埃塞俄比亚西北部青年友好服务的实施保真度水平
Level of Implementation Fidelity of Youth-Friendly Services in Northwest Ethiopia.
作者信息
Habitu Yohannes Ayanaw, Biks Gashaw Andargie, Worku Abebaw Gebeyehu, Gelaye Kassahun Alemu
机构信息
Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
Risk Manag Healthc Policy. 2021 Mar 15;14:1097-1108. doi: 10.2147/RMHP.S285317. eCollection 2021.
BACKGROUND
Youth-Friendly Services (YFS) is an evidence-based public health intervention aimed to reduce sexual and reproductive health problems among youth. To achieve the desired outcomes, YFS has to be implemented with a high level of fidelity. However, there is an evidence gap in its implementation with fidelity. Hence, the main objective of the study was to describe the level of implementation fidelity of YFS among public health centers in Central Gondar Zone, northwest Ethiopia. Therefore, this study investigated the level of implementation fidelity of YFS among public health centers in Central Gondar Zone, northwest Ethiopia.
METHODS
An institutional-based cross-sectional study was conducted from September to December in 2019. A total of 1029 youths, who came to 11 health centers where YFS has been implemented were randomly selected. A validated tool, comprised of 65 Likert scaled items, designed to measure the three dimensions of fidelity was used to collect data. Face to face clients exit interview approach was used to collect the data. Summary statistics were calculated for each fidelity dimension first, and then the overall fidelity of implementation score was computed.
RESULTS
Overall, only 48 (4.7%; 1.6-11.3%) of youth received the YFS with a high level of implementation fidelity. Whereas 770 (74.8%; 57.6-90.5%) and 211 (20.5%; 912.7-31.0%) of youth received the YFS with a medium and low level of implementation fidelity, respectively. Considering each fidelity dimension, 241 (23.4%) youth received the YFS with a high level of adherence, 212 (20.6%) received the YFS with a high level of the structural quality of care, 323 (31.4%) received the YFS with a high level of process quality of care, 508 (49.3%) received the YFS with a high level of outcome quality of care, and 114 (11.1%), received the YFS with a high level of participant responsiveness.
CONCLUSION
The identified low level of implementation fidelity of YFS indicates the urgent need to strengthen the YFS by the government and programmers. Further studies that can address barriers to the implementation fidelity of Youth-Friendly Services are recommended. In addition, further analysis to know the factors that may influence the fidelity of YFS are recommended.
背景
青年友好服务（YFS）是一项基于证据的公共卫生干预措施，旨在减少青年中的性与生殖健康问题。为实现预期成果，YFS必须高度保真地实施。然而，其保真实施方面存在证据空白。因此，本研究的主要目的是描述埃塞俄比亚西北部贡德尔中部地区公共卫生中心YFS的实施保真水平。所以，本研究调查了埃塞俄比亚西北部贡德尔中部地区公共卫生中心YFS的实施保真水平。
方法
于2019年9月至12月进行了一项基于机构的横断面研究。随机选取了前来已实施YFS的11家卫生中心的1029名青年。使用一个经过验证的工具收集数据，该工具由65个李克特量表项目组成，旨在测量保真度的三个维度。采用面对面的客户出院访谈方法收集数据。首先计算每个保真度维度的汇总统计数据，然后计算实施得分的总体保真度。
结果
总体而言，只有48名（4.7%；1.6 - 11.3%）青年接受了实施保真度高的YFS。而分别有770名（74.8%；57.6 - 90.5%）和211名（20.5%；912.7 - 31.0%）青年接受了实施保真度中等和低的YFS。考虑每个保真度维度，241名（23.4%）青年接受了依从性高的YFS，212名（20.6%）接受了护理结构质量高的YFS，323名（31.4%）接受了护理过程质量高的YFS，508名（49.3%）接受了护理结果质量高的YFS，114名（11.1%）接受了参与者反应性高的YFS。
结论
YFS实施保真度低表明政府和项目人员迫切需要加强YFS。建议开展进一步研究，以解决青年友好服务实施保真度的障碍。此外，建议进行进一步分析，以了解可能影响YFS保真度的因素。
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