Friendly Health Services Research Articles

Knowledge, attitude towards, and utilization of friendly health services among school adolescents in the pastoral community of Guji zone, Ethiopia: an institution-based comparative cross-sectional study.

Although sexual and reproductive health for adolescents is a recognized fundamental human right and a critical component of health policy, it is poorly addressed and seldom researched in pastoral communities. The study aimed to determine the status of sexual and reproductive health knowledge, attitudes, and practice among pastoral school adolescents in Ethiopia. An Institution-based comparative study was conducted from Nov. 2020 to Jan. 2021. We conducted a comparative cross-sectional study at four randomly selected high schools. Seven hundred seventy-three adolescent students participated, with 384 from Gorodola and 389 from Wadara districts, Guji zone Ethiopia. The data was collected using 34 self-administered questions and analyzed using descriptive, t-test, and linear regression models. The study found that only 44.2% of all the participants had good knowledge, 46.1% had good attitudes and 35.4% had good utilization of Sexual and Reproductive Health Services. Respondents from Wadara High School had significantly higher mean knowledge scores (49.3% vs. 44.2%, p < 0.01) than those of Gorodola High School. There was no significant difference in mean utilization scores between case and compare (45.08% vs. 37%, p > 0.01). Adolescents who were not communicated on SRH matters, previously utilized FHS, and visited Friendly Health facilities were associated with poor utilization of sexual and reproductive health services. Wadera High School adolescents have better Sexual and reproductive health knowledge and utilization than Gorodola high schools. Community public health care providers in Wadara District explain the outcome through their contributions. Within the context of inherent disadvantage in the school environment setting, there is a need to improve sexual and reproductive health education with a greater emphasis on school girls.

The Politics of Policy and Practices to Advance Adolescent and Youth Friendly Health Services in Nigerian States

The Politics of Policy and Practices to Advance Adolescent and Youth Friendly Health Services in Nigerian States

Utilization of adolescent-friendly health services and its determinants in a rural area of Maharashtra.

Adolescent phase is a very crucial period in one's life, much emotional and psychological support is needed for an adolescent to bloom into a responsible adult. But unfortunately adolescents do not get the support or they fail to seek support due to lack of awareness. Government of India, to address this issue has established dedicated adolescent friendly health services (AFHS). This study estimates the utilisation of adolescent friendly health clinics in a rural area of Maharashtra. Aim is to the study the utilisation of adolescent friendly health services and its various determinants in a rural area of Maharashtra. Objectives of this study were to assess the sociodemographic profile of study participants, to study the utilisation of adolescent friendly health services among them and to determine the factors associated with utilisation of adolescent friendly health services. A community based cross-sectional study was conducted among 290 late adolescents from a rural area of Maharashtra from October 2022 to December 2022. With the help of data from Gram panchayat about residing adolescents in the rural field practice area of tertiary care hospital, all late adolescents were included in this study after obtaining informed consent. Data was collected with and Statistical analysis was done using 'Open Epi Info' software. Out of 290 adolescents, 35% (102) were aware of adolescent friendly health clinics (AFHS), 20% (58) utilised AFHS, the significant sociodemographic components for utilisation were found to be females (AOR: 2.161,95% CI: 1.088-4.295), Bauddha religion (AOR: 2.465,95% CI: 0.585-10.383), socioeconomic class I and II- B.G Prasad classification (AOR: 1.544,95% CI: 0.786-3.030), higher secondary education (AOR: 8.025,95% CI: 1.434-44.916) and Government schooling (AOR:0.389,95% CI: 0.080-1.889). Though initiatives are taken from the Government to lend a helping hand to the adolescents, awareness and utilisation seems to be minimal.

Factors influencing the utilisation of Youth Friendly Health Services in Blantyre, Malawi.

Usage of Youth Friendly Health Services (YFHSs) remains unsatisfactory in sub-Saharan Africa despite global agreements on the utilisation of these services among the youths. The aim of the study was to identify factors that influence the utilisation of YFHSs in Blantyre, Malawi. Four health centres in Blantyre, Malawi. A descriptive quantitative research design using multistage sampling was used to randomly sample (N = 293) unmarried youths and collect data using a structured questionnaire. Data were analysed using a computerised statistical package for social sciences (SPSS) version 26. Chi-square (χ²) was used to test the significance of the association between variables, and the p-value (p < 0.05) was considered significant. Regression analysis was used to examine the influence of independent variables on the utilisation of the services. Less than half of the respondents have ever accessed YFHSs (43%). The Chi-square test showed that the following variables had a significant association with utilisation of the services (p < 0.05): gender, age, knowledge, signage, printed health education materials, provider attitudes and being shy or fear of being seen at the services. Age, knowledge, signpost, printed health education materials, provider attitudes and being shy or fear of being seen at the YFHSs are factors that influenced the utilisation of the services. Working on these factors would help to increase utilisation. The study findings will help to fill the gap in the provision of YFHSs and thus increase utilisation of the services.

