Background: Adolescents in Botswana, especially women, face many sexual and reproductive health (SRH) challenges including high maternal mortality, sexually transmitted infections (STIs) including HIV, and unintended pregnancies, despite available SRH services. The youth friendly service (YFS) concept has been initiated and various strategies developed to address adolescents concerns. However, services remain underutilized and barriers to accessing services still exist. Aim: The aim of this study was to determine patterns of utilization of sexual and reproductive health services by adolescents attending senior secondary schools in Gaborone in 2012. The specific objectives were to: identify SRH services utilized by adolescents in the district; identify factors associated with adolescent utilization of YFS in the district; and determine barriers and facilitators to utilization of available YFS by adolescents. Design: This was a health systems research, which was conducted through an observational study, with descriptive and analytic components. Methods: 506 adolescents attending at the three (3) senior secondary schools in Gaborone were sampled through a simple random sampling strategy in each school. Parental consent and assent from participants was requested before respondents completed a self-administered questionnaire which was designed for the data collection. The questionnaire was pilot tested prior to the study. SPSS version 16 was used to analyse the data. A chi-squared test and logistic regression were used investigate association, and a p-value <0.05 was considered as statistically significant. Results: The findings of this study revealed that utilization of SRH by adolescents was low and the level of awareness of youth friendly services was also low. The study revealed that utilization of SRH was higher among female adolescents compared to their male counterparts. The study identified factors which hinder adolescents YFS utilization, which include: location of the facility, no interest in YFS, staff attitudes and behaviours, and inconvenient hours of operation. Conclusion: Identifying patterns of utilization of SRH services by adolescents attending senior secondary schools in Gaborone can help strengthen programmes at all levels of service delivery and the country at large. The Botswana Ministries of Health, and Education and Skills Development can re-orientate, or develop new initiatives that will deal with barriers to access and assist adolescents to fully utilize the available services. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2014.

The concept of youth activity centre (YAC) has not yet been evaluated. The purpose of this study was to evaluate the YAC in Botswana. Accordingly, the researcher explored and described the lived experience of young people utilising the YAC as well as the perceptions of service providers at the Mochudi Centre in the Kgatleng District, in Botswana. Furthermore, the objective was to develop and describe guidelines for the facilitation of youth-friendly services (YFS) at YAC. A phenomenological, qualitative, explorative, descriptive and contextual research design was used to extract young people’s experiences and perceptions of service providers. Thirty-two young people and 27 service providers (peer educators and service delivery officers [SDOs]) were purposefully selected. Methods of data collection used were unstructured individual in-depth interviews, focus group discussions and observations in the forms of field notes. The data, mainly tape-recorded interviews and field notes were transcribed verbatim for data analysis. Tesch’s eight-step data analysis model (Creswell 1994:155) was used. One major theme, youth friendliness emerged with three categories, namely: physical, administrative, and psychological aspects of youth-friendly services. All the respondents indicated that they benefited and affirmed they were empowered and better people after using the facility. However, limited access to the facility by the target group due to location, cost of reaching the facility, and attitudes of service providers as well as failure to implement planned activities due to financial and staff shortage were obstacles to youth friendliness of the YAC. Based on the findings and literature review, the researcher developed guidelines to facilitate YFS and improved access to the YAC. Recommendations made are for practise in the YAC, education of SDOs and for further research. / Health Studies / D. Litt. et Phil. (Health Studies)

The concept of youth activity centre (YAC) has not yet been evaluated. The purpose of this study was to evaluate the YAC in Botswana. Accordingly, the researcher explored and described the lived experience of young people utilising the YAC as well as the perceptions of service providers at the Mochudi Centre in the Kgatleng District, in Botswana. Furthermore, the objective was to develop and describe guidelines for the facilitation of youth-friendly services (YFS) at YAC. A phenomenological, qualitative, explorative, descriptive and contextual research design was used to extract young people’s experiences and perceptions of service providers. Thirty-two young people and 27 service providers (peer educators and service delivery officers [SDOs]) were purposefully selected. Methods of data collection used were unstructured individual in-depth interviews, focus group discussions and observations in the forms of field notes. The data, mainly tape-recorded interviews and field notes were transcribed verbatim for data analysis. Tesch’s eight-step data analysis model (Creswell 1994:155) was used. One major theme, youth friendliness emerged with three categories, namely: physical, administrative, and psychological aspects of youth-friendly services. All the respondents indicated that they benefited and affirmed they were empowered and better people after using the facility. However, limited access to the facility by the target group due to location, cost of reaching the facility, and attitudes of service providers as well as failure to implement planned activities due to financial and staff shortage were obstacles to youth friendliness of the YAC. Based on the findings and literature review, the researcher developed guidelines to facilitate YFS and improved access to the YAC. Recommendations made are for practise in the YAC, education of SDOs and for further research. / Health Studies / D. Litt. et Phil. (Health Studies)