A system is required to bring adolescent and youth demand and available quality service
The service characteristic of accessible, acceptable, comprehensive, appropriate, equitable, effective, and efficient nature
So far, the non-clinical aspects are poorly addressed, and the clinical aspect focuses on SRH services
Recognized that the desired outcomes of adolescent and youth health can not be achieved without addressing the non-clinical aspects of the health system
Required a shift towards a responsive health system
Responsiveness
Response to individuals’ legitimate expectations on the way treated and the environment they are treated.
Responsive health system
The outcome when institutions and institutional relationships are designed in such a way they can respond appropriately
Elements of responsive health system
1.Dignity
2.Autonomy
3.Confidentiality
4.Prompt Attention
5.Qualities of clean amenities
6.Access to social support networks during care
7.Choice of Care Provider
National Standards for quality health care services for adolescents and youth
Evidences show that services for adolescents are:
Highly fragmented, poorly coordinated and uneven in quality
WHO/UNAIDS developed Global Standards for quality health care services
Asist policy-makers and health planners in improving quality
Make the health services accessible and available for the young people
These standards serve as a yard stick to measure a health system’s responsiveness to the health needs of adolescents.
AYH standards
National AYH quality standards adapted from the global AYH quality standards
1. Adolescents’ and youth health literacy:
The health system needs to ensure that adolescents are knowledgeable about their own health, and they know where and when to obtain health services
2. Comprehensive service package:
Health facilities provide a package of services including counseling, diagnostic, treatment and care services that fulfills client needs
Services may be provided in the facility and/or through referral linkages and outreach
3. Adolescents’ and youth’s participation:
Adolescents are involved in the planning, monitoring and evaluation of health services and in decisions
4. Community engagement:
These includes for parents, guardians , CBOs and other community members
5. Facility characteristics:
Convenient operating hours, a welcoming and clean environment and maintains privacy and confidentiality
Equipment, medicines, supplies and technology for effective service provision
6. Providers’ competencies:
Health-care providers demonstrate the technical competence.
Both health-care providers and support staff respect, protect and fulfill client/ patient rights
7. Equity and non-discrimination:
Health facilities provide quality services to diverse adolescent group/clients
8. Data and quality improvement:
Health facilities collect, analyze, and use data
Staffs participate in continuous quality improvement
9. Inter-sectoral Collaboration
Leading and promoting inter-sectoral collaboration
Building governance and capacity to facilitate multisector actions.
Synergistic action with other sectors and stakeholders
Policies and strategies on AYH
Global and regional policies and strategies
ICPD Plan of Action, 1994
Adolescent and Youth Regional Strategy and Plan of Action 2010–2018, WHO
The UN Sustainable Development Goals (SDG 2016-2030)
The UN Global Strategy on Women’s, Children’s, and Adolescents’ Health (2016-2030)
The Global Financing Facility (GFF)
The Global AA-HA document ( Accelerated Action for the Health of Adolescents)
Orientation programs on adolescent health for health care providers , WHO Etc…
National policies and strategies:
The National Health Policy, FDRE, 1994, Revised 2014
The National Adolescent and Youth Health Strategy (2021-2025)
National RH strategy (2021-2025)
National Youth Policy of Ethiopia, 2004
Health Sector Transformation Plan II(HSTP 20121-2025)
National Standards of adolescent and youth health service.
Minimum service package for AYH service
Motivated , Competent and Compassionate (MCC)
What is MCC?
Enthusiastic and energetic
Have the necessary technical and clinical knowledge and skills
Serving patients/clients
Being ethical
Living the professional oath
Being a model for fellow professionals
It’s a movement that requires champions who identify with their profession and take pride in helping people
Points to aspire
Medical care without compassion cannot be truly patient/client-centered
Compassionate care addresses the client’s innate need for connection and relationships
Compassion based on attentive listening and a desire to understand the client’s context and perspective
Compassionate, client-centered care is a top priority to improve the quality and equity in youth-friendly service delivery
Essential Characteristics of MCC
Clients are considered human beings with complex psychological, social, and economic needs and required person-centered care with empathy
Effective communication with different groups, overtime & across settings
Respect and facilitation of clients’ and families’ participation in decisions and care
Taking pride in the profession they are in and getting satisfaction by serving the people in need
Integrated management of common AY Conditions
It is a holistic approach of promoting health and treatment for common conditions
This approach benefits from having an integration /collaboration & linking
Current initiatives often focus on a limited range of issues, such as SRH
Often neglected health problems include
Mental health disorders,
Substance use and substance use disorders,
Intentional and unintentional injuries and
Chronic illness
We need to move from SRH focus to a comprehensive package of services that address all key causes of disease burden
Advantages of Integrated management of AYH
Attract a greater number and diversity of clients
Increase uptake of a range of AYH services at a contact
Increased quality of a range of AYH services, also screens
Lead to better healthier behavior, through health information & counseling
Reduced stigma at health facilities by providing range of services
Efficient use of resources, with a lower unit cost of provision of key services
SUMMARY
Individual, interpersonal, community, organizational, and structural factors make adolescent clients unique
This has implications for health care organizations and requires a transition from AF projects to adolescent-responsive health systems
This needs the implementation of AYH quality standards and appropriate monitoring systems
Young people are quite explicit about what they want from healthcare providers, hence competence in terms of knowledge, attitude, and skills is crucial
For this purpose, the provision of MCC is important
As the needs of AY are beyond SRH, an integrated and holistic approach of common conditions must be in place
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