To make sure that the service providers are equipped with skills and have the right attitude to provide services, local governments have trained and oriented over 1,850 providers since 2018 to-date. The main objective of the training was to address and overcome provider bias in providing youth with SRH services.

The WHO ‘quality of care’ framework (see Figure at the right) provides a useful guide to work on improving health service provision and utilization for adolescents and young people. It brings together the complementary imperatives of, on the one hand, making it easier for adolescents to obtain the health services they need and, on the other, providing them with the health services they need in the right way.

• Conduct a facility assessment, using IPPF’s Provide or WHO SEARO’s Supervisory/Self-Assessment Checklist for Adolescent Friendly Health Services, to assess the status of the characteristics of the health facility, service providers and program in place to evaluate how adolescent and youth-friendly the services currently are. Ensure that this facility assessment is part of the government’s periodic supportive supervision assessment. Introducing youth-friendly services in a health facility requires training and overcoming provider and staff biases as well as structural and operational time adjustments. As part of the assessment, engage adolescents and youth. There’s no better way to ensure whether or not young people find your facility to be youth-friendly than engaging them in the process of defining what it would look like. It can be as simple as holding focus groups and running through the different criteria that matter to them when accessing facility-based services.

• Develop an action plan based on the facility assessment results for improving the quality of service delivery. Ensure that health providers are trained in competencies in adolescent health care  (see Fig 1. WHO Core Competencies in AYSRH). Work with the Reproductive Health focal person and facility in-charges to identify topics that meet staff’s learning needs and interests in AYSRH. This orientation program is best provided through whole-site orientation. See this agenda for an example of six sessions that can be added to an existing whole site orientation, which should be done among all staff of a facility from support staff to the in-charge.

• Identify adolescent SRH/FP trainers who can act as mentors.
• Conduct coaching and mentorship on regular basis to increase the number of competent skilled service providers within the facility who are able to offer FP services as well as to ensure quality assurance.
• Ensure staff participation in continuous professional education in adolescent health care.
• Provide systems to inform adolescents and youth on how to access and obtain SRH health services, e.g., signages with appropriate services available and operating hours, display the AYFS national standards like a charter, ensure CHAs/CHEWs/VHTs are well-aware of AYFS facilities to refer to, etc.

• Monitor and evaluate the standard of care delivered to adolescents at service delivery points. The monitoring framework should make it possible to measure short- and medium-term progress including feedback from recipients of SRH services. This is a great step to make sure that youth are once again engaged in the process of collecting this information as well as providing it.

• Partner with the Reproductive Health Management teams to conduct assessments and certifications of eligible providers who receive positive feedback as being AYFS providers.

• Adolescents and youth have access to contraception services as and when they need them
• Increased support from various stakeholders towards adolescent and youth-friendly contraception services

• Maintain a register of providers who have completed AYFHS trainings
• Monitor AYFHS service data recorded (ideally, disaggregated by 10-14, 15-19, 20-24) and reported on a monthly basis through TCI referral forms
• Hold quality improvement meetings to report on progress
• Conduct routine gaps assessments using either of the following approaches: client satisfaction exits interviews, facility assessment, support supervision and focused group discussions
• Incorporate feedback from recipients of AYFHS services to improve quality
• Monitor on periodic basis the quality of AYFHS service provision through supportive supervision

• Number of whole site orientation sessions on AYFHS held in the last year
• Number of service providers competent to provide AYFHS
• Proportion of health facilities providing quality AYFHS according to the assessment/checklist
• Number of adolescents and youth counseled on SRH
• Number of adolescents and youth provided contraception by method
• Proportion of adolescents and youth clients who reported a positive experience when seeking services

• Venue space, if necessary, because should use space outside or inside the facility if possible
• Whole site orientation and training material printing costs
• Information, education and communication (IEC) materials: Job aids, tools and guideline material printing
• Refreshments and transportation costs for engaging youth
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• Inclusion of adolescents and young people in strategic planning
• Participation of adolescents and young persons in implementation/supervision working groups
• Inclusion and demonstration of non-judgmental and equitable attitudes towards adolescents and youth as part of annual staff performance assessments/reviews
• Continuous capacity building through mentorships/on-the-job trainings/whole site orientation for service providers
• Ensure supportive supervision tools, include the AYFHS checklist/assessment and is carried out periodically
• Incorporate AYFHS strengthening component in health budgets, including facility budgets for AYFHS