Adolescent-Friendly Health Services (AFHS) in the Philippines
Adolescent-Friendly Health Services (AFHS) in the Philippines aim to provide responsive sexual reproductive health (SRH) services to adolescents and young people. These services are governed by several directives, including the Responsible Parenthood and Reproductive Health Act of 2012 (Republic Act 10354), the Omnibus Health Guidelines for Adolescent, and the National Policy and Strategic Framework on Adolescent Health and Development (DOH AO 2013-0013), among others.
The Importance of an Enabling Environment
To ensure effective delivery of SRH services to adolescents, it is essential that health facilities create an environment where service providers are non-judgmental, unbiased, considerate, and equipped with the appropriate competencies. Moreover, the characteristics of the health facilities themselves play a crucial role in adolescents’ access to quality care and their ability to make informed decisions about their health. Recognizing the unique developmental stage of adolescents and youth, their meaningful participation is vital for the success of any intervention.
Adolescents should be actively engaged in the planning, implementation, monitoring, and evaluation of health services, as well as in decisions regarding their own care. To facilitate this participation, it is recommended to involve the Sangguniang Kabataan (SK) Federation and the City Youth Development Office (LYDO) as a central coordinating body or secretariat for the Technical Working Group.
Key Benefits of AFHS Implementation
- Improved Access: AFHS facilitates access for youth to higher-quality SRH services, ensuring they receive the care they need.
- Standardization: AFHS standards are institutionalized across service provision, capacity-building, and infrastructure development, ensuring consistency and quality in care delivery.
- Health Provider Advocacy: AFHS empowers health providers to become advocates for adolescents and youth, ensuring they receive appropriate care and support.
- Future Health-Seeking Behavior: AFHS encourages future health-seeking behavior among adolescents and youth by providing them with positive experiences and guidance during their interactions with health facilities.
- Tailored Services: Adolescents are more likely to seek sexual and reproductive health information and services when they feel understood and supported by health facility workers who are sensitive to their needs and contexts.
- Enhanced Referral System: AFHS helps mold the referral system for various adolescent-related services to be automatic, ensuring seamless access to care regardless of the person or office involved in the referral process.
AFHS as a High-Impact Practice (HIP)
The AFHS HIP aims to reduce adolescent birth rates and pregnancies among three primary groups as detailed below:
| Target Adolescent Group | Primary Goals and Actions |
|---|---|
| Non-pregnant | Encourage them to delay their sexual debut and utilize ASRH services to prevent unwanted pregnancies. |
| Pregnant | Ensure they have access to safe pregnancy and delivery services, and prevent immediate repeat pregnancies. |
| Postpartum | Support them in preventing immediate repeat pregnancies, practicing birth spacing, and receiving assistance in reintegrating back into school and society. |
Implementation Steps and Strategy
To achieve these goals, AFHS focuses on developing health systems conducive to ASRH programs through the following systematic approach:
Step 1: Identify issues and concerns
Develop a unified strategy for Adolescent Health and Development by gathering stakeholders to identify relevant adolescent issues and baseline data through preliminary interviews, focus group discussions (FGDs), and consultations. Use a Monitoring Tool to map out the number of service delivery points, providers, and available services.
Step 2: Engage Key Stakeholders
Identify Key Stakeholders and Engage in Dialogue. It is necessary to engage stakeholders representing various sectors involved in adolescent health and development to identify their roles, current programs, points of synergy, and potential gaps in service. Ideally, involve representatives from Youth and Governance (SK Federation, LYDO, ABC President) and the Health sector.
Step 3: Service Delivery and Human Resources
Focus on establishing fully-staffed and operational adolescent-friendly facilities in schools, barangays, and health centers. This includes:
- Offering comprehensive services to adolescents covering their holistic needs, including general health, social welfare, mental well-being, family planning, nutrition, education, and security.
- Establishing a referral network connecting all service providers to facilitate the screening, referral, processing, and after-care needs of adolescents.
- Providing training to all service providers in each facility to communicate with adolescents in a non-biased and non-judgmental manner.