Impact of the MEMA kwa Vijana Adolescent Sexual and Reproductive Health Interventions on Use of Health Services by Young People in Rural Mwanza, Tanzania: Results of a Cluster Randomized Trial
Impact of the MEMA kwa Vijana Adolescent Sexual and Reproductive Health Interventions on Use of Health Services by Young People in Rural Mwanza, Tanzania: Results of a Cluster Randomized Trial
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DOI：
10.1016/j.jadohealth.2010.03.020
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发表时间：
2010-11-01
影响因子：
7.6
通讯作者：
Ross, David A.
中科院分区：
文献类型：
--
作者：
Larke, Natasha;Cleophas-Mazige, Bernadette;Ross, David A.
目的：评估青少年性健康干预对坦桑尼亚年轻人使用卫生服务的影响。方法：将 20 个社区（包括 39 个卫生设施）随机分配到干预组或比较组。作为一揽子干预措施的一部分，干预部门的卫生工作者接受了提供青年友好卫生服务的培训。在卫生机构中进行了独立的过程评估，并利用性健康和生殖健康问题场景模拟患者到诊所就诊。 1998 年（基线）和 1999-2001 年评估了对医疗机构就诊率的影响。对试验队列中的年轻人报告的性传播感染 (STI) 症状和卫生服务使用情况进行了评估。结果：基线时，每个医疗机构每月平均就诊 STI 症状的年轻男性为 0.5 人，年轻女性为 1.0 人。调整基线差异后，1999-2000 年干预社区中年轻男性的出勤率更高 (p = .005)，并且这种差异随着时间的推移而增加 (p-趋势 = .022)。然而，出勤率的平均差异相对较小，在基线调整后，2001 年为每月 1.1 次（95% CI：0.5，1.7）。有较弱的证据表明干预对年轻女性出勤率的影响（p = .087）。尽管在干预设施中分发了较多的安全套，但分发的安全套却很少 (p = .008)。一般来说，干预卫生工作者往往较少做出判断，并提供更全面的信息。结论：培训工作人员提供更适合青少年的卫生服务可以增加年轻人，尤其是年轻男性对疑似性传播感染的卫生服务的利用。 (C) 2010 年青少年健康与医学协会。版权所有。
Purpose: To assess the impact of an adolescent sexual health intervention on the use of health services by young people in Tanzania.Methods: Twenty communities, including 39 health facilities, were randomly allocated to the intervention or comparison arm. Health workers from the intervention arm were trained in the provision of youth-friendly health services, as part of a package of interventions. Independent process evaluations were conducted in health facilities, and simulated patients visited clinics using sexual and reproductive health problem scenarios. The impact on health facility attendances were assessed in 1998 (baseline) and 1999-2001. Reported sexually transmitted infection (STI) symptoms and use of health services were evaluated in young people in the trial cohort.Results: The mean monthly attendance for STI symptoms per health facility, per month was .5 for young males and 1.0 for young females at baseline. Attendance by young males was greater in the intervention communities in 1999-2000 after adjustment for baseline differences (p = .005), and this difference increased over time (p-trend = .022). The mean difference in attendance was however relatively modest, at 1.1 per month in 2001 after adjustment for baseline (95% CI:.5, 1.7). There was weaker evidence of an intervention effect on attendance by young women (p = .087). Few condoms were distributed, although a greater number were distributed in intervention facilities (p = .008). Generally, intervention health workers tended to be less judgmental and provided more comprehensive information.Conclusions: Training staff to provide more youth-friendly health services can increase the utilization of health services for suspected STIs by young people, especially among young men. (C) 2010 Society for Adolescent Health and Medicine. All rights reserved.