Quality of youth friendly services at public health facilities in Debre Birhan Town: A mixed study

Introduction : Adolescents and youths require access to high-quality, youth-friendly services to address challenges related to sexual health, relationships, and the potential for early parenthood. In response, both the World Health Organization and the Ethiopian government have developed and implemented various strategies. However, despite these efforts, the quality of youth-friendly services provided by health facilities in Ethiopia remains inadequate. Objective : the aim of this study was to assess the quality of youth friendly services provided in public health facilities in Debre Berhan town, 2023 Methods : A facility-based cross-sectional study, incorporating both quantitative and qualitative methods, was conducted from May 1–30, 2023. The quality of youth-friendly services was assessed using the Donabedian framework, which evaluates structure, process, and output components. Data were collected through a systematic sampling technique, utilizing an interview-administered questionnaire and an observation checklist. A significant association was identified using an adjusted odds ratio, with a 95% confidence interval and a P-value of less than 0.05. Results : In this study a total of 422 youth friendly service clients’ age between 10-24 years were participated. The quality of youth-friendly services was 70.7%, 41.3, and 50.5% for structural, process, and output quality dimensions, respectively. Age (15-19) (AOR=0.31,95% CI:0.17, 0.56), clients who waited less than 30 minute (AOR=4.58,95% CI:1.67,12.55), clients who waited 30 minute to one hour(AOR=3.65,95% CI: 1.88, 7.06), not comfortable with sex of service providers (AOR=0.37,95% CI: 0.18,0.76), and payment status free of charge (AOR=2.38, 95%CI:1.36, 4.18) had statistically significant association with client satisfaction. Conclusion : The study shows that, the overall quality of youth friendly service at public health facilities of Debre Birhan town was 54.2%, which was below the standard of care.