Ghana’s population of 30.8 million people is predominantly young, with a median and mean age of 21 and 25.2 years, respectively. Yet, there are limited studies on quality of clinical care for Adolescent and Young Adult (AYA) aged 10-24years in Ghana. To better understand facility-level barriers and facilitators to AYA primary care, we conducted a qualitative study at the Tamale Teaching Hospital polyclinic as part of a broader quality improvement initiative for young people care. Convenience sampling was used to identify and recruit 12 AYAs, 8 guardians, and 22 staff for in-depth interviews and focus group discussions. In-depth interviews were conducted with AYAs and guardians and focus group discussions were conducted with staff. Interviews and focus group discussions explored topics including previous care experiences and reasons for visits, experiences and perceptions of service at registration or booking points, nursing services, consultations with doctors, services at the laboratory, pharmacy, and cash payment point. The study employed inductive and deductive reflexive thematic analysis of interviews and focus group discussions. All qualitative data were transcribed. The qualitative software NVivo 14 was used for coding and theme development. Five themes emerged: Healthcare quality and accessibility, systemic and administrative challenges, Autonomy, confidentiality and privacy, adolescent health conditions and needs, and participants’ perspectives on improvement. The major barriers to adolescent responsive care are system inefficiencies and negative staff attitudes, and the major facilitators are trust and confidence in doctors’ competence, perceived superior care in a Teaching Hospital, and convenient services and proximity. AYA and guardians want convenient, easily accessible and high-quality care, delivered by a friendly and trusted team, which views the healthcare workers also endorsed. There is a need for training of healthcare staff in adolescent friendly and responsive services, as well as facility level reforms and restructuring of mainstream services to make them more appropriate and responsive to the needs of this population. Not applicable.
Abaah et al. (Fri,) studied this question.