FACTORS INFLUENCING ADOLESCENTS’ USE OF SERVICES AT ADOLESCENT HEALTH CORNERS IN THE BRONG AHAFO REGION

Abstract

Introduction: Adolescents are generally a healthy population. Nonetheless, they face significant health challenges. Low contraceptive use, unplanned pregnancies and Sexually Transmitted Infections (STIs) including HIV/AIDS among adolescents in sub-Saharan Africa are unacceptably high and of public health concern. Complications from pregnancy and childbirth have been identified as the leading cause of death in girls aged 15-19 yrs in low and middle income countries, where almost all the estimated 3 million unsafe abortions occur. Adolescent Health Corners (AHCs) were established at selected public health facilities in the early 2000s to create conducive environments for service delivery and utilisation by adolescents. Consequently, scale up of the AHCs was embarked upon by Ghana Health Service and her partners where UKAID through the Palladium Group’s Ghana Adolescent Reproductive Health (GHARH) Project, refurbished and equipped 54 Adolescent Health Corners in the Brong Ahafo Region. This study sought to examine factors that influence adolescents in using the services provided at the AHCs. Methods A cross-sectional study was used by adopting a mixed method of data collection. Quantitative data was collected randomly from 509 study participants selected from 11 districts sampled randomly from the 27 administrative districts across the Brong Ahafo Region. Two focus group discussions were also conducted for adolescents within two of the selected districts. Eleven in-depth interviews were conducted for health care providers at the AHCs in the selected Districts. Results Majority (73.1%) of the adolescents were aware of the presence of AHCs in their catchment area. Majority (82.5%) of the respondents who were aware of AHCs had used services at the AHCs. Females had a significantly higher odds of awareness of the existence of AHCs compared to males (AOR=2.34, CI=1051-3.62, p=0.003). Adolescents whose mothers and fathers attained a primary education had higher odds [4.25 (1.93, 9.35), 3.94 (1.21, 12.79) respectively] of being aware of AHCs in their area of residence (p<0.05). Only 48.5% of schools had School Health Clubs (SHC). Adolescents who were members of SHC were 5.86 times more likely to use the services at the AHC (p<0.002). 35.2% of respondent said that providing recreational activities in the corners would attract more adolescents and 33.8% stated that services should be provided in a friendly manner. They also called for intensification of awareness creation campaign about the existence of AHCs and services provided (18.6%), provision of regular health screening (10.1%) and abortion services at the corner (2.3%). Conclusion: AHCs are crucial in reaching out to adolescents through the provision of adequate information and services during the period of adolescence. Majority of adolescents interviewed were aware of AHCs and had used the services provided. However, efforts should be made to create more demand for the services. Establishment of SHC in schools with school children being members of the clubs was found to create additional opportunity to reach out to adolescents and improve use of services at AHCs. Services provided at AHCs should be appealing to adolescents with assured privacy and confidentiality. Trained staff should create a friendly environment to address the concerns of adolescents.