Documenting the availability and accessibility of reproductive health services for youth in Albania
Bibliographic record
Abstract
Abstract Youth in Albania are initiating sexual activity at an earlier age. However, use of all forms of contraception has declined in the last decade and uptake now stands at 4%. The self-reported prevalence of sexually transmitted infections (STIs) and STI symptoms has risen dramatically, as has reliance on abortion as a predominant method of family planning. In 2020-2022, we conducted a multi-method qualitative study in Albania to document the availability and accessibility of sexual and reproductive health (SRH) services and examine challenges that youth face when seeking SRH care. This study comprised a document review, a curriculum review, a community-based survey with 273 youth, semi-structured interviews with 15 youth, semi-structured interviews with 15 key informants, and a service mapping exercise in Tirana. Lack of adequate infrastructure and bureaucratic hurdles make it difficult for youth to navigate and access SRH services in Albania. A third of survey participants (n = 90, 33%) expressed discomfort inquiring about SRH matters, while nearly two-thirds rarely or never sought SRH services from a doctor or clinic. Furthermore, Albania’s school-based sexuality education curriculum lacks in topics, content, and responsiveness, resulting in inconsistent learning experiences and limited knowledge of SRH. Sexuality education is primarily focused on the anatomy and physiology of reproduction, leading to significant knowledge gaps in other aspects of SRH. Only half of survey participants (n = 150, 55%) had received any education on birth control, contraception, or family planning; and only few had knowledge about gender identity (n = 103, 38%), or consent (n = 77; 28%). Widespread lack of awareness and fear of judgment contribute to the underutilization of SRH services among youth in Albania. Improving knowledge and awareness, alongside investing in infrastructure and capacities, are essential to enhancing accessibility and quality of SRH services for Albanian youth. Key messages • Lack of knowledge and awareness prevent youth from accessing SRH services. • Establishing youth-friendly services and training health providers and educators are crucial to delivering confidential and non-judgmental youth-friendly SRH care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".