{"doi":"10.1093/aje/kwae193","title":"The effect of youth-friendly health services on risk of pregnancy among adolescent girls and young women in Lilongwe, Malawi: a secondary analysis of the Girl Power–Malawi study","abstract":"In sub-Saharan Africa, adolescent girls and young women aged 15 to 24 (AGYW) experience a high risk of early and unintended pregnancy. We assessed the impact of youth-friendly health services (YFHS) on pregnancy risk among AGYW who participated in the Girl Power study. In 2016, Girl Power randomly assigned 4 government-run health centers in Lilongwe, Malawi, to provide a standard (n = 1) or youth-friendly (n = 3) model of service delivery. At 6 and 12 months, study participants (n = 250 at each health center) self-reported their current pregnancy status and received a urine pregnancy test. Because of missing pregnancy test results, we used multiple imputation to correct for outcome misclassification in self-reported pregnancy status and applied the parametric g-formula on the corrected data to estimate the effect of YFHS on the 12-month risk of pregnancy. After correcting for outcome misclassification, the risk of pregnancy under the scenario where all health centers offered YFHS was 15.8% compared to 23.2% under the scenario where all health centers offered standard of care (risk difference: -7.3%; 95% CI, -15.5% to 0.8%). Access to a model of YFHS that integrates provider training with youth-friendly clinic modifications and community outreach activities may decrease risk of pregnancy among AGYW relative to standard of care.","journal":"American Journal of Epidemiology","year":2024,"id":480685,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9106,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":277337,"name":"Daniel Westreich","orcid":"0000-0003-3069-1650","position":1,"is_corresponding":false},{"id":312045,"name":"Bertha Maseko","orcid":"0000-0003-2864-3844","position":2,"is_corresponding":false},{"id":312047,"name":"Twambilile Phanga","orcid":"0000-0002-9519-7672","position":3,"is_corresponding":false},{"id":1269612,"name":"Tiyamike Nthani","orcid":"0000-0002-4328-4571","position":4,"is_corresponding":false},{"id":312048,"name":"Dhrutika Vansia","orcid":"0000-0003-1370-0180","position":5,"is_corresponding":false},{"id":401977,"name":"H. Benjamin","orcid":"0000-0002-1435-8455","position":6,"is_corresponding":false},{"id":307596,"name":"Julie L. Daniels","orcid":"0000-0002-9658-3743","position":7,"is_corresponding":false},{"id":513307,"name":"Jennifer H. Tang","orcid":"0000-0003-4238-2791","position":8,"is_corresponding":false},{"id":273592,"name":"Linda‐Gail Bekker","orcid":"0000-0002-0755-4386","position":9,"is_corresponding":false},{"id":277332,"name":"Audrey Pettifor","orcid":"0000-0002-3387-0817","position":10,"is_corresponding":false},{"id":312051,"name":"Nora E. Rosenberg","orcid":"0000-0002-9759-9966","position":11,"is_corresponding":false},{"id":1155766,"name":"Lauren A. Graybill","orcid":"0000-0002-8679-642X","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-19T02:07:02.142014Z","pmid":"38992859","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}