Unpacking Barriers to Integrated Adolescent Health Services: Insight from Primary Care Implementation in Low Resource Settings”

Background Integrating adolescent health service into primary care is Essential for achieving Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs). Yet, in low-resorce settings such as Indonesia, implementation remains fragmented and inconsistently aligned with adolescent need. West Java Province continues to experience disparities in adolescent health outcomes due to weak intersectoral coordination, limited provider capacity, sociocultural stigma, and gaps between national policy frameworks and operational practice. Objective The study aimed to explore contextual and systemic barriers that hinder the integration of adolescent health services within primary care settings in West Java, Indonesia, by examining the perspective of policymakers, healthcare providers, and adolescent. Method A qualitative phenomenological approach was used to explore the perspectives of policymakers, healthcare providers, and adolescent. Data were collected through 25 in-depth interviews and four group discussion. All sessions were audio recorded, transcribed werbatim, and analyzed thematically following Braun and Clarke’s approach. NVivo 15 supported data management and coding. Credibility and trustworthiness were ensured through triangulation, member checking, reflexive documentation, and maintenance of an audit trail. Results Four themes emerged: (1) fragmented coordination across sectors resulting in discontinuous service pathways and weak referral mechanism; (2) limited provider competency and insufficient adolescent-centered communication reducing service acceptability; (3) sociocultural stigma, gender norms, and low awareness hindering help-seeking and utilization; and (4) inadequate policy translation, inconsistent local operationalization, and unstable funding compromising program sustainability. Cross-cutting issues included weak interprofessional collaboration and minimal adolescent engagement. Conclusion The integration of adolescent health services eithin Indonesia’s primary care system remains constrained by systemic, organizational, provider-level, and sociocultural barriers. Strengthening implementation requires clear operational guidelines, sustainable financing, structured intersectoral governance, enhanced provider capacity, and meaningful adolescent participation. These findings offer actionable evidence to support adolescent-responsive primary care in resource limited settings.