Assessing provision of adolescent-friendly services at six regional referral hospitals in Uganda

The stage of adolescence (10-19 years) is not just a period in which boys and girls become sexually active. It is also typically a time of experimentation, new experiences and, importantly, of vulnerability to HIV, other sexually transmitted infections, and teenage pregnancies among others. In the current global landscape where millions of adolescents live in countries with a high burden of HIV1 (Uganda inclusive), the need for hospitals to ensure access to information and services for HIV and sexual and reproductive health for adolescents becomes increasingly important.

Selected service providers at Jinja Regional Referral Hospital attending a presentation on AFHS service delivery organized by USAID/SUSTAIN and MOH. Photo credit@URC 2015 USAID/SUSTAIN /Julian Natukunda

Comprehensive data is essential for shaping accurate HIV-related messages and serves as a critical guide for the provision of other reproductive health services. As such, USAID Strengthening Uganda’s Systems for Treating HIV Nationally (SUSTAIN), in collaboration with the Uganda Ministry of Health (MOH), has assessed the provision of adolescent services offered at six regional referral hospitals in the country. These include: Moroto, Mbale Gulu, Lira, Jinja and Kabale regional referral hospitals. After jointly developing an assessment tool, USAID/SUSTAIN and the MOH visited the six hospitals to determine staffing levels and caregivers’ knowledgeability on the provision of adolescent services, availability of space where adolescents are attended, information and education materials and job aides, reporting and monitoring tools, and existing linkages between adolescent healthcare and other service delivery areas. The exercise also involved discussions with hospital leadership and all service unit in-charges on the state of adolescent healthcare in Uganda, and the need to avail services to adolescents and young people before risky behaviors are formed and become entrenched.

Adolescent Healthcare Services in Uganda
Towards establishing adolescent-friendly services at the six hospitals, USAID/SUSTAIN and MOH have planned a phased model of implementation that will involve training of healthcare providers on provision of the service, onsite coaching and mentoring, central learning sessions and engagement of hospital leadership. USAID/SUSTAIN is looking at the six hospitals as future model centers from which other regional referral hospitals and lower level health centers can learn on the provision of adolescent-friendly services.
Key assessment findings at the six hospitals
• Only 1 out of 6 hospitals has space designated for adolescents. Adolescents are served together with adults=no environment for confidentiality to address their unique needs.
• Limited knowledge and skills on adolescent healthcare services.
• Poor linkages, referral systems, and coordination
of services for adolescents.
• No Information and communication materials for adolescents.
• No disaggregated data tools on adolescent health care.
Written by Bernadeta M. Nagita,  Executive and Communications Officer, USAID/SUSTAIN Project