Availability of adolescent mental, sexual and reproductive health services (ASRH) and technical efficiency of ASRH service delivery in Niger

BACKGROUND: In developing countries, many organizations are attempting to implement interventions to improve adolescent mental, sexual, and reproductive health (ASRH). A key challenge in these efforts is the efficient utilization of available resources. However, there is a considerable lack of efficiency studies, particularly in high resource-constrained settings such as Niger. Addressing this gap, the present study assessed the delivery of adolescent mental, sexual, and reproductive health services in Niger, while evaluating the technical efficiency and its determinants within public health facilities providing adolescent sexual and reproductive health services. METHODS: A cross-sectional survey was conducted at 160 rural and urban health facilities in Niamey and Maradi, from May 31 to June 24, 2022. Descriptive frequency analysis assessed the availability of mental and sexual/reproductive health services. Stochastic frontier analysis (translog function) measured technical efficiency, while fractional logit regression identified influencing factors. RESULTS: Over 89% of surveyed health facilities in Maradi and Niamey reported providing sexual and reproductive health services to adolescents. Conversely, the availability of mental health services was limited, with only 10% of facilities offering such support in these regions. Stochastic estimation revealed an average technical efficiency score of 45.2% (95%CI: 0.410-0.49). Notably, higher-than-average efficiency scores were observed among facilities managed by male personnel. CONCLUSION: The findings highlight significant gaps in the provision of mental health services, underscoring the need for targeted interventions. Training health personnel to effectively manage adolescents with mental health disorders is recommended. The comparatively low technical efficiency score suggests room for improvement; establishing well-equipped and functional pharmacies with relevant sexual and reproductive health products may contribute to enhanced performance in health service delivery.