Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
The Global Fund to Fight AIDS, TB and Malaria, Geneva, Switzerland.
BMC Public Health. 2023 May 30;23(1):1015. doi: 10.1186/s12889-023-15956-6.
Routine adolescent health screening aiming at the detection of unnoticed medical problems may increase awareness among policy makers and contribute to improved health in this population. Research is needed to inform the World Health Organization (WHO) and national health programs to provide evidence-based guidance on whether public health systems should offer comprehensive adolescent health screening, what should be included in different contexts, and how it should be delivered. We conducted formative research to define the content and delivery strategies for health check-ups to be performed in young (10-14 years) and older (15-19 years) adolescents, and to assess whether such services are likely to be acceptable and feasible in Tanzania.
As part of a collaborative research program coordinated by WHO in Chitungwiza, Zimbabwe; Mwanza City, Tanzania; and Cape Coast, Ghana a series of key informant interviews were conducted from April to July 2020, using a semi-structured guide with purposively selected stakeholders from government departments, non-governmental and community-based organisations, schools and health facilities. Data transcripts were coded using NVivo 12 software and thematic analysis was performed.
We report results from 31 key informant interviews to address four main domains: proposed health conditions for routine health check-ups, health interventions to be combined with such check-ups, preferable venues, and the mode for delivering such screening activities. Stakeholders were supportive of introducing routine health check-ups among adolescents. They recommended focusing on non-communicable diseases, physical disabilities, common mental health problems, reproductive health problems, specific communicable diseases, and hygiene-related problems. They also recommended combining counselling and family planning information with these check-ups. Three venues were proposed: schools, community settings (to reach out-of-school adolescents), and youth-friendly health facilities (for conditions requiring a high level of confidentiality).
Stakeholders were supportive of the proposed routine health check-ups for adolescents, recommending specific health conditions to be screened for in both community and school settings. Based on the above, we plan to conduct implementation research to determine the number of new treatable conditions detected, and the costs of offering such services. In the longer term, evaluation of their health impact and cost-effectiveness will be required to guide policy.
旨在发现未察觉的医疗问题的常规青少年健康筛查可能会提高决策者的认识，并有助于改善这一人群的健康状况。需要开展研究，为世界卫生组织（世卫组织）和国家卫生规划提供依据，以便就公共卫生系统是否应提供全面的青少年健康筛查、在不同情况下应包括哪些内容以及应如何提供筛查等问题提供循证指导。我们开展了形成性研究，以确定在青少年（10-14 岁）和大龄青少年（15-19 岁）中进行健康检查的内容和提供策略，并评估在坦桑尼亚提供此类服务是否可能被接受和可行。
作为世卫组织在津巴布韦奇通圭扎、坦桑尼亚姆万扎市和加纳海岸角协调的合作研究方案的一部分，2020 年 4 月至 7 月期间，利用政府部门、非政府组织和社区组织、学校和卫生机构的有针对性选择的利益攸关方的半结构化指南进行了一系列关键知情者访谈。使用 NVivo 12 软件对转录本进行编码，并进行了主题分析。
我们报告了 31 次关键知情者访谈的结果，以解决四个主要领域：常规健康检查建议的健康状况、可与这些检查结合使用的健康干预措施、首选场所以及提供这些筛查活动的模式。利益攸关方支持在青少年中引入常规健康检查。他们建议重点关注非传染性疾病、身体残疾、常见心理健康问题、生殖健康问题、特定传染病和与卫生有关的问题。他们还建议将咨询和计划生育信息与这些检查结合起来。提出了三个场所：学校、社区环境（以覆盖校外青少年）和青年友好型卫生设施（用于需要高度保密性的情况）。
利益攸关方支持为青少年提供的常规健康检查，建议在社区和学校环境中筛查特定的健康状况。在此基础上，我们计划开展实施研究，以确定发现的新可治疗疾病的数量，以及提供此类服务的成本。从长远来看，需要评估其对健康的影响和成本效益，以指导政策。
