Primary healthcare and school health service utilisation by adolescents and young adults in KwaZulu-Natal, South Africa

Aoife M Doyle,Lerato Mchunu,Jane Ferguson,Siphephelo Dlamini,Sandile Mthembu,Janet Seeley,Olivier Koole,Nothando Ngwenya

doi:10.1186/s12913-019-4559-2

Abstract

BackgroundYoung people aged 10–24 years are a vulnerable group with poor health service access relative to other populations. Recent South African initiatives, the She Conquers campaign, the Integrated School Health Policy and the Adolescent & Youth Health Policy, include a focus on improving the breadth and quality of youth-friendly health service delivery. However, in some settings the provision and impact of scaled-up youth friendly health services has been limited indicating a gap between policy and implementation. In this study we reviewed existing sources of data on health service utilisation to answer the following question: ‘What health conditions do young people present with and what services do they receive at public health clinics, mobile clinics and school health services?’MethodsWe conducted a retrospective register review in three purposively selected primary healthcare clinics (PHCC), one mobile clinic, and one school health team in Hlabisa and Mtubatuba sub-districts of uMkhanyakude District, KwaZulu-Natal, South Africa. The focus was service utilisation for any reason by 10–24 year olds. We also conducted descriptive analysis of pre-existing data on service utilisation by young people available from the District Health Information System for all 17 PHCC in the study sub-districts.ResultsThree quarters of 4121 recorded young person visits in the register review were by females, and 40% of all young person visits were by females aged 20–24 years. The most common presenting conditions were HIV-related, antenatal care, family planning, general non-specific complaints and respiratory problems (excluding TB). There were relatively few recorded consultations for other common conditions affecting young people such as mental health and nutritional problems. Antibiotics, antiretrovirals, contraceptives, vitamins/supplements, and analgesics were most commonly provided. Routine health registers recorded limited information, were often incomplete and/or inconsistent, and age was not routinely recorded.ConclusionsMeasuring morbidity and service provision are fundamental to informing policy and promoting responsive health systems. Efforts should be intensified to improve the quality and completeness of health registers, with attention to the documentation of important, and currently poorly documented, young people’s health issues such as mental health and nutrition.

Highlights

Young people aged 10–24 years are a vulnerable group with poor health service access relative to other populations
We sought to answer the question ‘What health conditions do Young People (YP) present with and what services do they receive at public health clinics, mobile clinics and school health services?’
Quantitative data collection and analysis was made-up of two parts: Retrospective register review We reviewed paper registers in three purposively selected primary healthcare clinics (PHCC), one mobile clinic, and one school health team in Hlabisa and Mtubatuba sub-districts of uMkhanyakude to assess clinic attendance for any reason by males and females aged 10–24 years

Summary

Introduction

Young people aged 10–24 years are a vulnerable group with poor health service access relative to other populations. Young People (YP) aged 10–24 years have relatively poor access to health services. The focus of health services for YP in sub-Saharan Africa has been on sexual and reproductive health services including HIV testing, care and treatment. These remain important, but mental health, trauma-care related to violence/accidents, advice and early intervention for alcohol and substance use, and nutrition are important health issues for YP and have historically largely been ignored [2]

Methods

Results

Conclusion