Department of Health Service Management, Health Promotion, Reproductive Health, and Nutrition, School of Public Health, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghanaffi.
PLoS One. 2024 Jul 16;19(7):e0307142. doi: 10.1371/journal.pone.0307142. eCollection 2024.
Health facilities' level of readiness to provide adolescent and youth-friendly health services (AYFHS) is crucial for preventing and reducing teenage pregnancies and maternal mortality. This study examined friendliness and satisfaction with AYFHS among users.
A cross-sectional study was conducted among 419 adolescents and youths recruited from six health institutions in the East Shewa Zone, Oromia region, and Addis Ababa, Ethiopia from August 1 to October 28, 2022. Based on the WHO Quality Assessment Guidebook, the friendliness of AYFHS was evaluated as a proxy for the quality of care. Descriptive measures were computed to summarize the participants' socio-demographic characteristics. Bivariate and multivariable logistic regression analysis was used to evaluate the potential association between each independent variable and client satisfaction. The type, magnitude, and precision of association were presented using an adjusted odds ratio (AOR) with 95% Confidence Intervals (CI) and a p-value of < 0.05 ascertained statistical significance.
The overall friendliness was 69%: Specifically, 82% of the participants stated the service was accessible, 72% said it was acceptable, and 90% thought it was effective. However, only 33% and 34% of respondents reported the services were equitable and appropriate respectively. The overall satisfaction with AYFHS was 25.3%. Increased age (AOR = 0.70, 95% CI: 0.57-0.86), being female (AOR = 0.11, 95%CI: 0.04-0.33), no prior information about AYFHS (AOR = 0.20, 95%CI: 0.10-0.44), and higher number of sexual partners (AOR = 0.3, 95%CI: 0.21-0.65) were factors statistically associated with client satisfaction with AYFHS.
The overall quality of AYFHS was sub-optimal and did not meet the four components of WHO's good quality standards; equity, appropriateness, acceptability, and accessibility must be improved. Female and older adolescents and youths and those with a higher number of sexual partners should be targeted for intervention.
医疗机构提供青少年和青年友好型卫生服务（AYFHS）的准备水平对于预防和减少青少年怀孕和孕产妇死亡至关重要。本研究调查了使用者对 AYFHS 的友好程度和满意度。
2022 年 8 月 1 日至 10 月 28 日，在埃塞俄比亚奥罗米亚地区东谢瓦地区的六家卫生机构和亚的斯亚贝巴，对 419 名青少年和青年进行了一项横断面研究。根据世卫组织质量评估指南，AYFHS 的友好程度被评估为护理质量的代表。使用描述性措施来总结参与者的社会人口特征。采用二变量和多变量逻辑回归分析评估每个自变量与客户满意度之间的潜在关联。使用调整后的优势比（AOR）和 95%置信区间（CI）和 p 值<0.05 确定统计显著性来表示关联的类型、幅度和精度。
总体友好度为 69%：具体而言，82%的参与者表示服务可及，72%表示可接受，90%认为有效。然而，只有 33%和 34%的受访者分别报告服务公平和适当。对 AYFHS 的总体满意度为 25.3%。年龄较大（AOR=0.70，95%CI：0.57-0.86）、女性（AOR=0.11，95%CI：0.04-0.33）、没有 AYFHS 的事先信息（AOR=0.20，95%CI：0.10-0.44）和性伴侣较多（AOR=0.3，95%CI：0.21-0.65）是与客户对 AYFHS 的满意度相关的统计学因素。
AYFHS 的总体质量不理想，不符合世卫组织良好质量标准的四个组成部分；必须提高公平性、适当性、可接受性和可及性。应针对女性和年龄较大的青少年和青年以及性伴侣较多的人群进行干预。
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