Mbonye Anthony K
Reproductive Health Division, Ministry of Health, Box 7272, Kampala, Uganda.
Int J Adolesc Med Health. 2003 Apr-Jun;15(2):105-12. doi: 10.1515/ijamh.2003.15.2.105.
Adolescents in Uganda have a heavy burden of disease mainly from STD's, HIV and effects of unwanted pregnancy. Currently there are initiatives to address this problem. This paper presents results of a project which piloted a package of adolescent health services with the aim of identifying the best approach for providing quality, accessible, and affordable adolescent friendly services.
The main objective of the study was to evaluate the impact of adolescent-friendly health services piloted in the Jinja district Uganda. The specific objectives were to assess adolescents' knowledge, attitudes, and practices related to access and utilization of adolescent friendly services; to assess the perceptions and skills of health workers; and to identify options for scaling up services and sustainability of such services.
A KAP (Knowledge, Attitude and Practice) study was conducted among adolescents and service providers at eight health units. Four of the health units had implemented a package of adolescent friendly services, while four other health units had not implemented the package, but were comparable in terms of level of service delivery, catchment size and population characteristics. A structured questionnaire and in-depth interviews were used to collect data.
A total of 128 adolescents and 42 health workers were interviewed, and focus group discussions were used to collect data. More adolescents utilized routine services at four pilot health units as follows: antenatal care (72.8% vs. 53.7%, p = 0.000), maternity care (70.6% vs. 53.1%, p = 0.005), family planning (69.4% vs. 21.1%, p = 0.000), management of STD's (65.5% vs. 31.9%, p = 0.000) and access to laboratory services (49.8% vs. 4.4%, p = 0.000). Adolescents at pilot sites were more knowledgeable on adolescent health problems (74.8% vs. 48.9%, p = 0.000), factors predisposing adolescents to health problems (73.4% vs. 52.5%, p = 0.003), family planning methods (84.5% vs. 68.7%, p = 0.000), HIV as a problem to adolescents (84.5% vs. 68.7%, p = 0.011), and STD's as a problem to adolescents (76.3 vs. 50.2%, p = 0.004). One of the main constraints to the pilot project was an erratic supply of contraceptives and STD drugs mainly from inadequacies in the national health system.
Implementation of adolescent friendly services improved access and use of services among adolescents; this lead to reduced morbidity from STD's, HIV, and unwanted pregnancies. In order to reach more adolescents, services have to be scaled to lower health units up to the community level. Training of health workers, ensuring a constant supply of contraceptives, STD drugs, and availing voluntary HIV testing and counseling services are key program issues to consider.
乌干达的青少年疾病负担沉重，主要源于性传播疾病、艾滋病毒以及意外怀孕的影响。目前已有解决这一问题的举措。本文介绍了一个项目的成果，该项目试点了一系列青少年健康服务，旨在确定提供优质、可及且负担得起的青少年友好型服务的最佳方法。
该研究的主要目的是评估在乌干达金贾区试点的青少年友好型健康服务的影响。具体目标是评估青少年与获取和利用青少年友好型服务相关的知识、态度和行为；评估卫生工作者的认知和技能；并确定扩大服务规模及此类服务可持续性的方案。
在八个卫生单位对青少年和服务提供者开展了一项知识、态度和行为（KAP）研究。其中四个卫生单位实施了一系列青少年友好型服务，而另外四个卫生单位未实施该系列服务，但在服务提供水平、服务区域规模和人口特征方面具有可比性。使用结构化问卷和深入访谈来收集数据。
共访谈了128名青少年和42名卫生工作者，并通过焦点小组讨论收集数据。在四个试点卫生单位，更多青少年利用常规服务，情况如下：产前护理（72.8%对53.7%，p = 0.000）、孕产妇护理（70.6%对53.1%，p = 0.005）、计划生育（69.4%对21.1%，p = 0.000）、性传播疾病管理（65.5%对31.9%，p = 0.000）以及获得实验室服务（49.8%对4.4%，p = 0.
