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Barriers to utilization of adolescent friendly health services in primary healthcare facilities in Armenia: a qualitative study

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International Journal of Public Health



The study aimed to explore potential challenges that hamper utilization of adolescent friendly health services (AFHS) in primary healthcare (PHC) facilities in Armenia.


A qualitative study using in-depth interviews and focus group discussions was conducted with experts in adolescent health, PHC providers and facility managers from public PHC facilities and adolescents from the two largest cities in Armenia. We also collected data through observations in PHC facilities. We utilized a directed content analysis approach for data analysis.


The study identified various factors negatively influencing utilization of AFHS in Armenia. These factors included adolescents’ poor health literacy and awareness of health services, lack of PHPs’ professional competencies, and breaches of confidentiality. Several facility-level barriers such as lack of privacy, inconvenient operating hours and long waiting times also contributed to insufficient service utilization by adolescents.


The study findings shed light on different perspectives related to various challenges adolescents faced in PHC facilities in Armenia. Targeted interventions needed to improve adolescents’ health literacy, to enhance the PHPs’ competencies and to create a friendly and welcoming environment in PHC facilities.

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The study team is grateful to all participants for providing valuable insights and perspectives. We are thankful to Yerevan and Gyumri Municipalities’ Health Departments for supporting with the recruitment of participants.


The United Nations Population Fund (UNFPA) Armenia Country Office provided financial support for the study.

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Correspondence to Varduhi Hayrumyan.

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The authors declare that they have no conflict of interest.

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All procedures performed in this study were in accordance with the ethical standards of the Institutional Review Board of the American University of Armenia (AUA-2019-018) and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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This article is part of the special issue "Adolescent health in Central and Eastern Europe".

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Hayrumyan, V., Grigoryan, Z., Sargsyan, Z. et al. Barriers to utilization of adolescent friendly health services in primary healthcare facilities in Armenia: a qualitative study. Int J Public Health 65, 1247–1255 (2020).

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