Factors that influence utilization of primary health facilities by adolescents in Tafelsig, Mitchells Plain

Abstract

Promoting positive and healthy decision-making practices and encouraging the utilization of health care facilities amongst adolescents is an important public health priority given that the period of adolescence is characterized by experimentation and risk taking behaviour. In the Tafelsig area of Mitchell‟s Plain, a poor socio-economic community within the Cape Town metropole, adolescents are exposed to a range of social problems (such as alcohol and substance abuse) that can potentially be harmful to their health. Given this context there was some concern raised by the sub-district health management team that adolescents are not making sufficient use of the local health facilities. The purpose of this study was to gain a greater understanding of the factors that contribute to, or hinder, the utilization by adolescents of the public health facilities in the Tafelsig area and in turn provide the Department of Health with information on adolescents‟ preferences concerning access to and use of the local primary-level health services in Mitchells Plain.An exploratory descriptive study was conducted to explore the topic using qualitative research methods. Permission to conduct the research was obtained from the Higher Degrees Committee of the University of the Western Cape and the School Principal. In-depth interviews were conducted with eight Grade 9 and seven Grade 10 male and female learners from the local secondary school - all of whom were randomly selected from a list of learners who indicated their willingness to participate in the study and who had obtained the written consent from their parents or guardian to do so. Interviews with the learners explored the positive and negative experiences, perceptions and opinions they have of using – or contemplating the use of – the local health facilities. The data from these interviews were analyzed using thematic content analysis.The study demonstrated that even when public health services are available, adolescents are often not in a position themselves to choose for themselves: their parents or guardians invariably make the choice for them. At times they are also reluctant to use public health facilities for fear of being judged by health personnel for being sexually active. The idea of waiting for long periods of time to see a health professional, or being observed at the health facility by other members of their community, are also considered to be disincentives.Many of the learners interviewed expressed a need for more information about sexual and reproductive health issues and matters that affect their health. The findings of this study also suggest that there is an urgent need for youth-friendly health services to be made available in the Mitchells Plain community. It is thus recommended that the Department of Health strategically assess whether an existing public health facility can be re-orientated to cater for the specific health needs of adolescents in Mitchells Plain.