Routine health check-ups for adolescents in Mwanza City, Tanzania: stakeholders’ recommendations on its content, venue, and mode of delivery

Abstract

Background 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. Methods 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. Results 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). Conclusions 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.

Adolescent health and well-being check-up programme in three African cities (Y-Check): protocol for a multimethod, prospective, hybrid implementation-effectiveness study

“…Patient and public involvement The intervention was designed following formative research conducted in three African countries between 2019 and 2020. [19][20][21] This formative research revealed that the proposed adolescent health and well-being check-ups are likely to be feasible to implement and acceptable to stakeholders in Ghana, Tanzania and Zimbabwe, and are likely to meet the perceived needs of key stakeholders including adolescents, their parents and key policy makers in the health and education sectors. 22 Further, we showed that the programme is likely to produce a substantial yield of important, previously untreated, treatable conditions.…”

“…Interviews and participatory workshops with adolescents, parents of adolescents and key stakeholders from the ministries of health and education, non-governmental organisations, healthcare workers and teachers found that there was overall support for the introduction of routine health check-ups. [19][20][21] To navigate potential barriers, stakeholders suggested clear messaging, awareness building and sensitisation campaigns to overcome disinterest in preventative healthcare and, in some contexts, mitigate cultural or religious messaging against healthcare engagement. 19…”