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What are the preferences for clinic characteristics among young people in Malawi

Summary: A discrete choice experiment among young people in Malawi found that the most highly valued components of integrated services were confidentiality (highly significant), followed by price. The addition of sports and recreation was also highly valued – especially by boys.

Detail: To discover youth preferences for components of an integrated SRH and HIV package of outreach services, two discrete choice experiments (DCE) were conducted using a single questionnaire.  One DCE explored preferences for components of an integrated package of outreach services. The second – for which analysis of the results is still ongoing – addressed youth preferences for different FP service providers.

The detailed findings are:

  • Young people were less likely to choose an alternative in which the service provider is older, which suggests that they prefer younger providers.
  • Young people had no strong preferences for the gender of the service provider.
  • Young people valued confidentiality. This appeared to be statistically highly significant, indicating that this is the most important service characteristic across all respondents. Therefore, young people are more likely to choose a service where a private and confidential consultation is offered.
  • Young people valued the HIV service package (HCT and ART) positively.  This result suggests that people preferred accessing FP services where both HCT and ART are also available. This may also suggest that providing treatment does not stigmatise services.
  • The presence of Youth Friendly Services with an addition of sports and recreation was highly valued by young people though they did not have a strong preference for the addition of music and drama to the outreach service.
  • Young people valued the availability of health talks positively.
  • Price appears to also be important and young people were less likely to choose services at an increased price.


These findings look at how different options are valued but further operational research is needed to see how these components affect integrated service uptake by young people when included in the current service mix.

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