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      Young people’s perceptions of youth-oriented health services in urban Soweto, South Africa: a qualitative investigation

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          Abstract

          Background

          In 2006, the South African Department of Health adopted and scaled-up loveLife’s Youth Friendly Services (YFS) initiative to a national policy to improve youth utilization of health programmes by strengthening community sensitisation and counselling services. As these services roll-out, alternative services to target young people are also becoming more popular. Success of any of these services, however, is dependent upon young people’s perceptions of these health services as a whole.

          This paper aims to examine the knowledge and perceptions of current health services oriented towards young people and examine potential alternative approaches to health service delivery.

          Methods

          The study was conducted in urban Soweto, South Africa. Twenty-five in-depth interviews were conducted between May-July 2012. Twenty-three of these were analysed according to modified grounded theory.

          Results

          Knowledge of YFS was very low with no thorough knowledge of the programme’s purpose or activities. In general, young people were dissatisfied with the current health services in Soweto citing a lack of resources, long waiting times, and poor quality of care heightened by an underlying lack of choice and perceived inequity. When compared to alternative models of service delivery, no particular model was preferred over another.

          Conclusions

          Greater knowledge of whether and to what extent local clinics in Soweto are implementing YFS standards is needed. If implemented, improved outreach and advertisement is suggested. In-service training of nurses should be prioritized with a focus on sensitivity and equitable treatment to all.

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          Most cited references28

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          Cohort Profile: Mandela's children: the 1990 Birth to Twenty study in South Africa.

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            Report on the global AIDS epidemic

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              Barriers to and facilitators of the provision of a youth-friendly health services programme in rural South Africa

              Background Youth-friendly health services are a key strategy for improving young people’s health. This is the first study investigating provision of the Youth Friendly Services programme in South Africa since the national Department of Health took over its management in 2006. In a rural area of South Africa, we aimed to describe the characteristics of the publicly-funded primary healthcare facilities, investigate the proportion of facilities that provided the Youth Friendly Services programme and examine healthcare workers’ perceived barriers to and facilitators of the provision of youth-friendly health services. Methods Semi-structured interviews were conducted with nurses of all eight publicly-funded primary healthcare facilities in Agincourt sub-district, Mpumalanga Province, South Africa. Thematic analysis of interview transcripts was conducted and data saturation was reached. Results Participants largely felt that the Youth Friendly Services programme was not implemented in their primary healthcare facilities, with the exception of one clinic. Barriers to provision reported by nurses were: lack of youth-friendly training among staff and lack of a dedicated space for young people. Four of the eight facilities did not appear to uphold the right of young people aged 12 years and older to access healthcare independently. Breaches in young people’s confidentiality to parents were reported. Conclusions Participants reported that provision of the Youth Friendly Services programme is limited in this sub-district, and below the Department of Health’s target that 70% of primary healthcare facilities should provide these services. Whilst a dedicated space for young people is unlikely to be feasible or necessary, all facilities have the potential to be youth-friendly in terms of staff attitudes and actions. Training and on-going support should be provided to facilitate this; the importance of such training is emphasised by staff. More than one member of staff per facility should be trained to allow for staff turnover. As one of a few countrywide, government-run youth-friendly clinic programmes in a low or middle-income country, these results may be of interest to programme managers and policy makers in such settings.
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                Author and article information

                Contributors
                bschriver@alum.emory.edu
                meagleyk@gmail.com
                Shane.Norris@wits.ac.za
                becs.geary@gmail.com
                aryeh.stein@emory.edu
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                5 December 2014
                5 December 2014
                2014
                : 14
                : 1
                : 625
                Affiliations
                [ ]Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
                [ ]Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA USA
                [ ]MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
                [ ]Department of Population Studies, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, England UK
                Article
                625
                10.1186/s12913-014-0625-y
                4263109
                25475232
                e7c87482-bc25-41f3-9342-7e1493b275cb
                © Schriver et al.; licensee BioMed Central Ltd. 2014

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 1 March 2014
                : 21 November 2014
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2014

                Health & Social care
                Health & Social care

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