Health Promotion in Primary Health Care: A Model for Youth Friendly Services

The potential role of primary health care (PHC) as aunique setting for health promotion is becoming more recognized.Despite claims to promote health, most health careorganizations in Egypt do so within the narrow definition ofhealth. Global concern is growing about the health status ofyoung females. Health services, although available, lackcomprehensiveness that addresses the needs of this stillshadowed sector of the population. In an attempt to make oneof the PHC facilities be more Youth Friendly, an integratedinterventional approach for health promotion, with coordinatedefforts from relevant stakeholders, was conducted in a ruralPHC facility of Upper Egypt and the community within itscatchments area. Targeted young females were initially definedand characterized through an interview based householdsurvey. A total study sample of 671 females aged 12- 20 yearswas included. Health and health care problems were identifiedthrough different qualitative and quantitative techniques. Thiswas followed by a sequence of training courses for all thePHC providers, with community and local authority mobilization,and health education sessions for the targeted youngfemales. Results of the study revealed marked communitylevelimprovements and collaboration. At the PHC level,modifications in the organization of the delivery system, byarranging for convenient times to accommodate females wereestablished. In addition, the designed card system enableddocumentation of health education and counseling sessionsneeded by each female. The performance of the healthcareteam was progressively improved through training. Significantrising means of knowledge and performance post- trainingscores were found for various priority topics, with p-values 0.001. At the individual young females level, there weremarked improvements in the utilization of the PHC services,where 62% of the studied group visited the centre more than12 times during the 6-months post-intervention. This studyhighlights the strong belief that with changes in the wayhealthcare is organized, delivered and financed, new practice models beyond the level of the individual could be innovatedto provide a holistic approach of health promotion for populationsespecially the non-regular PHC users.