Youth-friendly Services

Young people, especially those who are sexually active, need access to a variety of reproductive health and HIV services. Frequently, youth seek services only when there is an acute illness or problem, such as a symptomatic sexually transmitted infection or pregnancy.

Youth often avoid using HIV prevention and other services because of inconvenient hours or location, unfriendly staff, and lack of privacy and confidentiality. Since many young people avoid using these services, special efforts must be made to attract, serve, and retain young clients. When youth do go to health sites, efforts need to be made to meet both the pregnancy and STI/HIV prevention needs of youth, even where clinical services are often separate. Also, youth have said they like to receive services when possible at pharmacies, and some programs are working with pharmacies to serve youth better.

Researchers have found that youth-friendly services generally share the following traits:

• Providers are trained to communicate with youth in a respectful and nonjudgmental manner
• The facility has policies of confidentiality and privacy for youth
• The facility has convenient hours and location for young people, as well as a nonthreatening environment
• The fees are affordable
• Youth participate in developing policies and implementing services through an advisory board, as peer educators, and in other roles
   

Recommended Resources

Curricula

Comprehensive Reproductive Health and Family Planning Training Curriculum Module 16: Reproductive Health Services for Adolescents (244 pages, 1.6 MB)
This module includes sections to sensitize providers to the needs of adolescents and to prepare them to offer reproductive health services in a way that is youth-friendly. It emphasizes dual protection against STI/HIV and pregnancy, safer sex, counseling, care for pregnant adolescents, and issues related to gender, sexual abuse, and sexual orientation. (Pathfinder, 2004)

The WHO Orientation Programme on Adolescent Health for Health-Care Providers
This comprehensive program for providers contains a planning and preparation section and nine training modules covering the meaning of adolescence, adolescent sexual and reproductive health, adolescent-friendly health services, sexually transmitted infections in adolescents, care of adolescent pregnancy and childbirth, unsafe abortion in adolescents, pregnancy prevention, and other topics. Some modules have multiple sessions. Only selected modules are available online, but the entire module can be ordered on a CD-ROM or in printed form. (World Health Organization, 2004)

Reproductive Health of Young Adults Training Module
This Web-based training module is designed to increase the awareness and understanding of the reproductive health needs of young adults among policy-makers, program directors, program planners, and health care providers. The module has sections on overview issues, information and services young adults need, contraceptive options, and issues regarding STI/HIV prevention and treatment. The modules can be used either as an interactive self-study program or as a participatory, group training experience with PowerPoint slideshow, presenter's notes, and other resources. (Family Health International, 2003)
 

Reports and Briefs

HIV Prevention in Young People in sub-Saharan Africa: A Systematic Review (103 pages, 2 MB)
This report presents an evaluation of 23 interventions to prevent HIV among young people in sub-Saharan Africa. Interventions took place in schools, health services, or geographically-defined communities, with results released between January 2005 and December 2008. The results’ implications can be used to generate clear recommendations for policies and programming. (London School of Hygiene and Tropical Medicine, 2010)

Evolution of the National Adolescent-friendly Clinic Initiative in South Africa Case (52 pages, 2.3 MB)  
This document describes an initiative for quality improvement in adolescent-friendly services implemented in public-sector primary health care clinics in South Africa.  The main steps of the program are described, as are the key lessons learned. (World Health Organization, 2009)

Increasing HIV/AIDS Therapy Adherence among Youth in Mozambique: the TAP/Pathfinder International Experience (8 pages, 455 KB)
This document provides an overview of the World Bank-funded Treatment Acceleration Project (TAP) in Mozambique. It outlines Pathfinder's comprehensive program for youth that integrates counseling, treatment, and care to promote HIV testing and antiretroviral therapy adherence for HIV-positive youth. The program demonstrates the effective role to be played by well-trained peer advocates and their collaboration with quality youth-friendly clinical services. (Pathfinder International, 2009)

National Standards and Implementation Guide for Youth Friendly Health Services (90 pages, 2.4 MB)
To ensure quality, youth-friendly health services for young people, the Bhutan Ministry of Health, in collaboration with Reproductive Health Program and the Comprehensive School Health program, has developed a guide to enable all health workers to mainstream youth-friendly services. (Bhutan Ministry of Health, 2009)

Creating Youth-Friendly Pharmacies (4 pages, 141 KB)
Pharmacies are an underused resource for providing reproductive health information and services to youth. Pilot programs have helped pharmacies function in a more youth-friendly way and make these services better known to youth. (Family Health International/YouthNet, 2005)

