An evaluation of a sexual and reproductive health (SRH) project on friendly health services utilisation by adolescents in Lesotho

Abstract

Background: Lesotho is one of the countries that have adopted and implemented strategies to address the challenges that impede negatively on utilisation of adolescent- friendly sexual and reproductive health services. In this regard, the Lesotho SRH and HIV linkage project of 2011 serves as the foremost point of reference for both the research problem and aim of the study. Aim: This study seeks to evaluate the sexual and reproductive health (SRH) and HIV linkage project on friendly health service provision and utilisation by adolescents in Lesotho. The evaluation will be based on the way services are offered to the targeted population at the selected healthcare site. Factors influencing access to and utilisation of health services were also explored. Methods: The qualitative, exploratory and descriptive design was used. Purposive sampling was employed for the selection of a total sample size of 21 adolescents and 5 (five) primary healthcare professionals who were sampled according to a pre-determined selection criteria. Two self-designed in-depth semi-structured interview guides were developed for data collection from the adolescents and nurses at the selected research sites. Clinical records were checked to assess utilisation of services by adolescents. The information gathered was triangulated with data collected from face-to-face interviews and analysed thematically. The data were transcribed considering content analysis for thematic aspects and patterns of the data obtained. Results: The results indicated that adolescent females utilise most of the sexual reproductive services than the males. Most of these adolescent females were pregnant and lactating, and visited healthcare centres for contraceptives as well. The results further indicated a significant decline in the use of sexual and reproductive health services for reasons such as: lack of human resources, poor infrastructure, fixed working hours; as well as location and attitudes of the healthcare workers, which influenced the accessibility and acceptability of services being provided. Most critically, the findings revealed that the selected healthcare site does not provide adolescents with friendly services. Conclusion and recommendations: The study recommends that a separate adolescent sexual reproductive healthcare facility be built at the same research site to provide the required level of service in a very conducive environment away from adults. Team building, school visits, and sporting activities are also recommended as part of up-scaling adolescent friendly services to the community in a tangible manner. The results of this study should not be generalized. Rather, a study of the same nature would be ideal to explore the phenomenon of adolescent-friendly sexual reproductive healthcare services in other settings.