Review of the evidence for interventions to increase young people's use of health services in developing countries.
Objective: This chapter reviews the evidence base for interventions that aim to increase young people's use of health services in developing countries. Methods: The authors identified published and unpublished studies and reports from developing countries (12 from Africa, 3 from Asia and one from Latin America) that provided information about interventions designed to increase young people's use of health services. The studies were classified into 6 different types based on whether they included some or all of the following characteristics: 1) training for service providers and clinic staff; 2) efforts to make the facilities more appropriate to the specific needs of young people; 3) community activities to generate demand and support for the services; and 4) involvement of other sectors such as schools and the media. The levels of evidence required to make decisions about policies and programmes were defined for each of these types. Findings: Despite the lack of detailed descriptions of interventions in the studies and difficulties interpreting the data reported in the evaluations, the studies provided evidence of increased use of health services by young people for interventions that included all of 1), 2) and 3) above, with or without the involvement of other sectors. Conclusion: The evidence was sufficient to recommend that interventions including all of 1), 2) and 3), but not those only including some of these interventions, should be widely implemented, with careful monitoring of quality and coverage, and that those that additionally involve other sectors should also be widely but cautiously implemented provided they involve a strong evaluation component. Operations research is also required to better understand the content of the interventions and their mechanisms of action.
In: Ross, D. A.; Dick, B.; Ferguson, J. (eds.) Preventing HIV/AIDS in young people: a systematic review of the evidence from developing countries. World Health Organization, Geneva, Switzerland (2006). ISBN 978-92-4-120938-0; pp. 151-204. (WHO Technical Report Series no. 938)