Department of Reproductive Health and Research, World Health Organization, 20 Avenue Appia, Geneva 27 CH-1211, Switzerland.
BMC Public Health. 2013 Jun 14;13:579. doi: 10.1186/1471-2458-13-579.
Adolescents in Tanzania require health services that respond to their sexual and reproductive health - and other - needs and are delivered in a friendly and nonjudgemental manner. Systematizing and expanding the reach of quality adolescent friendly health service provision is part of the Tanzanian Ministry of Health and Social Welfare's (MOHSW) multi-component strategy to promote and safeguard the health of adolescents.
We set out to identify the progress made by the MOHSW in achieving the objective it had set in its National Adolescent Health and Development Strategy: 2002-2006, to systematize and extend the reach of Adolescent Friendly Health Services (AFHS) in the country.
We reviewed plans and reports from the MOHSW and journal articles on AFHS. This was supplemented with several of the authors' experiences of working to make health services in Tanzania adolescent friendly.
The MOHSW identified four key problems with what was being done to make health services adolescent friendly in the country - firstly, it was not fully aware of the various efforts under way; secondly, there was no standardized definition of AFHS; thirdly, it had received reports that the quality of the AFHS being provided by some organizations was poor; and fourthly, only small numbers of adolescents were being reached by the efforts that were under way. The MOHSW responded to these problems by mapping existing services, developing a standardized definition of AFHS, charting out what needed to be done to improve their quality and expand their coverage, and integrating AFHS within wider policy and strategy documents and programmatic measurement instruments. It has also taken important preparatory steps to stimulate and support implementation.
The MOHSW is aware that the focus of the effort must now shift from the national to the regional, council and local levels. The onus is on regional and council health management teams as well as health facility managers to take the steps needed to ensure that all adolescents in the country obtain the sexual and reproductive health (SRH) services they need, delivered in a friendly and non-judgemental manner. But they cannot do this without substantial and ongoing support.
坦桑尼亚的青少年需要能够满足其性健康和生殖健康以及其他需求的医疗服务，并以友善和非评判的方式提供这些服务。系统地扩大和拓展优质青少年友好型卫生服务的提供范围，是坦桑尼亚卫生部和社会福利部（MOHSW）多部门战略的一部分，旨在促进和保障青少年的健康。
我们旨在确定 MOHSW 在实现其《国家青少年健康与发展战略：2002-2006 年》中设定的目标方面所取得的进展，该目标是系统地扩大和扩展该国的青少年友好型卫生服务（AFHS）的覆盖范围。
我们审查了 MOHSW 的计划和报告以及有关青少年友好型卫生服务的期刊文章。此外，作者还结合了他们在使坦桑尼亚的卫生服务对青少年友好方面的一些经验。
MOHSW 确定了该国在使卫生服务对青少年友好方面存在的四个主要问题：首先，它对正在进行的各种努力并不完全了解；其次，没有对 AFHS 的标准化定义；第三，它收到报告称，一些组织提供的 AFHS 质量较差；第四，只有少数青少年能够受益于正在进行的努力。MOHSW 针对这些问题做出了回应，包括绘制现有服务地图、制定 AFHS 的标准化定义、规划需要采取的措施以提高其质量和扩大覆盖范围，以及将 AFHS 纳入更广泛的政策和战略文件以及规划性测量工具。它还采取了重要的预备步骤来激发和支持实施。
MOHSW 意识到，现在的工作重点必须从国家层面转移到地区、理事会和地方层面。地区和理事会卫生管理团队以及卫生机构管理人员有责任采取必要措施，确保该国所有青少年都能获得友善和非评判的性健康和生殖健康（SRH）服务。但如果没有实质性和持续的支持，他们是无法做到这一点的。
