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

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A BSTRACT

Context:

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.

Aims:

Aim is to the study the utilisation of adolescent friendly health services and its various determinants in a rural area of Maharashtra.

Objectives:

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.

Settings and Design:

A community based cross-sectional study was conducted among 290 late adolescents from a rural area of Maharashtra from October 2022 to December 2022.

Methods and Material:

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.

Results:

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).

Conclusions:

Though initiatives are taken from the Government to lend a helping hand to the adolescents, awareness and utilisation seems to be minimal.

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Most cited references 16

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Twenty years after International Conference on Population and Development: where are we with adolescent sexual and reproductive health and rights?

Venkatraman Chandra-Mouli, Joar Svanemyr, Avni Amin … (2015)

The International Conference on Population and Development in Cairo in 1994 laid out a bold, clear, and comprehensive definition of reproductive health and called for nations to meet the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality. In the context of the ongoing review of the International Conference on Population and Development Programme of Action and the considerations for a post-2015 development agenda, this article summarizes the findings of the articles presented in this volume and identifies key challenges and critical answers that need to be tackled in addressing adolescent sexual and reproductive health and rights. The key recommendations are to link the provision of sexuality education and sexual and reproductive health (SRH) services; build awareness, acceptance, and support for youth-friendly SRH education and services; address gender inequality in terms of beliefs, attitudes, and norms; and target the early adolescent period (10-14 years). The many knowledge gaps, however, point to the pressing need for further research on how to best design effective adolescent SRH intervention packages and how best to deliver them.

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Health & Wellness Centers to Strengthen Primary Health Care in India: Concept, Progress and Ways Forward

Chandrakant Lahariya (2020)

In February 2018, the Indian Government announced Ayushman Bharat Program (ABP) with two components of (a) Health and Wellness Centres (HWCs), to deliver comprehensive primary health care (PHC) services to the entire population and (b) Pradhan Mantri Jan Arogya Yojana (PMJAY) for improving access to hospitalization services at secondary and tertiary level health facilities for bottom 40% of total population. The HWC component of ABP aims to upgrade and make 150,000 existing Government Primary health care facilities functional by December 2022. The first HWC was launched on 14 April 2018 and by 31 March 2020, a total 38,595 AB-HWCs were operational across India. This article documents and analyses the key design aspects of HWCs, against core components of PHC & the health system functions. The article reviews the progress and analyses the potential of HWCs to strengthen PHC services and therefore, advance Universal Health Coverage in India. Challenges emerged from COVID-19 pandemic & learnings thus far has also been analyzed to guide the scale up of HWCs in India. It has been argued that effectiveness and success of HWCs will be dependent upon a rapid transition from policy to accelerated implementation stage; focus on both supply and demand side interventions, dedicated and increased funding by both union and state governments; appropriate use of information and communication technology; engagement of community and civil society and other stakeholders, focus on effective and functional referral linkages; attention on public health services & population health interventions; sustained political will & monitoring and evaluation for the mid-term corrections, amongst other. Experience from India may have lessons and learnings for other low and middle-income countries to strengthen primary healthcare in journey towards universal health coverage.

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Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal

Krishtee Napit, Khadga Bahadur Shrestha, Sudip Magar … (2020)

Background The status of adolescent sexual and reproductive health (SRH) in Nepal is alarming. Adolescent-friendly services (AFS) were introduced to cater the health needs of adolescents. Optimal utilization of the services with wider accessibility is required to prevent adolescents from adopting life-threatening behaviors that result in poor SRH-related outcomes. Despite the upgrading of health facilities to adolescent-friendly sites, studies reveal low utilization of the service. However, these studies failed to explore the factors influencing the low levels of service utilization in these adolescent-friendly facilities. This study quantified the utilization of AFS and identified factors associated with its utilization among adolescents of Bhaktapur district. Methods A cross-sectional survey of 362 systematic randomly selected adolescents from four village development committees of Bhaktapur district was conducted, using a self-administered questionnaire. Relationships between utilization of AFS and associated factors were determined by multivariate logistic regression at a level of significance with a p value of less than 0.05 and adjusted odds ratio. Key informant interviews and focus group discussions with adolescents were used to collect qualitative data which were then described using thematic analysis. Result About a quarter (24.7%) of the respondents had utilized the adolescent-friendly services. Factors positively associated with the utilization of services included adolescents aged 15-19 years, female, heard about AFS, lack of fear of being seen while getting SRH services, lack of shyness about receiving SRH services, and the perceived need for SRH services as soon as illness became apparent. The qualitative findings revealed lack of awareness about the services, socio-cultural barriers, confidentiality, feasible service hours, and the preference for of same-sex service providers as the factors affecting utilization. Conclusion The utilization of adolescent-friendly services was very low in Bhaktapur district. Most of the adolescents were unaware of the existence of the AFS which emphasizes the need to focus on the increasing awareness of SRH and AFS by the government in coordination with local schools, clubs, etc. Creating an enabling environment in the service delivery sites, and ensuring privacy and confidentiality, as well as ensuring same-sex service providers and feasible service hours to adolescents, could increase the service utilization.

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Author and article information

Journal

Journal ID (nlm-ta): J Family Med Prim Care

Journal ID (iso-abbrev): J Family Med Prim Care

Journal ID (publisher-id): JFMPC

Journal ID (publisher-id): J Family Med Prim Care

Title: Journal of Family Medicine and Primary Care

Publisher: Wolters Kluwer - Medknow (India )

ISSN (Print): 2249-4863

ISSN (Electronic): 2278-7135

Publication date (Print): May 2024

Publication date (Electronic): 24 May 2024

Volume: 13

Issue: 5

Pages: 1950-1955

Affiliations

[1] Department of Community Medicine, Swami Ramanand Teerth Rural Government Medical College, Ambajogai, Beed District, Maharashtra, India

Author notes

Address for correspondence: Dr. Mohini S. Jogdand, Department of Community Medicine, Swami Ramanad Teerth Rural Government College Campus, Ambajogai - 431 517, Beed, Maharashtra, India. E-mail: mohinijogdand@ 123456gmail.com

Article

Publisher ID: JFMPC-13-1950

DOI: 10.4103/jfmpc.jfmpc_1507_23

PMC ID: 11213381

PubMed ID: 38948547

SO-VID: cdccebc9-4aac-4483-9854-7b6ec1223a0e

License:

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

History

Date received : 11 September 2023

Date revision received : 04 December 2023

Date accepted : 04 December 2023

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

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A BSTRACT

Context:

Aims:

Objectives:

Settings and Design:

Methods and Material:

Results:

Conclusions:

Related collections

Ecosystem services

Most cited references 16

Twenty years after International Conference on Population and Development: where are we with adolescent sexual and reproductive health and rights?

Health & Wellness Centers to Strengthen Primary Health Care in India: Concept, Progress and Ways Forward

Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal

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