14th International AIDS Conference Barcelona, Spain - July 7-12, 2002

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrD1277)

Cleophas-Frisch B, Obasi A, Mshana G, Wamoyi J, Plummer M, Rwakatare M, Ross D, Grosskurth H, Gavyole A
African Medical and Research Foundation -- (AMREF) Mwanza, Mwanza, Tanzania

BACKGROUND: Attitudes of health workers (HW) may have contributed to poor uptake of reproductive health services among young people. Health workers from 18 government health units (HU) were trained in March 1999 and June 2000 to provide integrated, youth-friendly reproductive health services as a part of a broader adolescent reproductive health intervention that is currently being evaluated in a community randomised trial in Mwanza, Tanzania. The impact of the youth-friendly services training was evaluated in December 2000 using simulated patients.

METHODS: 10 young-looking villagers aged between 15 - 17 years were trained to present themselves as patients using scripted scenarios in 20 randomly selected HU (10 intervention and 10 control). Consultations were recorded discreetly. Permission for the evaluation was sought from the Ministry of Health and HW were informed 6 months prior the evaluation, during training and supervision. HU were ranked on the basis of debriefing interviews with the simulated patients conducted immediately after the consultations. Transcripts of the clinic interactions were also analysed.

RESULTS: One intervention HU was closed. Of the remaining 19 units, 78% of intervention HU were found to have good HW attitudes towards youth, compared to only 10% of comparison communities. Similarly, none of the intervention HW made judgmental comments about the sexual behaviour of adolescents compared to 50% in comparison HU. However, only 50% of intervention sites and 40% of comparison sites ranked as either "good" or "fair" in terms of privacy. Furthermore, condom use was poorly discussed in both intervention and comparison health units.

CONCLUSIONS: Within this intervention, youth-friendly health services training has improved health worker attitudes and the confidentiality of the services provided to young people in rural Tanzania. Future training should also focus on greater improvement of privacy and the discussion of condom use.

020707
WeOrD1277

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.