Cargando…

Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal

BACKGROUND: The status of adolescent sexual and reproductive health (SRH) in Nepal is alarming. Adolescent-friendly services (AFS) were introduced to cater the health needs of adolescents. Optimal utilization of the services with wider accessibility is required to prevent adolescents from adopting l...

Descripción completa

Detalles Bibliográficos
Autores principales: Napit, Krishtee, Shrestha, Khadga Bahadur, Magar, Sudip Ale, Paudel, Rashmi, Thapa, Barsha, Dhakal, Bhup Raj, Amatya, Archana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011236/
https://www.ncbi.nlm.nih.gov/pubmed/32041664
http://dx.doi.org/10.1186/s41043-020-0212-2
_version_ 1783496028097347584
author Napit, Krishtee
Shrestha, Khadga Bahadur
Magar, Sudip Ale
Paudel, Rashmi
Thapa, Barsha
Dhakal, Bhup Raj
Amatya, Archana
author_facet Napit, Krishtee
Shrestha, Khadga Bahadur
Magar, Sudip Ale
Paudel, Rashmi
Thapa, Barsha
Dhakal, Bhup Raj
Amatya, Archana
author_sort Napit, Krishtee
collection PubMed
description BACKGROUND: The status of adolescent sexual and reproductive health (SRH) in Nepal is alarming. Adolescent-friendly services (AFS) were introduced to cater the health needs of adolescents. Optimal utilization of the services with wider accessibility is required to prevent adolescents from adopting life-threatening behaviors that result in poor SRH-related outcomes. Despite the upgrading of health facilities to adolescent-friendly sites, studies reveal low utilization of the service. However, these studies failed to explore the factors influencing the low levels of service utilization in these adolescent-friendly facilities. This study quantified the utilization of AFS and identified factors associated with its utilization among adolescents of Bhaktapur district. METHODS: A cross-sectional survey of 362 systematic randomly selected adolescents from four village development committees of Bhaktapur district was conducted, using a self-administered questionnaire. Relationships between utilization of AFS and associated factors were determined by multivariate logistic regression at a level of significance with a p value of less than 0.05 and adjusted odds ratio. Key informant interviews and focus group discussions with adolescents were used to collect qualitative data which were then described using thematic analysis. RESULT: About a quarter (24.7%) of the respondents had utilized the adolescent-friendly services. Factors positively associated with the utilization of services included adolescents aged 15-19 years, female, heard about AFS, lack of fear of being seen while getting SRH services, lack of shyness about receiving SRH services, and the perceived need for SRH services as soon as illness became apparent. The qualitative findings revealed lack of awareness about the services, socio-cultural barriers, confidentiality, feasible service hours, and the preference for of same-sex service providers as the factors affecting utilization. CONCLUSION: The utilization of adolescent-friendly services was very low in Bhaktapur district. Most of the adolescents were unaware of the existence of the AFS which emphasizes the need to focus on the increasing awareness of SRH and AFS by the government in coordination with local schools, clubs, etc. Creating an enabling environment in the service delivery sites, and ensuring privacy and confidentiality, as well as ensuring same-sex service providers and feasible service hours to adolescents, could increase the service utilization.
format Online
Article
Text
id pubmed-7011236
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-70112362020-02-13 Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal Napit, Krishtee Shrestha, Khadga Bahadur Magar, Sudip Ale Paudel, Rashmi Thapa, Barsha Dhakal, Bhup Raj Amatya, Archana J Health Popul Nutr Research Article BACKGROUND: The status of adolescent sexual and reproductive health (SRH) in Nepal is alarming. Adolescent-friendly services (AFS) were introduced to cater the health needs of adolescents. Optimal utilization of the services with wider accessibility is required to prevent adolescents from adopting life-threatening behaviors that result in poor SRH-related outcomes. Despite the upgrading of health facilities to adolescent-friendly sites, studies reveal low utilization of the service. However, these studies failed to explore the factors influencing the low levels of service utilization in these adolescent-friendly facilities. This study quantified the utilization of AFS and identified factors associated with its utilization among adolescents of Bhaktapur district. METHODS: A cross-sectional survey of 362 systematic randomly selected adolescents from four village development committees of Bhaktapur district was conducted, using a self-administered questionnaire. Relationships between utilization of AFS and associated factors were determined by multivariate logistic regression at a level of significance with a p value of less than 0.05 and adjusted odds ratio. Key informant interviews and focus group discussions with adolescents were used to collect qualitative data which were then described using thematic analysis. RESULT: About a quarter (24.7%) of the respondents had utilized the adolescent-friendly services. Factors positively associated with the utilization of services included adolescents aged 15-19 years, female, heard about AFS, lack of fear of being seen while getting SRH services, lack of shyness about receiving SRH services, and the perceived need for SRH services as soon as illness became apparent. The qualitative findings revealed lack of awareness about the services, socio-cultural barriers, confidentiality, feasible service hours, and the preference for of same-sex service providers as the factors affecting utilization. CONCLUSION: The utilization of adolescent-friendly services was very low in Bhaktapur district. Most of the adolescents were unaware of the existence of the AFS which emphasizes the need to focus on the increasing awareness of SRH and AFS by the government in coordination with local schools, clubs, etc. Creating an enabling environment in the service delivery sites, and ensuring privacy and confidentiality, as well as ensuring same-sex service providers and feasible service hours to adolescents, could increase the service utilization. BioMed Central 2020-02-10 /pmc/articles/PMC7011236/ /pubmed/32041664 http://dx.doi.org/10.1186/s41043-020-0212-2 Text en © The Author(s). 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Napit, Krishtee
Shrestha, Khadga Bahadur
Magar, Sudip Ale
Paudel, Rashmi
Thapa, Barsha
Dhakal, Bhup Raj
Amatya, Archana
Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal
title Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal
title_full Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal
title_fullStr Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal
title_full_unstemmed Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal
title_short Factors associated with utilization of adolescent-friendly services in Bhaktapur district, Nepal
title_sort factors associated with utilization of adolescent-friendly services in bhaktapur district, nepal
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011236/
https://www.ncbi.nlm.nih.gov/pubmed/32041664
http://dx.doi.org/10.1186/s41043-020-0212-2
work_keys_str_mv AT napitkrishtee factorsassociatedwithutilizationofadolescentfriendlyservicesinbhaktapurdistrictnepal
AT shresthakhadgabahadur factorsassociatedwithutilizationofadolescentfriendlyservicesinbhaktapurdistrictnepal
AT magarsudipale factorsassociatedwithutilizationofadolescentfriendlyservicesinbhaktapurdistrictnepal
AT paudelrashmi factorsassociatedwithutilizationofadolescentfriendlyservicesinbhaktapurdistrictnepal
AT thapabarsha factorsassociatedwithutilizationofadolescentfriendlyservicesinbhaktapurdistrictnepal
AT dhakalbhupraj factorsassociatedwithutilizationofadolescentfriendlyservicesinbhaktapurdistrictnepal
AT amatyaarchana factorsassociatedwithutilizationofadolescentfriendlyservicesinbhaktapurdistrictnepal