Assessment of quality of youth friendly services to fit the Universal Health Coverage
Uganda Youth and Adolescents Health Forum in collaboration with Naguru Youth Health Network (NYHN) and the AFRIYAN Network; and with support from PAI are working on a project to develop a joint youth advocacy action plan on GFF and RMNCAH processes in Uganda. As a foundation for this action plan, we conducted a youth led rapid assessment on access, uptake, availability and quality of youth friendly services in Busia and Pallisa district from 24th-27th February 2020 in six health facilities. The rapid assessment was seeking to understand the scope of youth friendly services, policy provisions and commitments in the RMNCAH investment case, challenges and experiences of young people in accessing youth friendly services and the extent to which these services fit the Universal Health Coverage framework. These findings from the rapid assessment are to be used to develop a joint youth advocacy action and coordination plan. On arrival in each district, we had an entry meeting with the district health team where we did a random selection from the health facilities and chose three health facilities per district either health centre lll or health centre iv. Pallisa district started implementing RBF in 2018 while Busia district is yet to roll out RBF in 2020.
Busia district discussions;
At Buteba health centre lll, we discovered that they have never undergone any training in adolescent health services and they have not had a focus on it. They however mentioned that they were recently introduced to RBF and were told to make a work plan where they included adolescent health services activities. The adolescents from Buteba said that when they come to the health center, they are given the services they need however they feel there is lack of young people involvement in health facility activities and decisions.
At luunyo health centre lll, we discovered that there is still no major focus or training in adolescent health services. The adolescents shared that when they come to the health facility, they are told elders first. They also mentioned that the health workers tend to be on phone and keep them waiting for long. The health workers come late and leave early so the adolescents give up on coming to the facility.
At Busia health centre lV, the adolescents informed us that they are challenged in accessing contraceptive services because they belong to a Moslem community which does not believe in it and they get isolated if one notices that they are sexually active and accessing contraceptive services. They also mentioned that the health workers abuse them and ignore their issues which makes it hard for them to access the services they need.
The adolescents in Busia district would like to have youth corners at each health facility, more youthful health providers and peer educators.
Pallisa district discussions;
At Gogonyo health centre lll, the adolescents expressed that the attitudes of the health workers is good and they avail them the services that they require. They also have school clubs where they inform them of their rights and the health workers plus senior woman keep giving them health talks.
At Kamuge health centre lll, the health workers have received adolescent health care training so are able to attend to the adolescents freely and appropriately. The adolescents mentioned that they are able to access services like contraceptives, HIV testing and STI testing.
At Kameke health centre lll, the adolescents acknowledge that the health workers are cooperative and provide all the services to young people. The health workers also have no discrimination against young people when they come for services and express that they are sexually active.
The adolescents in Pallisa district are happy with the ability to freely go to health facilities for services however, they would like an opportunity to be part of the decision-making meetings and also the issue of drug stock outs to be handled.