Skip to main content
Top
Published in: Indian Journal of Pediatrics 2/2019

01-02-2019 | Original Article

A Mixed Methods Evaluation of Adolescent Friendly Health Clinic Under National Adolescent Health Program, Puducherry, India

Authors: Thulasingam Mahalakshmy, Kariyarath Cheriyath Premarajan, Kathirvel Soundappan, Kanagarethinam Rajarethinam, Yuvaraj Krishnamoorthy, Adhisakthi Rajalatchumi, Vijayageetha Mathavaswami, Deepika Chandar, Palanivel Chinnakali, Amol R. Dongre

Published in: Indian Journal of Pediatrics | Issue 2/2019

Login to get access

Abstract

Objectives

To assess the awareness and utilization of Adolescent Friendly Health Clinic (AFHC) services among school going adolescents (14–19 y) and to explore the forces ‘for’ and ‘against’ the utilization of AFHC services in Puducherry, India.

Methods

This mixed-methods study was conducted in two primary health centres. Record review assessed the utilization of AFHC service. Survey assessed the awareness on AFHC services and self-reported illnesses and their treatment seeking behavior. Group interviews were conducted with adolescent girls, boys and healthcare providers. A summative content analysis was done to organize the ‘for’ and ‘against’ forces for service utilization.

Results

Of the 311 adolescents, less than 50% were aware of the services available at AFHC. Utilization of Weekly Iron and Folic Acid Supplementation was good. Only 2–10% of adolescents consulted the outpatient services of the Primary Health Centre for the treatment of their health problems. The authors found low utilization of AFHC services (15% among girls, zero among boys). One of the reasons for low utilization was poor awareness. Though free sanitary napkins motivated the girls to avail the services, boys considered the AFHC as a girl’s clinic. Healthcare providers suggested that building rapport and trust with adolescents and their parents, involving school teachers and ensuring privacy in the clinic would increase the utilization.

