Abstract
BackgroundYouth-friendly health services are a key strategy for improving young people’s health. This is the first study investigating provision of the Youth Friendly Services programme in South Africa since the national Department of Health took over its management in 2006. In a rural area of South Africa, we aimed to describe the characteristics of the publicly-funded primary healthcare facilities, investigate the proportion of facilities that provided the Youth Friendly Services programme and examine healthcare workers’ perceived barriers to and facilitators of the provision of youth-friendly health services.MethodsSemi-structured interviews were conducted with nurses of all eight publicly-funded primary healthcare facilities in Agincourt sub-district, Mpumalanga Province, South Africa. Thematic analysis of interview transcripts was conducted and data saturation was reached.ResultsParticipants largely felt that the Youth Friendly Services programme was not implemented in their primary healthcare facilities, with the exception of one clinic. Barriers to provision reported by nurses were: lack of youth-friendly training among staff and lack of a dedicated space for young people. Four of the eight facilities did not appear to uphold the right of young people aged 12 years and older to access healthcare independently. Breaches in young people’s confidentiality to parents were reported.ConclusionsParticipants reported that provision of the Youth Friendly Services programme is limited in this sub-district, and below the Department of Health’s target that 70% of primary healthcare facilities should provide these services. Whilst a dedicated space for young people is unlikely to be feasible or necessary, all facilities have the potential to be youth-friendly in terms of staff attitudes and actions. Training and on-going support should be provided to facilitate this; the importance of such training is emphasised by staff. More than one member of staff per facility should be trained to allow for staff turnover. As one of a few countrywide, government-run youth-friendly clinic programmes in a low or middle-income country, these results may be of interest to programme managers and policy makers in such settings.
Highlights
Youth-friendly health services are a key strategy for improving young people’s health
Interview questions were pre-defined to address the aims of the study and covered the following topics at each health facility: the services available to young people, opening hours, confidentiality, perceived community support for the provision of health services to young people, provision of the Youth Friendly Services programme or other activities related to youth-friendly health services and reflections on providing health services to young people
Participants reported that provision of the Youth Friendly Services programme is limited in this sub-district, and below the Department of Health’s target that 70% of primary healthcare facilities should provide these services
Summary
Youth-friendly health services are a key strategy for improving young people’s health This is the first study investigating provision of the Youth Friendly Services programme in South Africa since the national Department of Health took over its management in 2006. Nine percent report having had sex before the age of 15 years, and early sexual debut is associated with increased risk of HIV infection, other STIs, adolescent pregnancy, forced sex, and an increased number of lifetime partners as well as with decreased use of condoms and other contraceptives [9,10,11,12,13,14,15,16,17,18,19]. Fear of judgmental attitudes of healthcare workers has been reported as a barrier to young people’s use of a range of health services in South Africa [21,22,23,24,25]
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