Adolescent Sexual and Reproductive Health Care Service Availability and Delivery in Public Health Facilities of Plateau State Nigeria.

Esther Awazzi Envuladu,John de Wit,Karlijn Massar

doi:10.3390/ijerph18041369

Abstract

To assess the availability, accessibility, appropriateness and quality of adolescent sexual and reproductive health (ASRH) services in primary health care (PHC) facilities in Plateau State, Nigeria, a cross-sectional study was conducted in 230 PHC facilities across the three senatorial zones of Plateau state. Primary data were obtained through face-to-face interviews with heads of facilities from December 2018 to May 2019. An adapted questionnaire from the World Health Organization (WHO) was used, covering five domains, to ascertain the extent that ASRH services were available and provided. Very few PHC facilities in the state had space (1.3%) and equipment (12.2%) for ASRH services. The proportion of PHC facilities offering counselling on sexuality was 11.3%, counselling on safe sex was 17%, counselling on contraception was 11.3% and management of gender-based violence was 3%. Most facilities were not operating at convenient times for adolescents. Only 2.6% PHC facilities had posters targeted at ASRH and just 7% of the PHCs had staff trained on ASRH. These findings underscore that the majority of PHC facilities surveyed in Plateau State, Nigeria, lacked dedicated space, basic equipment, and essential sexual and reproductive health care services for ASRH, which in turn negatively affect general public health and specifically, maternal health indices in Nigeria. Structural changes, including implementation of policy and adequate additional training of healthcare workers, are necessary to effectively promote ASRH.

Highlights

Adolescents worldwide, including in sub-Saharan Africa, are known to engage in sexual behaviours that place them at risk of adverse sexual and reproductive health outcomes, such as condomless sex and multiple sexual partners [1]
The findings from this study show that the state did not met the criteria for adolescent friendly sexual and reproductive health (SRH) service as stated in the national policy
With regards to the availability of dedicated space and equipment for ASRH, the results shown in Table 2 highlight that very few primary health care (PHC) facilities in the state had a dedicated waiting area or consultation space for ASRH

Summary

Introduction

Adolescents worldwide, including in sub-Saharan Africa, are known to engage in sexual behaviours that place them at risk of adverse sexual and reproductive health outcomes, such as condomless sex and multiple sexual partners [1]. Despite a declining trend in HIV incidence globally, the HIV infection rate remains high among adolescents in sub-Saharan. Some studies have reported an HIV prevalence of 14–17%. In addition to increased risk of infection with HIV and other STIs, condomless sex is related to the high rates of teenage pregnancy that are reported in most sub-Saharan. A systematic review of evidence from 52 African countries reported an overall adolescent pregnancy rate of 18.8% in Africa and a pregnancy rate of. 19.3% in sub-Saharan African countries [9] This is similar to the pregnancy rate of 17%

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Results

Discussion

Conclusion