7.7 Making health facilities more youth friendly
The promotion of young people's access to health services is comprised of overcoming a set of barriers that make the access more accessible and less embarrassing.
The conditions of health services are not the only thing at stake, but also the quality of the relationship and communication between the professional and the young person, as promotors and facilitators of the access to services. It is also important that the expectations and needs of young people are considered.
In this sense, a set of initiatives has been developed, which are promoted by a diversified group of entities.
The World Health Organisation (2012) defines that youth friendly health services must meet a set of criteria, including being accessible and at locations and hours of easy access to teenagers; meeting the expectations and needs of young people in order to motivate their demand; promoting access equity and equality.
Following these guidelines, the Portuguese Society of Paediatrics (SPP) also provides a set of requirements that are necessary for youth care, stressing the importance of promoting integrated, accessible and adequate responses to the needs and expectations of young people, free of charge and confidential.
In Portugal “APARECE” (Show up) is a youth Service that started 20 years ago, headquartered at a primary health care facility. It has proven to be a model of care for young people. It has great acceptability for this target population (12-24 years of age) and is a model to replicate through the country. Regardless of the internal organization of primary health care and hospital care, it is important to assure specific aspects for young people, like being youth friendly, with open hours, free of costs, confidential and anonymous, and geographically open. The approach opens the health system to the adolescents and ensures continuity of care, disease prevention and health promotion. APARECE includes a team of professionals: general practitioners, nurses, psychologists, among others. They cover issues ranging from mental health, sexuality, dependencies, nutritional disorders, sexually transmitted infections, family planning counselling, contraception, among others. This youth-oriented health service is a successful example of health practice. It was created following legislation on family planning (FP) and youth care: Law 3/84 and Ordinance 52/85 – that regulates the consultation of FP and youth care centres, and Law 120 / 99 which strengthens the guarantees of the right to reproductive health and sets conditions for the promotion of sexuality education and young people's access to health care in the context of sexuality and family planning. More recently, also the National Programme for Child and Youth Health and the National Plan for Youth, both advocate specificities for health surveillance in this age group. In the framework of those WHO guidelines, National Programme for Children and Young People Health (PNSIJ) underlines the importance of providing free and confidential services that respect and promote the young person's autonomy. Thus, the young people must be involved in the decision-making process when resorting to this care.
The PNSIJ still proposes strategies for adolescent care, according to his/her age and development stage by providing a set of guidelines for the conduct of the interview (PNSIJ 2013,110).
"Friendly" measures for young people in Portugal
In 2010, the required age for the paediatric services was extended up to 17 years and 364 days, in the emergency service, external appointment, day hospital and inpatient. Before, the paediatric services were only available for young people under the age of 14 years and 365 days. Therefore, young people no longer are attended by the adult services until they are 18 years old, leading to a rehabilitation of spaces and an adaptation of health professionals to the needs and characteristics of this older age group.
Other measures- medical appointments for young people
There are several diversified appointments or Youth Spaces that provide support and information in the field of contraception, family planning or sexuality.
They areservices that are based on the principles of being free of charge, anonymous and confidential as a way of making the services more attractive to young people.
Portuguese Institute for Sport and Youth (IPDJ, I.P.)
IPDJ, I.P., through the Take Care of Yourself (Cuida-te) Programme, offers service spaces called "Offices of Youth Health and Youth Sexuality" where qualified technicians provide support in various valences in the field of health (Nutrition/Physical exercise; Harmful consumption; Sexual and reproductive health). These spaces are targeted at young people between the age of 12 and 30 years.
The Youth Health Offices are created in accordance with the protocols celebrated with the partner entities in the field of health, which must deliver an activity and financial implementation report to the IPDJ, I.P.
The IPDJ, I.P. still has information and services of interest for youth in "Ponto JA" Information Centres, providing, among other things, information about health. They work on a multichannel logic based on the offer of valences such as the Youth Portaland Youth Helpline.
Family Planning appointments in health centres
Under the care in Sexual and Reproductive Health, the Family Planning appointments offer a set of information and resources that promote family planning and prevention of sexually transmitted diseases.
It provides healthcare, counselling, information and sexual education, as well as the access to contraceptive methods and free screenings.
Some non-governmental associations, parish councils and/or city councils also offer free and confidential services, locally.
The National Reproductive Health Programme also offers a Youth Space with information about sexual and reproductive health.