BACKGROUND Access to and utilization of adolescent sexual and reproductive health (ASRH) services remains poor. ASRH services in Kenya are primarily offered in health facilities and include counselling, information, and services on family planning, sexually transmitted infections, and HIV and basic life skills. The Ministry of Education also provides age-appropriate sexual and reproductive health information in schools. This paper presents a study protocol that will evaluate the effectiveness of a combined approach toward improving utilization of ASRH services. METHODS This will be a quasi-experimental study utilizing qualitative and quantitative methods. During the formative phase, data will be collected through focus group discussions, in-depth interviews, and key informant interviews to explore the barriers and facilitators of provision and utilization of ASRH services. A quantitative design will be used to obtain baseline and endline data through household surveys and client exit interviews. Following the formative and baseline household and client exit assessments, an intervention focusing on provision of ASRH service package targeting boys and girls will be implemented for 18 months. The package will include contextualized ASRH services, including counselling and age-appropriate, comprehensive sexual education for behavior change with an aim to increase utilization of ASRH services. An analysis of the primary outcome (utilization of ASRH services) will be undertaken to establish the difference in difference between the control and intervention arm, before the intervention (using the baseline survey data) and after the intervention (using the endline survey data). DISCUSSION Adolescents have now been included in the World Health Organization's Global strategy for women's, children's and adolescents' health (2016-2030), acknowledging the unique health challenges facing young people and their pivotal role as drivers of change in the post-2015 era. This study will generate evidence on whether a combined school, facility, and community approach works toward improving utilization of ASRH services. The information generated from the study will be beneficial for programming as it will identify underlying reasons for low utilization of ASRH services. Results will help to shape ASRH programs and reduce teenage pregnancy within Kenya and other similar low middle-income countries. TRIAL REGISTRATION The study is registered at http://www.pactr.org/ , registration number PACTR201906738029948.

中文翻译：

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评估在肯尼亚提高青少年性生殖健康服务综合利用方法的有效性：一项准实验设计研究方案。

背景技术青少年性健康和生殖健康（ASRH）服务的获取和利用仍然很差。肯尼亚的ASRH服务主要在医疗机构中提供，包括有关计划生育，性传播感染，艾滋病毒和基本生活技能的咨询，信息和服务。教育部还在学校提供适合年龄的性健康和生殖健康信息。本文提出了一项研究协议，该协议将评估组合方法对提高ASRH服务利用率的有效性。方法这将是使用定性和定量方法进行的准实验研究。在形成阶段，将通过焦点小组讨论，深入访谈，以及主要的知情人士访谈，以探索提供和利用ASRH服务的障碍和促进者。定量设计将用于通过家庭调查和客户出口访谈获得基线和最终数据。在对家庭和客户出口进行形成性和基准性评估之后，一项针对男孩和女孩的提供ASRH服务包的干预措施将实施18个月。一揽子计划将包括情境化的ASRH服务，包括针对行为改变的咨询和适合年龄的全面性教育，旨在提高对ASRH服务的利用。将对主要结果（利用ASRH服务）进行分析，以确定控制和干预部门之间的差异，干预之前（使用基线调查数据）和干预之后（使用最终调查数据）。讨论青少年现已被纳入世界卫生组织《妇女，儿童和青少年健康全球战略》（2016-2030年），承认年轻人面临独特的健康挑战及其在2015年后时代变化的驱动力中的关键作用。这项研究将提供证据，证明学校，设施和社区相结合的方法是否有助于提高ASRH服务的利用率。该研究产生的信息将有助于编程，因为它将确定ASRH服务利用率低的根本原因。结果将有助于制定ASRH计划，并减少肯尼亚和其他类似的中低收入国家的少女怀孕。