Analytic Case Studies: Initiatives to Increase the use of Health Services by Adolescents: Estonia

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In 2006, the World Health Organization (WHO) department of Child and Adolescent Health and Development (CAH) published a systematic review of the effectiveness of interventions to improve the use of health services by adolescents in developing countries1. This review identified 12 initiatives that demonstrated clear evidence of the increase in the use of health services by adolescents. When presenting the findings of the review to policy-makers and programme managers in countries, WHO was pressed for information that went beyond the brief descriptions of interventions provided in the review, to more detailed information about what was being done in these different settings to scale up the provision of health services while maintaining and improving their quality. In response, CAH has supported the documentation of three outstanding initiatives in different developing country settings. These are intended to provide analytic case studies of what has been achieved, to assist: i) governmental and nongovernmental organizations in developing countries that are involved in scaling up adolescent-friendly health services; and ii) staff members in international organizations that provide technical and financial support for these services. WHO is pleased to share these three case studies from Estonia, Mozambique and South Africa. The key message emanating from each is that scaling up the provision of health services to adolescents in developing countries in a sustainable way is clearly doable, but it requires deliberate and concerted efforts. The Estonian case study was that of the nationwide spread of the Amor youth clinic network, led by the Sexual Health Association in that country.

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