Youth-Friendly Health Services in Ethiopia: What Has Been Achieved in 15 Years and What Remains to be Done

Abstract

Abstract
Since 2005, Pathfinder International has partnered with the Ethiopian Ministry of Health to implement integrated youth-friendly services (YFS), an evidence-based approach that reduces barriers to sexual and reproductive health (SRH) services for young people. Program experience shares the 15-years journey, including milestones, achievements, scale-up efforts, learnings, and remaining YFS-provision gaps that must be filled to improve adolescent health in Ethiopia.
The first phase of YFS initiation was an interactive process that involved consensus-building among public-sector stakeholders, the establishment of selection criteria for participating sites, readiness-assessment of facilities selected to initiate YFS, and collaborative development of action plans with the facilities. In the second phase, Pathfinder International and partners designed and implemented YFS using the World Health Organization (WHO) ExpandNet systematic scale-up framework to achieve institutionalized and sustainable impact at scale. As a result, from 2005 to 2020, more than 39,000 peer educators and 12,000 YFS providers received training on YFS, sexually transmitted infections (STIs), and contraception including long-acting reversible contraceptives (LARCs). More than 25-million-person contacts with young people were done on quality health information, and more than 8 million have received YFS, such as modern contraceptives, including LARCs, STI and HIV testing and treatment, and post-abortion care.
The lessons from Pathfinder International’s more than a decade of YFS implementation in Ethiopia, showed YFS that responding to the needs of young people beyond providing accessible, unbiased, and confidential (with privacy) services are critical to improving health service uptake among young people. This required continuous effort to create an enabling environment, use evidence for decision making, engagement of the public sector and young people from inception to scaling-up YFS. Improvement in SRH service uptake was possible by tailoring implementation to local context and institutionalizing YFS within existing public health systems. Furthermore, rigorous age-disaggregated data and evidence were needed to inform adolescent health and development programs in Ethiopia. [Ethiop. J. Health Dev. 2021: 35(SI-5):70-77]
Keywords: Health service, Youth friendly service, scale-up, Ethiopia