Format

Send to

Choose Destination
PLoS One. 2017 Mar 8;12(3):e0173342. doi: 10.1371/journal.pone.0173342. eCollection 2017.

Quality of reproductive healthcare for adolescents: A nationally representative survey of providers in Mexico.

Author information

1
Public Health Methods Department, Reproductive Health Division, Center for Population Health Research, National Institute of Public Health, Mexico City, Mexico.
2
Colectivo Sol, A.C., Mexico City, Mexico.
3
Reproductive Health Division, Center for Population Health Research, National Institute of Public Health, Mexico City, Mexico.
4
Gender and Health Department, Reproductive Health Division, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.

Abstract

OBJECTIVE:

Adolescents need sexual and reproductive health services but little is known about quality-of-care in lower- and middle-income countries where most of the world's adolescents reside. Quality-of-care has important implications as lower quality may be linked to higher unplanned pregnancy and sexually transmitted infection rates. This study sought to generate evidence about quality-of-care in public sexual and reproductive health services for adolescents.

METHODS:

This cross-sectional study had a complex, probabilistic, stratified sampling design, representative at the national, regional and rural/urban level in Mexico, collecting provider questionnaires at 505 primary care units in 2012. A sexual and reproductive quality-of-healthcare index was defined and multinomial logistic regression was utilized in 2015.

RESULTS:

At the national level 13.9% (95%CI: 6.9-26.0) of healthcare units provide low quality, 68.6% (95%CI: 58.4-77.3) medium quality and 17.5% (95%CI: 11.9-25.0) high quality reproductive healthcare services to adolescents. Urban or metropolitan primary care units were at least 10 times more likely to provide high quality care than those in rural areas. Units with a space specifically for counseling adolescents were at least 8 times more likely to provide high quality care. Ministry of Health clinics provided the lowest quality of service, while those from Social Security for the Underserved provided the best.

CONCLUSIONS:

The study indicates higher quality sexual and reproductive healthcare services are needed. In Mexico and other middle- to low-income countries where quality-of-care has been shown to be a problem, incorporating adolescent-friendly, gender-equity and rights-based perspectives could contribute to improvement. Setting and disseminating standards for care in guidelines and providing tools such as algorithms could help healthcare personnel provide higher quality care.

PMID:
28273129
PMCID:
PMC5342221
DOI:
10.1371/journal.pone.0173342
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center