Aninanya Gifty Apiung, Debpuur Cornelius Y, Awine Timothy, Williams John E, Hodgson Abraham, Howard Natasha
Navrongo Health Research Centre, Navrongo, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Navrongo Health Research Centre, Navrongo, Ghana.
PLoS One. 2015 Apr 30;10(4):e0125267. doi: 10.1371/journal.pone.0125267. eCollection 2015.
While many Ghanaian adolescents encounter sexual and reproductive health problems, their usage of services remains low. A social learning intervention, incorporating environment, motivation, education, and self-efficacy to change behaviour, was implemented in a low-income district of northern Ghana to increase adolescent services usage. This study aimed to assess the impact of this intervention on usage of sexual and reproductive health services by young people.
Twenty-six communities were randomly allocated to (i) an intervention consisting of school-based curriculum, out-of-school outreach, community mobilisation, and health-worker training in youth-friendly health services, or (ii) comparison consisting of community mobilisation and youth-friendly health services training only. Outcome measures were usage of sexually-transmitted infections (STIs) management, HIV counselling and testing, antenatal care or perinatal services in the past year and reported service satisfaction. Data was collected, at baseline and three years after, from a cohort of 2,664 adolescents aged 15-17 at baseline.
Exposure was associated with over twice the odds of using STI services (AOR 2.47; 95%CI 1.78-3.42), 89% greater odds of using perinatal services (AOR 1.89; 95%CI 1.37-2.60) and 56% greater odds of using antenatal services (AOR 1.56; 95%CI 1.10-2.20) among participants in intervention versus comparison communities, after adjustment for baseline differences.
The addition of targeted school-based and outreach activities increased service usage by young people more than community mobilisation and training providers in youth-friendly services provision alone.
尽管许多加纳青少年面临性健康和生殖健康问题，但他们对相关服务的利用率仍然很低。在加纳北部的一个低收入地区实施了一项社会学习干预措施，该措施融合了环境、动机、教育和自我效能以改变行为，旨在提高青少年对服务的利用率。本研究旨在评估该干预措施对年轻人性健康和生殖健康服务利用率的影响。
26个社区被随机分为两组：（i）干预组，包括校本课程、校外宣传、社区动员以及针对青年友好型健康服务的卫生工作者培训；（ii）对照组，仅包括社区动员和青年友好型健康服务培训。结果指标为过去一年中性传播感染（STIs）管理、HIV咨询与检测、产前护理或围产期服务的利用率以及报告的服务满意度。在基线期和三年后，从一组基线期年龄为15 - 17岁的2664名青少年中收集数据。
在对基线差异进行调整后，干预社区的参与者使用STI服务的几率是对照组的两倍多（调整后的比值比[AOR]为2.47；95%置信区间[CI]为1.78 - 3.42），使用围产期服务的几率高89%（AOR为1.89；95%CI为1.37 - 2.60），使用产前服务的几率高56%（AOR为1.56；95%CI为1.10 - 2.20）。
相较于仅进行社区动员和对提供者进行青年友好型服务提供方面的培训，增加有针对性的校本活动和校外宣传活动能更多地提高年轻人对服务的利用率。
