Clinical Scorecard: Impact of Youth-Centric Health Services on Pregnancy Risk in Adolescent Girls and Young Women in Lilongwe, Malawi: Insights from the Girl Power–Malawi Study Analysis

At a Glance

Key Highlights

• AGYW in sub-Saharan Africa face high rates of early and unintended pregnancy with significant health and socioeconomic consequences.
• Youth-friendly health services that include provider training, youth-dedicated spaces, flexible hours, and peer navigators increase contraceptive uptake among AGYW.
• The Girl Power study demonstrated a 7.3% absolute reduction in 12-month pregnancy risk among AGYW accessing YFHS compared to standard care.

Guideline-Based Recommendations

Diagnosis

• Use self-reported pregnancy status supplemented by urine pregnancy testing to ascertain pregnancy outcomes among AGYW.

Management

• Implement youth-friendly health services incorporating provider training, youth-dedicated clinic spaces, flexible clinic hours, and peer navigation to improve contraceptive uptake and reduce pregnancy risk.
• Integrate community outreach and sociobehavioral interventions to support AGYW in sexual and reproductive health.

Monitoring & Follow-up

• Conduct follow-up visits at baseline, 6 months, and 12 months to monitor pregnancy status and contraceptive use among AGYW.
• Use multiple imputation methods to address missing pregnancy test data and improve outcome accuracy.

Risks

• Early and unintended pregnancy among AGYW is associated with increased maternal morbidity and mortality, compromised education, and reduced economic opportunities.

Patient & Prescribing Data

Adolescent girls and young women aged 15 to 24 years attending government health centers in Lilongwe, Malawi

Access to youth-friendly health services that address structural barriers and provide tailored support reduces pregnancy risk by improving contraceptive uptake.

Clinical Best Practices

• Train healthcare providers in medical and psychosocial support tailored to young clients to reduce judgmental attitudes and eligibility restrictions.
• Create youth-dedicated clinic spaces with flexible hours, including afternoons and select Saturdays, to improve accessibility.
• Employ peer navigators to assist AGYW in assessing sexual and reproductive health needs and navigating clinical services.
• Incorporate community sensitization and sociobehavioral interventions to enhance acceptability and uptake of services.

References

• World Health Organization: Youth-friendly health services
• Girl Power Study Protocol and Outcomes