New tools needed to make sure youth-friendly reproductive health services are effective

Young people urgently need access to quality reproductive health services, yet they are often an underserved population. In a study of 70 low and middle income countries, almost all reported that 10% or fewer of adolescent women had visited a health facility in the past 12 months and were informed about family planning. Even when young people can access services, they may feel embarrassed, face stigma in their communities or fear seeing judgmental healthcare providers. Adolescents need tailored services that support their transition into adulthood.

Unfortunately, a review by the Institute for Health Policy Studies at UCSF found that there is currently no consensus on how to measure the effectiveness of youth-friendly sexual and reproductive health services. Researchers looked at 20 studies and found that they didn’t use common tools—in fact they used more than a hundred different indicators to assess services. The most common themes to arise were focus on accessibility; staff characteristics and competency; and confidentiality and privacy. Many of the indicators researchers used weren’t particularly relevant to youth-friendly services and were more focused on delivering a basic standard of care, like the availability of clean water and ventilation.

The researchers call for development of a core set of focus areas with standardized measurements so effectiveness can be easily compared across studies globally, with adjustments for local and cultural relevance. Some research indicates that young people might not care about the aspects that providers and programmers think are viable youth-specific approaches. Young people should play a role in developing these tools to ensure that they actually reflect what is most important to delivering services that are truly youth-friendly. Community stakeholders, researchers, NGOs and public institutions can play a role as well. Without these tools, clinics and policymakers are left with a vague definition of exactly what constitutes youth-friendly health services and limited information about their effectiveness. Future research that uses such tools to measure what most improves health outcomes could inform where to most effectively spend resources and ensure services meet the needs of youth.