Do primary healthcare providers have the competency of providing adolescent-friendly health services?

Abstract Background Investment in adolescents' health is one of the most rewarding efforts for meeting the Sustainable Development Goals. The national standard on state assured free-of-charge services defines the minimum requirements of adolescent-friendly healthcare services (AFHS) in primary healthcare facilities (PHCFs); however, services for adolescents are highly inconsistent in terms of quality and coordination. We aimed to assess the PHC providers' (PHPs) capacity to provide AFHS in PHC facilities in Armenia. Methods A qualitative cross-sectional study through in-depth interviews and focus-group discussions was conducted in two biggest cities of Armenia. Overall, six focus group discussions and 16 in-depth interviews were conducted with adolescents (18 and 19 years old), PHPs, managers of PHCFs, and experts in adolescent health. Eight PHC facilities were chosen for conducting observations. The WHO Global standards for quality health-care services for adolescents guided the deductive content analysis. Results PHPs' capacity to provide AFHS in assessed PHCFs was not satisfactory. PHPs did not know the specific age range of adolescence and the content of AFHS in the national standard. PHPs perceived friendliness of services as welcoming and good attitude. Facility managers and most PHPs did not participate in professional education activities to advance their expertise in adolescent health. Experts concluded that services provided to adolescents were not “friendly” and PHPs did not have appropriate competencies. However, PHPs' had the opposite opinion - they were confident in their knowledge and skills to work with adolescents. Adolescents complained that PHPs did not provide explanations for provided services and lacked appropriate communication skills. Conclusions The PHCFs have formal grounds to provide AFHS, however lack of appropriate competencies among PHPs and managers of PHCs hinder advancement of AFHS. Key messages Qualitative findings suggest that visited PHCFs fail to appropriately implement AFHS as guided by the national standard. Provision of AFHS can be promoted in PHCFs through strengthening PHPs' competencies via continuous professional development activities.