评估青少年友好型性与生殖健康服务：一项系统综述
Assessing youth-friendly sexual and reproductive health services: a systematic review.
作者信息
Mazur Amanda, Brindis Claire D, Decker Martha J
机构信息
Philip R. Lee Institute for Health Policy Studies and Bixby Center for Global Reproductive Health, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA, 94143-0936, USA.
Adolescent and Young Adult Health National Resource Center, University of California, San Francisco, 3333 California Street, Suite 245, San Francisco, CA, 94143-0503, USA.
出版信息
BMC Health Serv Res. 2018 Mar 27;18(1):216. doi: 10.1186/s12913-018-2982-4.
BACKGROUND
Over the last quarter century, there has been an emergence of evidence-based research directed toward the development, implementation, and assessment of youth-friendly health services (YFHS) to improve the delivery of sexual and reproductive health services for young people. Despite these research efforts, evidence supporting the effectiveness of YFHS is limited, which may be attributed to a lack of consensus on how to define and measure youth-friendliness to track progress and evaluate outcomes. The purpose of this systematic review is to assess how youth-friendly sexual and reproductive health services are measured worldwide.
METHODS
We conducted a systematic review of studies measuring youth-friendly sexual and reproductive health services at health facilities published between January 2000 and June 2015 using PubMed, Web of Science, and POPLINE databases. Additional studies were identified by reviewing references of selected articles. Studies were screened to identify measurements and indicators that have been used to measure YFHS.
RESULTS
Our review identified 20 studies from an initial search of more than 11,000 records, including six from high-income countries and 14 from low-and middle-income countries. The review identified 115 indicators used for measuring youth-friendly sexual and reproductive health services. Our review found a lack of consistency in the tools and indicators used to measure YFHS. The three most frequently assessed domains were accessibility, staff characteristics and competency, and confidentiality and privacy. The majority of the indicators were not specific to young people's needs and often reflected basic standards of care.
CONCLUSIONS
This review shows the need for standardization and prioritization of indicators for the evaluation of YFHS. The results can be used to identify a core set of indicators that can be incorporated into a framework for assessing youth-friendly sexual and reproductive health services. There is a need to further distinguish between those variables that may have greatest impact on the use of services by young people, such as respect and privacy, those that impact the quality of services offered, and those that have limited relevance. Conducting more rigorous studies using a refined set of indicators is critical to measure and compare the impact and effectiveness of YFHS efforts.
背景
在过去的四分之一世纪里，出现了基于证据的研究，旨在开发、实施和评估青少年友好型卫生服务（YFHS），以改善为年轻人提供的性与生殖健康服务。尽管有这些研究努力，但支持YFHS有效性的证据有限，这可能归因于在如何定义和衡量青少年友好程度以跟踪进展和评估结果方面缺乏共识。本系统评价的目的是评估全球范围内如何衡量青少年友好型性与生殖健康服务。
方法
我们对2000年1月至2015年6月期间发表在PubMed、科学网和POPLINE数据库上的关于在卫生设施中衡量青少年友好型性与生殖健康服务的研究进行了系统评价。通过查阅所选文章的参考文献确定了其他研究。对研究进行筛选，以确定用于衡量YFHS的测量方法和指标。
结果
我们的综述从最初搜索的11000多条记录中确定了20项研究，其中6项来自高收入国家，14项来自低收入和中等收入国家。该综述确定了115项用于衡量青少年友好型性与生殖健康服务的指标。我们的综述发现，用于衡量YFHS的工具和指标缺乏一致性。三个最常评估的领域是可及性、工作人员特征和能力以及保密性和隐私性。大多数指标并非针对年轻人的需求，且往往反映的是基本护理标准。
结论
本综述表明，需要对评估YFHS的指标进行标准化和优先排序。研究结果可用于确定一组核心指标，可将其纳入评估青少年友好型性与生殖健康服务的框架。有必要进一步区分那些可能对年轻人使用服务影响最大的变量，如尊重和隐私，那些影响所提供服务质量的变量，以及那些相关性有限的变量。使用一套完善的指标进行更严格的研究对于衡量和比较YFHS努力的影响和效果至关重要。
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