Adolescent Services Research Articles

Measuring and Comparing Service Delivery Time in Government and Outsourced Health Posts Affiliated with Tehran University of Medical Sciences

Background: The duration of healthcare services has a significant impact on the quality of care and patient's satisfaction. Having information on service delivery time in both government and outsourced Health Posts (HPs) can contribute to evidence-based policymaking and better resource management. Therefore, this study aims to estimate and compare service delivery time in government and outsourced HPs. Methods: This descriptive-analytical cross-sectional study was conducted in six affiliated HPs under Tehran University of Medical Sciences in 2019–2020. Data were collected through a census using a stopwatch and a time recording form during one working week. The average duration of each service (in minutes) was obtained. The results were reported using descriptive statistics and were analyzed using SPSS24 software and multivariate analysis of variance (ANOVA). Results: The total mean of duration of services provided in government HPs (777.6 minutes) was greater than that in outsourced HPs (788.5 minutes). Among the 10 services provided, the average duration of services for adolescents (20.4±4.5 minutes), young adults (20.5±5.6 minutes), middle-aged adults (26.1±10.4 minutes), and elderly individuals (24.3±13.6 minutes) in government HPs was significantly longer than in outsourced HPs (p<0.05). Additionally, the average duration of health education services (23.1±10.5 minutes) and health ambassador training (36.1±13.7 minutes) in private HPs was significantly longer than in government HPs (p<0.05). Conclusion: In outsourced HPs, it is important to focus on creating a balance between the number of visits and the staff available for services which target adolescents, young adults, middle-aged adults, and elderly individuals. In government HPs, emphasis should be placed on increasing the time allocated for educational and promotional health services. By considering the importance of service delivery time and the observed differences in findings of this study, it is crucial to prioritize the duration of service delivery as an important performance measure when comparing government and outsourced HPs.

Reimagining care: effectiveness of modifying an adolescent eating disorder intensive service.

The COVID-19 pandemic prompted a surge in adolescent eating disorders and rapid changes in the delivery of intensive community treatments. This study investigates the modification from a group-based day programme to an intensive family treatment approach. A retrospective chart review was performed on data from 190 patients who accessed the intensive service for anorexia nervosa in the past 6 years. Outcomes from the traditional model were compared with the new intensive family model, namely length of admission, percentage median body mass index difference and transfers to in-patient services. There was a significant reduction in the length of intensive treatment (from 143.19 to 97.20 days). The number of transfers to specialist eating disorder in-patient services also significantly reduced, and is decreasing year on year. The findings hold particular relevance as intensive services for adolescent eating disorders continue to be established within health services, with no clear unified approach to treatment.

Assessing the Access and Affordability of Mental Healthcare Services for Adolescents in the United States

Adolescent mental health is a worsening crisis in the United States. Adding to the problem is the ability of parents and caregivers to find timely and affordable mental healthcare services for this population, one that is vulnerable to suicide, substance abuse and other devastating outcomes due to mental health issues. This research project evaluates the access and affordability of outpatient mental healthcare services for adolescents in the U.S., as well as possible causes and solutions for identified mental healthcare delivery issues. An anonymous survey developed by the author was distributed and completed specifically by parents and caregivers in the U.S., who have sought mental healthcare services for adolescents between 10-19 years of age. Survey results indicate that there are indeed problems within the insurance and medical professional industry with regard to parity between timely and affordable access to mental healthcare services compared to services for physical medical healthcare for adolescents. This causes additional stress for parents and caregivers seeking critical help for their children, while the child’s mental health status declines during this time. One could argue that ethically, access to mental healthcare should not be any more difficult or costly to families than access to physical medical healthcare.

Humanist education: a case study on educational services for children and adolescents in situations of social vulnerability

Considering the challenges found today in society, especially in the area of Education, this work seeks to reflect on the propositions of Humanist Education, which considers the person in a continuous process of discovering his own Being, connecting with other people and groups, aiming at self-realization, as well as valuing the full use of their potential and capacities, in which feelings and experiences play an important role as a growth factor. Thus, the phenomenological research at Mansão do Caminho aimed to find out how Humanist Education is put into practice. The research allowed the knowledge of the didactic-pedagogical fundamentals of Mansão do Caminho in Salvador (BA) in the educational service for children and adolescents in socially vulnerable situations, focusing on pedagogical practices that aim to educate for the appropriation of humanist values. As the main objective of Mansão do Caminho, the Institution not only exercises the function of teaching and social assistance, but seeks to educate and promote the Human Being in an integral way.

