title: A systematic review of the role of school-based healthcare in adolescent sexual, reproductive, and mental health.
abstract: BACKGROUND
  Accessible sexual, reproductive, and mental healthcare services are crucial for adolescent health and wellbeing. It has been reported that school-based healthcare (SBHC) has the potential to improve the availability of services particularly for young people who are normally underserved. Locating health services in schools has the potential to reduce transport costs, increase accessibility and provide links between schools and communities.
  
  
  METHODS
  A systematic review of the literature was undertaken. Pubmed, Psychinfo, Psychnet, Cochrane CENTRAL, and Web of Science were searched for English language papers published between January 1990 and March 2012
  
  
  RESULTS
  Twenty-seven studies were found which fitted the criteria, of which, all but one were from North America. Only three measured adolescent sexual, reproductive, or mental health outcomes related to SBHC and none of the studies were randomized controlled trials. The remaining studies explored accessibility of services and clinic utilization or described pertinent contextual factors.
  
  
  CONCLUSIONS
  There is a paucity of high quality research which evaluates SBHC and its effects on adolescent sexual, reproductive, and mental health. However, there is evidence that SBHC is popular with young people, and provides important mental and reproductive health services. Services also appear to have cost benefits in terms of adolescent health and society as a whole by reducing health disparities and attendance at secondary care facilities. However, clearer definitions of what constitutes SBHC and more high quality research is urgently needed.
authors.affiliation: Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa. amanda.mason-jones@york.ac.uk
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Mason-Jones
authors.forename: Carolyn
authors.initials: C
authors.lastname: Crisp
authors.forename: Mariette
authors.initials: M
authors.lastname: Momberg
authors.forename: Joy
authors.initials: J
authors.lastname: Koech
authors.forename: Petra
authors.initials: P
authors.lastname: De Koker
authors.forename: Cathy
authors.initials: C
authors.lastname: Mathews
mesh_terms: D000293:Adolescent; D003362:Cost-Benefit Analysis; D006297:Health Services Accessibility; D006801:Humans; D008603:Mental Health; D008605:Mental Health Services; D009656:North America; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D060728:Reproductive Health; D034121:Reproductive Health Services; D012572:School Health Services