Conclusions

There is a huge gap between the awareness and utilization of AFHC services. The reasons for non-utilization were poor awareness and misconceptions about the clinic. Training of health staffs on communication skills, and supportive supervision could improve the utilization.
Literature
5.
go back to reference Sheehan P, Sweeny K, Rasmussen B, et al. Building the foundations for sustainable development: a case for global investment in the capabilities of adolescents. Lancet. 2017;390:1792–806. Sheehan P, Sweeny K, Rasmussen B, et al. Building the foundations for sustainable development: a case for global investment in the capabilities of adolescents. Lancet. 2017;390:1792–806.
9.
go back to reference Sivagurunathan C, Umadevi R, Rama R, Gopalakrishnan S. Adolescent health: present status and its related programmes in India. Are we in the right direction? J Clin Diagn Res. 2015;9:LE01–6.PubMedPubMedCentral Sivagurunathan C, Umadevi R, Rama R, Gopalakrishnan S. Adolescent health: present status and its related programmes in India. Are we in the right direction? J Clin Diagn Res. 2015;9:LE01–6.PubMedPubMedCentral
10.
go back to reference Nath A, Garg S. Adolescent friendly health services in India: a need of the hour. Indian J Med Sci. 2008;62:465–72.CrossRefPubMed Nath A, Garg S. Adolescent friendly health services in India: a need of the hour. Indian J Med Sci. 2008;62:465–72.CrossRefPubMed
11.
go back to reference Hoopes AJ, Agarwal P, Bull S, Chandra-Mouli V. Measuring adolescent friendly health services in India: a scoping review of evaluations. Reprod Health. 2016;13:137.CrossRefPubMedPubMedCentral Hoopes AJ, Agarwal P, Bull S, Chandra-Mouli V. Measuring adolescent friendly health services in India: a scoping review of evaluations. Reprod Health. 2016;13:137.CrossRefPubMedPubMedCentral
15.
go back to reference Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. Thousand Oaks, California: SAGE Publications; 2011. p. 457. Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. Thousand Oaks, California: SAGE Publications; 2011. p. 457.
20.
go back to reference Artino AR Jr, La Rochelle JS, Dezee KJ, Gehlbach H. Developing questionnaires for educational research: AMEE guide no. 87. Med Teach. 2014;36:463–74.CrossRefPubMedPubMedCentral Artino AR Jr, La Rochelle JS, Dezee KJ, Gehlbach H. Developing questionnaires for educational research: AMEE guide no. 87. Med Teach. 2014;36:463–74.CrossRefPubMedPubMedCentral
21.
go back to reference Barbour S. Doing focus groups. 4th ed. London: SAGE publications Limited; 2007.CrossRef Barbour S. Doing focus groups. 4th ed. London: SAGE publications Limited; 2007.CrossRef
22.
go back to reference Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15:1277–88.CrossRef Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15:1277–88.CrossRef
23.
go back to reference Lewin K. Field theory in social science: selected theoretical papers. New York: Harper & Row; 1951. Lewin K. Field theory in social science: selected theoretical papers. New York: Harper & Row; 1951.
24.
go back to reference Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research [Internet]. BMC Med Res Methodol. 2013;13:117.CrossRefPubMedPubMedCentral Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research [Internet]. BMC Med Res Methodol. 2013;13:117.CrossRefPubMedPubMedCentral
25.
go back to reference Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–57.CrossRef Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–57.CrossRef
27.
go back to reference Kagee A, Remien RH, Berkman A, Hoffman S, Campos L, Swartz L. Structural barriers to ART adherence in Southern Africa: challenges and potential ways forward. Glob Public Health. 2011;6:83–97.CrossRefPubMedPubMedCentral Kagee A, Remien RH, Berkman A, Hoffman S, Campos L, Swartz L. Structural barriers to ART adherence in Southern Africa: challenges and potential ways forward. Glob Public Health. 2011;6:83–97.CrossRefPubMedPubMedCentral
28.
go back to reference Garg R, Goyal S, Gupta S. India moves towards menstrual hygiene: subsidized sanitary napkins for rural adolescent girls-issues and challenges. Matern Child Health J. 2012;16:767–74.CrossRefPubMed Garg R, Goyal S, Gupta S. India moves towards menstrual hygiene: subsidized sanitary napkins for rural adolescent girls-issues and challenges. Matern Child Health J. 2012;16:767–74.CrossRefPubMed
30.
go back to reference Health seeking behavior among adolescent students in coastal district of South India [Internet]. Int J Tech Res Appl. 2015;24:23–8. Health seeking behavior among adolescent students in coastal district of South India [Internet]. Int J Tech Res Appl. 2015;24:23–8.
31.
go back to reference Kumar T, Pal P, Kaur P. Health seeking behaviour and health awareness among rural and urban adolescents in Dehradun District, Uttarakhand, India. Int J Adolesc Med Health [Internet]. 2017;29:1–7.CrossRef Kumar T, Pal P, Kaur P. Health seeking behaviour and health awareness among rural and urban adolescents in Dehradun District, Uttarakhand, India. Int J Adolesc Med Health [Internet]. 2017;29:1–7.CrossRef
32.
go back to reference Santelli JS, Nystrom RJ, Brindis C, et al. Reproductive health in school-based health centers: findings from the 1998-99 census of school-based health centers. J Adolesc Health. 2003;32:443–51. Santelli JS, Nystrom RJ, Brindis C, et al. Reproductive health in school-based health centers: findings from the 1998-99 census of school-based health centers. J Adolesc Health. 2003;32:443–51.
33.
go back to reference Prasad K. An analysis on school education aspects of Puducherry. Int J Acad Res. 2015;2:118–24. Prasad K. An analysis on school education aspects of Puducherry. Int J Acad Res. 2015;2:118–24.
34.
go back to reference Kumar R, Prinja S, Lakshmi PV. Health care seeking behavior of adolescents: comparative study of two service delivery models. Indian J Pediatr. 2008;75:895–9.CrossRefPubMed Kumar R, Prinja S, Lakshmi PV. Health care seeking behavior of adolescents: comparative study of two service delivery models. Indian J Pediatr. 2008;75:895–9.CrossRefPubMed
Metadata
Title
A Mixed Methods Evaluation of Adolescent Friendly Health Clinic Under National Adolescent Health Program, Puducherry, India
Authors
Thulasingam Mahalakshmy
Kariyarath Cheriyath Premarajan
Kathirvel Soundappan
Kanagarethinam Rajarethinam
Yuvaraj Krishnamoorthy
Adhisakthi Rajalatchumi
Vijayageetha Mathavaswami
Deepika Chandar
Palanivel Chinnakali
Amol R. Dongre
Publication date
01-02-2019
Publisher
Springer India
Published in
Indian Journal of Pediatrics / Issue 2/2019
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-018-2755-4

Other articles of this Issue 2/2019

Indian Journal of Pediatrics 2/2019 Go to the issue