Abstract
ABSTRACTOBJECTIVETo assess the quality of adolescent friendly health services.METHODSQualitative assessment using the simulated user technique in first level clinics of Health Services of Morelos, Mexico, during 2018. Ten out of 17 facilities with non-exclusive adolescent friendly services were randomly selected. An additional facility with exclusive adolescent friendly services was included as an intensive subsample. Four adolescents served as simulated users interpreting different cases in the clinics. The total of 43 semi-structured exit interviews were conducted, and two nominal groups were made to assess the perceived quality from the adolescents’ perception of friendliness and experience. Thematic analysis of the data obtained was performed.RESULTSStaff attitude was highlighted as a key element in the adolescents’ experience. Failures were found, such as the existence of bureaucratic barriers to access, lack of signage in clinics, lack of privacy and confidentiality, failure of physical examination during the appointment and lack of monitoring of the reasons for appointment. The exclusive clinic for adolescents offered more appropriate friendly services compared with nonexclusive clinics.CONCLUSIONAlthough the service is accessible in most of the clinics visited, it is still far from being friendly according to international recommendations. The exclusive clinic for adolescents stood out for having better structured mechanisms that can be implemented in nonexclusive clinics to improve the care process.
Highlights
Adolescents face problems such as pregnancy, early sexual activity, lack of knowledge and use of contraceptive methods, as well as an increased incidence of sexually transmitted infections (STI) that affect their well-being[1]
CONCLUSION: the service is accessible in most of the clinics visited, it is still far from being friendly according to international recommendations
The total of 43 exit semi-structured exit interview (SSI) were collected, the results found are presented in the five dimensions analyzed, the central findings with theoretical saturation and the exceptional or deviant ones are pointed out
Summary
Adolescents face problems such as pregnancy, early sexual activity, lack of knowledge and use of contraceptive methods, as well as an increased incidence of sexually transmitted infections (STI) that affect their well-being[1]. Adolescent pregnancy is associated with school dropout, few job opportunities, early marriage, predisposition to poverty and can place young people in situations of insecurity and abuse. These conditions limit their personal, occupational and social development[4]. The problem of adolescent reproductive health affects both women and men in this age group, the consequences of adolescent pregnancy and the experience of the phenomenon itself are differentiated according to genre. Maternity has a disproportionate and very negative impact on adolescent women, which is directly related to gender inequalities and socio-cultural factors[5]
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