School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia.
Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia.
BMC Health Serv Res. 2020 Mar 24;20(1):245. doi: 10.1186/s12913-020-05113-9.
Although there has been momentum in implementing sexual and reproductive health services in Ethiopia, young people remain underserved despite their demonstrated needs. Quality care improves utilization of health service and increases the likelihood of obtaining ongoing care. However, little is known about the quality of youth-friendly sexual and reproductive health service in Ethiopia. Therefore, this study sought to investigate the quality of youth-friendly sexual and reproductive health service in West Gojjam Zone, North West Ethiopia.
Health facility-based cross-sectional study was conducted in West Gojjam zone in 2018 to assess the quality of the service using the Donabedian model. The assessment was done through the triangulation of multiple methods: simulated client study; structured interviews with service providers; observations; and key informant interview with providers and expertise. Fifty-four visits were made to 18 randomly selected health facilities by three simulated clients trained to present three different scenarios (i.e., adolescent with sexually transmitted infection, pregnancy test request and a lady with dry cough). Data were entered and analyzed using SPSS version 21. Facility visit score of ≥ 75% in all quality component categorized as "good quality" otherwise classified as performing below the standard. Thematic analysis was done to analyze qualitative data.
In this study, none of the health facilities achieved ≥ 75% in the three components of quality measurement. From 18 health facilities, 6(33.3%) provided low quality in all domains. Process component, which measures client-provider interaction and privacy/confidentiality, was the most compromised one. However, a promising result was reported in the input quality that measured the availability of trained providers, drugs, and supplies. The presence of community-based health insurance and age driven comprehensive youth-friendly service delivery approach were identified as challenges to deliver quality services.
The quality of the service ranges from low to medium, with adolescent related elements performing poorly. Minor renovations of health facilities, training on client handling, and contextual modifying the age driven youth-friendly service approach may improve the quality of the services.
尽管在埃塞俄比亚实施性健康和生殖健康服务方面已经取得了一定的进展，但年轻人的服务需求仍未得到满足。优质的护理可以提高卫生服务的利用率，并增加持续获得护理的可能性。然而，对于埃塞俄比亚青年友好型性健康和生殖健康服务的质量知之甚少。因此，本研究旨在调查西戈贾姆地区青年友好型性健康和生殖健康服务的质量。
2018 年在西戈贾姆地区进行了基于卫生机构的横断面研究，采用 Donabedian 模型评估服务质量。评估通过多种方法的三角测量来完成：模拟客户研究；与服务提供者进行结构化访谈；观察；以及与提供者和专家进行关键信息者访谈。由三名接受过培训的模拟客户对 18 个随机选择的卫生机构进行了 54 次访问，他们呈现了三种不同的情景（即患有性传播感染的青少年、妊娠测试请求和患有干咳的女士）。数据使用 SPSS 版本 21 进行输入和分析。所有质量组成部分的设施访问得分≥75%的被归类为“高质量”，否则被归类为低于标准。使用主题分析对定性数据进行分析。
在这项研究中，没有一个卫生机构在三个质量测量组成部分中达到≥75%。在 18 个卫生机构中，有 6 个（33.3%）在所有领域提供低质量服务。衡量医患互动和隐私/保密性的过程部分是最受影响的部分。然而，在输入质量方面报告了一个有希望的结果，该质量衡量了培训提供者、药物和供应品的可用性。社区为基础的健康保险的存在和以年龄为驱动的全面青年友好型服务提供方法被确定为提供优质服务的挑战。
服务质量从低到中不等，与青少年相关的元素表现不佳。对卫生设施进行小规模翻修、培训客户处理技能以及根据背景调整以年龄为驱动的青年友好型服务方法，可能会提高服务质量。
