Validation of a measure of youth-friendly primary healthcare services in Tshwane District

Abstract

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 barriers.