title: Standardizing and scaling up quality adolescent friendly health services in Tanzania.
abstract: BACKGROUND
  Adolescents in Tanzania require health services that respond to their sexual and reproductive health - and other - needs and are delivered in a friendly and nonjudgemental manner. Systematizing and expanding the reach of quality adolescent friendly health service provision is part of the Tanzanian Ministry of Health and Social Welfare's (MOHSW) multi-component strategy to promote and safeguard the health of adolescents.
  
  
  OBJECTIVE
  We set out to identify the progress made by the MOHSW in achieving the objective it had set in its National Adolescent Health and Development Strategy: 2002-2006, to systematize and extend the reach of Adolescent Friendly Health Services (AFHS) in the country.
  
  
  METHODS
  We reviewed plans and reports from the MOHSW and journal articles on AFHS. This was supplemented with several of the authors' experiences of working to make health services in Tanzania adolescent friendly.
  
  
  RESULTS
  The MOHSW identified four key problems with what was being done to make health services adolescent friendly in the country - firstly, it was not fully aware of the various efforts under way; secondly, there was no standardized definition of AFHS; thirdly, it had received reports that the quality of the AFHS being provided by some organizations was poor; and fourthly, only small numbers of adolescents were being reached by the efforts that were under way. The MOHSW responded to these problems by mapping existing services, developing a standardized definition of AFHS, charting out what needed to be done to improve their quality and expand their coverage, and integrating AFHS within wider policy and strategy documents and programmatic measurement instruments. It has also taken important preparatory steps to stimulate and support implementation.
  
  
  CONCLUSIONS
  The MOHSW is aware that the focus of the effort must now shift from the national to the regional, council and local levels. The onus is on regional and council health management teams as well as health facility managers to take the steps needed to ensure that all adolescents in the country obtain the sexual and reproductive health (SRH) services they need, delivered in a friendly and non-judgemental manner. But they cannot do this without substantial and ongoing support.
authors.affiliation: Department of Reproductive Health and Research, World Health Organization, 20 Avenue Appia, Geneva 27 CH-1211, Switzerland. chandramouliv@who.int
authors.forename: Venkatraman
authors.initials: V
authors.lastname: Chandra-Mouli
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mapella
authors.forename: Theopista
authors.initials: T
authors.lastname: John
authors.forename: Susannah
authors.initials: S
authors.lastname: Gibbs
authors.forename: Christina
authors.initials: C
authors.lastname: Hanna
authors.forename: Nagbandja
authors.initials: N
authors.lastname: Kampatibe
authors.forename: Paul
authors.initials: P
authors.lastname: Bloem
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D011787:Quality of Health Care / Q000592:standards*; D034121:Reproductive Health Services / Q000592:standards; D013636:Tanzania