Exploring challenges and improvement strategies of adolescent-friendly health services in the northwest region of Namibia: A qualitative descriptive study.

Despite global agreements on adolescents' sexual and reproductive health and rights, access to and the utilisation of these services by the adolescents remain underutilised in low and middle-income countries. The aim of the study was to explore challenges and improvement strategies of adolescent-friendly health services in the northwest of Namibia. This study employed a qualitative approach utilising an explorative strategy. Semi-structured interviews were used to collect the data. Fifteen nurses were selected using a convenience sampling technique. The interviews were audio recorded, transcribed verbatim and the data were analysed using thematic analysis. The data analysis led to the emergence of the following three themes: Challenges affecting the delivery of Adolescent Friendly Health Services, Challenges affecting participation of adolescent to AFHS and strategies to improve the provision of adolescent-friendly health services. Findings from this study revealed several barriers reportedly faced by adolescents in accessing AFHS as including a lack of comprehensive sexual reproductive health (SRH) services in many healthcare facilities, a lack of trained staff, unfavourable environments for adolescents, a lack of information about the services provided, and recruitment of providers who are not friendly to young people and adolescents. This study findings may lead to an improvement in the provision of such services in healthcare settings. The study can lead to an improvement in the provision of adolescent-friendly services in health care settings. It can help the Ministry of Health and Social Services, along with its agencies, to formulate strategies that can be used to mitigate the challenges d in the provision of adolescent-friendly services.

What's holding back youth-friendly health services in Blantyre, Malawi? A qualitative exploration.

The use of Youth Friendly Health Services remains sub-optimal in Sub-Saharan Africa despite global agreements on the same. The aim of this study was to explore barriers to utilization of Youth Friendly Health Services in Blantyre, Malawi. This was a qualitative study drawing on three focus group discussions of youths aged 10 to 24 (N=24) and individual interviews with Youth Friendly Health Service providers from four health facilities (N=6). Thematic analysis by Braun and Clark 2006 was used to analyse collected data. Seven themes emerged from the findings: frequent stockouts of medical supplies, lack of entertainment, sporting activities and supporting equipment, lack of dedicated space for Youth Friendly Health Services, lack of knowledge, financial constraints, misconceptions, and distance to the health facilities. Addressing these barriers would increase the utilization of Youth Friendly Health Services and, in turn, increase contraceptive uptake, hence reducing unintended pregnancies and their associated complications.

Utilization of adolescent friendly health services and its associated factors among higher secondary students in mid-western Himalayan mountainous district of Nepal.

Adolescent friendly health services (AFHS) are designed to make health services accommodate the unique needs of adolescents. AFHS are characterized by three basic characteristics (programmatic, health facilities and health service providers) that should be applied. However, limited is known about the use of AFHS in the context of Nepal. This study aimed to assess the extent of AFHS utilization and associated factors among higher secondary students in the Jumla district of Nepal. A cross-sectional quantitative study was conducted in October-November 2017. Data were collected from a random sample of 528 aged 16-19 years old using a self-administered survey in their classroom. Adjusted Odds Ratios (AOR) and a 95% confidence level were estimated to measure the strength of association between the outcome variable (utilization of AFHS) and independent variable using multivariable logistic regression. Knowledge related to AFHS, measured by a seven-item scale, was based on information about the availability of AFHS. More than two-thirds (67.05%) of adolescents had utilized AFHS at least once in the last twelve months before the survey. In multivariable logistic regression analysis, knowledge level [AOR = 14.796, 95%CI (5.326-41.099)], cost of services [AOR = 2.971, 95%CI (1.764-5.003)], satisfaction from services [AOR = 1.817, 95%CI (1.037-3.185)] and availability of waiting room [AOR = 1.897, 95%CI (1.096-3.283)] were significantly associated with the utilization of AFHS. The utilization of AFHS was less than the country's target of universal utilization in this study. Adolescents' knowledge level about AFHS was importantly associated with its utilization. Utilization increases with lower service costs, client satisfaction, and availability of waiting rooms in the health facility. The health planners should make efforts to create a conducive environment for the adolescent by training the AFHS providers, particularly those who work in government institutions, and strengthening the awareness creation strategies among adolescents to increase the utilization of the services.

