The purpose of this study was to adapt an existing measure of youth-friendliness (the Youth-
Friendly Health Services-World Health Organization+ questionnaire [YFHS-WHO+
questionnaire]) to validly and reliably measure youth-friendliness of public PHC services in
the Tshwane District. Validity of a measure is specific to the context it is used in and
adaptation of the existing YFHS-WHO+ questionnaire was therefore required.
The existing YFHS-WHO+ questionnaire is a measure developed and validated by an
international collaboration for use in a study of youth-friendly primary care medical services
in Herzegovina and Bosnia. This YFHS-WHO+ questionnaire is the first questionnaire to
comprehensively measure youth-friendliness according to the perceptions of the youth
themself. The YFHS-WHO+ questionnaire uniquely also contributes to research as it
measures all characteristics of youth-friendly health services (YFHS) as described by the
WHO and quantifies the result.
The YFHS-WHO+ questionnaire was originally developed in English, but only validated in the
languages of Herzegovina and Bosnia. It has not been validated in English. This study
adapted the English version of the questionnaire to fit the circumstances of the youth in the
metropolitan municipality of Tshwane District. The YFHS-WHO+ questionnaire was further
adapted to establish good psychometric properties while reducing its length. The YFHSWHO+
questionnaire length was reduced to 57 items. The validity of the adapted YFHSWHO+
questionnaire was tested through hypotheses for construct validation. The
hypotheses were supported.
The adapted YFHS-WHO+ questionnaire can therefore be used for research purposes and
for quality improvement to measure youth-friendliness of PHC in the Tshwane District. The
voice of the youth can be heard through measurement with the adapted YFHS-WHO+
questionnaire to identify barriers in access to the required youth-friendly health services. The
morbidity and mortality among South African youth require interventions to address such
Dissertation (MCur)--University of Pretoria, 2016.