Health facilities' readiness to provide friendly reproductive health services to young people aged 10-24 years in Wakiso district, Uganda.

Abstract

While adolescents aged 10-19 years make up to 23.3% of Uganda's population, health facilities offering adolescent sexual and reproductive health services are few and do not fully address young people's needs. There is a paucity of evidence on the extent to which Ugandan health facilities in rural and peri-urban settings offer these services. This study assessed the readiness of health facilities to provide friendly reproductive health services to young people in rural and peri-urban contexts in Uganda. The data for this paper come from a cross-sectional study that used quantitative and qualitative approaches to capture information. The study was conducted in 2012 in 32 health facilities in Wakiso district. It involved reviewing health facility records to assess client load for reproductive health services in the three months preceding data collection as well as key informant interviews with health managers and providers to identify gaps in service provision for young people. Quantitative data were entered into Epi-data and analysed using STATA10, while qualitative data were analysed using content analysis. Among the 32 facilities visited; 41% (13/32) young people had to walk a distance of more than 5kms to access them, only one health centre had a separate space for providing services for adolescent clients and all facilities visited lacked a waiting room exclusive for young people. On the other hand, only 29% (9/32) and 22% (7/32) of the health facilities reported sufficient supplies and equipment respectively that are necessary for providing services that meet the needs of young people. Deliveries within the facilities were very low representing just 23% (1843/7975) of the number of young people who sought antenatal care services. Moreover 19% (6/32) of the facilities were not routinely screening for STIs yet in facilities where screening was being done, individuals younger than 15 years were being diagnosed with STIs. In addition, most facilities 86% (27/32) provided restricted family planning services to young people. No facility reported providing services responding to gender based violence while most facilities indicated verbal referrals for these services. The findings of this paper suggest the need for training and equipping health care workers in order to improve the provision of reproductive health services to young people.