A Vital Part of Creating a Safe and Healthy Society: Adolescent Friendly Health Services

A Vital Part of Creating a Safe and Healthy Society: Adolescent Friendly Health Services

A STUDY OF PATTERN OF MENSTRUAL PROBLEMS IN ADOLESCENT GIRLS IN A TERTIARY CARE HOSPITAL

Introduction: Many adolescent girls with menstrual disturbances never present to their family doctor or gynaecologist due to embarrassment about discussing menstruation and fear of disease.This may lead to delayed presentation.The objective of the current study was to evaluate the socio-demographic aspects of adolescent girls having menstrual problems as well as type of menstrual problems and its management.Materials and Methods:This retrospective study was carried out at the department of obstetrics and gynaecology of tertiary care teaching hospital from June2022 to Nov2022. Head Results: Total of 184 adolescent girls visited our hospital with menstrual problems. Amongst them 117(63.5%) belonged to the late adolescent group, 176(96.6%) were residing at urban areas, 93(50.54%) were from middle socio-economic class and 164(89.13%) were unmarried. Dysmenorrhoea, menstrual irregularities and amenorrhoea were present in 49(26.63%), 99(53.8%) and 23(12.5%) respectively. Patients were managed either medical and/or surgical management along with proper counselling. Conclusion: Majority of the adolescent girls in our study were anaemic.Hence,prevention and management of anaemia along with health education regarding normal physiology, various menstrual problems and importance of nutrition is necessary. In India attempts and success to develop adolescent friendly health services in public and private systems have met with partial success. Hence, counselling and management of menstrual problems in adolescents needs to be provided in existing health and medical care services.

Factors Associated With Utilization Of Adolescent-Friendly Health Services In Sunsari District Of Nepal

Objectives: Adolescent friendly health services are the tailored health services for adolescents in a friendly environment where adolescents can easily and comfortably access and enjoy sexual and reproductive health services. Utilization of such services helps to address sexual and reproductive health problems faced by adolescents and the status of adolescent sexual and reproductive health (SRH) in Nepal is alarming. However, limited studies have been conducted on utilization of Adolescent Friendly Health Services and its associated factors among school adolescents. Thus, this study was carried out to assess the factors associated with utilization of adolescent friendly health services in Sunsari district of Nepal. Methods: This study was a descriptive, cross-sectional study carried out among 502 secondary school adolescents of grade 9 and 10 studying either in public or private schools of Inaruwa Municipality Sunsari District, Nepal. Single stage cluster sampling was followed in this study. Data was collected through administration of pre-tested semi-structured questionnaire during the period of January to March, 2022. Results : Regarding socio-demographic characteristics, majority of the participants were female (56.2%) compared to male (43.8%). Mean age of the participants was 15 years with standard deviation of 1.359 years and most (92.8%) of them followed Hinduism. More than half of the participants (54.0%) belonged to Madhesi ethnicity and most (61.0%) of them were from nuclear family. Likewise, majority (90.6%) of the adolescents were unmarried whereas 5.6 % were in relationship. More than three-fourth of the participants (79.5%) were staying with their parents. Most participants (53.2%) reported having very close relationship with their family. Similarly, majority (70.9%) of the adolescents had not seen the logo of adolescent friendly health services but three fourth (75.5%) of them had heard about adolescent friendly health services. Only 38.5% of participants were known about the availability of adolescent friendly health institution in their locality and more than three fourth (79.9%) of participants said that the time required to reach health facility was less than 30 minutes. Less than one fourth (24.1%) of the participants had felt needs for sexual and reproductive health services. The utilization of adolescent friendly health services among adolescents was low i.e., 14.5% (CI: 0.115-0.176) and more than half (54.8%) of them had used counselling services. Regards of preference, 44.4% of the participants stated that they preferred private health facilities and most of them (79.3%) preferred the health facility nearby their residence. Conclusion: Based on the findings of the study, different intervention programs could be conducted to increase the awareness about adolescent friendly health services among adolescents which may increase its utilization.

Using Healthcare Complaints Analysis Tool to Evaluate Patient Complaints during the COVID-19 Pandemic at a Medical Center in Taiwan.

