Utilization of sexual and reproductive health services and associated factors among adolescents in youth-friendly service implemented and non-implemented high school of South Ari District, South Omo Zone, Southern Ethiopia, 2019.

Abstract Background In Ethiopia a number of efforts have been made to support sexual and reproductive health services (SRHS) for adolescents. However, there is limited information regarding the level of SRH utilization and associated factors among adolescents. Therefore, this study aimed to assess the magnitude of utilization of sexual and reproductive health services and associated factors among secondary school adolescents in youth friendly services (YFS) implemented and non-implemented areas of South Ari Woreda, South Omo zone, Southern Ethiopia, 2019. Methods Institution based comparative cross-sectional study with multistage stage sampling procedure was employed. Data were collected by self- administered questionnaire. The collected data were entered in to Epi Data version 4.4.1 software and then exported to SPSS version 20 statistical packages for further analysis. Descriptive statistics were computed and summarized by tables, frequencies, graphs, mean, and proportion. Both Bivariate and multivariable analysis were carried by using binary logistic regression. Variables with a p-value ≤ 0.25 in Bivariate logistic regressions were taken as potential candidate for multivariable logistic regression analysis to control confounders. Association between reproductive health services utilization and associated factors were reported by odds ratio at 95% CI. Variables having p-value less than 0.05 in multivariable logistic regression model were considered as statistically significant. Results The magnitude of SRHS in YFS implemented and non-implemented schools were 33.8% [95% CI (28.2-40.4)] and 9.4% [95% CI (5.6, 13.6)] respectively. Grade ten level adolescents and those who discuss SRH issues with their family members were three times [AOR=3.28, 95% CI (1.7, 6.29)] and [AOR=3.3, 95% CI (1.47, 7.41)] more likely to have sexual and reproductive health care-seeking behavior as compared to grade nine level adolescents and those who didn’t discuss respectively. Furthermore, adolescents who travel less than 30 minutes were six times [AOR=5.72, 95%CI, 2.58, 12.64] more likely to uptake the SRHS as compared to those travel more an hour. Conclusion The magnitude of utilization of SRH services were low in YFS non implemented school when compared to YFS implemented school. There is a need of more efforts to scale up SRHS in YFS non implemented schools among stakeholders at different hierarchies. In addition, it is better to promote open discussion with adolescents at family level, and emphasizes should be given for women education.

Download Full-text

Uptake of Sexual And Reproductive Health Services and Associated Factors Among Rural Adolescents in Southern Ethiopia, 2020

Journal of Gynecology & Reproductive Medicine ◽

10.33140/jgrm.05.01.05 ◽

2021 ◽

Vol 5 (1) ◽

Keyword(s):

Logistic Regression ◽

Reproductive Health ◽

Health Service ◽

Health Services ◽

Service Utilization ◽

Sexual And Reproductive Health ◽

Burden Of Illness ◽

Reproductive Health Service ◽

Southern Ethiopia ◽

Reproductive Health Services

Introduction: Although 25% of Ethiopia’s population is an adolescent cohort of age 15-19 yrs, the Adolescent Sexual and Reproductive Health Service (ASRH) service utilization has not been adequately researched and addressed, and, therefore, they have had to deal with multiple reproductive health problems. Therefore, assessing the determinants of sexual and reproductive health service uptake in this age group is critical to boosting service use and, in doing so, reducing the burden of illness and disability among adolescents. And so, the motivation at the rear of this research was to look into the level of sexual and reproductive health services utilization and to find out determinants among adolescents who reside in rural districts of Guraghe zone, southern Ethiopia. Methods: A community-based cross-sectional study was undertaken from May 1-30, 2020. A multi-stage method of sampling was employed. A total of 1028 adolescents have been randomly chosen and participated in the study. Pre-tested structured questionnaires were used for data collection. The data was encoded and entered into Epi-Data version 3.1 and exported for analysis to SPSS version 23. A bivariable logistic regression analysis was conducted, and variables with a p-value less than 0.25 were considered candidates for a multivariable logistic regression model. In multivariate logistic regression, variables with p-values <0.05 were declared as statistically significant. Results: of the sampled 1028 participants, 1009 took part in the study and yielded a response rate of 98.1%. The study found that 281 (27.8%) of adolescents received sexual and reproductive health services. Accordingly, among these SRH service users (n = 281), provision of SRH information and education was the most common item received by 171(60.8%) of adolescents whereas relatively few respondents 32(11.4%) got safe and /or postabortion care. Variables that became important determinants of SRH service utilization were; taking part in peer education (AOR:2.07; 95%CI:1.46-2.94), parental discussion (AOR:3.94; 95%CI:2.77-5.60), availability of youth clubs (AOR:3.15; 95%CI:2.22-4.49), and being knowledgeable on SRH issues (AOR:3.48; 95%CI: 2.44-4.96). Conclusion: In the study area, sexual and reproductive health service utilization was low. Since most adolescents are enrolled in school, schools can be an excellent way to increase adolescents’ awareness of SRH services through behavioral change communication (BCC). Furthermore, special attention should be given to promoting discussion between parents and adolescents and the creation and strengthening of youth clubs as important steps to improving the use of Sexual and reproductive services for adolescents by the relevant stakeholders.

