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Addressing Adolescent Health Needs at WHO Global Consultation
Taking Action to Enhance Quality in Adolescent Friendly Health Services

Dr. Diana Silimperi, MD, Deputy Director, the Quality Assurance Project, participated in a three-day consultation on adolescent friendly services, sponsored by the Child and Adolescent Health division of the World Health Organization in Geneva in early March 2001.

The consultation’s objectives were to understand adolescents’ health and development-related needs and problems - including their health care seeking behaviors, contributions health services could make in their health and well-being, and the availability of health services to adolescents in different parts of the world. Objectives included defining best practices to enhance quality of health services and to deliver services in a user-friendly manner (especially in light of many countries’ economic and socio-cultural constraints), and to reach consensus on global research and action necessary to make it easier for adolescents to obtain the quality health services they need.

About 60 representatives from adolescent service organizations, bilateral agencies, United Nations’ agencies, WHO headquarters and regional representatives, and international NGOs attended. Presenters from 25 countries in Africa, Latin America, the Middle East, Asia, and the NIS shared their experiences.

Dr. Silimperi discussed QAP’s work with the National Adolescent Friendly Clinic Initiative in South Africa in her presentation "Achieving Quality in Adolescent Healthcare Services," which addressed Assumption 11 (see text below). She discussed the development of adolescent friendly standards, criteria, and the tools to measure compliance with the standards. The presentation evoked much interest, and this work in South Africa appears to be the first of its kind.

Topics of discussion included the content of essential service packages, clinical and quality standards for adolescent care, focused accreditation, the role of the private sector and alternative delivery approaches, including outreach, and linking adolescent health with the major donor initiatives of poverty reduction and health sector reform.

A final report on the Global Consultation will include the revised 12 assumptions and recommended research and actions for the six WHO regions around the world.

Governing Assumptions

The consultation analyzed 12 governing assumptions about adolescent healthcare, which were drawn from international literature and research. Participants determined whether each assumption was supported by evidence, revised the assumptions, delineated practical implications of each assumption by the six WHO regions, and recommended future research and actions.

The 12 assumptions include:

  1. Good health in adolescence requires different but complementary actions, by different players.
  2. Although many adolescents make the transition to adulthood in good health, a proportion face health problems with serious immediate and future consequences. Hence, all adolescents need good access to preventive and curative services.
  3. Adolescents have different health-related needs from adults, because they are maturing sexually, physically, and psychologically.
  4. Adolescents in many places are unwilling or unable to obtain the health services they need.
  5. Adolescents have a clear idea about user-friendliness, which describes the ethos, rather than the content, of the services.
  6. User-friendliness, however, does not necessarily ensure that adolescents will use the services.
  7. There are promising approaches with the potential to increase service utilization by adolescents of both sexes, if a friendly health service exists.
  8. Channels other than government-run health facilities could make health services available to adolescents, who are more likely to obtain the services they need if existing resources are networked.
  9. It would be helpful to define a minimum, or optimum, package of services that could be made widely available, and would meet defined adolescent needs.
  10. Technical competence and "human qualities" relevant to adolescent health are required by health care providers.
  11. New quality assurance methods and tools need to be developed that apply to the unique aspects of adolescent health services. (The participants recommended this assumption be changed to: "Existing QA methods can be adapted and used to improve the quality of adolescent healthcare services.")
  12. There are still many practical issues for which there are no single, or simple, solutions.  (April 2001)

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The Quality Assurance Project (QAP) is funded by the U.S. Agency for International Development
(USAID) under Contract Number GPH-C-00-02-00004-00.