Table 4 Joint display of factors promoting or hindering acceptability and appropriateness of Youth Health Africa
TFAa Domain | Facilitator/ Barrier | Integrated Findings | Key Data | |
|---|---|---|---|---|
Interviews | Surveysb | |||
Nature of YHA | ||||
Affective Attitude | Facilitator | HCWs liked participating in YHA, specifically because interns addressed healthcare worker shortages | Theme 1: YHA is mutually beneficial (Interns alleviate HCW burdens) | Almost everyone liked supervising interns (98%) and having facilities host interns (97%) |
Ethicality | Facilitator | HCWs liked that participation in YHA gave them chance to support young people and improve future society | Theme 1: YHA is mutually beneficial (HCWs appreciate helping interns) | Almost all felt good about the program as an on-the-job experience for youth (98%) and felt good about supporting the interns (97%) |
Implementation of YHA | ||||
Intervention Coherence | Barrier | HCWs lacked fully understanding of YHA and what was expected of them, needing more communication with YHA staff in early stages of program | Theme 2: Facilities need agency (Poor communication) | Many felt tasks they were asked to do as an intern supervisor made sense (87%); fewer (67%) were satisfied with the orientation they received to be supervisor |
Self-Efficacy | Facilitator | HCWs were well-equipped to manage and supervise interns because this was similar to overseeing other staff | Theme 2: Facilities need agency (Easy integration) | Most thought supervising interns aligns with their job description (93%); almost all had prior supervisory experience (98%) |
Facility Fita | Facilitator | Youth interns were integrated easily into facilities because HCWs assumed responsibility for them once at facilities | Theme 2: Facilities need agency (Easy integration) | Almost all felt the intern program fit with the health facility culture (98%) and how the health facility operated (98%) |
Burden | Barrier | Supporting YHA can be burdensome, as frontline HCWs had to train interns and interns added to supervisory responsibilities for intern supervisors | Theme 3: Short internships can be burdensome | Many HCWs viewed tracking intern progress as something they should do in their job (83%); fewer were satisfied with the support received while supervising interns (69%) |
Opportunity Cost | Mixed | Opportunity costs appear low for all HCWs. While frontline HCWs think current benefits of program exceed costs, they express reservations that costs could exceed benefits if there are no plans to sustain help from interns | Theme 3: Short internships can be burdensome | Most felt health facilities could support interns without negatively affecting other services (90%) and that it was worth allocating resources to host interns at health facilities (91%). 85% thought benefits of YHA were equal to/outweighed time required of HCWs |
Results of YHA | ||||
Perceived Effectiveness | Facilitator | HCWs perceive YHA to be effective, contributing to a wide range of positive outcomes for healthcare workers, the facility, and its patients | Theme 1: YHA is mutually beneficial Theme 4: Success is more than numbers | Almost everyone felt health facilities benefited from having youth interns (98%), that YHA was effective in addressing staff shortages (96%), and that youth interns in clinics helped facilities be more successful (96%) |