National Statistical Office, Zomba, Malawi.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
J Glob Health. 2019 Dec;9(2):020901. doi: 10.7189/jogh.09.020901.
To assess the strength of implementation of family planning programs targeting youth (15-24) in Malawi with a specific focus on youth and the Youth-Friendly Health Services program.
We conducted 9781 mobile phone interviews with facility in-Charge Nurses and health workers (health facility workers, health surveillance assistants [HSAs] and community-based distribution agent [CBDAs]) who provide family planning (FP) services across the 28 districts. Responses were entered in tablet using Open Data Kit. They were summarized and presented using R, Stata (College Station, TX, USA, StatsReport, JHU, Baltimore, MD, USA) and ArcView GIS (ESRI, Redlands, CA, USA).
Availability of key products was a challenge across all health worker types as only 39% of health facilities, 29% of HSAs and 45% of CBDAs had all the FP methods they are supposed to provide on the day of the interview. About 50% of health workers were supervised within past 90 days preceding the study. Despite most facilities saying that they provide youth friendly health services, youth-specific FP guidelines or protocols were not available in 43% of facilities that provide these services and only 33% of facilities had special rooms and 58% have special days for youth.
The commodity supply system needs to ensure that all facilities and workers have a consistent supply of all contraceptive methods. Government and program implementers should ensure availability of all FP guidelines and information, education, communication materials at all service delivery points and facilitate creation of special rooms or days for youth.
本研究旨在评估马拉维针对青年（15-24 岁）实施计划生育项目的执行力度，尤其关注青年和“青年友好型卫生服务”项目。
我们对全国 28 个区的 9781 名负责设施的护士和卫生工作者（卫生机构工作者、卫生监督助理员[HSAs]和社区分销代理[CBDAs]）进行了手机访谈，这些工作者提供计划生育（FP）服务。使用 Open Data Kit 在平板电脑上输入回答。使用 R、Stata（美国德克萨斯州 College Station，StatsReport，JHU，美国马里兰州巴尔的摩）和 ArcView GIS（美国加利福尼亚州雷德兰兹 ESRI）对数据进行总结和呈现。
所有卫生工作者类型的关键产品供应都存在挑战，只有 39%的卫生机构、29%的 HSA 和 45%的 CBDA 在接受访谈的当天拥有他们应该提供的所有 FP 方法。大约 50%的卫生工作者在研究前的 90 天内接受过监督。尽管大多数机构表示他们提供青年友好型卫生服务，但在提供这些服务的 43%的机构中没有青年计划生育的具体指南或方案，只有 33%的机构有专门的房间，58%的机构有专门的青年日。
商品供应系统需要确保所有设施和工作人员都有稳定的所有避孕方法供应。政府和项目执行者应确保所有计划生育指南和信息、教育、宣传材料在所有服务提供点都可用，并为青年创造专门的房间或日提供便利。
