Adolescent Health Services in Primary Health Care and Providers’ Perspectives on Access, Quality, and Utilisation Gaps

Adolescent sexual and reproductive health (SRH) services constitute an essential component of comprehensive primary healthcare delivery. This study assessed the availability, delivery, and perceived quality of adolescent SRH services in Albanian primary healthcare centers, barriers faced by healthcare personnel and the role of NGOs. A cross-sectional study was conducted among 399 healthcare professionals across three districts of Albania (Elbasan, Shkoder, and Durres). Data were collected on service provision, staff training, resource availability, and perceived quality of adolescent SRH services. Associations between training, service coverage, geographic location, and proposed improvement strategies were analyzed using chi-square tests. Service delivery varied significantly between rural and urban settings (p < 0.001). Staff training was strongly associated with broader SRH service coverage (p < 0.001). Key barriers to service provision included inadequate training, limited resources, and institutional constraints. Nurses were identified as the primary service providers. However, SRH services rarely targeted high-risk or marginalized adolescent populations. Perceived service quality was significantly associated with proposed improvement strategies (p = 0.002). Only 19.3% of respondents reported the presence of NGO-led adolescent sexual and reproductive health (SRH) projects in their facilities, whereas 50% indicated no NGO involvement. Support from non-governmental organizations (NGOs) to primary health centers (PHCs) was limited, with only 15.5% reporting such assistance. Adolescent SRH services in Albania remain fragmented and uneven. Strengthening staff training, enhancing coordination with NGOs, and developing targeted approaches for high-risk adolescent groups are essential to improve access, quality, and equity of adolescent SRH services.