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Do European Union countries adequately address the healthcare needs of adolescents in the area of sexual reproductive health and rights?
  1. Pierre-André Michaud1,
  2. Annemieke Visser2,
  3. Johanna Vervoort2,
  4. Paul Kocken3,
  5. Sijmen Reijneveld4,
  6. Mitch Blair5,
  7. Denise Alexander6,
  8. Michael Rigby6,
  9. Martin Weber7,
  10. Danielle Jansen2
  1. 1 Lausanne University Hospital, Lausanne, Switzerland
  2. 2 Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  3. 3 Department Public Health and Primary Care, TNO, Department Child Health, Leiden University Medical Centre, Leiden, The Netherlands
  4. 4 University Medical Center Groningen, Groningen, The Netherlands
  5. 5 Paediatrics, Imperial College London, Harrow, UK
  6. 6 Imperial College London, London, UK
  7. 7 WHO Regional Office for Europe, WHO, Copenhagen, Denmark
  1. Correspondence to Dr Danielle Jansen, Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; d.e.m.c.jansen{at}


Background and objectives Adolescent sexual and reproductive health and rights (SRHR) are of particular relevance given their potential short-term or long-term health consequences. This study evaluates recommendations and policies regarding access to care in this area in 31 European countries (European Union (EU) plus Iceland, Norway and Switzerland).

Methods As part of the EU funded Models of Child Health Appraised project, data were gathered using a 43-item questionnaire sent to experts responsible for collecting information in each country.

Results Ten countries have not developed any formal policy or recommendation that guarantee the respect of confidentiality and the possibility of consulting a physician without parents knowing. Nearly half of the countries do not have centres specialised in adolescent healthcare, tackling comprehensive health issues or focusing specifically on SRH. Access to emergency contraception and information regarding pregnancy, including testing, is easy in most countries. However, oral contraception is delivered free of charge in only 10 countries. Twenty-three countries do not meet current standards in terms of providing policy-based pregnancy care, and only 13 have set up special programmes for pregnant adolescents. In only seven countries can adolescents definitely have their pregnancy terminated without their parents knowing (and in another seven countries in selected situations).

Conclusion The provision and availability of adolescent-friendly SRHR care are far from optimal in around half of the surveyed countries. These results call for the review and implementation of policies, specialised healthcare centres and training initiatives for primary care providers.

  • adolescent
  • health care
  • sexual and reproductive health
  • rights
  • policy

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  • Contributors P-AM, AV, JV and DJ have been heavily involved in the design of the questionnaire, the analyses, the writing and the review of the paper. MR, MB and MW have revised the manuscript on several. PK and SR have reviewed the questionnaire and the manuscript. DA has been heavily involved in the gathering of the data and has reviewed the questionnaire.

  • Funding This work was funded by the European Commission through the Horizon 2020 Framework, Grant No. 634201 (Models of Child Health Appraised; DJ) and by the Swiss State Secretariat for Education Research and Innovation, Grant No. 15.0152 (PA-M).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement We have a complete list of all the questions of our questionnaire with the detailed answers provided by all country agents.

  • Patient consent for publication Not required.

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