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Adolescence is a time when a young person develops his or her identity, acquires greater autonomy and independence, experiments and takes risks and grows mentally and physically. To successfully navigate these changes, an accessible and health system when needed is essential.

We assessed the structure and content of national primary care services against these standards in the field of adolescent health services. The main criteria identified by adolescents as important for primary care are as follows: accessibility, staff attitude, communication in all its forms, staff competency and skills, confidential and continuous care, age appropriate environment, involvement in health care, equity and respect and a strong link with the community.

We found that although half of the Models of Child Health Appraised countries have adopted adolescent-specific policies or guidelines, many countries do not meet the current standards of quality health care for adolescents. For example, the ability to provide emergency mental health care or respond to life-threatening behaviour is limited. Many countries provide good access to contraception, but specialised care for a pregnant adolescent may be hard to find.

Access needs to be improved for vulnerable adolescents; greater advocacy should be given to adolescent health and the promotion of good health habits. Adolescent health services should be well publicised, and adolescents need to feel empowered to access them.

The purpose of this paper is to assess the situation of accessibility to reproductive health rights, and the conditional factors of accessibility to such rights of adolescents.

A qualitative method was used to extract information from 80 informants. Data were collected through in-depth interview, focus group discussion, observation, data recording, audio recording and the review of related documents during August to October 2016.

Adolescents had not accessed to their right on informing of their decision making; information and education; health; confidentiality and privacy; and treating with equity and no discrimination. Also, the conditional factors influenced to the accessibility on such rights were lacking of knowledge on reproductive health and negative attitude toward this matter among the people concerned. There were still no regulations or policies on the performance of authority agencies and the factors on social dimensions, traditions, customs, sexual culture and religion.

The findings from this study would be a help to promote the accessibility for adolescents to reproductive health rights under the Prevention and Solution of Adolescent Pregnancy Problem Act, B.E. 2559 (2016) specific on standard criteria reproductive health services from hospitals and the involvement from Ministry of Education for the development of sex life skill and reproductive health for the teacher.

This paper assessed factors affecting adolescent-friendly health services (AFHS), education and utilization among youth (10–19 years) in Kumbungu district, Ghana.

The study used a cross-sectional design involving 416 adolescents from households using a random sampling technique. The authors collected data on sociodemographic characteristics, education and utilization of AFHS using a semi-structured questionnaire between June and September 2017. Logistic regression models were used to determine the factors associated with AFHS education and utilization.

Of the 416 adolescents interviewed, 66% were between 15 and 19 years. Half (50%) of the adolescents received AFHS education, 54% utilized existing services and 85% knew about health challenges. Females (aOR = 0.64; p = 0.031) were less likely to receive AFHS education compared to males. Muslims (aOR = 0.21; p < 0.001) were less likely to utilize AFHS compared to Christians. Adolescents with primary (aOR = 6.65; p = 0.020), junor high school (JHS) (aOR = 10.66, p = 0.079) or senior high school (SHS) (aOR = 1.04; p = 0.954) education were more likely to utilize AFHSs compared to those with no education.

This study reports a moderate level of education and the utilization of adolescent health services. Sex, religion and education are the key predictors of AFHS education and utilization. This study contributes to the understanding of adolescent health services and the foundation for future studies. It may be used for the planning of adolescent health service programs in disadvantaged settings.

The purpose of this paper is to explore perceived barriers to accessing and using adolescent health services in Ghana.

The study was a qualitative study adopting a case study design. In total, 24 adolescents were recruited from four adolescent health facilities in Tema, a suburb of Ghana, using convenient sampling. In-depth interviews with respondents were conducted coupled with the taking of field notes and personal observations. Data collection took place between January and May 2017. Data were transcribed, managed and coded for themes. Thematic analysis was guided by Braun and Clarke’s (2006) Framework.

The findings of this study revealed that majority of the respondents were females (54 percent) older adolescents (above 15 years (60 percent), students (79 percent)), had junior high school education and stayed with their biological parent(s) (70 percent). Adolescents in this study perceived four main barriers that restrict their access to or use of adolescent health services. The barriers were found at the facility level, provider level, community level and personal level.

The findings of this study provide evidence-based information for planning adolescent health care interventions that would improve adolescents’ access to and use of health services in Ghana.

Adolescent pregnancy and sexually transmitted infections including HIV are important public health issues in many countries around the world. The trend is escalating among adolescents of younger ages. Many programmes aim to prevent adolescent sexual risk behaviours associated with these health outcomes. The purpose of this paper is to describe and analyse methodological and substantive features of research on interventions to delay the initiation of sexual intercourse and prevent other sexual risk behaviours among early adolescents.

The review includes studies published between 2006 and 2017 that appear in Thai and international databases.

