Background
Methods
Results
Author | Settinga | Study design | Participants | Domainsb | Outcomes measured |
---|---|---|---|---|---|
Alli F. et al. (2013) [28] | South Africa; Upper middle income; Youth friendly university clinic | Cross-sectional study 1. In-depth interviews with managers and senior staff 2. Exit interviews with youth | 200 youth aged 18–24 years 4 in-depth interviews with clinic managers and senior staff | 1,2,5–8 | Perception |
Baumgartner et al. (2012) [37] | Kenya; Low income; HIV voluntary testing and counselling (VCT) youth friendly and non-youth friendly clinics | Repeated cross-sectional study 1. Baseline and 3 month follow-up client interviews 2. Baseline provider interviews structured observations of facilities | 277 youth aged 15–24 years 46 providers 20 clinic observations | 1–4, 6–8,12 | Contraceptive use |
Brindis et al. (2005) [23] | USA; High income; 10 Primary care facilities, SRH clinics and alternative settings | Pre-post evaluation study 1. Semi-structured interviews with administrator/provider 2. Questionnaire for administrators 3. Exit survey questionnaires for youth | Program administrator Service providers Youth clients | 1–3, 7,8,11,12 | Relationship of YFHS with service integration |
Adapted from Philliber Research and Associates checklist for assessing teen friendliness of family planning services | |||||
Dickson et al. (2007) [24] | South Africa; Upper middle income National Adolescent Friendly Clinic Initiative (NAFCI)/LoveLife clinics and control clinics | Quasi-experimental case-control study 1. Interviews with clinic manager 2. Clinic document review 3. Inventory of clinic 4. Provider interviews 5. Non clinical support staff interviews 6. Client-provider observations 7. Client exit interviews 8. Key informant interviews Adapted from NAFCI/LoveLife criteria | 11 NAFCI clinics, 22 control clinics | 1,2,5,7–12 | Quality |
Geary et al. (2014) [29] | South Africa; Upper middle income; 8 Primary health clinics | Cross-sectional study 1. Semi-structured interviews | 8 nurses | 1, 7, 10, 11 | Perception |
Geary et al. (2015) [25] | South Africa; Upper middle income; 15 health facilities | Cross-sectional study 1. Simulated clients debriefing questionnaires | 50 visits by youth simulated clients | 1–3,5,7,8,11,12 | Perception and condom provision |
Godia et al. (2014) [30] | Kenya; Low income; 9 facilities, youth center, district hospitals with integrative services | Cross-sectional study 1. Focus group discussions 2. In-depth interviews | 18 focus group discussions 39 in-depth interviews of young people aged 10–24 years | 1,2,5–11 | Perception |
Ingram and Salmon (2007) [26] | United Kingdom; High income; Drop-in primary care facility | Cross-sectional study 1. Questionnaires 2. interviews | 122 young people aged 12–24 years | 1, 5–8,11 | Satisfaction |
Adapted from London School of Hygiene and Tropical Medicine Questionnaire for Service Users: Evaluation Kit | |||||
Kavanaugh et al. (2013) [12] | USA; High income; Publically funded family planning facilities | Cross-sectional study 1. Close-ended questionnaires | 584 Facility or agency directors | 1,4,6,9,12 | Contraception provision |
Adapted from Guttmacher family planning facilities tool | |||||
Larke et al. (2010) [35] | Tanzania; Low income; 6 Health facilities | Simulated client clustered randomized control trial 1. Simulated client debriefing interviews | 6 facility visits by youth mystery clients | 4, 7,8,11 | Quality and attendance, health seeking behavior, contraceptive distribution |
Lesedi et al. (2011) [38] | Botswana; Upper middle income; 2 youth friendly clinics | Cross-sectional quantitative 1. Questionnaires | 110 youth aged 15–29 years | 1–3,5–12 | Perception |
Adapted from Pathfinder Rapid Assessment of Youth Friendly Services (2003) 2. Mystery client interviews | |||||
Adapted from the African Youth Alliance Botswana interview guide (2005) | |||||
Mashamba and Robson (2002) [27] | Zimbabwe; Low income; Youth advisory center | Cross-sectional study 1. Exit questionnaires 2. Focus group discussions | 30 youth aged 15–24 years | 1,2,4–10 | Perception |
Mathews et al. (2009) [31] | South Africa; Upper middle income; 12 NAFCI facilities and clinics | Cross-sectional study 1. Mystery client debrief questionnaires | 137 youth mystery clients | 6–8, 10 | Compliance to quality criteria |
