ArticlePloS one2022
Individual and contextual factors affect the implementation fidelity of youth-friendly services, northwest Ethiopia: A multilevel analysis.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Bridging policy and practice: a scoping review of health system implementation research practice in Ethiopia.Implementation science communications · 2026Review
- Implementation fidelity of Ethiopia's Malaria test-and-treat guideline amid a resurgence in Amhara Region: A mixed-methods study.PloS one · 2026Article
- Implementation fidelity of tuberculosis screening for Diabetes mellitus patients among healthcare providers offering diabetes services in Ubungo District, Dar es Salaam, Tanzania.PLOS global public health · 2026Article
- Characterizing models of adolescent and youth-friendly health services in sub-Saharan Africa: a scoping review.International journal of adolescent medicine and health · 2024Article
- Empowering youth and ensuring health: utilization of youth friendly service among preparatory school students in Gambella, Southwest Ethiopia.Frontiers in reproductive health · 2024Article
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Authors and funding
4 authors.
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Abstract
backgroundThe evaluation of all potential determinants of implementation fidelity of Youth-Friendly Services (YFS) is crucial for Ethiopia. Previous studies overlooked investigating the determinants at different levels. Therefore, this study aimed to assess the determinants of implementation fidelity of YFS considering individual and contextual levels.
methodsThis study was conducted among 1,029 youths, from 11 health centers that are implementing the YFS in Central Gondar Zone. Data were collected by face to face interview and facility observation using a semi-structured questionnaire. A Bivariable multi-level mixed effect modelling was employed to assess the main determinants. Four separate models were fitted to reach the full model. The fitness of the model was assessed using Akaike Information Criterion (AIC) and level of significance was declared at p-values < 0.05. The results of fixed effects were presented as adjusted odds ratio (AOR) at their 95% CI.
resultsFour hundred one (39.0%) of the respondents got the YFS with high level of fidelity. Had high level of involvement in the YFS provision (AOR = 1.35, 95% CI: 1.15, 1.57), knew any peer educator trained in YFS (AOR = 1.60, 95% CI: 1.36, 1.86), and involved as a peer educator (AOR = 1.46, 95% CI: 1.24, 1.71), were the individual level determinants. Whereas, got capacity building training; (AOR = 1.93, 95% CI (1.12, 3.48), got supportive supervision, (AOR 2.85, 95% CI (1.99, 6.37), had a separate waiting room (AOR = 9.84, 95%CI: 2.14, 17.79), and system in place to provide continuous support to staff (AOR = 2.81, 95%CI: 1.25, 6.34) were the contextual level determinants.
conclusionsThe level of implementation fidelity remains low. Both individual and contextual level determinants affect the implementation fidelity of YFS. Therefore, policy makers, planners, managers and YFS providers could consider both individual and contextual factors to improve the implementation fidelity.
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