The magnitude of stunting and its determinants among late adolescent girls in East Africa: Multilevel binary logistics regression analysis.

Stunting poses a significant health risk to adolescent girls aged 15-19 in low- and middle-income countries, leading to lower education levels, reduced productivity, increased disease vulnerability, and intergenerational malnutrition. Despite the inclusion of adolescent nutrition services in the Sustainable Development Goals, little progress has been made in addressing malnutrition among adolescent girls in several African nations. Limited evidence exists in East Africa due to small sample sizes and methodological limitations. To overcome these constraints, this study utilizes the latest Demographic and Health Survey data to estimate the prevalence and factors influencing stunting among late adolescent girls in ten East African countries. This study utilized the most recent Demographic and Health Survey (DHS) data from 10 East African countries, including a total sample weight of 22,504 late-adolescent girls. A multilevel mixed-effect binary logistic regression model with cluster-level random effects was employed to identify factors associated with stunting among these girls. The odds ratio, along with the 95% confidence interval, was calculated to determine individual and community-level factors related to stunting. A p-value less than 0.05 was considered statistically significant in determining the factors influencing stunting among late-adolescent girls. The prevalence of stunting among late adolescent girls in East Africa was found to be 13.90% (95% CI: 0.13-0.14). Religion, relationship to the head, presence of under-five children in the household, lactating adolescent, marital status, Time to get water source, and country of residence were significantly associated with Stunting. This study highlights the complexity of stunting in East Africa and identifies key factors that need attention to reduce its prevalence. Interventions should focus on improving water access, supporting lactating girls, addressing socioeconomic disparities, promoting optimal care practices, and implementing country-specific interventions to combat stunting and improve adolescent girls' nutrition.

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.

Enablers and barriers to primary health care access for Indigenous adolescents: a systematic review and meta-aggregation of studies across Australia, Canada, New Zealand, and USA

BackgroundIndigenous adolescents access primary health care services at lower rates, despite their greater health needs and experience of disadvantage. This systematic review identifies the enablers and barriers to primary health care access for Indigenous adolescents to inform service and policy improvements.MethodsWe systematically searched databases for publications reporting enablers or barriers to primary health care access for Indigenous adolescents from the perspective of adolescents, their parents and health care providers, and included studies focused on Indigenous adolescents aged 10–24 years from Australia, Canada, New Zealand, and United States of America. Results were analyzed against the WHO Global standards for quality health-care services for adolescents. An additional ninth standard was added which focused on cultural safety.ResultsA total of 41 studies were included. More barriers were identified than enablers, and against the WHO Global standards most enablers and barriers related to supply factors – providers’ competencies, appropriate package of services, and cultural safety. Providers who built trust, respect, and relationships; appropriate package of service; and culturally safe environments and care were enablers to care reported by adolescents, and health care providers and parents. Embarrassment, shame, or fear; a lack of culturally appropriate services; and privacy and confidentiality were common barriers identified by both adolescent and health care providers and parents. Cultural safety was identified as a key issue among Indigenous adolescents. Enablers and barriers related to cultural safety included culturally appropriate services, culturally safe environment and care, traditional and cultural practices, cultural protocols, Indigenous health care providers, cultural training for health care providers, and colonization, intergenerational trauma, and racism. Nine recommendations were identified which aim to address the enablers and barriers associated with primary health care access for Indigenous adolescents.ConclusionThis review provides important evidence to inform how services, organizations and governments can create accessible primary health care services that specifically meet the needs of Indigenous adolescents. We identify nine recommendations for improving the accessibility of primary health care services for Indigenous adolescents.

2023 clinical practice guidelines on autism spectrum disorder in children and adolescents in Singapore.

