Quality assessment in primary health care: Adolescent and Youth Friendly Service, a Mozambican case study

The Pan African Medical Journal

Emiliana Bomfim¹  David Zakus²  Paulo Henrique das Neves Martins Pires³  Regina de Arminda Bernardo³  Ahmed Abdirazak³  Celso Fernando Belo³  Delmar Mário Mutereda dos Santos⁴  Martins Abudo Mupueleque⁵  Ron Siemens⁶ 

[1] College of Medicine, University of Saskatchewan, Saskatoon, Canada;Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;Faculty of Health Sciences, Lúrio University, Nampula, Mozambique;Marrere Health Centre and Hospital Director, Nampula, Mozambique;Mussa Bin Bique University, Nampula, Mozambique;Pediatric Emergency Medicine at the University of Saskatchewan. Canadian Co-PI of the Alert Community Prepared Hospital Project, Saskatoon, Canada;

关键词: adolescents;    family planning;    mozambique;    primary health care;    sexual and reproductive health;    youth;   

DOI  :  10.11604/pamj.2020.37.1.22983

来源: DOAJ

【 摘 要 】

INTRODUCTION: despite the Mozambican Ministry of Health's efforts to deliver family planning to all girls of childbearing age, the adolescent pregnancy rate remains high. The Adolescent and Youth Friendly Service (AYFS), integrated into overall primary health care programs throughout the country, aims to reverse this situation. Our study objective was to assess this health care service's quality in its location in Marrere Health Centre, Nampula, northern Mozambique, using clients' perspective. METHODS: we implemented a descriptive cross-sectional quantitative study was implemented, sampling 124 individuals, who had recently accessed the AYFS at Marrere Health Centre. Data were collected through a questionnaire using a 5-point Likert scale in questions regarding satisfaction level (i.e. always, most times, sometimes, few times, never) and additional open answer questions to gain greater specific understanding. RESULTS: a total of 126 users of the AYFS were evaluated, all from the Emacua ethnic-linguistic group. 85 (67%) were adolescents (19 years), 78.2% female. The mean age was 17.6 years. We found an average of 0.54 pregnancies per woman and 87 participants (69%) never had a pregnancy; of 39 (31%) who had been pregnant, 17 (44%) were able to report the date of the first prenatal visit, on average performed at week 16 (2nd trimester), though with 9 (53%) having performed it during the first trimester. Spontaneous and induced abortions were reported respectively in 4 and 34 cases, respectively, and none with adolescents. The overall satisfaction rate was more frequent in both groups, being answered by 93.8% of youth and adults (= 19 years) and 72.0% of adolescents, a statistically significant difference between the two groups (p =0.05). CONCLUSION: while most users are satisfied with the services there was, however, some sharp criticism. Health professionals practice with the protocol varied, and there were significant deficiencies in information and communication with users. Open communication within families and information reinforcement about sexual and reproductive health and male participation in family planning were found to be in need of strengthening. Our recommendations include reinforcing health professional's training to protect adolescents and young people' sexual health, an important strategy in primary health care to achieve universal health coverage.

【 授权许可】

Unknown