Utilization of quality assessments in improving adolescent reproductive and sexual health services in rural block of Maharashtra, India

Chauhan, Sanjay; Joshi, Beena; Raina, Neena; Kulkarni, Ragini

doi:10.18203/2394-6040.ijcmph20181249

Cited by 7 publications

(7 citation statements)

References 4 publications

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“…The WHO framework helped in identifying the good practices and services provided by the counsellors and the gaps identified that may require support in improving the services they offer [ 24 ]. A study conducted in Maharashtra, India describes the feasibility and usefulness of using the WHO framework to monitor and improve the quality of services [ 14 ]. A similar study conducted in Tanzania that uses this framework describes the challenges that the Ministry of Health and Social Welfare (MOHSW) Tanzania identified and the way in which those challenges were addressed with the support of WHO, UNFPA and other partners.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the quality of sexual and reproductive health services delivered to adolescents at Ujala clinics: A qualitative study in Rajasthan, India

Dayal

Gundi

2022

PLoS ONE

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The Adolescent Friendly Health Clinic (AFHCs), a key component of the Government of India’s National Adolescent Health Programme a.k.a. Rashtriya Kishor Swasthya Karyakram (RKSK), aims to increase the accessibility and utilization of sexual-reproductive health services by adolescents and youth. However, low quality of care provided at AFHCs by counsellors calls for attention. We, thus, explore both the clients’ and providers’ perspectives using the World Health Organization’s (WHO) global standards for quality health-care services for adolescents to assess the quality of the sexual reproductive health service delivery at AFHCs in Rajasthan, India. We conducted a qualitative study, comprising observation of the service delivery using mystery clients (MCs) (n = 12) and in-depth interviews with the counsellors (n = 4) in four AFHCs. Interviews were transcribed in local language and were translated in English. The transcripts were coded thematically. Our study, using five of the eight WHO global standards for quality health-care services for adolescents highlighted several gaps in the quality-of-service delivery at AFHCs. We unearth various intricacies related to the quality of the services provided at the AFHCs by referring to the relevant input, process, and the output criteria of WHO global standards I, III, IV, V and VI. Our study calls for efforts to improve- (i) the counsellors’ competencies to increase adolescents’ health literacy on sensitive topics, (ii) the facilities at the clinic to ensure privacy, comfort and confidentiality of the adolescents seeking services, (iii) the referrals to improve appropriate package of services, and (iv) an overall environment to ensure an equity and non-discrimination for all the adolescents. Our findings unearth the barriers that both the service providers and the adolescents face at the AFHCs and underscore the need for regular monitoring and evaluation of the AFHCs to strengthen the facility-based intervention of the RKSK programme.

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Section: Discussionmentioning

confidence: 99%

Assessment of the quality of sexual and reproductive health services delivered to adolescents at Ujala clinics: A qualitative study in Rajasthan, India

Dayal

Gundi

2022

PLoS ONE

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“…30 To overcome health and development issues, AFHCs can be a one-stop clinic as they are intended to be the first point of contact between an adolescent beneficiary and the formal healthcare system. 33 …”

Section: Discussionmentioning

confidence: 99%

“…Periodic interventions resulted in improving the average facility score from 27% to 83% and overall standards score from 28% to 81% at baseline and end line survey, respectively. 33 This method can be used across all Indian states to assess the functionality of AFHC at all facility levels and timely and tailor-made intervention can be given to fill the existing lacunae. United Nations agencies’ help can be sought in restructuring the AFHCs and this model has been used in other countries as well, like Tanzania.…”

Section: Discussionmentioning

confidence: 99%

Adolescent Friendly Health Clinics (AFHCS) in India and their compliance with government benchmarks: A scoping review

2023

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Background: Adolescent Friendly Health Clinics (AFHCs) are one of the critical pillars of India’s Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram that seeks to enable all adolescents to realize their full potential by making informed decisions concerning their health and by accessing the services. Thus, a review was conceptualised to assess the compliance of AFHCs with the benchmark proposed by the Government under Rashtriya Kishor Swasthya Karyakram. Methods: Three databases (PubMed, Scopus and Google Scholar) were searched for articles published between 2014 and December 2022. A snowball search strategy was also used to retrieve all published articles. Based on the search strategy eight studies were included. Results: AFHCs are not fully compliant with all the benchmarks proposed by the government of India. Evidence from the primary studies showed that the benchmarks need attention as privacy was lacking (six out of seven studies), unavailability of Information Education and Communication material (four out of five), signages (two out of four), referrals (one out of two), and judgemental attitude of health care providers (one out of 3). Conclusions: There is a pressing need to focus on the fulfilment of these gaps to make the clinics adolescent-friendly. This might increase the utilisation of available services in AFHCs by adolescents and will improve their health. The improved health will catalyse achieving the Sustainable Development Goals indicators that are associated with nutrition, reproductive health, sexual and intimate partner violence, child marriage, education, and employment.

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“…In another study by Chauhan SL, et al it was found that baseline service utilization was as low as 20%-23% at some places. [26]…”

Section: Discussionmentioning

confidence: 99%

Perceptions and preferences regarding sex and contraception, amongst adolescents

Ahuja¹,

Patnaik

Gurchandandeep

et al. 2019

J Family Med Prim Care

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Introduction:Conceptually and by the outlook, the reproductive and sexual health needs of adolescents differ from those of adults. Adolescent girls are coerced into unwanted sex or marriage, putting them at risk of unwanted pregnancies, unsafe abortions, sexually transmitted infections (STIs) including HIV, and dangerous childbirth. A majority of young people do not have correct information on the use of contraceptives or the prevention of pregnancy and STIs, and youth-friendly reproductive health services are not readily available.Materials and Methods:A community-based cross-sectional study conducted among school-going 500 adolescent girls in the field practice area of Urban Health Training Centre, Tripuri, of Government Medical College, Patiala (Punjab). A survey with semi-structured, self-administered, and pretested questionnaire was conducted to collect the information on demographic characteristics, and knowledge and perceptions about safe sex.Results:Only 39.71% of girls were aware that the legal age of marriage of girls in India is 18 years. About 22% of girls said that they would prefer to have pre-marital sex and majority, out of them, belonged to nuclear families. Around 38.4% of girls knew that condom is the safest contraceptive method but a preferred choice of contraceptive method among the girls for condoms (24.40%), oral pills (20.20%), and emergency pill (19.60%).Conclusion:Choice of the method with lower levels of knowledge regarding STIs and 22% preferring premarital sex may expose them to higher risks. Increasing trends of pre-marital sex with lower levels of awareness about contraception and STIs is very detrimental.

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Utilization of quality assessments in improving adolescent reproductive and sexual health services in rural block of Maharashtra, India

Cited by 7 publications

References 4 publications

Assessment of the quality of sexual and reproductive health services delivered to adolescents at Ujala clinics: A qualitative study in Rajasthan, India

Assessment of the quality of sexual and reproductive health services delivered to adolescents at Ujala clinics: A qualitative study in Rajasthan, India

Adolescent Friendly Health Clinics (AFHCS) in India and their compliance with government benchmarks: A scoping review

Perceptions and preferences regarding sex and contraception, amongst adolescents

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