Autism is a neurodevelopmental condition that is increasing in prevalence worldwide. There has been an exponential increase in autism-related research since 2010, when the first Singapore Clinical Practice Guidelines (CPG) on autism was published. Understanding of autism has since evolved to adopt a lifespan approach beyond that of a childhood condition. The aim of this CPG was to provide an updated set of recommendations for children and adolescents to aid clinical practice for professionals. A multidisciplinary workgroup that comprised representatives from various sectors worked on this CPG. Clinical questions were organised into 10 different sections, each with its own subgroup of members. Seventeen existing international guidelines were evaluated using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE-II) framework, of which 4 met criteria to act as references. Literature review across multiple databases was conducted between January 2011 to 2023; Grading of Recommendations, Assessment, Development and Evaluation (GRADE-like) methodology was used to synthesise evidence. Recommendation statements were derived, following Delphi-style consensus surveys among the workgroup. The draft guidelines underwent external review and public consultation before being formalised. Recommendation and good practice statements pertaining to care of children and adolescents on the autism spectrum across 10 different sections were developed. Evidence matrices complement these recommendations and detail relevant evidence behind each recommendation statement. It is intended for these guidelines to promote effective management and healthcare services for children and adolescents on the autism spectrum, by reinforcing good and evidence-based clinical practice within our national context.

Factors Associated with Teenage Pregnancy in Mutasa District, Zimbabwe

Teenage pregnancies are a global problem mainly in marginalised communities resulting in complications, societal rejection and deaths. In Zimbabwe, 48% of the teenage pregnancies occurred between 13-19 years. Mutasa District, one of the Districts in Zimbabwe has high rate of teenage pregnancies. Teenage abortions rose from 3/1000 in 2018 to 5/1000 in 2019. We conducted a study on the factors associated with teenage pregnancies in Mutasa District in the year 2018 and 2019. The specific objectives were to determine the prevalence of teenage pregnancies, to determine the sociocultural, economic and religious factors influencing teenage pregnancies and to assess the availability and utilisation of Adolescent Sexual and Reproductive Health Services. A multi-methods+ study design was used with a sample size of 80 cases and 80 controls from four hospitals in Mutasa. Systematic sampling was employed where every <i>3<sup>rd</sup> </i>subject was systematically selected upon satisfaction of the inclusion criteria, with sampling interval observed. A quantitative survey and Focus Group Discussions (FGDs) were used to collect data. The results showed that 72 (90%) of the cases only had primary school education. Being single orphans 60 (75%), having information and education gaps 77 (96.3%), being chased off home to go to the male partner 49 (61.3%) were the prevalent factors linked to teenage pregnancies. Having been disciplined when found with contraceptives led to 41 (51.3%) of the pregnancies. Having the boyfriend as a source of livelihood allowances contributed to 59 (73.8%) of teenage pregnancies while being a member of an Apostolic Sect contributed 65 (82.3%) of the cases. The FGDs revealed that the Youth Friendly Centres were inadequate for the community, poorly resourced having no comprehensive preventive services and therefore poorly utilised. In addition, teenage pregnancy preventions were stereotyped to females only with current interventions being predominantly reactionary than preventive. The findings of this study suggest the need for reproductive health information, gender inclusive programming, and provision of a sundry of well-resourced Youth Friendly Centres in the District and a focus on tailor-made preventive interventions rather than punitive ones.

Data-Informed Communication: How Measurement-Based Care Can Optimize Child Psychotherapy.

Measurement-based care (MBC) research and practice, including clinical workflows and systems to support MBC, are grounded in adult-serving mental health systems. MBC research evidence is building in child and adolescent services, but MBC practice is inherently more complex due to identified client age, the family system and the need to involve multiple reporters. This paper seeks to address a gap in the literature by providing practical guidance for youth-serving clinicians implementing MBC with children and their families. We focus on MBC as a data-informed, client-centered communication process, and present three key strategies to enhance usual care child and adolescent psychotherapy via developmentally-appropriate MBC. These strategies include (1) go beyond standardized measures; (2) lean into discrepancies; and (3) get curious together. Case-based examples drawn from various child-serving settings illustrate these key strategies of MBC in child psychotherapy.

Managing major depressive disorder in adolescents in primary care.

