# Implementation and evaluation of the Y-Check comprehensive adolescent health check-up intervention in Zimbabwe: a pre−post mixed-methods study

## TL;DR

A health check program for Zimbabwean adolescents was found to be feasible and effective in improving health outcomes.

## Contribution

The study provides evidence on the feasibility and impact of a comprehensive adolescent health check-up in a low-income setting.

## Key findings

- 70.8% of adolescents with health issues received appropriate care or referral.
- Improvements were observed in nutrition, quality of life, self-esteem, and educational outcomes.
- The program successfully identified untreated conditions and linked adolescents to services.

## Abstract

Routine adolescent health check-ups can support healthy development and well-being, but evidence on the feasibility, acceptability and effectiveness of contextually relevant comprehensive check-ups in low- and middle-income settings is limited. We conducted a hybrid implementation-effectiveness study incorporating a mixed-methods pre−post design of Y-Check, a comprehensive health check-up intervention in Zimbabwe, as part of a multicountry study developed and coordinated by the World Health Organization. Eligible participants were 10–19-year-old adolescents attending school or community venues. We used self-administered digital questionnaires, provider-led clinical tests and nurse reviews to screen for 25 conditions/behaviors. We provided health promotion, on-site care and referral to relevant providers. From October 2022 to September 2023, 2,097 adolescents were enrolled, of whom 1,843 (87.9%) were seen at 6 months. The primary outcome of appropriate care and/or referral(s) for all identified issues was achieved for 70.8% (95% confidence interval: 68.7–72.9%) of 1,865 participants with at least one issue. At follow-up, there were improvements in nutrition, health-related quality of life, self-esteem, behaviors and educational outcomes. The intervention was feasible and largely acceptable. Uptake of referral services varied by issue. Y-Check cost US$47 per participant. Through Y-Check, we identified untreated conditions and risk behaviors and successfully treated and linked adolescents to services. Here we provide evidence on the potential of the intervention to positively impact health and well-being.

A WHO-supported pre−post study shows that implementation of the Y-Check comprehensive health check program is feasible and acceptable for adolescents in Zimbabwe, offering screening for 25 health conditions and behaviors, health promotion, on-site care and referral.