"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)

Permanent URL: https://etd.library.emory.edu/concern/etds/gf06g278x?locale=pt-BR
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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

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