Beyond Service Availability: Adolescents’ Perceptions of Barriers to Youth-Friendly Health Services in Urban Indonesia
Abstract
Adolescent health remains a key concern at both the global and national levels, particularly in urban areas where socio-cultural dynamics shape patterns of healthcare-seeking behaviour. In Indonesia, the Youth-Friendly Health Services (PKPR) programme has been implemented to improve access to and the quality of services for adolescents; however, empirical evidence from the perspective of service users remains limited. This study aims to explore adolescents’ perceptions and attitudes towards PKPR services in Denpasar City.
A phenomenological qualitative research design was used to explore adolescents' real-life experiences. Data were collected from 15 adolescents aged 13–19 through in-depth interviews, focus group discussions (FGDs), and document analysis. Thematic analysis was carried out to identify the main patterns influencing these perceptions and attitudes.
The research findings revealed four main barriers affecting adolescents’ engagement in PKPR: (1) limited awareness and understanding of the scope of services, leading to a low perceived benefit; (2) negative experiences with healthcare professionals, characterised by judgemental attitudes, which erode trust; (3) structural barriers, particularly limited service hours that clash with school timetables; and (4) strong social stigma surrounding access to healthcare services, which hinders their use. These barriers were described across personal, interpersonal, structural, and social contexts, with participants describing them as overlapping constraints on PKPR access.
This study highlights that increasing the uptake of adolescent health services requires more than just the availability of services; it demands adolescent-centred communication, stigma-reduction strategies, and structural adjustments that are in line with the everyday realities of adolescents. Strengthening service providers’ capacity in empathic communication and integrating community-based interventions are crucial to enhancing the effectiveness of PKPR in urban areas of Indonesia.
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