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Malahlela AM, Muthelo L, Mbombi MO, Ntho TA, Phukubye TA, Ntshayintshayi PN, Ramalata TA. Challenges experienced by nurses in implementing Adolescent and Youth Friendly Services in clinics of the Limpopo province. Health SA 2024; 29:2472. [PMID: 39364195 PMCID: PMC11447694 DOI: 10.4102/hsag.v29i0.2472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 03/01/2024] [Indexed: 10/05/2024] Open
Abstract
Background Effective implementation of Adolescent and Youth Friendly Services (AYFS) that are accessible, acceptable and effective for diverse youth population groups is significant to enhancing youth health. Because of various factors, improving youth health is a challenge in clinics in rural areas. Aim This study aims to explore and understand the challenges nurses experience while implementing AYFS programmes in Kganya local area clinics of the Capricorn district, Limpopo province, South Africa. Setting The study was conducted in the clinics of Kganya local area of Capricorn district, Limpopo province, South Africa. Method A qualitative, phenomenological, exploratory, descriptive design is employed in this study. Twelve nurses were selected using purposive sampling. Data were collected through semi-structured interviews with an interview guide. Notably, data were analysed using Tesch's open coding method. Results Two themes emerge from this study: 'Challenges experienced related to the implementation of Adolescent and Youth Friendly Services' and 'Suggestions to improve Adolescent and Youth Friendly Services'. Conclusion The results of this study confirm that nurses experience diverse challenges while implementing AYFS. Challenges include a lack of trained staff and material resources and the negative attitudes of adolescents, parents and community members. Contributions This study's findings might help identify the gaps in implementing the AYFS programmes. The findings may assist policymakers and the National Department of Health (NDoH) to monitor and review the effectiveness of the AYFS programme standards.
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Affiliation(s)
- Anna M Malahlela
- Department of Nursing Science, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Livhuwani Muthelo
- Department of Nursing Science, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Masenyani O Mbombi
- Department of Nursing Science, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Tshepo A Ntho
- Department of Nursing Science, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Thabo A Phukubye
- Department of Nursing Science, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Peaceful N Ntshayintshayi
- Department of Nursing Science, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Tendani A Ramalata
- Department of Nursing Science, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
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Bahl D, Bassi S, Maity H, Krishnan S, Dringus S, Mason-Jones A, Malik A, Arora M. Compliance of Adolescent Friendly Health Clinics with National and International Standards: Quantitative findings from the i-Saathiya study. BMJ Open 2024; 14:e078749. [PMID: 38355176 PMCID: PMC10868312 DOI: 10.1136/bmjopen-2023-078749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/28/2024] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE Indian adolescents experience several health challenges requiring acceptable, equitable, appropriate and effective healthcare services. Our objective was to assess the compliance of Adolescent Friendly Health Clinics (AFHCs) in two of India's largest states, using both national benchmarks (under Rashtriya Kishor Swasthya Karyakram-RKSK) and global standards (by WHO). DESIGN Cross-sectional study comprising structured observations and interactions (November 2021 to June 2022). SETTING Fourteen AFHCs across all levels of health system were included from two districts of Maharashtra (n=8) and Madhya Pradesh (n=6). These AFHCs were observed using checklist, and few items of checklist were verified by interactions with AFHC's health workers (medical officers/auxillary nurse midwives/counsellors) handlings adolescents. The developed checklist included 57 items based on adapted global standards and 25 items using national benchmarks. RESULT High compliance of AFHCs with RKSK's benchmarks was attributed to various items including the accessibility through local transport (n=14, 100%), clean surroundings (n=11, 78.5%), presence of signage (n=10, 71.4%), convenient operating days and time (n=11, 78.5%), and secure storage of records (n=13, 92.9%). Concurrently, items that showed low compliance encompassed, the availability of Information, Education and communication (IEC) resources, which were deficient in 57.1% of AFHCs (n=8). Similarly, designated areas for clinical services (n=10, 71.4%) and commodity disbursement (n=9, 64.3%) lacked in more than half of the recruited AFHCs. Additionally, lack of guidelines for referrals (n=13, 92.9%), as well as standard operating procedures to ensure equity, non-judgemental attitude, competence, confidentiality and referral as per WHO standards. CONCLUSION Evidence spotlights the strengths and gaps in AFHCs, aligning with, government's priorities on adolescent health. Addressing the identified gaps is crucial to creating healthcare facilities that are adolescent-friendly, easily accessible and effectively navigate adolescent health challenges. This concerted effort would contribute to their development and transformation, playing a pivotal role in India's progress.
