Adolescent reproductive health in Uganda: issues related to access and quality of care.

UNLABELLED: Adolescent health in Kabarole district, Uganda, is seriously jeopardized by both high teenage pregnancy rates and high rates of sexually transmitted diseases, including HIV infection.

OBJECTIVES: To elucidate views, perceptions and attitudes of key informants who are involved in the delivery of reproductive health services to adolescents.

STUDY GROUP: Four managers of youth-related nongovernmental organizations, two government nurses, and four youth leaders.

METHODS: Qualitative study with content analysis using in-depth interviews.

RESULTS: Participants agreed that reproductive health services in Kabarole district are not adolescent friendly. Most often, lack of privacy and confidentiality for the adolescents attending a health unit was cited as one important reason. Other factors contributing to a less adolescent friendly service environment were inconvenience of services including the fragmentation of different service components and lack of specific traIning for health workers on how to relate appropriately to adolescents. Also noted was that several participants had a negative attitude toward the sexual activity of adolescents. Suggestions for service improvement were limited to training of health workers and increased support for the infrastructure.

CONCLUSIONS: Reproductive health services for adolescents in Kabarole district could be strengthened by improving the privacy and confidentiality of services. Health workers must also be trained in counseling and in treating adolescents in a youth-appropriate and high quality fashion. Staff attitudes must also be addressed.