Promotion of adolescent sexual health in primary care: survey in Finnish health centres

Abstract

Objectives To describe adolescent sexual health services in primary care in Finland, focusing on services for contraceptive counselling, sexually transmitted infections and abortion.

Methods Service provision, accessibility and practices were surveyed in all 63 health centre organizations (HCOs) in a hospital district in Western Finland via separate e-mailed questionnaires to chief physicians (n = 49, response rate 78%), directors of nursing (58, 92%), doctors (49, 78%) and nurses (62, 98%).

Results Dedicated youth clinics existed in only three HCOs. In others, services were provided in family planning, maternity or outpatient clinics. The average wait for contraceptive consultation was 4.8 days to a nurse and 12.5 days to a doctor. In 15 HCOs doctors stipulated a minimum age for combined hormonal contraception. Free supply of contraceptives was often limited to initiation. On-site instructions for chlamydia screening existed in 11 HCOs. Nurses could test for chlamydia without doctor's involvement in 46 HCOs. School nurses participated actively in sexuality education in secondary schools.

Conclusions Adolescent sexual health services were generally adequately available in the HCOs studied. However, services tailored for adolescents were rare. Some medical barriers to access to contraception were found. To improve the system, further involvement of nurses in service provision is recommended.

Keywords:

• Adolescent
• Sexual health services
• Contraception
• Sexually transmitted infections
• Chlamydia
• Abortion
• Counselling
• Primary health care