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Affiliation(s)
- Deepika Bahl
- Health Promotion Division, Public Health Foundation of India, New Delhi, Delhi, India
| | - Shalini Bassi
- Health Promotion Division, Public Health Foundation of India, New Delhi, Delhi, India
| | - Heeya Maity
- Health Promotion Division, Public Health Foundation of India, New Delhi, Delhi, India
| | - Supriya Krishnan
- Health Promotion Division, Public Health Foundation of India, New Delhi, Delhi, India
| | | | | | - Anku Malik
- Health Promotion Division, Public Health Foundation of India, New Delhi, Delhi, India
| | - Monika Arora
- Health Promotion Division, Public Health Foundation of India, New Delhi, Delhi, India
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Sharma M, Khatri B, Amatya A, Subedi N, Upadhyaya DP, Sapkota BP, Bista P. Utilization of adolescent friendly health services and its associated factors among higher secondary students in mid-western Himalayan mountainous district of Nepal. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001616. [PMID: 36963100 PMCID: PMC10022795 DOI: 10.1371/journal.pgph.0001616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/30/2023] [Indexed: 03/19/2023]
Abstract
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.
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Affiliation(s)
- Mahesh Sharma
- United Nations Development Programme Nepal, Pulchowk, Lalitpur, Nepal
- Ministry of Health and Population, Kathmandu, Nepal
| | - Bijay Khatri
- Academic & Research Department, Hospital for Children, Eye, ENT, & Rehabilitation Services (CHEERS), Madhyapur Thimi, Bhaktapur, Nepal
| | | | - Narayan Subedi
- Central Department of Public Health, Institute of Medicine (IoM), Tribhuvan University, Kathmandu, Nepal
| | - Dipak Prasad Upadhyaya
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States of America
| | | | - Parvati Bista
- Ministry of Health and Population, Kathmandu, Nepal
- School of Public Health, B.P. Koirala Institute of Health Science, Dharan, Sunsari, Nepal
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Azhary JMK, Leng LK, Razali N, Sulaiman S, Wahab AVA, Adlan ASA, Hassan J. The prevalence of menstrual disorders and premenstrual syndrome among adolescent girls living in North Borneo, Malaysia: a questionnaire-based study. BMC Womens Health 2022; 22:341. [PMID: 35964024 PMCID: PMC9375346 DOI: 10.1186/s12905-022-01929-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/08/2022] [Indexed: 11/12/2022] Open
Abstract
Background This study aimed to determine menstrual characteristics and related morbidities among adolescent girls living in Sabah, North Borneo, a less-developed state in Malaysia. Methods Data were obtained from a quantitative survey conducted in three government high schools located in Ranau, Sabah. The participants were adolescent girls who had attained menarche between the ages of 14 and 19. Results Based on the analysis of questionnaires completed by 757 adolescent girls, the mean age at the time of the survey was 17 ± 1.4 years, and the mean menarche age was 12.2 ± 1.1 years. Our data demonstrated that 85.7% of the participants experienced dysmenorrhoea, of which at least 42.1% (mean pain score ± SD: 4.81 ± 0.76, 95% confidence interval (CI) 4.72, 4.90) experienced moderate dysmenorrhoea, and 11.2% (mean pain score ± SD: 7.86 ± 0.94, 95% CI 7.64, 8.08) experienced severe dysmenorrhoea. Over 70% of these girls complained of tiredness, headache, and appetite changes during menses. Conclusions The prevalence of menstrual disorders and related morbidities was high among the girls residing in Sabah. Reproductive health issues in rural and socioeconomically deprived areas remains poorly addressed. The main consequence of neglecting menstrual disorders and their related morbidities is impaired future sexual reproductive health in adults. Thus, addressing adolescent reproductive health issues is crucial, especially for girls living in areas where access to healthcare is difficult. The information gathered from this study can be used to strategize effective interventions to improve adolescents' reproductive health status in rural areas.
