Assessment of Health Facility Compliance with Standards and Perception of Adolescents to Quality of Sexual and Reproductive Health Services in Kilindi, Tanga Tanzania

Promoting healthy practices during adolescence and taking steps for better protection of young people from health risks is critical to the future of countries‘ health. Young people aged 15-24years account for 60% of the new HIV infection in sub Sahara Africa. The risk of dying from pregnancy-related causes is much higher for adolescents than for older women. Quality of Sexual and Reproductive Health (SRH) services is poor in most areas in rural settings leading to low utilization of services. The study aim at assessing health facility compliance with standards and perception of adolescents to quality of sexual and reproductive health services in Kilindi, Tanga Tanzania. Main Objective of this study was to assess health facilities compliance with standards and perception of adolescents to quality of sexual and reproductive health services in Kilindi, Tanga Tanzania with Specific objectives of determining quality of SRH service in relation to MoHSW standard guidelines in Kilindi District, to assess adolescents perception towards quality of SRH services offered in Health facilities in Kilindi District and to assess attitudes of health workers towards adolescents SRH services in Kilindi District A multi-stage sampling strategy was employed to select the study sample in this cross sectional community and facility based study. Three hundred (300) young people were interviewed while 14-health facilities were assessed. Data were generated using structured interviews and standard serviqual questionnaire and analyzed using stata version 12 statistical packages. Serviqual questionnaires were analyzed using standard serviqual analysis stages where the five quality dimensions of tangibility of service, assurance, empathy, responsiveness and reliability gape scores were assessed. Quality of SRH services was perceived low with average gap score of 4.57 among all fivequality dimensions. Health facilities also showed very low scores of 2.57 out of 4 in terms of functioning fully following the seven standards for provision of Youth friendly services. Knowledge of SRH was high among young people who had higher education (p <0.001). Young people with advanced age also had higher knowledge of STIs. Health care \ud providers had no enough training on youth friendly SRH services. Quality of SRH services offered by existing health facilities to young people in Kilindi is very low regardless of awareness of young people on key SRH services available at health facilities. It is important for the program and policy makers to ensure standards set for services reflect ability of facilities to offer them\u

Rapid Urban Malaria Appraisal (RUMA) III: epidemiology of urban malaria in the municipality of Yopougon (Abidjan)

BACKGROUND: Currently, there is a significant lack of knowledge concerning urban malaria patterns in general and in Abidjan in particular. The prevalence of malaria, its distribution in the city and the fractions of fevers attributable to malaria in the health facilities have not been previously investigated. METHODS: A health facility-based survey and health care system evaluation was carried out in a peripheral municipality of Abidjan (Yopougon) during the rainy season of 2002, applying a standardized Rapid Urban Malaria Appraisal (RUMA) methodology. RESULTS: According to national statistics, approximately 240,000 malaria cases (both clinical cases and laboratory confirmed cases) were reported by health facilities in the whole of Abidjan in 2001. They accounted for 40% of all consultations. In the health facilities of the Yopougon municipality, the malaria infection rates in fever cases for different age groups were 22.1% (under one year-olds), 42.8% (one to five years-olds), 42.0% (> five to 15 years-olds) and 26.8% (over 15 years-olds), while those in the control group were 13.0%. 26.7%, 21.8% and 14.6%, respectively. The fractions of malaria-attributable fever were 0.12, 0.22, 0.27 and 0.13 in the same age groups. Parasitaemia was homogenously detected in different areas of Yopougon. Among all children, 10.1% used a mosquito net (treated or not) the night before the survey and this was protective (OR = 0.52, 95% CI 0.29–0.97). Travel to rural areas within the last three months was frequent (31% of all respondents) and associated with a malaria infection (OR = 1.75, 95% CI 1.25–2.45). CONCLUSION: Rapid urbanization has changed malaria epidemiology in Abidjan and endemicity was found to be moderate in Yopougon. Routine health statistics are not fully reliable to assess the burden of disease, and the low level of the fractions of malaria-attributable fevers indicated substantial over-treatment of malaria