Experience in implementing adolescent friendly health services in rural districts of Bangladesh.

Abstract

The government of Bangladesh has initiated Adolescent Friendly Health Services (AFHS) at health facilities to improve access of adolescents to quality health care. This study aimed to document the AFHS program experiences and interventions implemented in four districts of Bangladesh. The study adopted review of literature, relevant project documents, research reports and analysis of secondary data on AFHS. The secondary data was extracted from the government District Health Information System (DHIS-2) and the HMIS (Health Management Information System) of Family planning department of the four study districts in Bangladesh from 2017 to 2019. Introduction of the AFHS program in Government health facilities had a positive impact on raising awareness among the community. It increased the proportion of adolescents receiving health services (from 6% in the pre-intervention period to 86% in the post-intervention period). The involvement of school authorities in disseminating AFHS program activities resulted in a 68.51% rise in adolescent referrals from schools. Publicity of the program and privacy of the service recipients are considered as enabling factors for the acceptance of AFHS. However, training of the service providers on comprehensive adolescent healthcare packages and expanding logistics support to the health facilities are needed for improvement of the overall service. The government of Bangladesh is committed to implementing adolescent friendly services, evident by adoption of national level strategy and guidelines through government health system, using existing resources with an additional financial support from development partners. The IEC (Information, Education and Communication) materials on AFHS, developed by different organizations were used for awareness program on AFHS. The healthcare providers were oriented/trained on AFHS, mental health, nutrition and counseling skills. Multi-sectoral collaboration at all levels: national to local level (schools, communities, adolescents club) were adopted for sustainability of this initiative.