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Melo LS, Bonelli MA, Ayres JRDCM, Silva GWDS, Borges FA, Wernet M. Enfermeiros diante do cuidado à saúde de adolescentes gays. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6293.3793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Resumo Objetivo: analisar narrativas de enfermeiros sobre o cuidado à saúde de adolescentes gays. Método: estudo qualitativo, ancorado na Análise Temática de Clarke e Braun, adotando como referencial teórico o Interacionismo Simbólico, uma vez que ele favorece a apreensão da relação de comportamentos, interações e significados sociais. Foram entrevistados remotamente 12 enfermeiros, recrutados a partir da técnica de bola de neve, por meio da plataforma de vídeo Google Meet ® . Resultados: ao longo do processo compreensivo-interpretativo, foram elaborados quatro temas: “Adolescente gay, pautas e relação com a saúde”; “A família do adolescente gay e o cuidado”; “Relação com adolescente gay no cuidado” e “Limites para o cuidar de enfermagem ao adolescente gay”. Conclusão: as narrativas denunciam estigmas e símbolos derivados da cisheteronormatividade como intervenientes da relação e indicam premência de apostas no encontro intersubjetivo com os adolescentes gays e seus familiares em relação horizontal, afetiva e empática, com chances de favorecer defesa pública do direito à saúde. Há apontamentos para a atitude dos enfermeiros e qualificação do cuidado a essa população.
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Melo LS, Bonelli MA, Ayres JRDCM, Silva GWDS, Borges FA, Wernet M. Los enfermeros frente al cuidado de la salud de los adolescentes gays. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6293.3791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Resumen Objetivo: analizar los relatos de los enfermeros sobre el cuidado de la salud de los adolescentes gays. Método: estudio cualitativo, anclado en el Análisis Temático de Clarke y Braun, adoptando el Interaccionismo Simbólico como marco teórico, ya que favorece la aprehensión de la relación de comportamientos, interacciones y significados sociales. Fueron entrevistados remotamente 12 enfermeros, reclutados a partir de la técnica de bola de nieve, por medio de la plataforma de video Google Meet ® . Resultados: a lo largo del proceso comprensivo-interpretativo, se elaboraron cuatro temas: “Adolescente gay, pautas y relación con la salud”; “La familia del adolescente gay y el cuidado”; “Relación con adolescente gay en el cuidado” y “Límites para el cuidado de enfermería al adolescente gay”. Conclusión: las narrativas denuncian los estigmas y símbolos derivados de la cisheteronormatividad como intervinientes de la relación e indican la urgencia de apuestas en el encuentro intersubjetivo con los adolescentes gays y sus familiares en relación horizontal, afectiva y empática, con posibilidades de favorecer la defensa pública del derecho a la salud. Hay apuntes para la actitud de los enfermeros y calificación del cuidado a esa población.
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Melo LS, Bonelli MA, Ayres JRDCM, Silva GWDS, Borges FA, Wernet M. Nurses and health care for gay adolescents. Rev Lat Am Enfermagem 2022; 30:e3792. [PMID: 36351093 PMCID: PMC9647932 DOI: 10.1590/1518-8345.6293.3792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/11/2022] [Indexed: 11/09/2022] Open
Abstract
Objective: to analyze nurses’ statements about health care for gay adolescents. Method: qualitative study, anchored on the Thematic Analysis of Clarke and Braun, with adoption of Symbolic Interactionism as a theoretical framework, since it favors the understanding of the relationship between behaviors, interactions, and social meanings. Twelve nurses recruited using the snowball sampling technique were remotely interviewed via the Google Meet® video-conferencing app. Results: four themes were elaborated throughout the comprehensive-interpretative process: “Gay adolescents, agendas, and relation with health;” “The gay adolescent’s family and care;” “Relationship with gay adolescents in care,” and “Limits to nursing care for gay adolescents.” Conclusion: the statements denounce stigmas and symbols derived from cisheteronormativity as intervening in the relationship and indicate the urgency of investing in the intersubjective encounter with gay adolescents and their families in a horizontal, affective, and empathic relationship, with chances of favoring public defense of the right to health. There are comments on the nurses’ attitude and qualification of care for this population.
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