Major depressive disorder (MDD) remains a significant risk to adolescent health and well-being, recently amplified by the COVID-19 pandemic. Access to adolescent mental health care services remains challenging in many areas, resulting in many adolescents diagnosed with MDD remaining untreated. Primary care providers are becoming increasingly crucial in promptly diagnosing and treating this concern. Various clinical guidelines can support clinicians in developing strategies for screening, diagnosing, and managing a vulnerable population with MDD. Standardized screenings, algorithms, and treatment guidelines can help improve the quality of life and functional impairment of those with MDD.

Key informant perspectives on delivering adolescent pregnancy-related services in Eastern Visayas

Key informant perspectives on delivering adolescent pregnancy-related services in Eastern Visayas

P095 Association between autism and chronic musculoskeletal pain; a single tertiary adolescent rheumatology centre experience

Abstract Background/Aims Autism is a common neurodevelopmental disorder and can present with atypical sensorimotor function and altered pain response. Evidence suggests that patients with autism have a different processing mechanism which can alter pain perception. Pain evaluation and management is often insufficient in patients with autism. Chronic musculoskeletal pain in adolescents is common and is frequently associated with other co-morbidities. The adolescent musculoskeletal pain service at University College London Hospital uses a multidisciplinary approach to provide treatment and ongoing support for young people with chronic musculoskeletal pain up to the age of 19 years, bridging significant and often stressful life events such as exams and moving away from home. Methods A retrospective review of patient records was conducted between October 2021 and October 2023. New patients attending the adolescent chronic musculoskeletal pain clinic at University College London Hospital were identified and the prevalence of autism was noted. The presence of other co-morbidities and symptoms was also recorded. Statistical analysis was undertaken using GraphPad Prism (Fisher’s exact test) to determine any differences between patients with and without a diagnosis of autism. Results Retrospective data was obtained on 82 new patients aged between 13 and 18 years seen in the adolescent chronic musculoskeletal pain clinic. 28 patients (34%) had a diagnosis of autism. A higher proportion of autistic patients with chronic musculoskeletal pain were male compared to those without autism (36% vs 11%, p = 0.016). More patients with autism reported co-existing mental health difficulties, especially anxiety and depression (68% vs 37%, p = 0.011). Conversely, patients without autism reported a higher incidence of postural orthostatic tachycardia symptoms (POTS) or symptoms of postural dizziness (57% vs 25%, p = 0.009). Other co-morbidities and symptoms were found to be similar between patients with and without autism (headaches 18% vs 39%, abdominal pain 36% vs 54%, fatigue 61% vs 46%, sleep difficulties 68% vs 54%, attention deficit hyperactivity disorder 18% vs 9%). Conclusion This small retrospective study demonstrates that over a third of new patients seen in the adolescent chronic musculoskeletal pain service are autistic. This suggests a possible link between autism and chronic pain but more research is needed to evaluate this and larger studies are required. Patients with chronic musculoskeletal pain and autism were more likely to be male and have mental health difficulties compared to those without autism. The high incidence of mental health difficulties highlights the need for multidisciplinary team working, in particular psychological support. The results of this study have important implications for training and suggest that novel treatment strategies are needed to help advance therapies for chronic musculoskeletal pain in young people with autism. Disclosure E. Williams: None. S. Mavrommatis: None. J. Glanville: None. M. Leandro: None. D. Sen: None. C. Fisher: None.

E049 Including psychosocial approaches in paediatric and adolescent rheumatology: a service evaluation of an online art therapy group intervention for children, young people, and families

