Facility-level assessments of the quality of service provision for adolescents
Monitoring progress toward universal health coverage requires assessment of the quality of health services, not just of coverage. During the past decade some progress has been made in measuring the quality of health services for adolescents, based on nationally developed standards, as discussed in Section 6. Data are currently available to WHO from 10 countries: Bangladesh, India, Indonesia, Kyrgyzstan, Malawi, the Republic of Moldova, Mongolia, Tajikistan, Ukraine and the United Republic of Tanzania. In four of these countries that link quality assessments to service utilization —India, Malawi, Mongolia and Ukraine—the results show greater utilization of services with improved quality assumedly related to meeting national standards.10 Quality measures include provision of a prescribed package of services and clients’ satisfaction with services received.
service provisionIn Bangladesh and India it was possible to compare quality in facilities that had carried out interventions to meet the national standards for adolescent-friendly health services with quality in comparable facilities where no such intervention had taken place.
Indonesia, Kyrgyzstan, Malawi, the Republic of Moldova, Tajikistan, the United Republic of Tanzania and Ukraine assessed compliance with national standards but did not collect data from comparison facilities. The results showed that performance, and difference in performance between facilities, could be measured: Some facilities performed better than others across all standards. At the same time, all facilities fell below some standards, an observation that has implications for refining the interventions and planning scale-up.
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
Barriers to using services- Negative / judgmental attitude of health care providers, long waiting periods, lack of trust in diagnosis.
female, 18-19 Romania
I just found out that my school has a nurse (two years after getting there).
female, 18-19 Peru
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
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