Youth-Friendly Pharmacies and Partnerships: The CMS-CELSAM Experience (33 pages, 290 KB)
The Commercial Market Strategies project developed a network of youth-friendly pharmacies to provide reproductive health information and contraceptives to youth in Guanajuato, Mexico. This report documents lessons learned in the design, development, and implementation of the youth-friendly pharmacy model. (USAID/PSP-One, 2005)

Franchised Youth Clinics Motivate Behavior Change in Madagascar (2 pages, 168 KB)
A study of franchised youth clinics in Madagascar demonstrates that the program contributed to removing barriers to condom use and motivated sexually experienced young people to use condoms. (PSI, 2004)

Applying Social Franchising Techniques to Youth Reproductive Health/HIV Services (34 pages, 338 KB)
This working paper analyzes what role social franchising techniques might have in expanding youth reproductive health/HIV services, with an emphasis on making these services more youth-friendly. It applies critical analysis to four case studies of programs using social franchising techniques for youth, including how friendly the services were to youth. (Family Health International/YouthNet, 2003)

Adolescent-friendly Health Services: An Agenda for Change
This document draws on case studies from around the world to provide a rationale for improving health services for adolescents, summarize common health problems adolescents face, and discuss what makes services more adolescent-friendly. It highlights the critical role that adolescents themselves can play, in conjunction with committed adults, to contribute to their own health and well-being. (World Health Organization, 2002)
 

Tools

Adolescent Job Aid
The Adolescent Job Aid is a handy desk reference tool for health workers (trained and registered doctors, nurses and clinical officers) who provide services to children, adolescents and adults. It aims to help these health workers respond to their adolescent patients more effectively and with greater sensitivity. It provides precise, step-by-step guidance on how to deal with adolescents when they present with a problem or a concern about their health or development.
It comprises three main parts:
Part 1: The clinical interaction between the adolescent and the health worker.
Part 2: Algorithms, communication tips and frequently asked questions on 25 presentations related to developmental conditions, pregnancy-related conditions, genital conditions including sexually transmitted infections, HIV and other common presentations.
Part 3: Information for adolescents and their parents or other accompanying adults on important health and development issues.
The Adolescent Job Aid is intended to be used along with the Orientation Programme on Adolescent Health, a tool which is being used in many countries. (World Health Organization, 2010)

Adolescent Contraceptive Counseling Cue Cards
These colorful and user-friendly job aids for providers are designed to offer helpful information and tips specific to the reproductive health needs of youth. Each of the eight cards covers a contraceptive method, from male condoms and IUDs to injectable contraceptives and lactational amenorrhea. (Pathfinder, 2003)

Adolescent-Friendly Health Services. An Impact Model to Evaluate their Effectiveness and Cost (33 pages, 389 KB)
To help programs formulate appropriate questions and establish rationale for evaluation and systematic appraisal of health services, WHO offers a framework/model, including selecting an appropriate package of services, establishing a network of service providers, determining a delivery model, improving the quality of health services provision, and creating a demand for adolescent services. (World Health Organization, 2002)

Adolescent Sexual and Reproductive Health: A Training Manual for Program Managers
This manual provides comprehensive training for providers on youth perspectives and needs, behavior change issues, life skills, youth-friendly services, monitoring and evaluation, and more. The manual, available in English and Spanish, is based on training processes directed by PROFAMILIA/Colombia over the past decade. (CEDPA, Profamilia/Colombia, 2003)

A Rapid Assessment of Youth-Friendly Reproductive Health Services (12 pages, 203 KB)
This tool was developed to facilitate the rapid assessment of youth-friendly characteristics, using the clinic assessment tool described above, providing the basis for developing and implementing a comprehensive action plan. (Pathfinder, 2003)

Clinic Assessment of Youth-Friendly Services. A Tool for Assessing and Improving Reproductive Health Services for Youth (24 pages, 3.5 MB)
This short, hands-on tool is designed for program personnel working on a project to assess and improve youth services. Staff can record data on service delivery and information on 12 youth-friendly characteristics, which are described here. (Pathfinder, 2002)

Youth-Friendly Services: A Manual for Service Providers
This comprehensive curriculum covers biases toward serving youth, provider values, adolescent development, contraception and STIs/HIV, effective communication and counseling skills, and other issues. It talks about creating youth-friendly services through a system called COPE (client-oriented, provider efficient). You can download segments of the manual. (EngenderHealth, 2002)

Meeting the Needs of Young Clients: A Guide to Providing Reproductive Health Services to Adolescents
This desk-reference-sized handbook is designed to help service providers and health workers strengthen the reproductive health care and services offered to adolescents. It covers barriers to good reproductive health care, pregnancy prevention, prevention of STIs and HIV, counseling, strategies to make services more youth-friendly, and importance of building a referral network. (Family Health International, 2000)