Output data
Output data include facility-level information on service readiness, service statistics and service quality. For health services for adolescents, considerably more data are available on outputs than on inputs. This is particularly so with the increased focus on monitoring health system improvements through WHO-supported surveys on service readiness, services quality and through age-disaggregated data in health management information systems (HMIS).
Routine information from health facilities: cause-specific utilization. Through facility-level registers HMIS collect data that includes client information about age, sex, presenting problem, diagnosis and services provided. However, in most low and middle income countries, by the time that these data are aggregated at the national level, it is not possible to identify the data specific to adolescents; HMIS tend to focus on children less than 5 years of age and women of reproductive age, 15–49 years. Even in high income countries where HMIS are better developed, nationally available data are frequently not sufficiently disaggregated by age to be able to focus on the adolescent age group.
Age and sex disaggregation. Recently, however, a number of countries have started age and sex disaggregation in their national-level reporting. These countries include El Salvador, Indonesia, Malawi, the Republic of Moldova, Tajikistan and the United Republic of Tanzania. These HMIS data provide a yearly overview of which adolescents are using services and why. Such data are timelier and less resource-intensive to collect than self-reported household survey data, which usually are collected only every four years, or school-based data, which also are less frequently collected. Health facility statistics can make an important contribution to monitoring and strengthening service provision for adolescents. However, as data from facilities are not representative of the general population, they need to be interpreted with caution.
Malawi adolescent Indonesia Involving youngRoutine facility-level assessment of services for adolescents. In addition to facility-level data about adolescents’ use of services, strategic information is needed about the functioning of these facilities. To this end WHO recommends regular facility assessments of services availability and readiness. The recommended approach, based on the Service Availability and Readiness Assessment (SARA) methodology,9 includes assessment of service delivery outputs for adolescents, including availability of HIV test and counselling services, family planning and provision of contraceptive pills and antiretroviral therapy for HIV. Data are currently available to WHO on 10 countries.
Percentage of facilities with adolescent health services
Percentage of facilities providing HIV testing and counselling service
Percentage of facilities providing family planning service
Adolescent-specific data. Among the 10 countries reporting SARA data, Burkina Faso and Sierra Leone have national standards for improving services for adolescents, which include standards for having service providers trained and for having guidelines available on the provision of services according to standards. SARA results indicate that the national standards are frequently not being met. The percentage of facilities reporting that they provide “adolescent health services” is 75% in Burkina Faso and 72% in Sierra Leone. However, further probing regarding the quality of services may be needed as only 19% of facilities in Burkina Faso and 28% of facilities in Sierra Leone reported having a service provider trained in adolescent health. Competence of health workers is a critical element of quality as reflected in the global standards for quality health services for adolescents.
I just found out that my school has a nurse (two years after getting there).
female, 18-19 Peru
Adolescents on what stops them from using health services: Delays in public services, like at the hospital; often they attend to your needs but it’s already too late, and they can be very rude, which is psychologically damaging.
female, 18-19 Mexico
Barriers to using services- Negative / judgmental attitude of health care providers, long waiting periods, lack of trust in diagnosis.
female, 18-19 Romania
Adolescents on what stops them from using health services: Fear, distance, not being aware that they (health services) are available in your region
female, 15-17 Switzerland
I do not find enough time to perform sports and I find unhealthy food in front of me.
female, 18-19 Saudi Arabia
Adolescents on what stops them from using health services: Long distance from the health center, lack of information on available health services and lack of money to pay for health services like STI's treatment
female, 18-19 Uganda
I don’t sleep well often; sometimes I don’t eat enough because I’m scared of gaining weight and sometimes I just don’t feel the need. I am also enormously stressed.
female, 18-19 France