Adapted from UNAIDS (2002) and Family Health International VCT Toolkit | |||||
Mauerhofer et al. (2010) [39] | Switzerland; High income; Multidisciplinary clinic | Cross-sectional study 1. Questionnaires | 311 female return clients aged 12–20 years | 1,2, 5–10 | Satisfaction |
Adapted from WHO framework and Sovd et al. (2006) [34] study | |||||
Mayeye et al. (2010) [40] | South Africa; Upper middle income; 11 Primary health clinics | Cross sectional study 1. Exit questionnaires | 200 youth aged 16–19 years | 1,2,4–11 | Satisfaction and perception |
Adapted from International Planned Parenthood Federation Your Comments Count survey | |||||
Mchome et al. (2015) [36] | Tanzania; Low income; 33 health facilities | Clustered randomized trial 1. Simulated client debriefings 2. interview checklist | 48 visits by youth mystery clients | 1,4,5,7,8,11 | Quality |
Mmari KN and Robert Magnani (2003) [33] | Zambia; Lower middle income; 10 health clinics | Quasi-experimental case control 1. In-depth interviews with managers, nurses, and staff 2. Focus group discussions with youth 3. Exit interviews with youth | 200 youth in focus groups 60 youth interviews 10 Managers 20 Staff | 1,3,4,7 | Quality |
Adapted from the Pathfinder Focus on Young Adults Program | |||||
Perry and Thurston (2007) [41] | United Kingdom; High income; 2 health facilities with youth only hours | Cross sectional study 1. Questionnaires | 425 young people 10–18 years | 1,2,4–8,10 | Satisfaction |
Sovd et al. (2006) [34] | Mongolia; Lower middle income; 51 YFHS facilities and 31 Controls | Quasi-experimental case control study 1. Exit survey questionnaires | 1301 adolescents aged 10–19 | 1,2,5–10 | Satisfaction and quality |
Adapted from collaboration with MOH, WHO and UNFPA | |||||
Tanner et al. (2014) [32] | USA; High income; 15 clinics | Cross sectional study 1. Semi-structured interviews with staff 2. Photographs consistent and inconsistent with youth-friendliness | 60 providers, outreach workers and case managers | 3, 6–11 | Perception |
Adapted from WHO Adolescent Friendly Health Services Agenda for Change Framework (2002) |
Domains and indicators
Domains and Indicators | Total |
---|---|
Accessiblea | 18 |
• Convenient opening hours (after school, weekends) | 14 |
• Distance/availability of transport to facility | 11 |
• Services are affordable or free | 10 |
• Outreach in the community | 7 |
• Awareness of location, hours and services | 5 |
• Appointment drop in available | 5 |
• Dedicated services (LARC insertion, HIV testing) available at certain times of the day/week | 3 |
• Youth-only hours | 3 |
• Appointments available online or by text | 2 |
• Social media presence for education and services | 1 |
• Facilities open during entire posted time | 1 |
• Partners welcome | 1 |
Acceptablea | 13 |
• General satisfaction | 6 |
• Provider demographics reflect clients (young, similar gender) | 6 |
• Client would recommend the clinic to friend | 6 |
• Community members understand benefits and support provision of YFHS | 3 |
• Client willingness to return to clinic | 3 |
• Clinic has good reputation | 1 |
• No corruption in facility | 1 |
• All expectations of service are met | 1 |
Appropriatea | 8 |
• Package of care fulfills needs either at point of develiry or through referral linkages | 7 |
• Client has choice of treatment options | 2 |
• Data collected to determine young people’s health needs in community | 1 |
Equitablea | 8 |
• Welcome regardless of age | 4 |
• Welcoming services for young men | 3 |
• Open to all racial groups | 1 |
• Open to all religious groups | 1 |
• Welcome regardless of marital status | 1 |
• Welcome regardless of relationship status | 1 |
• Open to persons of all sexual orientations | 1 |
• Females and males receive equal access to family planning services | 1 |
• Males and females receive similar service care and respect | 1 |
• Policies and guidelines for staff on SRH rights of young people | 1 |
Effectivea | 8 |
• Supplies available onsite (medical testing) | 6 |
• Providers are medically competent | 2 |
• Provider takes client history | 2 |
• Client follows caregivers advice, adherence to treatment | 1 |
