Quality Youth Friendly Sexual and Reproductive Health Services, Youths' Satisfaction Levels, and their Determinants in Selected Public Health Facilities of Addis Ababa, Ethiopia
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Date
2022-07
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Addis Ababa University
Abstract
Background: Adolescence, age between 10 and 19 years, is marked as a period of transition and experimentation. This period not only brings changes to their body but also vulnerabilities to the undesirable effect of sexuality, marriage, and childbearing. Globally, pregnancy and childbirth are among the main contributors to diseases and disability among adolescents: early childbearing is linked with a higher risk of unsafe abortions, maternal mortality, and morbidity. Teen pregnancy and sexually transmitted infections (STIs) can have negative consequences for maternal and child health, as well as limit women's future chances, resulting in increased gender and social inequities Objective: The main objective of the study was to assess quality of youth-friendly sexual and reproductive health service and determinants of satisfaction among youth in selected public health facilities of Addis Ababa, Ethiopia, 2022. Method: Facility-based cross-sectional study supplemented with the qualitative design was conducted from 27 April to 10 June 2022 in 25 selected public health centers in Addis Ababa, Ethiopia. To determine the satisfaction of youth, 238 clients were included in the study using a simple random sampling technique. Data was collected by using an interview-administered questionnaire, observation checklist, and key informant interview. Both descriptive statistics was used to measure the quality of YFS and multi-variable binary logistic regression was employed, and the odds ratio with a 95% confidence interval along with p-values were used in reporting the results. Result: The study revealed that only six (24%), seven (28%) and three (12%) of the sampled health care facilities have good structural quality, process quality and output quality respectively. Only 2 (8%) of the health facilities had good overall quality of YFS. Regarding client satisfaction, 33.6% of the study participants were satisfied. Female clients were nearly two times [AOR (95%CI) 1.87 (1.07- 3.26)] more likely to be satisfied than their male counter parts. Similarly, youths aged ≥20 years were about 2.5 times [AOR (95% CI) 2.52(1.35-4.70)] more likely to be satisfied than those aged 15-19 years of age. Students were 76% less likely [AOR (95% CI) 0.24(0.04- 1.40)] to be satisfied when compared to unemployed. Our qualitative assessment showed that weak support system, inadequate capacity of the service provider, overburden of the health service provider and lack of adequate infrastructure are barriers for implementation of quality YFS. Conclusion: The quality of YFS in Addis Ababa is low even when compared to studies done in regional facilities. Both the overall quality and each dimension of YFS quality is lower when evaluated based on the WHO standard. In addition, our study revealed that two-third of youths who were using YFS were not satisfied. Barriers such as weak support system, inadequate capacity of the service provider, high workload of the health service provider and lack of adequate infrastructure contributed for low quality of YFS.
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Keywords
Youth friendly service, Sexual and reproductive health, Quality, Adolescent, servicesatisfaction, AddisAbaba.