Table 3 Analysis of the context in which the quality of health service provision to adolescents was assessed, who assessed it, what the objectives of the assessment were, how the assessment was done, and findings of the assessment
Country | What was the context in which quality was assessed? | Who did the quality assessment? | What were the objectives of the quality assessment? | What were the findings of the quality assessment on the acceptability dimension of quality (i.e. adolescents are willing to obtain the health services that are available)? |
|---|---|---|---|---|
What methods were used in the quality assessment? | ||||
Bangladesh [18] | National quality assessment study | National research institution with support from WHO | Objectives: To assess compliance of the quality of health service provision with the 10 national standards and to determine if there were differences between intervention and comparison health facilities. | Performing well: Young People feel comfortable with the surroundings and procedures of Health Service Delivery Points 74% versus 66%. |
Need some improvement: The privacy and confidentiality of all young people who visit delivery points is maintained 63% versus 58% | ||||
Service providers are motivated to provide health services to young people in a youth friendly manner 66% versus 63%. | ||||
Methods: Quality assessment in 44 intervention and 44 comparison facilities | ||||
India (Haryana state) [19] | State level quality and coverage assessment study | Nongovernment organization with support from WHO | Objectives:To assess compliance with national standards and to determine if there were differences between intervention and comparison health facilities. | Performing well: Adolescents find the environment at health facilities conducive to seek services 86% versus 33% |
Service providers are sensitive to the needs of adolescents and are motivated to work with them 94% versus 59% | ||||
Methods: Quality assessment in 10 intervention and 10 comparison health facilities | ||||
Both samples consisted of 2 Primary Health Care centers and 8 Sub-centers. | ||||
Indonesia [20] | National level quality assessment survey | Ministry of Health with support from WHO | Objectives:To assess compliance with national quality standards. | Performing well: Adolescents are satisfied with the services 73%, health providers have positive attitudes about working with adolescents 73% |
Methods:Cross sectional study of 62 adolescent friendly Primary Health Centers | Need some improvement: Adolescent perceive that their confidentiality will be respected 42% | |||
Need considerable improvement: Adolescents feel comfortable about using the health services 38%; staff ae oriented on adolescent friendly health services 27%; services are provided outside regular hours 9%; adolescents are engaged in planning 10%; adolescents are engaged in monitoring 3%; mechanisms are in place to ensure privacy 18% | ||||
Malawi [21] | National level quality assessment study to assess readiness for accreditation | National youth council of Malawi and Ministry of Health, Malawi with the support of UNFPA | Objectives:To assess compliance with national quality standards. | Performing well: Privacy and respect for adolescents 83% |
Methods:Cross-sectional study involving 266 randomly sampled sites | Need some improvement: Involvement of young people 60%; availability of educational materials 50%; support staff oriented on youth friendly health services 51% | |||
Need considerable improvement: Recreational materials are available 37% | ||||
Moldova [22] | National level quality assessment study | National working group with support from WHO | Objective: To study the compliance of Youth Friendly Health Services with national quality standards. | Need some improvement: Service providers respect youth confidentiality and privacy 68% |
Methods: Assessment of 12 Youth Friendly Clinics | ||||
Mongolia [23] | National level quality assessment study | Consultant team engaged by Ministry of Health and supported by WHO | Objectives: To compare the quality of health facilities in intervention and comparison sites. | Performing well: Written confidentiality policy 86.3% versus 7.1%; providers respect adolescent opinions 82.1% versus 47.6% ; Information Education and Communication services provided 98% versus 75%,; receptionists are friendly 92.9% versus 82.9%, doctors are friendly 96.1% versus 86.5%; waiting area is comfortable and convenient 71.7% versus 18.8% |
Methods: Assessment of quality in 82 sites (51 intervention sites and 31 comparison sites), to determine which dimensions of quality and most important for client satisfaction. | ||||
Need some improvement: Toilets are of good quality 53.2% versus 42.9%,youth participation present 45.5% versus 27.1%, confidentiality policy is posted 48% versus 0%; clients are satisfied with services 45% versus 33% | ||||
Need considerable improvement: Long waiting time (15.4% versus 10.2%), written policy on patient consent 13.7% versus 0% | ||||
Tanzania [24] | National level quality assessment | Nongovernment Organization on behalf of the Ministry of Health | Objectives: To assess compliance with national quality standards. | Performing well: Service Delivery Points ensure privacy and confidentiality78%; clean and appealing 72% |
Methods: Cross-sectional survey involving 90 health facilities randomly chosen. Nine districts of mainland Tanzania were involved, covering all 8 Ministry of Health and Social Welfare zones. | ||||
Ukraine [25] | National level quality assessment study | Academic institution with the support of the Ministry of Health and UNICEF. | Objectives: To compare progress made in compliance with national standards, with the findings of a previous assessment. | Performing well: Friendly behaviour from registration staff 90%; mentioned similar treatment by physicians and psychologists 95%; clients reported specialists were not distracted by external interruptions 97 |
Repeat Evaluation report | Â | Methods: Repeat assessment in 23 Health Centres |