• Equipment to provide services available | 1 |
• Process for ongoing quality improvement | 1 |
• Client receives correct treatment | 1 |
• Infection control procedures are followed | 1 |
• Provider takes appropriate physical examination according to guidelines | 1 |
Administrative proceduresb | 12 |
• Waiting times | 9 |
• Choice and availability to be seen with same clinician during return visit | 5 |
• Plan for follow up care explained and scheduled | 4 |
• Referral care available, explained, and scheduled | 4 |
• Sufficient time for consultation | 3 |
• Frequency of appointments is convenient | 1 |
• Do not need appointment for refills | 1 |
• Number of times needed to return to clinic to obtain test results | 1 |
• Hormonal contraceptive provision without appointment for pelvic exam | 1 |
Staff characteristics and compentency | 20 |
• Non judgemental | 12 |
• Client recieves adequate information from provider | 11 |
• Friendly | 9 |
• Respectful | 9 |
• Welcome/greeting | 8 |
• Client has opportunity to ask all questions | 7 |
• Listens to client problems | 7 |
• Number of staff trained in YFHS | 7 |
• Positive attitude | 7 |
• Comfort in communicating | 6 |
• Provider uses language that is understandable to clients | 5 |
• Interested in client | 3 |
• Willing to help | 3 |
• Provider develops relationship with client | 3 |
• Support and supervision for staff available on ongoing basis | 3 |
• Responsive | 2 |
• Client given time for test results to be absorbed and undertrstood | 2 |
• Client is able to express opinion | 2 |
• Provider answers questions to client’s satisfaction | 2 |
• Explanation of services and treatment | 1 |
• Training plan in place that meets needs of staff | 1 |
• Provider perceives he/she has sufficient ability to provide services to youth | 1 |
• Trustworthy | 1 |
• Staff trained on how to communicate with teens over the phone | 1 |
Confidentiality and Privacy | 19 |
• Confidentiality is respected | 8 |
• Client consultation cannot be heard or seen by other clients or staff | 8 |
• Privacy is respected | 6 |
• Staff explains services are confidential | 4 |
• Parental consent is not required | 3 |
• Consultation is not interrupted by outside staff or clients | 3 |
• Passive disclosure of services avoided (being seen in the waiting room discloses reason client is seeking service) | 3 |
• Tests are handled confidentialy | 2 |
• Privacy asking for services in reception | 1 |
• Staff uses shielded language when calling for appointment or follow-up | 1 |
Educational Activitiesb | 8 |
• Understandable and accurate SRH materials available | 7 |
• Text message for follow-up or education | 1 |
Environmentb | 12 |
• Comfortable | 6 |
• Reading and/or entertainment materials available | 4 |
• Clean | 4 |
• Youth-only space | 3 |
• Young people specific décor and materials | 3 |
• Private waiting room for young people | 2 |
• Ease of finding services within the facility | 1 |
• Adequate lighting and ventilation | 1 |
• Toilet facility quality | 1 |
• Clean piped water | 1 |
• Good phone access | 1 |
• No overcrowding | 1 |
Services Providedb | 12 |
• Counselling (prevention, condom demonstration, test results) | 7 |
• Contraceptive services | 7 |
• STI services (counselling, testing, treatment and prevention) | 7 |
• VCT available/HIV services | 4 |
• Pregnant and parenting teen services | 4 |
• Holistic approach (services available beyond reproductive health including mental, psychosocial, lifeskills etc) | 3 |
• Pap smears and pregnancy tests | 2 |
• Non-health services (youth development services, domestic violence) | 2 |
• Emergency contraception | 1 |
• Abortion services | 1 |
• Mental heath services | 1 |
• Treatment for minor ailments | 1 |
Youth Involvementb | 7 |
• Youth have input on service delivery | 4 |
• Peer educator on staff | 3 |
• Youth organize outreach | 2 |
• Peer educator program in clinic | 1 |
1. Non-xjudgmental providers and staff | |
2. Ease of access to location of facility | |
3. Client receives adequate information from provider | |
4. Services are affordable or free | |
5. Staff is friendly | |
6. Staff is respectful | |
7. Reasonable waiting times | |
8. Welcoming staff | |
9. Confidentiality is respected | |
10. Consultation cannot be heard or seen by other clients or staff |