Youth-Friendly Health Service Model Development at Huairat Hospital, Buriram Province - การพัฒนารูปแบบบริการคลินิกวัยรุ่นห้วยราช โรงพยาบาลห้วยราช จังหวัดบุรีรัมย์

Abstract

            This research aimed to develop a model of youth-friendly health service (so-called "Teen Clinic") to improve accessibility of adolescents to reproductive health services. The model was designed for adolescent of Huairat district with 2 major strategies: (1) a proactive networking with stakeholders including teenagers, families, local government bodies and communities, and (2) a comprehensive health service package comprising of 4 measures: safe virgin (abstinence), safe sex, safe maternal care for adolescents, and safe abortion. Friendly charateristics of the clinic included simple procedure, welcoming and secured atmosphere, confidentiality, and quick one-stop service. Health service was managed in accordance with
those stakeholders' suggestions. Data were collected from October 2014 - September 2015, and the statistics used were frequency and percentage. Process and content analysis were also conducted. It was found that there was a significant increase in number of visits to Teen Clinic. The number of visits increased from 108 in 2013 to 401 in 2014, a 3.7 times increase). More stakeholders including schools and local administration authorities had involved in the model development process. Consultations on unwanted pregnancies increased from 18 to 190 cases (10.6 times increase) and half of them were teenagers. Majority of unwanted pregnancies were terminated after a participatory counseling process (175 pregnancies; 92.1%), of whom 49.7% were teenagers. After abortion, two-thirds (67.4%) used some forms of contraception to prevent repeated pregnancy. The rate of live births per 1,000 of 15-19 years old female population reduced from 54.8 in 2013 to 40.0 in 2014. Patient satisfaction was as high as 98.1%. This model of youth-friendly health services of comprehensive health service package through stakeholder participation was found to be feasible and effective in increasing accessibility and satisfaction of the young population, as well as reducing the rate of teenage pregnancies in the community.
Key words: model development, youth-friendly health service, teen clinic, adolescent pregnancy