ArticleBMC health services research2026
Health facility capacities for providing adolescent sexual and reproductive health services in Southwestern Uganda.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
backgroundProvision of adolescent-friendly Health services (AFHS) at lower primary health care centres (PHCs) is a core strategy for improving access and health outcomes of adolescents. In this study we assessed the health facility-based prevalence of repeat adolescent pregnancies and the capacity of PHCs (Health centres (HC) level III and IV) to provide AFHS in Uganda.
methodsWe conducted a cross-sectional study between April and May 2023 involving 43 healthcare facilities (33 HC III and 10 HC IV) across 4 districts in Southwestern Uganda. Using pretested structured questionnaires, we interviewed the health facility in-charges or their delegates. We extracted the 6-month information from registers on: number of repeat adolescent pregnancies, post-abortion, and post-natal adolescents attending each facility. With a checklist, we assessed the availability of family planning materials/services and other medical equipment. Descriptive statistics were generated.
resultsAdolescent contributed 4.9%, 16.3% and 14.8% of all repeat pregnancy, post-abortion and post-natal consultations documented at all PHCs. We noted a low perinatal care staffing with the majority of HC IIIs lacking adolescent peer educators (n = 34; 79%), and counsellors (n = 26; 60.5%). The need for training in the provision of adolescent-friendly services, post-natal or post-abortion care in adolescents (> 90%) was high. PHCs were inadequately supplied with equipment for post-abortion care and IUD insertion. Female and male sterilization and emergency contraception were less offered. Health workers were willing to give family planning to previously pregnant adolescents (90.7%), without parental consent (65.2%), but did not support contraceptive administration to adolescents who had formerly been pregnant in fear of promoting sexual promiscuity (41.9%). A quarter of the PHCs had a dedicated clinic for adolescents and had a day in the week for adolescent services.
conclusionsThis study reveals major gaps in adolescent perinatal care in Southwestern Uganda, including limited peer educators, inadequate post-abortion care, and poor healthcare worker training. Strengthening services requires interactive, peer-based training and addressing staffing shortages through peer educators and community health workers. Equipping Health Centre IIIs to deliver comprehensive, adolescent-friendly care is essential to improving access and closing these critical service gaps.
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