Promotion of adolescent sexual health in primary care: survey in Finnish health centres.
OBJECTIVE
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.
Sannisto
Tuire
T
Department of General Practice, Medical School, University of Tampere, Tampere, Finland. tuire.sannisto@uta.fi
Kosunen
Elise
E
D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D000367:Age Factors; D003267:Contraception; D003376:Counseling / Q000458:organization & administration*; D005387:Finland / Q000453:epidemiology; D006293:Health Promotion / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D024802:Nurse's Role; D010819:Physician's Role; D034121:Reproductive Health Services / Q000458:organization & administration*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis; D014850:Waiting Lists