Unlocking adolescent and youth health - Insights from adolescent youth-friendly services in Migori County, Kenya: A cross-sectional mixed-methods study

The provision of adolescent and youth-friendly services (AYFS) can be facilitated by various strategies, including capacity building of health care providers (HCPs), coordination of AYFS, community engagement, and networking of AYFS stakeholders. Adolescents and youth face various health challenges including but not limited to adolescent pregnancies, HIV infections, sexual and gender based violence, strategies that would help curb these challenges is paramount. Although various studies have evaluated AYFS utilization and integration in Kenya, scant data exist on strategies facilitating or hindering the provision of the AYFS in accordance with the Kenya 2016 AYFS guidelines. The aim of this study was to document the implementation of AYFS strategies and how they affect the provision of AYFS in Migori County, Kenya. This cross-sectional study targeted 159 public health facilities and 455 HCPs in Migori County. The study utilized Taro Yamane’s formula to determine a sample size of 114 health facilities with a target population of 455HCPs, from which a sample of 213 HCPs was drawn. The data were collected from the 210 providers using a structured questionnaire, whereas the qualitative data were collected from three health facility-in-charges using a key informant interview guide. Statistical significance was set at p < 0.05 for quantitative data. Bivariate analysis reported positive and significant associations between capacity building, coordination of actors and activities, stakeholder networking, and community engagement and the provision of the AYFS, with p = 0.001, r = .548; p = 0.001, r = .482; p = 0.001, r = .390; and p = 0.001, r = .460, respectively. There was a 10.092-fold ( CI 4.007–25.417) increase in the odds of providing AYFS among workers who were trained on the AYFS compared with those who were not trained; a 2.987-fold (CI 1.124–7.937) increase in the odds of providing an AYFS when the coordination of AYFS actors and activities was performed compared with that where coordination was not performed; and a 4.979-fold ( CI 1.844–13.441) increase in the odds of providing AYFS when there was community involvement compared with that where there was no community involvement. The networking of stakeholders ( p = 0.135) was not found to be significant in the provision of the AYFS. Policy interventions should prioritize healthcare worker training initiatives, foster effective coordination mechanisms, and promote community involvement. These strategies demonstrate substantial increases in AYFS provision, emphasizing the need for sustained investment and commitment. Prioritizing these factors can catalyze transformative policy actions toward youth-centric healthcare services. • Capacity building, coordination of actors and activities, stakeholder networking, and community engagement facilitate provision of (AYFS). • Healthcare providers training on AYFS increases 10-fold the odds of providing AYFS. • Mapping all relevant stakeholders within health facilities and building partnerships for advocacy will strengthen stakeholder involvement in AYFS. • Policy interventions should prioritize healthcare worker training , foster effective coordination mechanisms of actors and promote community involvement in AYFS.