Global Health Division, RTI International, 701 13th Street, N.W., Suite 750, 20005, Washington, DC, USA.
Global Health Division, RTI International, Research Triangle Park, NC, USA.
BMC Public Health. 2023 Mar 14;23(1):493. doi: 10.1186/s12889-023-15102-2.
Due to the COVID-19 pandemic, many challenges in adolescent health have been exacerbated including increased cases of early marriages, domestic violence, higher rates of anxiety and depression, and reduced access to sexual and reproductive health services for adolescents. This study examines the impacts of the pandemic on adolescent health services utilization and potential adaptations in the Philippines.
The data used in this study was from a rapid telephone assessment survey of 148 adolescent-friendly health facilities (rural health units) in the Philippines. We employed a mixed-methods research approach comprising both quantitative and qualitative analyses in three phases. First, we conducted a descriptive analysis of the status of adolescent healthcare access and utilization during COVID-19. Next, we examined using multivariate ordered logistic regressions how staff availability and adolescent health (AH) service provision modalities influenced AH service utilization in terms of the average number of adolescents served per week during compared to before the pandemic. We also conducted a complementing qualitative analysis of the challenges and corresponding adaptive solutions to ensuring continuity of AH services in facilities.
We find that two months into the pandemic, 79% of adolescent-friendly trained staff were reporting for duty and 64% of facilities reported no staff disruptions. However, only 13% of facilities were serving the same number of adolescents or greater than before COVID-19. The use of more modalities for AH service provision (including telehealth) by facilities was significantly associated with increased likelihood to report serving the same number of adolescent or greater than before COVID-19 compared to those who used only one modality.
Investments in multiple modalities of care provision, such as telehealth could improve AH services utilization and help sustain connection with adolescents during shocks, including future outbreaks or other stressors that limit physical access to health facilities.
由于 COVID-19 大流行，青少年健康面临的许多挑战加剧，包括早婚、家庭暴力、焦虑和抑郁发生率上升，以及青少年获得性健康和生殖健康服务的机会减少。本研究考察了大流行对菲律宾青少年健康服务利用的影响以及潜在的适应措施。
本研究使用的数据来自菲律宾对 148 个青少年友好型卫生设施（农村卫生单位）的快速电话评估调查。我们采用了混合方法研究方法，包括定量和定性分析，共分三个阶段进行。首先，我们对 COVID-19 期间青少年医疗保健的获取和利用状况进行了描述性分析。接下来，我们使用多元有序逻辑回归检验了工作人员的可用性和青少年健康（AH）服务提供模式如何影响 AH 服务的利用，即与大流行前相比，每周服务的青少年人数。我们还对设施中确保 AH 服务连续性的挑战和相应的适应性解决方案进行了补充定性分析。
在大流行两个月后，79%的接受过培训的青少年友好型工作人员报告上岗，64%的设施报告没有工作人员中断。然而，只有 13%的设施每周服务的青少年人数与大流行前相同或更多。设施中 AH 服务提供模式（包括远程医疗）的使用增加与报告与大流行前相比服务相同或更多青少年的可能性增加显著相关，而仅使用一种模式的设施则没有。
对多种护理模式（如远程医疗）的投资可以提高 AH 服务的利用率，并有助于在冲击期间（包括未来的疫情爆发或其他限制对卫生设施的身体接触的压力源）与青少年保持联系。