The purpose of this study is to evaluate patient complaints using the Healthcare Complaints Analysis Tool (HCAT) during the COVID-19 pandemic in 2021 in Taiwan. Additionally, the study examines the distribution and type of patient complaints before and during the COVID-19 pandemic to provide a better clinical procedure, hospital management and patient relationship. This study utilizes a cross-sectional design. We collected patient complaints from January 2021 to December 2021 at a medical center in Southern Taiwan. Using the Healthcare Complaints Analysis Tool (HCAT), the patient complaints are classified and coded into three major domains (clinical, management and relationship), and seven problem categories (quality, safety, environment, institutional process, respect and patient rights, listening and communication). We further compared and categorized the complaints based on whether they were COVID-19-related or not and whether it was before or during the COVID-19 pandemic to understand the differences in patient complaints. In total, we collected 584 events of patient complaints. Based on the HCAT domains, the complaints about management were the highest, at 52.9%, followed by complaints about relationship, about 37.7%. According to the types of problem, the complaints about the environment were the highest, about 32.5% (190/584), followed by communication at about 29.6% (173/584), and institutional process at about 20.4% (119/584). There were 178 COVID-19-related complaints and they were made more frequently during Q3 and Q4 (from mid-June to December) which was the pandemic period in 2021 in Taiwan. Among the COVID-19-related complaints, the most frequent were in the environment domain with 114 cases (about 65.7% of COVID-19-related complaints). The domains of patient complaints were statistically different between COVID-19-related and non-related (p < 0.001). During the COVID-19 pandemic, the proportion of COVID-19-related complaints increased 1.67 times (117/312 vs. 61/272, p < 0.001). Both prior to and during the COVID-19 pandemic, management-related complaints represented the highest domain. During the COVID-19 pandemic, the implementation of infectious disease prevention and control policies and actions may have developed some inconvenience and difficulty in seeking medical practice and process. These characteristics (complaints) are more prominent, and timely and patient-first consideration is required immediately to build up better clinical procedures, the healthcare environment and comprehensive communication. Using the HCAT can allow health centers or health practitioners to understand the needs and demands of patients through complaints, provide friendly medical and health services, avoid unequal information transmission, build trust in doctor−patient relationships and improve patients’ safety.

Experiences and Expectations of the Characteristics of Friendly Primary Health Services from the Perspective of Men: A Phenomenological Qualitative Study.

Inadequate men’s engagement with health services may be influenced by unmet needs and demands of the local men’s community. This study aimed to explore men’s experiences with primary health services and their expectations of the characteristics of friendly primary health services, from the perspective of men in Kelantan, Malaysia. A qualitative study using in-depth interviews was conducted with 15 men from six primary health facilities in Kelantan, Malaysia, who were selected based on maximum variation sampling. The data were transcribed and analyzed using the thematic analysis method. The study found that experiences with the existing primary health services were categorized into four subthemes: provision of health services, health promotion delivery, attributes of healthcare providers, and the physical environment of the health facilities. Meanwhile, the expectations of the characteristics of friendly primary health services were categorized into four subthemes: meeting the needs of men in primary health services, approaching men through effective health promotion strategies, standards of a healthcare provider from the viewpoint of men, and a comfortable physical environment for men. Prior experiences hugely influenced men’s expectations of friendly primary health services. Men want these health service characteristics customized to meet their needs, allowing them to use health services with confidence and comfort. Thus, to strengthen primary health services for men, it is essential to comprehend their prior experiences with and expectations of the services.

Factors Influence in Provision of Adolescent Friendly Health Services by Outreach Workers

Factors Influence in Provision of Adolescent Friendly Health Services by Outreach Workers

Indian Academy of Pediatrics Consensus Guidelines for Adolescent Friendly Health Services

JustificationAdolescent health is critical to the current and future well- being of the world. Pediatricians need country specific guidelines in accordance with international and national standards to establish comprehensive adolescent friendly health services in clinical practice.ProcessIndian Academy of Pediatrics (IAP) in association with Adolescent Health Academy formed a committee of subject experts in June, 2019 to formulate guidelines for adolescent friendly health services. After a review of current scientific literature and drafting guidelines on each topic, a national consultative meeting was organized on 16 August, 2019 for detailed discussions and deliberations. This was followed by discussions over e-mail and refining of draft recommendations. The final guidelines were approved by the IAP Executive Board in December, 2021.ObjectiveTo formulate guidelines to enable pediatricians to establish adolescent friendly health services.RecommendationsPediatricians should coordinate healthcare for adolescents and plan for transition of care to an adult physician by 18 years of age. Pediatricians should establish respectful, confidential and quality adolescent friendly health services for both out-patient and in-patient care. The healthcare facility should provide preventive, therapeutic, and health promoting services. Pediatricians should partner with the multidisciplinary speciality services, community, and adolescents to expand the scope and reach of adolescent friendly health services.Electronic Supplementary MaterialSupplementary material is available for this article at 10.1007/s13312-022-2539-9 and is accessible for authorized users.

