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Evaluating youth-friendly health services: young people’s perspectives from a simulated client study in urban South Africa

BACKGROUND: Few youth-friendly health services worldwide have been scaled up or evaluated from young people’s perspectives. South Africa’s Youth Friendly Services (YFS) programme is one of the few to have been scaled up. This study investigated young people’s experiences of using sexual and reproduc...

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Autores principales: Geary, Rebecca S., Webb, Emily L., Clarke, Lynda, Norris, Shane A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306747/
https://www.ncbi.nlm.nih.gov/pubmed/25623610
http://dx.doi.org/10.3402/gha.v8.26080
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author Geary, Rebecca S.
Webb, Emily L.
Clarke, Lynda
Norris, Shane A.
author_facet Geary, Rebecca S.
Webb, Emily L.
Clarke, Lynda
Norris, Shane A.
author_sort Geary, Rebecca S.
collection PubMed
description BACKGROUND: Few youth-friendly health services worldwide have been scaled up or evaluated from young people’s perspectives. South Africa’s Youth Friendly Services (YFS) programme is one of the few to have been scaled up. This study investigated young people’s experiences of using sexual and reproductive health services at clinics providing the YFS programme, compared to those that did not, using the simulated client method. DESIGN: Fifteen primary healthcare clinics in Soweto were randomly sampled: seven provided the YFS programme. Simulated clients conducted 58 visits; young men requested information on condom reliability and young women on contraceptive methods. There were two outcome measures: a single measure of the overall clinic experience (clinic visit score) and whether or not simulated clients would recommend a clinic to their peers. The clinic visit score was based on variables relating to the simulated clients’ interactions with staff, details of their consultation, privacy, confidentiality, the healthcare workers’ characteristics, and the clinic environment. A larger score corresponds to a worse experience than a smaller one. Multilevel regression models and framework analysis were used to investigate young people’s experiences. RESULTS: Health facilities providing the YFS programme did not deliver a more positive experience to young people than those not providing the programme (mean difference in clinic visit score: −0.18, 95% CI: −0.95, 0.60, p=0.656). They were also no more likely to be recommended by simulated clients to their peers (odds ratio: 0.48, 95% CI: 0.11, 2.10, p=0.331). More positive experiences were characterised by young people as those where healthcare workers were friendly, respectful, knew how to talk to young people, and appeared to value them seeking health information. Less positive experiences were characterised by having to show soiled sanitary products to obtain contraceptives, healthcare workers expressing negative opinions about young people seeking information, lack of privacy, and inadequate information. CONCLUSIONS: The provision and impact of the YFS programme are limited. Future research should explore implementation. Regular training and monitoring could enable healthcare workers to address young people’s needs.
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spelling pubmed-43067472015-02-18 Evaluating youth-friendly health services: young people’s perspectives from a simulated client study in urban South Africa Geary, Rebecca S. Webb, Emily L. Clarke, Lynda Norris, Shane A. Glob Health Action Original Article BACKGROUND: Few youth-friendly health services worldwide have been scaled up or evaluated from young people’s perspectives. South Africa’s Youth Friendly Services (YFS) programme is one of the few to have been scaled up. This study investigated young people’s experiences of using sexual and reproductive health services at clinics providing the YFS programme, compared to those that did not, using the simulated client method. DESIGN: Fifteen primary healthcare clinics in Soweto were randomly sampled: seven provided the YFS programme. Simulated clients conducted 58 visits; young men requested information on condom reliability and young women on contraceptive methods. There were two outcome measures: a single measure of the overall clinic experience (clinic visit score) and whether or not simulated clients would recommend a clinic to their peers. The clinic visit score was based on variables relating to the simulated clients’ interactions with staff, details of their consultation, privacy, confidentiality, the healthcare workers’ characteristics, and the clinic environment. A larger score corresponds to a worse experience than a smaller one. Multilevel regression models and framework analysis were used to investigate young people’s experiences. RESULTS: Health facilities providing the YFS programme did not deliver a more positive experience to young people than those not providing the programme (mean difference in clinic visit score: −0.18, 95% CI: −0.95, 0.60, p=0.656). They were also no more likely to be recommended by simulated clients to their peers (odds ratio: 0.48, 95% CI: 0.11, 2.10, p=0.331). More positive experiences were characterised by young people as those where healthcare workers were friendly, respectful, knew how to talk to young people, and appeared to value them seeking health information. Less positive experiences were characterised by having to show soiled sanitary products to obtain contraceptives, healthcare workers expressing negative opinions about young people seeking information, lack of privacy, and inadequate information. CONCLUSIONS: The provision and impact of the YFS programme are limited. Future research should explore implementation. Regular training and monitoring could enable healthcare workers to address young people’s needs. Co-Action Publishing 2015-01-23 /pmc/articles/PMC4306747/ /pubmed/25623610 http://dx.doi.org/10.3402/gha.v8.26080 Text en © 2015 Rebecca S. Geary et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Geary, Rebecca S.
Webb, Emily L.
Clarke, Lynda
Norris, Shane A.
Evaluating youth-friendly health services: young people’s perspectives from a simulated client study in urban South Africa
title Evaluating youth-friendly health services: young people’s perspectives from a simulated client study in urban South Africa
title_full Evaluating youth-friendly health services: young people’s perspectives from a simulated client study in urban South Africa
title_fullStr Evaluating youth-friendly health services: young people’s perspectives from a simulated client study in urban South Africa
title_full_unstemmed Evaluating youth-friendly health services: young people’s perspectives from a simulated client study in urban South Africa
title_short Evaluating youth-friendly health services: young people’s perspectives from a simulated client study in urban South Africa
title_sort evaluating youth-friendly health services: young people’s perspectives from a simulated client study in urban south africa
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306747/
https://www.ncbi.nlm.nih.gov/pubmed/25623610
http://dx.doi.org/10.3402/gha.v8.26080
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