Healthcare Workers’ Delivery of Adolescent Responsive Sexual and Reproductive Healthcare Services: An Assessment in Plateau State, Nigeria

Abstract

Abstract Background Adolescents should have access to high quality and responsive sexual and reproductive health services (SRHS), and recently, in Nigeria a national policy on the health and development of adolescent and young people was developed to ensure adolescents’ sexual and reproductive health needs will be met. However, it is unclear to what extent the policy is implemented by healthcare workers (HCW’s) in health facilities across the country. The current study assessed the general availability of SRHS and the delivery of SRHS to adolescents in primary care facilities from the perspective of HCW. We also assessed HCWs views of facilities meeting the SRH needs of adolescents, and their understanding of what constitutes adolescent responsive SRHS. Methods Using a cross sectional design, we included 409 HCWs selected by multistage sampling technique, mostly females (66.3%) and above 40 years, across six Local Government Areas (LGAs) of Plateau State, Nigeria and interviewed them using an interviewer-administered survey questionnaire. Results The most frequently available SRHS was antenatal and delivery care (69.2%). Availability of contraception was reported by 25.9%, and 14.9% reported the availability of post abortion care. Only 1.2% indicated that all four SRHS recommended for adolescents (counselling/information provision, provision of contraceptives, testing/treatment for sexually transmitted infection (STI) /HIV, and post abortion care) were available. Little over half (58.4%) felt their facilities were adequate in meeting the SRH needs of adolescent, and this was associated with duration of working experience (AOR = 0.407; CI = 0.238–0.698; p = .001), delivery of post abortion care (AOR = 3.612; CI = 1.886–6.917; p = .001), and providing SRHS to adolescents without parental consent (AOR = 3.612; CI = 1.886–6.917; p = .001). Most HCWs had poor understanding of adolescent responsiveness of SRHS, and better understanding was associated with lower HWC’s age, and also better among HCWs who provided SRHS without parental consent and in a separate room for privacy and confidentiality. Conclusion We conclude that ASRHS is not yet as stipulated in the national policy in Plateau State, Nigeria and HCW’s perception of their services being adolescent responsive was higher when they actually delivered relevant ASRHS. In general they have poor understanding of what it means to provide adolescent-responsive services.