Barriers to utilization of adolescent friendly health services in primary healthcare facilities in Armenia: a qualitativ
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ORIGINAL ARTICLE
Barriers to utilization of adolescent friendly health services in primary healthcare facilities in Armenia: a qualitative study Varduhi Hayrumyan1 Arusyak Harutyunyan1
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Zaruhi Grigoryan1 • Zhanna Sargsyan1 • Serine Sahakyan1 • Lusine Aslanyan1
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Received: 2 May 2020 / Revised: 21 September 2020 / Accepted: 25 September 2020 Swiss School of Public Health (SSPH+) 2020
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 Adolescents Adolescent friendly health services Barriers to utilization Primary healthcare facilities Reproductive health Youth friendly
Introduction This article is part of the special issue ‘‘Adolescent health in Central and Eastern Europe’’. & Varduhi Hayrumyan [email protected] Zaruhi Grigoryan [email protected] Zhanna Sargsyan [email protected] Serine Sahakyan [email protected] Lusine Aslanyan [email protected] Arusyak Harutyunyan [email protected] 1
Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
Adolescence is a critical phase of change when young people develop their behavioral patterns that may impact their health status and health outcomes over the full life span (Sawyer et al. 2018). Therefore, investments in adolescents’ health have significant implications for meeting the Sustainable Development Goals (World Health Organization 2017a). Though adolescent mortality has declined by 17% between 2000 and 2016, yet in 2016, 1.1 million adolescents died because of various avertable or curable diseases (World Health Organization 2018). The most common causes of adolescent mortality included respiratory infections, drowning, road injuries, diarrheal diseases and meningitis (World Health Organization 2017b). Othe
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