Adolescent access to and utilisation of health services in two regions of Côte d'Ivoire: A qualitative study

ABSTRACT

Adolescence is a critical time for physical, cognitive, social and emotional development, yet adolescents are prone to unique barriers and unmet needs for receiving proper health care services and information. This study explored barriers and facilitators to adolescent (15–19 years) access to and utilisation of health services in two regions of Côte d’Ivoire. Focus group discussions were conducted with adolescent females and males, caregivers, and health care workers at eight health facilities. Barriers and facilitators emerged within three themes: cultural, structural, and ‘accueil’, a French term encompassing overall feelings and experiences of a situation. Cultural barriers included community beliefs and stigma, and adolescent knowledge, while caregiver support and medical preference were both barriers and facilitators. Structural barriers included financial costs, distance to health facilities, waiting times, and lack of supplies and medications. Feelings of fear, shame and discomfort were barriers related to ‘accueil’ while interactions with health care workers were both barriers and facilitators. Similarities and differences in perspectives arose between groups. Future work to increase adolescent access to and utilisation of health services should take into consideration both participant recommendations and the interconnectedness of the barriers faced to create multidimensional approaches that improve health outcomes for this priority population.

KEYWORDS:

• Adolescent health
• Côte d’Ivoire
• adolescent friendly health services
• qualitative
• health-related behaviours

Acknowledgements

The authors would like to acknowledge and thank the staff of Health Alliance International Côte d’Ivoire, with special recognition to Seydou Kouyaté, Luc N’Goran, Sitaffa Ouattara, Valerie Kourai, and Christelle Kouassi, as well as Health Alliance International Seattle, the Department of Global Health at the University of Washington, and the Global Opportunities Health Fellowship for their support of this study. We also recognise the participation and collaboration of district and regional officials from the Ministère de la Santé et de l’Hygiène Publique of Côte d’Ivoire. Finally, we offer the upmost recognition and thanks to the study participants for sharing their time, stories, and ideas with us.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 ‘Tantie’ translates to ‘aunt’ but is used in a broader sense as a term of endearment for older women.