
Adolescent Health Services
Female
Reproductive Health Services
Health Facilities
Thematic analysis
0305 other medical science
business
Psychology
Research Article
Food Science
Zdroj: Journal of Health, Population and Nutrition, Vol 39, Iss 1, Pp 1-9 (2020)
Journal of Health, Population, and Nutrition
ISSN: 2072-1315
Popis: Background The status of adolescent sexual and reproductive health (SRH) in Nepal is alarming. Adolescent-friendly services (AFS) were introduced to cater the health needs of adolescents. Optimal utilization of the services with wider accessibility is required to prevent adolescents from adopting life-threatening behaviors that result in poor SRH-related outcomes. Despite the upgrading of health facilities to adolescent-friendly sites, studies reveal low utilization of the service. However, these studies failed to explore the factors influencing the low levels of service utilization in these adolescent-friendly facilities. This study quantified the utilization of AFS and identified factors associated with its utilization among adolescents of Bhaktapur district. Methods A cross-sectional survey of 362 systematic randomly selected adolescents from four village development committees of Bhaktapur district was conducted, using a self-administered questionnaire. Relationships between utilization of AFS and associated factors were determined by multivariate logistic regression at a level of significance with a p value of less than 0.05 and adjusted odds ratio. Key informant interviews and focus group discussions with adolescents were used to collect qualitative data which were then described using thematic analysis. Result About a quarter (24.7%) of the respondents had utilized the adolescent-friendly services. Factors positively associated with the utilization of services included adolescents aged 15-19 years, female, heard about AFS, lack of fear of being seen while getting SRH services, lack of shyness about receiving SRH services, and the perceived need for SRH services as soon as illness became apparent. The qualitative findings revealed lack of awareness about the services, socio-cultural barriers, confidentiality, feasible service hours, and the preference for of same-sex service providers as the factors affecting utilization. Conclusion The utilization of adolescent-friendly services was very low in Bhaktapur district. Most of the adolescents were unaware of the existence of the AFS which emphasizes the need to focus on the increasing awareness of SRH and AFS by the government in coordination with local schools, clubs, etc. Creating an enabling environment in the service delivery sites, and ensuring privacy and confidentiality, as well as ensuring same-sex service providers and feasible service hours to adolescents, could increase the service utilization.
Databáze: OpenAIRE
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