Menstrual problems of adolescent girls attending urban tertiary care hospital: One-year study

Many adolescent girls with menstrual disturbances never present to their family doctor or gynaecologist due to embarrassment about discussing menstruation and fear of disease. This may lead to delayed presentation. The objective of the current study was to evaluate the socio-demographic aspects of adolescent girls having menstrual problems as well as type of menstrual problems and its management.This retrospective study was carried out at the department of obstetrics and gynaecology of tertiary care teaching hospital from July 2019 to July 2020. Total of 141 adolescent girls visited our hospital with menstrual problems. Amongst them 90(63.8%) belonged to the late adolescent group, 135(95.7%) were residing at urban areas, 70(49.6%) were from middle socio-economic class and 126(89.3%) were unmarried. Dysmenorrhoea, menstrual irregularities and amenorrhoea were present in 86(61%), 38(27%) and 17(12%) respectively. Patients were managed either medical and/or surgical management along with proper counselling. Majority of the adolescent girls in our study were anaemic. Hence, prevention and management of anaemia along with health education regarding normal physiology, various menstrual problems and importance of nutrition is necessary. In India attempts and success to develop adolescent friendly health services in public and private systems have met with partial success. Hence, counselling and management of menstrual problems in adolescents needs to be provided in existing health and medical care services.

A qualitative study of risks and protective factors against pregnancy among sexually-active adolescents in Soweto, South Africa.

Risky sexual behaviors contribute to increased risk of adolescent pregnancy. This qualitative study sought to understand risks and protective factors against pregnancy amongst sexually-active adolescents in Soweto, South Africa. We used purposive sampling to recruit women at age 24 years from Soweto, who self-reported having sexual debut by age 15 years. Twenty women were recruited: (i) women who did not become pregnant before 18 years (n = 10) and (ii) women who became pregnant before 18 years (n = 10). In-depth interviews were conducted to understand their family backgrounds, conversations about sex, sexual behaviors, and initiatives taken (or not) during adolescence to prevent pregnancy. Both groups of women reported predisposing risks to early pregnancy including influence from peers to engage in early sex, unstable family relationships and limited conversations about sex. We found that the family is a key institution in supporting adolescents' decisions regarding their behaviors and choices, as are peers and exposures to information. Community Youth Centers, high schools and Youth Friendly Health Services should ensure that adolescents have access to relevant information, including sex education and contraceptives.

Health Status and Barriers to Healthcare Access among "Son-in-Law Westerners": A Qualitative Case Study in the Northeast of Thailand.

The northeast of Thailand is well-known as a popular destination where many male Westerners marry Thai women and settle down there. However, little is known about their health and well-being. This study aims to explore the Western husbands’ health status and identify barriers hindering their healthcare access. A qualitative case study was conducted from November 2020 to May 2021. In-depth interviews and focus group discussions with 42 key informants who were involved with social and health issues among these expatriates were carried out. The social determinants framework was adapted for guiding the interviews. Data were triangulated with field notes, document reviews, and researchers’ observations. Inductive thematic analysis was applied. Results showed that most male expatriates who married Thai women in the northeast were in their retirement years and had non-communicable diseases, health risk behaviors, and mental health problems. Most of them did not purchase health insurance and held negative impressions toward Thai public hospitals’ quality of care, which was denoted as the main barrier to accessing healthcare services. Other significant barriers consisted of high treatment costs commonly charged by private hospitals and language issues. While the improvement of healthcare quality and the provision of friendly health services are important, public communication with foreign residents, especially male expatriates, is recommended to increase understanding and improve perceptions of the Thai healthcare systems. A regular population-based survey on the health and well-being of expatriates in Thailand, a cost study of a health insurance package, a survey study on willingness to pay for health insurance premiums, and a feasibility survey exploring the opportunity to establish either voluntary or compulsory health insurance among this group should be undertaken.