Abstract Background/Aims Children and young people with long-term physical conditions may develop mental health problems that have an impact upon their daily lives and families. Rates of anxiety and depression in children with juvenile idiopathic arthritis are higher than in peers without this diagnosis. The impact of long-term conditions on children and young people’s mental health and the pressure it puts on family life has been observed and reported in paediatric rheumatology clinics in the UK. Art therapy has long been considered to be a developmentally appropriate way to support children and young people with long-term conditions and it is routinely provided in some NHS services. A service evaluation of manualised online art therapy groups was carried out at the Great North Children’s Hospital to seek further understanding about the accessibility, acceptability, and uptake of this service. Methods A service evaluation was registered and undertaken at the Great North Children’s Hospital, Newcastle Upon Tyne. Art therapy groups consisted of six online 90min sessions with additional resources provided to parents to encourage conversations at home prior to the young people attending the group. Groups were facilitated by a HCPC registered art psychotherapist and included completion of structured activities/worksheets and art making time. Young people who attended the rheumatology service art therapy groups were asked for feedback about their experiences and a audio-recorded focus group style discussion with the art therapy delivery team was conducted. In addition, children and parents were asked to comment on the acceptability of standardised assessment measures that could be utilised in future outcome studies of psychosocial interventions of this kind. Results Thirteen young people who had accessed the art therapy group were included in the service evaluation which was carried out by members of the therapy team and nursing staff. Young people attending the group reported experiencing personal benefits, including valuing opportunities to speak with other young people who had a long-term condition and engagement and sharing a group experience through art activities. Parents responded positively to having time to reflect using the home-based resources and some observed their children appearing calmer and more able to express themselves. Online and digital access difficulties did create barriers to consistent attendance for some group members. Measures of outcome that were considered acceptable for completion by young people and family members included a validated quality of life assessment. Parents and staff reported underestimating the severity of mental health symptoms (anxiety and depression) indicated in young people’s response to completion of a validated measure. Conclusion Online group art therapy was considered to be accessible and acceptable as routinely provided in a paediatric and adolescent rheumatology service. Future research could be undertaken to formally assess the effectiveness of these types of psychosocial interventions. Disclosure S.S. Hackett: None. S. Jandial: None. L. Craig: None. P. Watts: None.

Factors influencing contraceptive uptake among women of reproductive age in Kenya

Background Modern Contraceptive Methods (MCM) use is among the interventions preventing unplanned pregnancies and unsafe abortions globally. Nevertheless, MCM uptake is still low. We aimed at determining factors influencing contraceptive uptake among women of reproductive age 15 to 49 years, in Kenya. Methods We used secondary data collected by Performance, monitoring for Action (PMA). PMA used cross sectional multi-stage cluster survey design and collected the data between November and December 2019. The study was approved by NACOSTI/202974 and KNERC KNH/ERC/R/192. Results The study obtained a sample size of 9477 women of reproductive age (WRA) from 11 counties in Kenya. Both descriptive and inferential statistical analysis with a P value of 0.05 was done using Stata 16.1. The prevalence of modern contraceptives uptake was 43.2% among all WRA, which was lower among rural dwellers 41.4% (95% CI 39.62, 43.17) as compared to urban dwellers 47.5 (95% CI 44.39,50.55). More than half (53.4%) of the married women were using a modern contraceptive, while only about two in every 10 of the unmarried were using a modern contraceptive. Women affiliated with the Islam religion were less likely to use modern contraceptive (aPOR 0.6, 95% CI 0.42, 0.89 p=0.010) as compared to the Catholics. Family planning (FP) services were found to be lower (aPOR 0.535(95% CI 0.29,0.98 p=0.043) in National Hospital Insurance Fund (NHIF)-covered facilities than in non-NHIF-covered ones. Adolescent FP service provision and prescription was significant (aPOR 4.0 95% CI; 1.05,15.41, p=0.42). Conclusion Low uptake for MCM is influenced by sociodemographic factors and Health system factors. Efforts to increase MCM uptake should focus on rural residents, unmarried women, Islamic religion women and accreditation of NHIF services in all facilities.

Access to adolescent sexual and reproductive health services in Accra, Ghana: An exploratory qualitative study

ABSTRACT Nearly 31% of the Ghanaian population are adolescents, and these populations persistently face high rates of teenage pregnancies and unsafe abortions. This is despite sexual and reproductive health (SRH) being taught in the school curriculum. In this qualitative study, we explore the factors affecting adolescents’ access to, and experiences of, SRH services in Accra, Ghana. We conducted 12 focus group discussions (FGDs) with adolescents and 13 key informant interviews (KIs) in Ghana. The FGDs were conducted with school-going and out-of-school adolescents. KIIs were conducted with various stakeholders working with adolescents or in SRH services. All interviews were conducted in English, audio recorded and transcribed verbatim. We applied the Dahlgren-Whitehead Rainbow model of health determinants and used a thematic analysis. Eight themes were identified, across micro, meso and macro levels, that influence adolescents’ SRH access and experience in Accra. These included: family, social networks, the role of schools, health providers and services, the policy landscape, gender norms, cultural norms, and poverty. The findings highlight several factors that influence adolescents’ access to appropriate SRH services in this context and demonstrate the need for a multisectoral effort to address structural factors such as harmful gender norms and persistent poverty.

