# Utilization of youth corners: a model for improving youth-friendly health services in Neno District, Southern Malawi

## TL;DR

Youth Corners in Malawi aimed to improve access to health services for young people, but the study found that distance and age, especially for 15–19-year-olds, significantly limited their use.

## Contribution

The study identifies sub-optimal performance of Youth Corners and highlights age and geographic barriers to adolescent health service access in low-resource settings.

## Key findings

- Youth aged 15–19 and those living over 10 km from health facilities were less likely to use Youth Corners.
- Distance and age were significant barriers to accessing Youth-Friendly Health Services.
- The utilization rate was 829 visits per 1,000 young people aged 10–24.

## Abstract

Adolescents in low- and middle-income countries often struggle to access sexual and reproductive health services (SRHS). To address this, the Ministry of Health, with support from Partners In Health, implemented Youth Corners in selected health facilities in Neno District to improve the utilisation of Youth-Friendly Health Services (YFHS).

This study examines the role of Youth Corners in enhancing YFHS usage in Neno District, Malawi.

A descriptive cross-sectional study was conducted by extracting data from Youth Corner registers and DHIS2 from health facilities between October 2022 and September 2023. Population estimates were obtained from the National Statistical Office projections. Descriptive statistics and chi-square tests were used to describe service utilization patterns, and binary logistic regression was used to assess the association between distance and service attendance.

During the study period, 1,877 young people aged 10–24 accessed YFHS, with 45% (n = 852) aged 15–19 and 57% (n = 1,063) female. They completed 2,869 visits, all receiving information and counselling. The utilisation rate was 829 visits per 1,000 young people aged 10–24. An association was found between distance, age, and attendance (p < 0.05). Adolescents aged 15–19 were less likely to attend youth corners (OR = 0.57, p = 0.003), and those living more than 10 km from facilities participated less frequently (OR = 0.59, p = 0.011).

While Youth Corners are highly suggested as a way for improving YFHS uptake among young people, their impact in Neno District was found to be suboptimal.

Main findings: We found the sub-optimal role of Youth Corners influencing Youth Friendly Health Services uptake in Neno district and that distance and age significantly influence adolescents’ access to Youth Corners influencing Youth Friendly Health Services, with those aged 15–19 and those living more than 10 km from health facilities being less likely to attend, highlighting critical barriers to healthcare utilization among adolescents.Added knowledge: The finding that adolescents aged 15–19 were less likely to attend Youth Corners influencing Youth Friendly Health Services than other age groups (despite being in a high-risk category for many health issues) adds to the understanding of age-related barriers in healthcare utilization. This suggests a gap in engagement for older adolescents, calling for targeted interventions that consider the unique challenges faced by this group.Global health impact for policy and action: The study highlights that distance to healthcare facilities significantly affects adolescents’ access to Youth Corners influencing Youth Friendly Health Services, with those living more than 10 km away attending less frequently. This finding underscores the need for global health policies that prioritize geographical accessibility in the design of adolescent health programs. Governments and health organizations should consider expanding services through mobile health units, community health workers, or telemedicine to reach adolescents in remote areas.

Main findings: We found the sub-optimal role of Youth Corners influencing Youth Friendly Health Services uptake in Neno district and that distance and age significantly influence adolescents’ access to Youth Corners influencing Youth Friendly Health Services, with those aged 15–19 and those living more than 10 km from health facilities being less likely to attend, highlighting critical barriers to healthcare utilization among adolescents.

Added knowledge: The finding that adolescents aged 15–19 were less likely to attend Youth Corners influencing Youth Friendly Health Services than other age groups (despite being in a high-risk category for many health issues) adds to the understanding of age-related barriers in healthcare utilization. This suggests a gap in engagement for older adolescents, calling for targeted interventions that consider the unique challenges faced by this group.

Global health impact for policy and action: The study highlights that distance to healthcare facilities significantly affects adolescents’ access to Youth Corners influencing Youth Friendly Health Services, with those living more than 10 km away attending less frequently. This finding underscores the need for global health policies that prioritize geographical accessibility in the design of adolescent health programs. Governments and health organizations should consider expanding services through mobile health units, community health workers, or telemedicine to reach adolescents in remote areas.