"They're treating us bad now, never the same": Young people's perceptions of health services in Soweto, South Africa: A qualitative investigation Público
Schriver, Brittany Lauren (2013)
Abstract
Background
Previous research has indicated that South African youth feel
estranged from health care facilities and health care workers, and
as a result are more reluctant to seek out medical treatment,
tests, or counseling. In 2006, the South African Department of
Health adopted and scaled-up loveLife's Youth Friendly Services
(YFS) initiative to a national policy to improve youth utilization
of health services by strengthening counseling services and
community sensitization. As YFS services roll-out, alternative
services to target young people are also becoming more popular.
Success of any of these services, however, is dependent upon a
greater perception of health services as a whole.
Objective
This project aims to examine the knowledge of YFS initiatives,
perceptions of current health services, and opinions on alternative
health interventions for future implementation.
Methods
The study was conducted in Soweto, South Africa utilizing the Birth
to Twenty (BT20) cohort. Twenty-five in-depth interviews were
conducted between May-July 2012. Twenty-three of these were
utilized for analysis according to modified grounded theory.
Results
Overall, knowledge of YFS programs was very low and no participant
was able to express deep knowledge of the program's purpose or
activities. In general, young people are dissatisfied with the
current health services in Soweto due to a lack of resources, long
waiting times, and poor quality of care heightened by an underlying
lack of choice and perceived inequity. With regards to alternative
services, there was no particular service that was preferred over
another (8 YFS, 6 SBHC, 9 CHW).
Conclusions
Assurance of implementation of YFS standards should occur in all
public health clinics with improved outreach and marketing in
nearby communities. In-service training of nurses should be
prioritized for all clinics with a focus on sensitivity to young
people and equitable treatment to all.
Table of Contents
Chapter 1:
Introduction.....................................................2
1.1
Background................................................................2
1.2
Purpose.....................................................................3
1.3
Significance...............................................................3
1.4 List of
Acronyms.........................................................5
Chapter 2: Literature
Review..............................................6
2.1 The State of Adolescent Health
Worldwide.......................6
2.2 Adolescent Friendly
Services.........................................8
2.3 Adolescent Health and Health Services in South
Africa......11
2.4 Historical Context of South African Health
Services..........15
Chapter 3:
Methods.........................................................21
3.1 Setting and
Sampling..................................................21
3.2 In-depth
Interviews....................................................22
3.3 Data
Analysis............................................................24
3.4 Strengths and
Limitations............................................24
Chapter 4: Results &
Discussion.........................................26
4.1 Knowledge of YFS
Initiatives........................................26
4.2 Perception of Current Health
Services............................29
4.3 Attitudes toward Alternative Health
Services...................38
School Based Health
Clinics...............................................38
Community Health
Workers................................................39
Chapter 5: Conclusions and
Implications...............................42
5.1 Knowledge of YFS
Initiatives.........................................42
5.2 Perceptions of Current Health
Services...........................43
5.3 Attitudes towards Alternative
Services...........................44
5.4 Summary of
Recommendations......................................45
References.....................................................................46
Appendix A: In-depth Interview
Guide..................................48
Appendix B: Participant Recruitment Call
Script......................54
Appendix C: Informed Consent
Sheets..................................55
Appendix D: IRB Exemption
Letter........................................59
About this Master's Thesis
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