Views of Secondary School Students on Adolescent Friendly Health Services in Level Two Facilities in Mombasa County, Kenya

Abstract

Background: Sexual and reproductive health problems remain a major cause of ill health and/death among adolescents. Despite the adoption of adolescent-friendly health services in all government facilities in Kenya, incidences of teenage pregnancies and HIV infections among adolescents aged 15-19 years continue to rise. Understanding adolescents’ views on the health services offered at facilities is important to develop services that are responsive to their needs.

Methods: The study was conducted to assess the views of secondary school students on adolescent-friendly health services in level 2 facilities in Kisauni Sub-County, Mombasa County, Kenya. The study looked at staff characteristics, facility characteristics, interpersonal relationships and their relationship on students’ perceptions on friendliness of services. A survey was conducted with 313 secondary school going students from two public schools in Kisauni Sub-County, Mombasa County Kenya. Students were selected using a simple random selection process and structured questionnaires used to collect data. Additionally, researchers assessed four public primary care facilities using an observational checklist. Key informant interviews conducted on the facility in charges. Relationships between variables were assessed using Chi-Square at a 95% confidence interval.

Results: Of all the respondents (n=313), 42% reported the services to be friendly. More than half (65.5%, n=205), of all the respondents thought the facilities had appropriate staff to provide adolescent and youth-friendly health services (AYFHS) as well as majority (98%) of all the respondents reporting preference of staff of the same sex and age to offer services to them since they could understand them easily. Media (radio, newspapers) and static advertisements significantly influenced AYFHS (p - values 0.017 and 0.004 respectively). Less than half of those who reported friendly services mentioned being aware of services offered in other settings such as drop-in centres (43.2%, n=32), community outreach (43.7%, n=44) and school health programs (39.2%, n=65). Accessing facility by use of vehicle and walking on foot had a significant influence on AYFHS (p- values of 0.001 and 0.003 respectively). Involvement of other agencies in service review had a significant influence on the friendliness of services (p-value 0.003).

Conclusion: Adolescents perceive the Adolescent and Youth Friendly Services as unfriendly, with access to service as a barrier to accessing these services.

Keywords: Adolescence, Adolescent Health Services, Reproductive Health Services, Health, Kenya, Friendly Services