Implications for action

Ministries of health should take the lead in guiding the provision of health services to adolescents, both within and outside the government. They should put in place initiatives grounded in national programmes on HIV, sexual and reproductive health or other topics, to improve the coverage and quality of health services for adolescents (especially those who are more likely to face health and social problems) in order to achieve clearly defined health outcomes. A combination of dedicated and integrated youth-friendly service-delivery models needs to be considered, depending on the health-system context, to ensure both universal coverage and targeted provision. The quality of services needs to be defined, measured, monitored and systematically improved.

WHO/Europe support

WHO/Europe supports countries in increasing the coverage and quality of youth-friendly services, through a national step-by-step process:

• conducting a situation analysis of adolescent health or review of selected public health programmes (such as school health services);
• developing a strategy to strengthen the health sector’s response to adolescent health, within the context of a broader multisectoral strategy;
• developing, approving and disseminating national quality standards for health service provision to adolescents;
• making quality assessment surveys in selected facilities to identify problems;
• developing a quality-improvement plan, and overseeing its implementation;
• reassessing quality, to monitor progress towards meeting standards for health service provision to adolescents; and
• developing/adapting generic materials to promote and guide the implementation and monitoring of activities to implement and monitor the standards.

The approach has been applied in Kyrgyzstan, the Republic of Moldova, Tajikistan and Ukraine. Its implementation started in Kosovo (in accordance with Security Council Resolution 1244 (1999)) and Turkmenistan.

WHO/Europe facilitates experience sharing to accelerate efforts across the WHO European Region, by mapping youth-friendly service-delivery models and documenting good practices. WHO/Europe has made available 12 case studies from 9 countries on youth-friendly health services and policies, describing innovative and socially and culturally acceptable initiatives.

Background

A range of barriers hinders adolescents’ use of health services. Nongovernmental organizations (NGOs) in many countries take part in providing health services that are intended to respond to the needs of adolescents. These initiatives are often small in scale, limited in duration and uncertain in quality. Where governments provide youth-friendly services, much more needs to be done to make them widely accessible by young people regardless of their socioeconomic circumstances. So far, little effort has gone into enabling primary care practitioners to deliver services that are sensitive to young people’s needs, and experience is lacking in ways of reaching the adolescents most at risk. The potential of school health services, where available, to contribute effectively to health and development outcomes of school-age children is underexplored.