RESUMEN
In Guatemala, adolescent health indicators are collected using the Sistema Informático del Adolescente (SIA), a clinical survey developed by the Pan-American Health Organization. Recent analysis revealed significant gaps in data, limiting the ability of clinicians and policy makers to effectively address health disparities. Our objective was to explore adolescent health stakeholders' perceptions of the SIA. We conducted semi-structured interviews with 22 clinic personnel recruited from six adolescent health clinics throughout Guatemala. Stakeholders included multi-disciplinary providers and key database personnel. Interviews were conducted in Spanish, recorded and transcribed; a coding scheme was developed using a phenomenological approach, and Dedoose was used for analysis. Four major themes emerged: (1) Collecting baseline adolescent health data was useful for prevention, diagnosis and treatment of adolescent health issues. (2) The SIA was instrumental in streamlining clinical care and informing the psychosocial needs of patients. (3) The questionnaire was time-intensive, repetitive and often problematic for data input/extraction. (4) Condensing the survey and using a web-based version may improve the system for future use. Our findings show that despite the use of a standardized system, multiple barriers contribute to gaps in comprehensive data collection in Guatemala. Refining the system may enhance adolescent health surveillance and improve quality of care in this vulnerable population.
RESUMEN
BACKGROUND: Despite the inclusion of adolescent health in recent global frameworks, limited data exist on health indicators in low-income countries. Our objective was to identify socioeconomic measures, risk behaviors and health indicators of young people in Guatemala. METHODS: We conducted a secondary data analysis of the Pan American Health Organization's Sistema Informático del Adolescente of 2831 participants ages 10-24 y from 2008 to 2014. We examined frequencies for a core set of items, and generalized regression models assessed correlations between age, sex and ethnicity with health outcomes of interest. RESULTS: Fewer than 17% of participants reported a history of chronic illness (16.6%) and severe psychological problems (16.8%). While 66.1% of participants' mothers and 36.6% of fathers reported job instability, far fewer families had housing instability (1.9% with no electricity, 6.3% with no running water). Fewer than one-third (29.1%) were sexually active and the majority (76.0%) routinely used condoms. About one-quarter (22.6%) reported abnormal mood. Indigenous participants were significantly more likely to have experienced psychological problems (odds ratio [OR] 1.75 [confidence interval {CI} 1.65-1.86]) and violence (OR 1.34 [CI 1.27-1.42]) compared with whites. CONCLUSIONS: The prevalence of risk behaviors and mental health concerns is low compared with other sources of national and regional data. Further work is needed to examine the benefits and limitations of this system in order to improve health surveillance.