Interdisciplinary care for gender diverse adolescents. The example of the Centre hospitalier universitaire vaudois (CHUV)

This article outlines the management of transgender and non-binary adolescents at CHUV. The current rise in visibility of this topic is associated with an increased demand for intervention and at the same time with an increased generation of continuously expanding medical evidence to guide interventions. The close collaboration among various specialized adolescent health services enables an interdisciplinary evaluation of diagnostic elements and indications for potential psychological, social or medical interventions. This article underscores the significance of an interdisciplinary and individualized approach to transgender and non-binary adolescents, respecting the diversity of the human being.

Implementing Quality Improvement Initiatives to Improve the Use of Adolescent- and Youth-Friendly Health Services in Zou, Benin.

In Benin, the unmet need for family planning services is especially high for adolescent girls and youth aged 15-24 years. The Challenge Initiative (TCI) supported the health system to assess and improve the quality of adolescent and youth sexual reproductive health services and enhance contraceptive uptake in 65 service delivery points (SDPs) of the Zou department. Between June 2019 and March 2021, TCI supported the health districts in Zou to train an assessment team to complete 3 cycles of quality assessments (QAs) using a QA checklist adapted to the local context. Based on assessment scores, the SDPs were categorized into poor, moderate, or good to excellent quality. The SDP managers developed remedial action plans after each cycle and for each SDP and followed up with supportive supervision. The first QA cycle showed that 52% of assessed SDPs achieved a good to excellent classification; by the second QA cycle, this reached 74%. However, the quality of adolescent- and youth-friendly health services regressed during the third QA cycle (during COVID-19 pandemic disruptions), when only 40% of SDPs achieved the good to excellent category. Between the first and second QA cycles, contraceptive uptake for adolescents and youth improved in the SDPs that had good or excellent quality of services, compared to the ones that were of lower quality (established significance level of 5% with a P value of .031). Further assessments could deepen our understanding of the internal and external factors that can affect service quality. The findings reinforce the importance of investing in quality improvement strategies to maximize the use of sexual and reproductive health services among adolescents and youth. They also underscore the need for a contextual and nuanced approach to ensure enduring results.

Qualitative Study of Street Children’s Awareness, Perceptions, Needs and Barriers in Accessing Sexual and Reproductive Health in Lusaka District, Zambia

Background: Sexual and reproductive health services for adolescents are fundamental for the prevention and control of sexual and reproductive health problems. The sexual and reproductive health services play a critical role in enhancement of adolescent’s health generally. However, children living on the streets are ill-placed to draw benefit from such services. The main purpose of this study was to assess streets children’s awareness, perceptions, needs and barriers in accessing sexual and reproductive health in Lusaka district. Methods: A qualitative approach was adopted for this study. Snow ball sampling was used to identify and collect data from a total of 61 children living on the streets in Lusaka Central Business District. Instruments for data collection consisted of interview schedules used to collect data from children living on the streets as well as Key informant interviews with adolescent health focal point persons from health facilities. All data collection instruments were pre-tested. Data analysis was done using categorization. Results: A total of 61 participants were interviewed among them males constituting (70.49 per cent) per cent while females constituted (29.51 per cent). The majority (59.01per cent) reported that they were not aware of what sexual and reproductive health was. A majority (81.96 per cent) of respondents were aware of at least more than one sexual and reproductive health service with condoms being reported by (68.95 per cent) of respondents. The study also found that the majority (83.6 per cent) of respondents reported awareness on where to access sexual and reproductive health services. The study also showed that the majority (60.65 per cent) reported as perceiving sexual and reproductive health as important to them. Additionally, (68.85 per cent) of respondents reported that condoms are the sexual and reproductive health service they needed. The study showed that (77.04 per cent) of respondents were sexually active and out of ...

16. Assessment of Inpatient Sexual and Reproductive Health Services for Adolescents Assigned Female at Birth: A Survey of Children's Hospitals

16. Assessment of Inpatient Sexual and Reproductive Health Services for Adolescents Assigned Female at Birth: A Survey of Children's Hospitals