Many of the barriers that youth face in accessing health services are unique to young people due to their stage in life and associated special needs, perceptions, and abilities. Youth-friendly services are services that all adolescents are able to obtain, and these services should meet adolescents’ expectations and needs and improve their health.
Youth-friendly services are able to effectively attract young people, meet their needs comfortably and responsively, and succeed in retaining young clients for continuing care.[1]
The World Health Organization identified five key dimensions of youth-friendly services[2]:
- Equitable
- Accessible
- Acceptable
- Appropriate
- Effective
A study published in 2013 explored whether publicly-funded family planning clinics in the U.S. provide youth-friendly services[3]. Results from the nationally-representative sample showed the availability of youth-friendly family planning services varies greatly. In 78% of facilities surveyed, staff had received special training to meet teens’ contraceptive needs. About two thirds (64%) of facilities had evening and/or weekend hours. However, only 10% had separate check-in areas for adolescents.
Youth-friendly service characteristics include characteristics about providers and staff, the health facility, and the health facility programming:
Youth-Friendly Provider Characteristics
- Familiarity with adolescent physiology and development
- Knowledge of appropriate medical options for adolescents according to age and maturity
- Counseling training
- Working with and serving youth training
- Skills to communicate fluently in the youth language
- Effective interpersonal skills
- Ability to relate to youth in a respectful manner
- Skills to honor youth privacy and confidentiality
- Skills to engage in conversation about body image and development, sex, relationships, and contraceptive method options
- Skills to bring myths to the surface, to discuss and dispel them
- Sexual health assessment taken or updated at every visit
Youth-Friendly Health Facility Characteristics
- Convenient location
- Adequate space
- Counseling areas that provide visual and auditory privacy
- Examination areas that provide visual and auditory privacy
- Comfortable surroundings
- High quality adolescent health materials available, in all the languages that young people in the community speaks and for various reading levels, including low literacy
- Clear and visible information about youth clinic hours and location
- Automated voice messaging on telephones providing information about location, visiting hours, and telephone number for counseling
- Displays of information and health education materials on issues related to adolescent sexual and reproductive health
- Teen-focused magazines and poster displayed on the walls
Youth-Friendly Health Facility Programming Characteristics
- Youth involvement in design and continuing feedback of programming
- Affordable fees
- Boys and young men welcomed and served
- Wide range of services available including pregnancy and birth control counseling, STI/HIV testing and treatment
- Use of number system calling instead of names in the waiting room
- System to “red-flag” youth with particular confidentiality concerns
- Flexible hours; offering lunch, evening and weekend appointments
- Well-established mechanism to allow for slightly longer visits with adolescents
- Clinic staff is called by first name to make the environment more informal and welcoming
- Drop-in clients welcomed and appointments arranged rapidly
- Participation in the federal 3408 drug discount purchasing program
- Well-established linkages and referrals to mental health, education, employment, and social services
Healthy Teen Network was contracted by Baltimore City Healthy Department and the Teen Pregnancy Prevention Initiative to design and deliver two separate client-centered trainings to increase the youth-friendliness of clinics, one targeted toward clinicians and the other toward frontline staff and clinic administrators. Additionally, Healthy Teen Network was also contracted to conduct clinic site visits to perform baseline assessments of youth-friendliness and offer relevant technical assistance.
To find out more about Healthy Teen Network can support your efforts to increase the youth-friendliness of your services, contact Training@HealthyTeenNetwork.org or fill out a Service Request form.
How do you work to improve the youth-friendliness of your services?
Are there other factors important to consider when providing youth-friendly services?
[1] United Nations Educational, Scientific and Cultural Organization (UNESCO). (2004). FRESH tools for effective school health: Characteristics of youth-friendly services.
[2] World Health Organization (WHO). (2009). Quality assessment guidebook: A guide to assessing health services for adolescent clients. http://whqlibdoc.who.int/publications/2009/9789241598859_eng.pdf . Accessed 10/30/2013.
[3] Kavanaugh, M.L., Jerman, J., Ethier, K., & Moskosky, S. (2013). Meeting the contraceptive needs of teens and young adults: Youth-friendly and long-acting reversible contraceptive services in U.S. family planning facilities. Journal of Adolescent Health, 52: 284-292.
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