Strategies to improve uptake of adolescent family planning and post-abortion care services in Northern Uganda: a qualitative descriptive study

In many parts of the world, young people face a difficult gap between their need for health information and the services available to them. This is especially true for family planning, which involves methods to prevent pregnancy, and post-abortion care, which provides medical support after a pregnancy ends. For adolescents, accessing these services is often complicated by social stigma, a lack of private information, and health systems that are not designed for their specific needs. When young people cannot find safe, confidential, or respectful care, they may turn to unsafe options or avoid seeking help entirely, leading to serious health risks. Understanding how to bridge this gap requires looking beyond simple medical facts to the complex web of community attitudes, school environments, and hospital policies that shape a young person's daily reality.

Researchers in Northern Uganda set out to understand exactly how to improve access to these critical services for adolescents in Lira District. They did not simply ask doctors or officials what they thought; instead, they listened directly to the young people themselves and the adults who work with them. The team organized thirteen group discussions with sixty-five adolescents, aged ten to nineteen, who were trained as citizen scientists to lead the conversations. They also held thirteen private interviews with key stakeholders, including health workers and community leaders. By recording these talks and analyzing the themes that emerged, the researchers mapped out the specific barriers and solutions that exist on the ground. They found that the problem is not just a lack of knowledge, but a tangled mix of individual fears, social pressures, and system failures that must be untangled together.

The study revealed five main areas where change is needed to make services work better for young people. First, education about sexual and reproductive health must be strengthened in schools, communities, and places of worship. The participants emphasized that accurate information needs to be accessible and delivered in a way that respects their age and context. Second, the health system itself requires improvement to ensure that care is confidential, respectful, and reliable. Young people expressed a strong desire for privacy and for health workers who treat them with dignity rather than judgment. Third, there is a need for clearer policies and laws that guide how these services are delivered, removing confusion for both providers and patients. Fourth, building trust within the community is essential; when families and local leaders are engaged and supportive, adolescents feel safer seeking help. Finally, the study highlighted the importance of integrating family planning and post-abortion care so that a young person does not have to navigate two separate systems to get the support they need.

The findings suggest that improving uptake of these services depends on connecting community-generated knowledge with health system improvements. The researchers found that a young person's decision to seek care is shaped by how individual, social, health-system, and policy conditions interact, rather than by knowledge alone. The study proposes that a participatory approach, where adolescents and stakeholders work together to design solutions, offers a feasible path forward. Priority actions identified include ensuring reliable supplies of medical commodities, providing clear operational guidance for staff, and creating coordinated referral systems. By addressing these interconnected layers, from the classroom to the clinic, the study indicates that it is possible to create an environment where adolescents in Northern Uganda can access the family planning and post-abortion care they need with confidence and safety.