Assessment of Operational Efficiency and Service Utilization of Adolescent Reproductive and Sexual Health Clinic in an Urban Health Center of Surat City

Abstract

Background and Objectives: “ Adolescent Reproductive and Sexual Health (ARSH) ” has been included in the existing public health system in Gujarat from 2006 for addressing issues of adolescents. This study was done to identify the operational gaps and service utilization of ARSH clinic in one of the urban health centers (UHC) in Surat city. Methodology: Mixed approach having in-depth interviews and observation and record-based analysis was done to assess operational efficiency of ARSH clinic. In-depth interviews were carried out among four service providers and secondary data of 157 adolescents were analyzed from the UHC records. The ARSH assessment check list was developed using national guidelines. Quantitative data analysis was done by MS excel 2007. Interviews were transcribed, translated and content analysis was done. The problem analysis was done using Fish-bone diagram and SWOC analysis. Action plan was prepared by developing the critical pathway method . Results: Only 1.9% beneficiaries were boys. Service utilization was done mainly for STI/ RTI counseling (96.83%), IFA tablets (59.23%) and Immunization (81.53%). Inadequacy of infrastructure, materials, human resources, referral linkages, monitoring and supervision was observed. SWOC analysis revealed that the staff was empathetic towards the needs of adolescents but lack of IEC was identified as a major challenge to prepare an action plan. Demand generation was identified as the critical pathway. Conclusion: Service utilization was comparatively very low among boys and only for few services even among girls. Demand generation in schools and community and strengthening of weaknesses in operational aspects of ARSH may improve service utilization.