‘ I can get all the services I want, without fear of being judged ’: Acceptability of a sexual and reproductive health service for youth in Zimbabwe

Résumé fourni par la source

Sexual and reproductive health (SRH) services often do not appeal to youth, leading to limited engagement and poor outcomes. We co-designed a community-based integrated HIV and SRH service with and for youth (16−24 years) in Zimbabwe (CHIEDZA) and investigated its acceptability. Qualitative data from observations of CHIEDZA services (n = 58), and in-depth interviews with healthcare providers (n = 51), mobilisers (n = 23), and clients (n = 63) were analysed inductively and thematically. Participants who attended CHIEDZA in an endline population-based survey completed a questionnaire assessing their experiences. 96.1% of attendees rated their experience as excellent/very good. Four key features were core to CHIEDZA's acceptability. First, in a context where ordinarily ‘condoms and [menstrual] pads are expensive’, and clinics charge user fees, free services at CHIEDZA were valued. Second, integrated SRH services was seen as convenient and increased service uptake: ‘I came wanting pads, and then also got tested for HIV’. Third, youth-focused ‘open-minded’ interactions with healthcare providers were central to acceptability. Fourth, a social and safe space for youth was popular. The key reasons for non-attendance was not knowing about CHIEDZA and distance. Youth engagement with SRH services could be enhanced by offering free-of-cost, integrated services and supporting healthcare providers to deliver compassionate and youth-focused care.

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