Key informant perspectives on policy- and service-level challenges and opportunities for delivering adolescent and youth-friendly health services in public health facilities in a Nigerian setting

Integrating the care of adolescents into existing public health facilities requires deliberate efforts. This study assessed key informant perspectives on policy and service-level challenges and opportunities for delivering adolescent and youth-friendly health services (AYFHS) in public health facilities in a Nigerian setting. Seventeen key informants were interviewed including members of the Adolescents Sexual and Reproductive Health (ASRH) Technical Working Group (TWG), program managers of Non-Governmental Organizations (NGO), and State and local level health officials in Ogun State, Southwest Nigeria. Findings from this study indicate that health workers continue to have a negative attitude towards adolescent and young people’s sexual and reproductive health. There was some level of inclusion of AYPs living with disabilities in ASRH programming which is welcome and extremely important. The coordination of activities of donors/partners working in the adolescent health space was said to be insufficient. Also, there was missed opportunity to strengthen policy implementation with research. Participants in this research expressed the need for increased focus on mental health, substance use, and other aspects of adolescent and young people’s health. This study provided the context of the implementation of a strategic framework for adolescent reproductive health in a Nigerian setting from the perspectives of policy and service-level stakeholders. The findings indicate the need for continued implementation of adolescent-responsive contraceptive services, expanding the reach of programs to include adolescents living with disabilities, stronger coordination among partners, and leveraging new sources of funding. Opportunities for improving program delivery identified include ensuring research-based policy implementation and seeking program sustainability through tapping into internal funding such as the Basic Health Care Provisions Funds (BHCPF).