Quality of care provided to adolescents aged between 10 and 19 years in Kenyatta National Hospital, Nairobi, Kenya

Abstract

Background: A health care system that seeks to improve the quality of care across all population groups must ensure that it provides health care that is; Effective, Accessible, Acceptable, Equitable and Safe.

Objectives: To describe and compare the quality of care provided to adolescents [aged 10 to 19 years] in Kenyatta National Hospital (KNH) against WHO Global Standards for Quality Healthcare Services for Adolescents (2015). To identify the existing gaps in healthcare services and challenges faced by adolescents seeking medical services at KNH.

Design,Setting and Participants: A mix research method was used for the study by combining quantitative and qualitative approaches. The study was conducted at KNH among participants aged between 10 -19 years.

Methods: Data was collected using structured interviewer-based questionnaires. The following eight standards of quality care were used: Adolescents’ health literacy, Community support, Appropriate package of services, Healthcare providers’ Competencies, Facility characteristics, Equity and non-discrimination, Data and quality improvement and Adolescent participation.

Results: The adolescents that were more likely to report acceptable quality of service were older (p<0.0001), revisits (p=0.03), saw the signboard (p<0.0001), those, whose guardians supported facility use (p=0.026). Older age (OR 1.5, p<0.0001) and accompaniment by parents/guardians (OR 0.5, p=0.006) were independently associated with acceptable quality care. There was limited training on adolescent care reported by healthcare providers (21.7%). According to WHO Criteria, 69% of the services offered do not meet the quality threshold.

Conclusion: The quality of care provided to adolescents at Kenyatta National Hospital requires significant improvement despite adolescents’ overall good perception. Progress towards universal health coverage for adolescents will require renewed attention to health care provider training.