Adolescent health care and perceptions in a provincial hospital in Papua New Guinea.

Abstract

Adolescents make up an estimated 22 % of the 11.8 million population of Papua New Guinea (PNG), yet, as in many low and middle income countries, there are limited specific services for adolescents, who in traditional health service design fall between paediatric and adult patients. With more survivors of chronic illnesses, including tuberculosis and HIV, congenital and acquired heart disease, epilepsy and cerebral palsy, diabetes, cancer and other chronic conditions, there are gaps in the care of such young people, and in their eventual transition to adult services. Moreover, traditional health service design rarely addresses many adolescent health concerns- mental health, self-esteem, substance use, and adolescent-friendly sexual and reproductive health. This study, amongst a cohort cared for in a provincial hospital in Milne Bay Province, Papua New Guinea, aimed to explore the perceptions of adolescents on the health care they receive, and their views on their health priorities. A qualitative study was carried out from April to August 2022, amongst adolescents (persons aged 10-19 years) attending or admitted to Alotau Provincial Hospital. Data were collected via semi-structured wide-ranging interviews, and contextual data obtained from their medical charts. Thematic data analysis was done. Fifty-four adolescents were interviewed. Adolescents were generally content with the care they received, although many raised concerns regarding feeling out of place in a ward with older adults or infants, and staff attitudes towards them including not directly communicating. Forty four adolescents preferred an adolescent-friendly setting, as opposed to the adult or children's wards, stating that it would allow for positive peer-interaction, improve their experience in the hospital, and improve the quality of health care received. Many adolescents with chronic illnesses had concerns regarding loneliness and isolation, and uncertainty of their future. Pregnant adolescents highlighted the lack of education on sexual and reproductive health, and experiences of gender-based violence. This study shows that adolescents can perceive the need for adolescent-friendly health services and advocate for improvement in the quality of health care they receive, and the breadth of adolescent health care concerns.