title: Quality of counselling of young clients in Zimbabwe.
abstract: Researchers observed 418 consultations with clients aged 12-24 years at 38 health facilities throughout Zimbabwe and interviewed both the clients and providers. Less than one per cent of clients at these facilities were aged 12-14 years; between 5% and 20% were aged 15-19 years. Compared with older clients, those aged 12-16 years came more often for antenatal care and medical problems and less often for family planning. In sessions with 12-16 years, the most common topics were STDs (48%) and school (46%), while sessions with older clients focused more on family planning (56-68%). Providers rarely discussed adolescence or non-sexual problems such as alcohol and drugs. Younger clients were less likely than older clients to ask questions without prompting (16%), expressed their concerns (27%), and they were more likely to appear embarrassed (58%) and shy (64%). Most service providers believed that the parents should be notified if a young, unmarried client was pregnant (89%), had HIV/AIDS (74%), or engaged in sex at "an early" age (73%). The findings suggest that young people may be reluctant to seek advice at health facilities because of legitimate concerns about privacy, providers' attitudes, and narrow focus on reproductive health.
authors.affiliation: Johns Hopkins Population Communication Services, Baltimore, Maryland, USA.
authors.forename: Y M
authors.initials: YM
authors.lastname: Kim
authors.forename: C
authors.initials: C
authors.lastname: Marangwanda
authors.forename: A
authors.initials: A
authors.lastname: Kols
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001291:Attitude of Health Personnel; D002648:Child; D003376:Counseling / Q000592:standards*; D005260:Female; D006302:Health Services Research; D006801:Humans; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000592:standards*; D010358:Patient Participation; D017060:Patient Satisfaction; D011247:Pregnancy; D011795:Surveys and Questionnaires; D015030:Zimbabwe