Perceived Barriers and Facilitators of Adolescent Friendly Reproductive Health Services in the World: A Qualitative Systematic Review Protocol

Background: Adolescents need services that improve their physiological, cognitive, emotional, and social alteration into adulthood. Since the adolescent health needs have been identified, the focus of service delivery has mainly been on access to sexual health care assistance, including HIV issues. Objectives: This systematic review aims to assess the perceived barriers and facilitators of adolescent friendly health services in the world because teens are a positive and energetic force for the present and future of a community. Methods: All qualitative studies from 2000 to 2019 have been considered in this review. The searched databases include Cochrane Central Register, MEDLINE, Google Scholar, Embase, ProQuest, Scopus, Web of Science, CINAHL, and the Ovid platform. The studies included those conducted on all gender and ethnic groups adolescents between 10 to19 years that received health services, as well as their families and health care providers. Selected studies will be critically appraised by two independent reviewers using the Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research. Qualitative data will be extracted from papers using the standardized data extraction tool from JBI SUMARI (System for the Unified Management, Assessment, and Review of Information) by two independent reviewers. Qualitative research findings will, where possible, be integrated using JBI SUMARI and the meta-aggregation approach, and the final synthesized findings will be graded according to the ConQual approach for establishing confidence in the output of qualitative research synthesis and illustrated in the summary of results. Conclusions: This systematic review addresses perceived barriers and facilitators of adolescent friendly health services in the world. Developing and extending young people’s demands is a concern for all societies. So the results of this study can help us to discover barriers and providers of adolescent friendly health services, and by removing barriers and strengthening facilitators, we will promote the possibility of adolescents accessing adolescent friendly health services.

The Implementation of Fardiyah Da'wah in Peer Counseling to Prevent Free Sex

This paper explains how to analyze teenagers’ life using a case study in Adolescent Friendly Health Services (AFHS) at Public Health (Puskesmas) Blora. The research data were obtained through observation, interviews with the client, peer counseling, doctor, and paramedics in Puskesmas. The result found some forms of teenager’s free sex in Adolescent Friendly Health Services (AFHS) at Puskesmas Blora. Those actions were holding hands, kissing hands, kissing lips, making out, and doing premarital sex. The prevention effort with the peer counseling had been conducted in two ways of methods that are personal approach with the client and couching with the material given to them. The analysis showed that the implementation of fardiyah da'wah in peer counseling was in line with stages of fardiyah da’wah proposed by Abdul Wahid, namely building good relationships with mad’u and giving motivation to mad’u.

Are rhetorical commitments to adolescents reflected in planning documents? An exploratory content analysis of adolescent sexual and reproductive health in Global Financing Facility country plans

BackgroundThe Global Financing Facility (GFF) offers an opportunity to close the financing gap that holds back gains in women, children’s and adolescent health. However, very little work exists examining GFF practice, particularly for adolescent health. As momentum builds for the GFF, we examine initial GFF planning documents to inform future national and multi-lateral efforts to advance adolescent sexual and reproductive health.MethodsWe undertook a content analysis of the first 11 GFF Investment Cases and Project Appraisal Documents available on the GFF website. The countries involved include Bangladesh, Cameroon, Democratic Republic of Congo, Ethiopia, Guatemala, Kenya, Liberia, Mozambique, Nigeria, Tanzania and Uganda.ResultsWhile several country documents signal understanding and investment in adolescents as a strategic area, this is not consistent across all countries, nor between Investment Cases and Project Appraisal Documents. In both types of documents commitments weaken as one moves from programming content to indicators to investment. Important contributions include how teenage pregnancy is a universal concern, how adolescent and youth friendly health services and school-based programs are supported in several country documents, how gender is noted as a key social determinant critical for mainstreaming across the health system, alongside the importance of multi-sectoral collaboration, and the acknowledgement of adolescent rights. Weaknesses include the lack of comprehensive analysis of adolescent health needs, inconsistent investments in adolescent friendly health services and school based programs, missed opportunities in not supporting multi-component and multi-level initiatives to change gender norms involving adolescent boys in addition to adolescent girls, and neglect of governance approaches to broker effective multi-sectoral collaboration, community engagement and adolescent involvement.ConclusionThere are important examples of how the GFF supports adolescents and their sexual and reproductive health. However, more can be done. While building on service delivery approaches more consistently, it must also fund initiatives that address the main social and systems drivers of adolescent health. This requires capacity building for the technical aspects of adolescent health, but also engaging politically to ensure that the right actors are convened to prioritize adolescent health in country plans and to ensure accountability in the GFF process itself.