Analyzing Adolescent-friendly Tuberculosis Services in Lima, Peru: A Qualitative Study

Arango, David

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Year:: 2023
Contributor:: Arango, David (creator); Chiang, Silvia (Advisor); Benitez, Tanya (Reader); Brown University. School of Public Health (sponsor)
Genre:: theses
Subject:: Qualitative research; Adolescent; Tuberculosis; Infectious diseases; Global Health
Extent:: , 30 p.

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Abstract:: Every year, an estimated 800,000 adolescents (ages 10-19 years) develop tuberculosis (TB) disease [1, 2]. Unfortunately, most surveillance systems fail to disaggregate adolescent data, grouping those <15 years old with children and those ≥15 years old with adults [1, 2]. Adolescents have specific healthcare needs due to their unique life stage as they undergo rapid physical and emotional developmental changes [3]. In addition, adolescents are transitioning from dependence on caregivers to autonomy [3]. A needs assessment and review of national healthcare services for adolescents from 25 countries revealed that adolescents face multiple healthcare barriers due to restrictive laws, limited health services, and treatment protocols that are not tailored to their age group [4, 5, 6]. To improve healthcare services for adolescents, the World Health Organization (WHO) has published guidelines for the provision of quality adolescent-friendly services (AFS) [4]. The fundamental framework of AFS consists of equity, accessibility, acceptability, appropriateness, and effectiveness as dimensions of care [4, 6]. More specifically, the guidelines include promoting adolescents’ health literacy, providing community support, training healthcare workers to provide adolescent-friendly care, designing health facilities to appeal to adolescents, collecting disaggregated data on adolescent health for research and quality improvement, and involving adolescents in their own healthcare decisions [4, 6]. Most national TB programs (NTPs) have not defined specific standards to address the needs of adolescents in TB care [7]. Several NTPs have not recognized the need for specific guidelines for providing adolescent-friendly care [8]. However, there is growing recognition of importance of considering adolescents’ specific needs when providing TB care. Acknowledging this need, the WHO commissioned an international expert consensus panel to propose interventions to optimize care for adolescents with TB or at risk of TB [3]. The findings of this expert panel are included in the most recent WHO Operational Handbook on pediatric TB [3, 9]. Assessment of critical gaps in TB services for adolescents with respect to the WHO’s AFS framework is vital to improve TB treatment outcomes for this vulnerable group [2, 4]. To address this gap in the literature, we conducted a secondary analysis of data from a qualitative study in Lima, Peru, that focused on investigating factors that impact TB treatment adherence among adolescents. The purpose of this analysis is to identify the barriers and facilitators relating to adolescent-friendly TB services, as defined by the WHO’s AFS framework.
Notes:: Thesis (M. P. H.)--Brown University, 2023

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Citation

Arango, David, "Analyzing Adolescent-friendly Tuberculosis Services in Lima, Peru: A Qualitative Study" (2023). Public Health Theses and Dissertations. Brown Digital Repository. Brown University Library. https://repository.library.brown.edu/studio/item/bdr:k2agm44y/

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Public Health Theses and Dissertations

Theses and Dissertations for the Public Health department.
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