Evaluating the implementation fidelity of national standards for adolescent- and youth-friendly sexual and reproductive health services in Tanzania: a descriptive cross-sectional survey.
IF 3.4 2区 医学Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Gerald Kihwele, Michael Nienga Mbele, Walter C Millanzi
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引用次数: 0
Abstract
Background: Adolescents and youth require age-appropriate, comprehensive sexuality education and health services to support healthy growth and development. This study evaluated the coverage and fidelity of implementation of the National Standards for Adolescent- and youth-friendly Sexual and Reproductive Health (SRH) Services across types of health facilities in Tanzania.
Methods: A descriptive cross-sectional study was conducted from November,1st - 30th, 2022, in eleven purposely selected health facilities across three Tanzanian regions: Dar es Salaam, Dodoma, and Kigoma. Facilities were stratified by ownership (government versus faith-based) and type (Dispensary, Health Center, Hospital). Data were collected using an observation checklist adapted from the Tanzanian Ministry of Health and analyzed with an International Business Machine (IBM®) Statistical Package for Social Sciences (SPSS™) version 26, and the findings are presented in frequencies (n) and percentages (%).
Results: Of the 11 health facilities assessed, 9(82%) were government-owned and 2(18%) fatith-based; 3(27%) were Dispensaries, 55% (n = 6) Health Centers and 18% (n = 2) Hospitals. Findings revealed that all facilities (100%) offered adolescent- and youth-friendly SRH services. However, the average implementation fidelity of the National Standards of SRH services was 65%, of which none achieved full compliance with the National Standards. Health centers, including Tandale health center (73%), Kigogo health center (71%), Ujiji health center (67%), Baptist Council Designated Hospital, and Magomeni (60%) health center had the highest coverage and fidelity implementation of the adolescent-and youth-friendly SRH national standards, while Murufiti dispensary was the lowest (43%). Nevertheless, government-owned facilities achieved the highest coverage and fidelity in implementing adolescent- and youth-friendly SRH services compared to faith-based facilities.
Conclusion: The study revealed suboptimal coverage and incomplete implementation fidelity of National Standards for adolescent- and youth-friendly SRH services in Tanzanian health facilities. Enhancing infrastructures, strengthening healthcare worker capacity, and improving access to SRH education and associated services are critical to advancing the quality and reach of these services across the country.
期刊介绍：
Reproductive Health focuses on all aspects of human reproduction. The journal includes sections dedicated to adolescent health, female fertility and midwifery and all content is open access.
Reproductive health is defined as a state of physical, mental, and social well-being in all matters relating to the reproductive system, at all stages of life. Good reproductive health implies that people are able to have a satisfying and safe sex life, the capability to reproduce and the freedom to decide if, when, and how often to do so. Men and women should be informed about and have access to safe, effective, affordable, and acceptable methods of family planning of their choice, and the right to appropriate health-care services that enable women to safely go through pregnancy and childbirth.
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