Adolescent-friendly health services in Nepal: usage and key determinants
Abstract Background Adolescent-Friendly Health Services (AFHS) are crucial for addressing the sexual and reproductive health needs of adolescents. Despite AFHS integration into public health facilities in Nepal since 2009, the utilization of these services remains suboptimal and concerning. The purp...
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BMC
2025-07-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-025-13157-y |
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| author | Sandip Pahari Shiva Raj Acharya Amritraj Pokhrel Jagat Prasad Upadhyay Sagar Parajuli Muskan Pudasainee Monika Koirala |
| author_facet | Sandip Pahari Shiva Raj Acharya Amritraj Pokhrel Jagat Prasad Upadhyay Sagar Parajuli Muskan Pudasainee Monika Koirala |
| author_sort | Sandip Pahari |
| collection | DOAJ |
| description | Abstract Background Adolescent-Friendly Health Services (AFHS) are crucial for addressing the sexual and reproductive health needs of adolescents. Despite AFHS integration into public health facilities in Nepal since 2009, the utilization of these services remains suboptimal and concerning. The purpose of this study was to investigate the utilization and key determinants of AFHS in Pokhara, Nepal. Methods An analytical quantitative study involving 569 adolescents aged 12–19 years was conducted from July 12 to October 25, 2023. Study participants were selected using simple random sampling and proportionate stratified sampling methods. The study utilized a self-administered questionnaire, and key determinants of AFHS usage were identified using logistic regression analyses. Results The mean age of the participants was 14.66 ± 1.09 years. Only 37.1% of the adolescents had utilized AFHS at the time of the study. More than half of the participants (51.7%) mentioned the need for AFHS. The key determinants of AFHS utilization were: perceived healthcare need as seeking health facilities directly (AOR: 1.62, 95% CI: 1.07–2.46, vs. seeking care after home remedies); hospital as the first treatment point (AOR: 2.50, 95% CI: 1.68–3.72, vs. grassroots health facilities); perceived need for AFHS (AOR: 1.57, 95% CI: 1.06–2.33); not paying for AFHS (AOR: 2.06, 95% CI: 1.39–3.04), feasible service time (AOR: 1.51, 95% CI: 1.02–2.46); proper counselling services (AOR: 1.97, 95% CI: 1.19–3.26); and adequacy of AFHS facilities (adequate water supply and sanitation facilities, AOR: 1.70, 95% CI: 1.12–2.58). Conclusions The utilization of AFHS remains low within the study population. Key factors influencing AFHS utilization include perceived healthcare need, the first point of treatment, payment for services, perceived necessity of AFHS, service time feasibility, availability of counselling services, and access to reliable water supply and sanitation facilities. Therefore, it is crucial to establish proper infrastructure, implement effective planning, allocate adequate budgets, train personnel, and provide comprehensive counselling services tailored to adolescents’ needs to ultimately enhance AFHS utilization. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-53daba7e28b944049d5045891e7f0c27 |
| institution | Kabale University |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-53daba7e28b944049d5045891e7f0c272025-08-20T03:46:04ZengBMCBMC Health Services Research1472-69632025-07-012511910.1186/s12913-025-13157-yAdolescent-friendly health services in Nepal: usage and key determinantsSandip Pahari0Shiva Raj Acharya1Amritraj Pokhrel2Jagat Prasad Upadhyay3Sagar Parajuli4Muskan Pudasainee5Monika Koirala6School of Health and Allied Sciences, Pokhara UniversityKorea University College of MedicineOxford University Clinical Research Unit NepalSchool of Health and Allied Sciences, Pokhara UniversitySchool of Health and Allied Sciences, Pokhara UniversitySchool of Health and Allied Sciences, Pokhara UniversityKapilvastu Integrated Development ServicesAbstract Background Adolescent-Friendly Health Services (AFHS) are crucial for addressing the sexual and reproductive health needs of adolescents. Despite AFHS integration into public health facilities in Nepal since 2009, the utilization of these services remains suboptimal and concerning. The purpose of this study was to investigate the utilization and key determinants of AFHS in Pokhara, Nepal. Methods An analytical quantitative study involving 569 adolescents aged 12–19 years was conducted from July 12 to October 25, 2023. Study participants were selected using simple random sampling and proportionate stratified sampling methods. The study utilized a self-administered questionnaire, and key determinants of AFHS usage were identified using logistic regression analyses. Results The mean age of the participants was 14.66 ± 1.09 years. Only 37.1% of the adolescents had utilized AFHS at the time of the study. More than half of the participants (51.7%) mentioned the need for AFHS. The key determinants of AFHS utilization were: perceived healthcare need as seeking health facilities directly (AOR: 1.62, 95% CI: 1.07–2.46, vs. seeking care after home remedies); hospital as the first treatment point (AOR: 2.50, 95% CI: 1.68–3.72, vs. grassroots health facilities); perceived need for AFHS (AOR: 1.57, 95% CI: 1.06–2.33); not paying for AFHS (AOR: 2.06, 95% CI: 1.39–3.04), feasible service time (AOR: 1.51, 95% CI: 1.02–2.46); proper counselling services (AOR: 1.97, 95% CI: 1.19–3.26); and adequacy of AFHS facilities (adequate water supply and sanitation facilities, AOR: 1.70, 95% CI: 1.12–2.58). Conclusions The utilization of AFHS remains low within the study population. Key factors influencing AFHS utilization include perceived healthcare need, the first point of treatment, payment for services, perceived necessity of AFHS, service time feasibility, availability of counselling services, and access to reliable water supply and sanitation facilities. Therefore, it is crucial to establish proper infrastructure, implement effective planning, allocate adequate budgets, train personnel, and provide comprehensive counselling services tailored to adolescents’ needs to ultimately enhance AFHS utilization. Clinical trial number Not applicable.https://doi.org/10.1186/s12913-025-13157-yAdolescent health servicesHealthcare needsUtilizationDeterminants |
| spellingShingle | Sandip Pahari Shiva Raj Acharya Amritraj Pokhrel Jagat Prasad Upadhyay Sagar Parajuli Muskan Pudasainee Monika Koirala Adolescent-friendly health services in Nepal: usage and key determinants BMC Health Services Research Adolescent health services Healthcare needs Utilization Determinants |
| title | Adolescent-friendly health services in Nepal: usage and key determinants |
| title_full | Adolescent-friendly health services in Nepal: usage and key determinants |
| title_fullStr | Adolescent-friendly health services in Nepal: usage and key determinants |
| title_full_unstemmed | Adolescent-friendly health services in Nepal: usage and key determinants |
| title_short | Adolescent-friendly health services in Nepal: usage and key determinants |
| title_sort | adolescent friendly health services in nepal usage and key determinants |
| topic | Adolescent health services Healthcare needs Utilization Determinants |
| url | https://doi.org/10.1186/s12913-025-13157-y |
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