Facility Preparedness, Barriers, and Facilitators to the integration and implementation of Adolescent and Youth-friendly health services in Primary Health Care centres in Southwest Nigeria - A mixed method study

Background Adolescences/youth (A/Y) make the transition to adulthood in good health, but there are particular public health challenges within this age group, such as injuries from accidents or violence, mental health problems, problems from substance use, problems from undernutrition and overnutrition, endemic diseases (e.g. malaria), and sexual and reproductive health (SRH) problems. Adolescent and youth-friendly health services (AYFHSs) provide access to information and services on prevention, diagnosis, counselling, treatment, and care and allow all people to safely reach services without travelling long distances. This study aimed to describe the existing services provided for A/Y at PHCs, assess the knowledge, perceptions, and practices of AYFHS among the healthcare providers (HCPs), and understand the medical officers of health (MOHs) perceived facilitators and barriers to integration of AYFHS at PHCs in Ogun State. Methods The study was a descriptive cross-sectional with a mixed-method approach. A checklist, questionnaire, and interview guide were used to collect data from the PHCs, HCPs and MOHs, respectively. The quantitative data were analysed via SPSS version 27. Qualitative data were transcribed verbatim, analysed manually and presented in narrations using rapid, deductive thematic analysis. The level of significance was set at a P-value < 0.05. Results Ten model PHCs, 32 HCPs, and ten MOHs participated in the study. In the assessment of the facility readiness for AYFHSs, basic amenities, medical equipment, etc., were available or adequate, but there was a lack or absence of clearly visible signboards, comfortable waiting areas, displays of IEC materials, and confidentiality procedures and practices. More than 80% and 62.5% of the HCPs had good knowledge and positive perceptions of providing AYFHS, respectively. There were statistically significant associations between the overall perception scores of the respondents and the practices of some AYFHSs, such as A/Y having a consultation without an appointment (p=0.020). In the interviews with the MOHs, some factors were identified as facilitators (e.g. existing relationships with NGOs for support) and barriers (e.g. inadequate staffing) to the AYFHS. Conclusion Most of the PHCs in this study are inadequately prepared to provide AYFHSs and fall short of national recommendations. Most of the identified barriers to AYFHS integration were health system-related.