Title: Organising adolescent and youth friendly RH services
Course: Adolescent and Youth Reproductive Health - Ethiopia (Full)

Organising adolescent and youth friendly RH services

Stop reading for a moment and think of your past experience. How did you organise and start providing adolescent- and youth-friendly reproductive health (AYFRH) services at your health post?

In order to organise AYFRH services it is important to start with a needs assessment of the adolescent and youth reproductive services at the health post. In Box 13.2 you see the five steps that you can follow to organise AYFRH services at your level.

Box 13.3 Steps in organising AYFRH services

1. Conduct a needs assessment of adolescent and youth services provided at the health facility
2. Assess whether the health workers are trained to provide AYFRH services and find out what materials are available in the health facility
3. Identify existing problems in providing RH service for young people
4. Develop proposals to solve the problems identified
5. Present an action plan to implement the proposals.

We will now show you how you go about each of the above five steps.

Step 1: Conducting a needs assessment of existing services at the health post

You use it to collect the required information on the services already provided. It will help you identify existing problems and the people and materials available to provide RH services for young people. In addition, a needs assessment tool will help you collect information on how the health post keeps track of data on AYRH services provided. Overall, the tool will help you determine whether the facility has youth-friendly characteristics.

Figure 13.3 Discussing with young people helps to identify their needs.

What are the characteristics of AYFRH services? (If you do not remember, reread Section 10.1.1. in this Module.)

Show answer

The major characteristics of AYFRH services include:

- Convenient hours
- Convenient location
- Adequate space and sufficient privacy
- Availability of peer education and a counselling programme
- Affordable fees for the service
- Involves young people in the provision of information and services (Figure 13.3)
- Informs the community about services for AYRH
- Availability of health workers trained in AYFRH services
- Materials available for AYFRH service provision

There are about 11 questions related to AYFRH service categorised under the following main headings:

- Materials/supplies and services
- Training of health workers
- Involvement of the young people and the community
- Convenience of the location and service hours

Step 2: Assess whether the health workers are trained to provide AYFRH services and find out what materials are available in the health facility

How will you carry out step 2?

Show answer

The information that you want should be gathered using a needs assessment tool.

Step 3: Identifying problems related to AYFRH

Activity 13.1

An assessment tool is used  like any other tool to enable you to carry out a task (e.g. a spoon is a tool that can be used to stir food in a cooking pot). Use an assessment tool  to collect information about the services that are available at your health post. If you have worked for sometime in the health post, you will be familiar with the facilities and you can be the source of information for the assessment. If you are a newcomer to the facility and there are other health workers or practitioners you should talk to them and collect the information jointly.

Based on the information you collect, use Table 13.2 to categorise the problems you found. Copy the table into your study diary and show this to your Tutor.

Table 13.2 Problems identified.

Materials and services | Training of health workers | Involvement of the young people and the community | Convenience of the location and service hours

Steps 4: Developing a proposal

Now you should develop a proposal to show how you are going to solve the problems you identified in your assessment. You may not be able to respond to all of the problems you have identified. Therefore you should prioritise the problems based on the importance of the problem and the resources you have or you could acquire. If you can't address the problems at your level, the proposal would help you request support from the health centre or woreda health office. The proposal should have the problems identified (it is good if you have prioritised the problems and put only two or three priority problems in your proposal). You need to include in your proposal what you want to achieve by addressing the identified problem-we usually call this the objective. You may have different ways of achieving your objectives -- we call these ways strategies -- and it is good also to indicate your strategies in your proposal.

You may need to do one or more activities for each of your prioritised problems. You should put the major activity for each problem in your proposal. Addressing some of your identified problems may require resources; if you think you need resources for your priority problems, indicate in your proposal what resources you need. Finally, you should include the time within which you would like to accomplish your proposed activities. Table 3.3 is a form that is suitable for developing a proposal. It has been completed to show you how you can use it. For example, let us say that when you conducted your needs assessment you saw that the health post had no health education materials on contraceptives. You decided to prioritise this as a major problem and used a form (see Table 13.3) to develop your proposal.

Table 13.3 Form for developing a proposal

Problem: Materials and services

No health education materials on contraception available at the health post
Objective | Make health education materials on contraceptives available at the health post
Strategy | Mobilise support from the woreda health office, health centre and NGOs working in the kebele
Activity | Collect available health education materials
Resource | Transport and perdiem cost to travel to the woreda health office and health centre
Time | One month

Step 5: Developing an action plan

With the proposal it is useful to develop an action plan for each problem that you have identified. The action plan is a very simple tool which will help you organise yourself to respond to the problems to AYFRH service provision at your health post. In the action plan you put very specific actions. The activities you have put in the proposal may be more general activities. Table 13.4 shows a form that you can use to help you develop an action plan. You need to indicate in your action plan by whom and when the specific action will be carried out. Just as for the proposal Table 13.4 has been completed for the problem identified in the needs assessment.

Table 13.4 Action plan

Problem | Action Required | Person responsible | Date to be carried out
Lack of health education materials on contraceptives at the health post
Collecting health education materials

Request both orally and through formal letter that

(i) the woreda health office

Or

(ii) the NGO working in the kebele (if any)

Or

(iii) the health centre provides you with health education materials on contraceptives
Health Extension Practitioner
September 1st 2005 (E.C.)