Review of the evidence for interventions to increase young people's use of health services in developing countries.
OBJECTIVE
This chapter reviews the evidence base for interventions that aim to increase young people's use of health services in developing countries.


METHODS
We identified published and unpublished studies and reports from developing countries that provided information about interventions designed to increase young people's use of health services. The studies were classified into six different types based on whether they included some or all of the following characteristics: training for service providers and clinic staff; making efforts to improve the quality of the facilities; implementing community activities to generate demand and support for the services; and involving other sectors, notably schools and the media. The levels of evidence required to make decisions about policies and programmes were defined for each of these types.


RESULTS
Despite the lack of detailed descriptions of interventions in the studies and difficulties interpreting the data reported in the evaluations, the studies provided evidence of increased use of health services by young people for those types of interventions that included training for service providers, making improvements to clinic facilities and implementing activities in the community, with or without the involvement of other sectors.


CONCLUSIONS
The evidence for the effectiveness of interventions to increase young people's use of health services was sufficient to recommend that interventions that include training for service providers, making improvements to clinics and using activities in the community should be widely implemented with careful monitoring of quality and coverage and that those that additionally involve other sectors should also be widely but cautiously implemented, provided they include a strong evaluation component. Operations research is also required to better understand the content of the interventions and their mechanisms of action.
Dick
Bruce
B
Department of Child and Adolescent Health and Development, WHO, Geneva, Switzerland. dickb@who.int
Ferguson
Jane
J
Chandra-Mouli
Venkatraman
V
Brabin
Loretta
L
Chatterjee
Subidita
S
Ross
David A
DA
D000293:Adolescent; D000328:Adult; D003906:Developing Countries; D014943:Global Health; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education / Q000458:organization & administration; D006291:Health Policy; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male