Gwyn Hainsworth, MEd, Judith Senderowitz, MA, and Sophia Ladha, MSc. Pathfinder International, 9 Galen Street, Suite 217, Watertown, MA 02472, 617-924-7200, ghainsworth@pathfind.org

Under the African Youth Alliance project in Botswana, Ghana, Tanzania and Uganda, Pathfinder International conducted 60 clinic assessments of public-sector and NGO clinics to determine the current status of “youth-friendliness.” Teams comprised of MOH/NGO personnel, youth and AYA staff conducted one-day assessments using a field-tested Clinic Assessment Tool for Youth-Friendly Services (YFS).

Findings showed significant need for quality improvement (QI) for most clinics in all four countries, with NGO clinics showing a significantly higher degree of youth-friendliness compared to government clinics. Areas for needed improvement were broken into those that were essential: convenient hours, time/space dedicated to youth, staff training, supervision, data collection, counseling, supplies, referral, privacy, and confidentiality; and those that were supportive: promotion of services, availability of educative materials, and youth involvement.

Findings were used as a basis for preparing action plans to improve the quality of YFS and as a baseline for follow-up assessments. Action plans, developed by clinic staff with assistance from the assessment team, identified a range of quality improvements from those that the clinic staff could easily do themselves (e.g. minimize interruptions during client visits) to those that required technical assistance (e.g. improving commodity supply logistics to reduce stockouts).

The assessment process was essential to the development and improvement of YFS. The overall challenge has been how to sustain the momentum of the QI process when there is limited staff to provide technical assistance and oversight. This presentation will discuss the QI process and how it can be adapted and used by other projects.

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