A total of 33 studies met specified review criteria. Of the studies reviewed, 14 used randomized control designs, 16 used quasi-experimental designs and three used a pre-test, post-test design. Sample sizes ranged from 64 to 4,776 subjects; nearly two-thirds of the studies (n = 22) included multiple follow-up surveys. The programmes evaluated in these studies can be grouped into three categories: abstinence-based sexuality education programmes (n = 12), comprehensive sexuality education programmes (n = 13) and youth development programmes designed for early adolescents (n = 10). In total, 22 programmes reviewed were effective in changing targeted adolescent psychosocial and/or behavioural outcomes.

One of the limitations encountered in this study involved the search in library databases published only in Thai and English. Due to the limitation of searching library databases included in the review that reported the effects and differences among the included studies. Moreover, the search included publications consisted of heterogeneous designs and purpose with reports of different types of outcomes made it impossible to compare effect sizes.

The knowledge gained can be used to design and implement effective sexual health promotion programmes for early adolescents. Moreover, the findings can be applied as a guideline for health provider working in a schools, communities and adolescent health services. Recommendations for future studies are needed to consider methodological and substantive characteristics as well as the people who are involved in youth sexual health outcomes.

It is necessary for government to develop a policy for encouraging parents to be aware and participate in solving the problems.

The review indicated that the positive effects of parental involvement and technology media as a programme material on the psychosocial and behavioural outcomes.

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.

Sixteen million adolescents give birth each year, constituting 11% of all births worldwide. Adverse adolescent pregnancy outcomes are well-documented. Available data on adolescent pregnancies have mainly relied on self-reported age and retrospective survey data, which might not capture adolescent births accurately. This paper reports on trends in adolescent pregnancy and associated adverse birth outcomes in Matlab, Bangladesh, using data from the Matlab Heath and Demographic System (HDSS) which precisely documents maternal age.

The study was conducted in the rural subdistrict of Matlab in Bangladesh. HDSS data were used to examine trends in adolescent motherhood (10–19 years) in the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b) service areas (ISA) and government service areas (GSA) between 2007 and 2015. A total of 4,996 adolescent mothers were included in the analysis. Chi-square testing and binary logistic regression were used to document adolescent pregnancy trends and the differences in and causes of perinatal death.

The fertility rate was 27 per 1000 adolescent mothers in ISA and 20 per 1000 adolescent mothers in GSA, during the 9 years of the study period. The adjusted odd of an adolescent mother having a perinatal death in ISA, relative to GSA was 0.69. Significant determinants of perinatal death among adolescent mothers included maternal education, paternal education, mother’s age at first birth, asset score and distance from the nearest health facility.

This paper documents the real trend of adolescent pregnancy by capturing the accurate age at pregnancy for the first time in Bangladesh.

This study aims to gain a comprehensive understanding of adolescent’s experiences of individual school social work counselling in Swedish elementary schools.

The study encompasses interviews with 16 adolescents about their experiences of individual counselling with school social workers (SSWs). The data was analysed using conventional content analysis.

The main result was the adolescents’ desire “to navigate to shore” to speak freely about their whole lives with a professional SSW and find a “ safe haven,” […] where a trusting professional cared for and comforted them in counselling. The counselling contact contributed to increased knowledge about oneself. The results reveal the importance of the SSWs paying attention and listening to the adolescents’ narratives. The creation of a coherent life narrative enables to finally end counselling and “Cast off.”

The results highlight the importance of Swedish SSWs focusing on individual counselling sessions with adolescents to provide a setting for growth.

Adolescent mental health is a global concern. There is an urgent need for creative, multimedia interventions reflecting adolescent culture to promote mental health literacy and well-being. This study aims to assess the impact of a film-based intervention on adolescent mental health literacy, well-being and resilience.

A pretest-posttest intervention with a multi-methods evaluation was used. A convenience sample of ten schools facilitated students aged 15–17 years to engage in an online intervention (film, post-film discussion, well-being Webinar). Participants completed surveys on well-being, resilience, stigma, mental health knowledge and help-seeking. Five teachers who facilitated the intervention participated in post-implementation interviews or provided a written submission. Analysis included paired-t-test and effect size calculation and thematic analysis.

Matched pretest-posttest data were available on 101 participants. There were significant increases in well-being, personal resilience and help-seeking attitudes for personal/emotional problems, and suicidal ideation. Participants’ free-text comments suggested the intervention was well-received, encouraging them to speak more openly about mental health. Teachers similarly endorsed the intervention, especially the focus on resilience.

Intinn shows promise in improving adolescents’ mental health literacy and well-being. Film-based interventions may encourage adolescents to seek professional help for their mental health, thus facilitating early intervention.