title: Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?
abstract: BACKGROUND
  Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents.
  
  
  METHODS
  We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services.
  
  
  RESULTS
  Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents.
  
  
  CONCLUSIONS
  With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.
authors: Department of Reproductive Health and Research, World Health Organization, Avenue Appia, Geneva, 1211, Switzerland. chandramouliv@who.int.
authors: Venkatraman
authors: V
authors: Chandra-Mouli
authors: Independent expert, Kolkata, India.
authors: Subidita
authors: S
authors: Chatterjee
authors: Department of Maternal Newborn Child and Adolescent Health, World Health Organization, Geneva, Switzerland.
authors: Krishna
authors: K
authors: Bose
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D000349:Africa; D001208:Asia; D003906:Developing Countries; D005060:Europe; D005260:Female; D006077:Government Agencies; D000069576:Health Equity / Q000592:standards / Q000639:trends; D006297:Health Services Accessibility / Q000592:standards / Q000639:trends; D006801:Humans; D008297:Male; D010139:Pacific Islands; D010342:Patient Acceptance of Health Care; D011204:Poverty Areas; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D011787:Quality of Health Care / Q000592:standards / Q000639:trends; D034121:Reproductive Health Services / Q000458:organization & administration / Q000592:standards / Q000639:trends; D012959:Socioeconomic Factors; D014944:World Health Organization