Predictors of adolescent friendly health services implementation in two administrative districts of the Eastern Region of Ghana

Lisa Ulmer, Drexel University
Yeetey A. Enuameh, Kintampo Health Research Centre (KHRC)
Renee Turchi, Drexel University
Angela Diaz, Mount Sinai School of Medicine
John Rich, Drexel University
Edmund Browne, Kwame Nkrumah University of Science and Technology (KNUST)
Zekarias Berhane, Drexel University
Aatanor Enuameh, Kwame Nkrumah University of Science and Technology (KNUST)

Adolescents are special, but vulnerable with special healthcare needs, which are mostly ignored on the presumption that they are healthy. Adolescent Friendly Health Services (AFHS) aim at providing accessible, developmentally appropriate and comprehensive evidence-based promotional, preventive, therapeutic, and rehabilitative health care to adolescents through well-trained professionals and well-equipped health facilities. Using a cross-sectional study design with a multi-informant and mixed method survey, adherence to AFHS criteria was assessed in health facilities providing AFHS-oriented care in the Akwapim North and South Districts of Ghana. Early adopters (health facilities trained in AFHS) had significantly higher AFHS implementation outcomes compared to late adopters (not trained in AFHS implementation). Location (urban or rural) did not influence AFHS implementation outcomes. Three (clinical care infrastructure, logistics monitoring and capacity building) and not the fourth (administrative functions) of 4 organizational characteristics were significantly associated with implementation outcomes (equity, accessibility, acceptability, appropriateness and effectiveness). Major barriers to AFHS implementation included care provider attitude/behavior towards adolescents, community attitudes about adolescents receiving sexual and reproductive health services and health care costs.