Barriers to utilization of adolescent friendly health services in primary healthcare facilities in Armenia: a qualitative study

Int J Public Health. 2020 Nov;65(8):1247-1255. doi: 10.1007/s00038-020-01499-9. Epub 2020 Oct 16.

Abstract

Objectives: The study aimed to explore potential challenges that hamper utilization of adolescent friendly health services (AFHS) in primary healthcare (PHC) facilities in Armenia.

Methods: A qualitative study using in-depth interviews and focus group discussions was conducted with experts in adolescent health, PHC providers and facility managers from public PHC facilities and adolescents from the two largest cities in Armenia. We also collected data through observations in PHC facilities. We utilized a directed content analysis approach for data analysis.

Results: The study identified various factors negatively influencing utilization of AFHS in Armenia. These factors included adolescents' poor health literacy and awareness of health services, lack of PHPs' professional competencies, and breaches of confidentiality. Several facility-level barriers such as lack of privacy, inconvenient operating hours and long waiting times also contributed to insufficient service utilization by adolescents.

Conclusions: The study findings shed light on different perspectives related to various challenges adolescents faced in PHC facilities in Armenia. Targeted interventions needed to improve adolescents' health literacy, to enhance the PHPs' competencies and to create a friendly and welcoming environment in PHC facilities.

Keywords: Adolescent friendly health services; Adolescents; Barriers to utilization; Primary healthcare facilities; Reproductive health; Youth friendly.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Adolescent Health Services / statistics & numerical data*
  • Adult
  • Ambulatory Care Facilities / statistics & numerical data*
  • Armenia
  • Cross-Sectional Studies
  • Female
  • Focus Groups
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Male
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*
  • Qualitative Research
  • Young Adult