Download Full-text

What do service providers in Southern Ethiopia say about barriers to using youth-friendly sexual and reproductive health services for adolescents?: Qualitative study

10.21203/rs.3.rs-61064/v3 ◽

2021 ◽

Author(s):

Yitagesu Habtu ◽

Mirgissa Kaba ◽

Hussen Mekonnen

Keyword(s):

Reproductive Health ◽

Health Services ◽

Healthcare System ◽

Sexual And Reproductive Health ◽

Service Providers ◽

Healthcare Providers ◽

System Level ◽

Southern Ethiopia ◽

Reproductive Health Services ◽

Youth Friendly

Abstract Background: In Ethiopia, the utilization coverage of adolescent-friendly health services (AFSRHs) ranged only from 9% to 55% and it was the lowest of all Sub-Saharan African countries in 2016. Little is known why adolescents were not accessing the existing services to the side of healthcare providers. Objective: The aim of this study is to explore contextual perceived and actual barriers to accessing AFSRHs by adolescents in Southern Ethiopia.Methods: Phenomenological study design supplemented with observation was used to explore perceived and actual barriers to accessing AFSRHs in 2020. Criterion sampling was used to select study participants. In-depth interviews with healthcare providers and non-specialist sexual and reproductive healthcare providers were conducted. Transcribed interviews and observations were imported to Open Code 4.02 for coding, categorizing, and creating themes. Finally, barriers to accessing existing services were explained using thematic analysis. Results: The study explores contextual barriers to accessing sexual and reproductive health services in five emergent themes. According to providers’ points of view, the barriers include ranging from providers (e.g poor providers’ competency), health facilities (e.g. supply constraints and unsupportive environment), adolescents (e.g perceived lack of information and attitude towards SRHs), community (e.g. lack of parental and social support), and broader health system (e.g. poor implementation and multi-sectorial engagement). Conclusion: As to providers, adolescents face multiple barriers to accessing youth friendly sexual and reproductive health services. Healthcare facilities and all levels of the healthcare system should implement varieties of approaches to increase access to the services for adolescents. Given the lack of progress in utilization of adolescents- youth friendly sexual and reproductive services, the existing strategy should be re-evaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.

Download Full-text

What do service providers in Southern Ethiopia say about barriers to using youth-friendly sexual and reproductive health services for adolescents?: Qualitative study

Reproductive Health ◽

10.1186/s12978-021-01092-0 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Yitagesu Habtu ◽

Mirgissa Kaba ◽

Hussein Mekonnen

Keyword(s):

Reproductive Health ◽

Health Services ◽

Healthcare System ◽

Sexual And Reproductive Health ◽

Service Providers ◽

Healthcare Providers ◽

System Level ◽

Southern Ethiopia ◽

Reproductive Health Services ◽

Youth Friendly

Abstract Background In Ethiopia, the utilization coverage of adolescent-friendly health services (AFSRHs) ranged only from 9 to 55% and it was the lowest of all Sub-Saharan African countries in 2016. Little is known why adolescents were not accessing the existing services to the side of healthcare providers. Objective The aim of this study is to explore contextual perceived and actual barriers to accessing AFSRHs by adolescents in Southern Ethiopia. Methods Phenomenological study design supplemented with observation was used to explore perceived and actual barriers to accessing AFSRHs in 2020. Criterion sampling was used to select study participants. In-depth interviews with healthcare providers and non-specialist sexual and reproductive healthcare providers were conducted. Transcribed interviews and observations were imported to Open Code 4.02 for coding, categorizing, and creating themes. Finally, barriers to accessing existing services were explained using thematic analysis. Results The study explores contextual barriers to accessing sexual and reproductive health services in five emergent themes. According to providers’ points of view, the barriers include ranging from providers (e.g. poor providers’ competency), health facilities (e.g. supply constraints and unsupportive environment), adolescents (e.g. perceived lack of information and attitude towards SRHs), community (e.g. lack of parental and social support), and broader health system (e.g. poor implementation and multi-sectorial engagement). Conclusion As to providers, adolescents face multiple barriers to accessing youth friendly sexual and reproductive health services. Healthcare facilities and all levels of the healthcare system should implement varieties of approaches to increase access to the services for adolescents. Given the lack of progress in utilization of adolescents- youth friendly sexual and reproductive services, the existing strategy should be re-evaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.

Download Full-text

What do Service Providers in Southern Ethiopia Think About Barriers to using Youth-Friendly Sexual and Reproductive Health Services for Adolescents?: Qualitative Study

10.21203/rs.3.rs-61064/v1 ◽

2020 ◽

Author(s):

Yitagesu Habtu ◽

Mirgissa Kaba ◽

Hussen Mekonnen

Keyword(s):

Reproductive Health ◽

Health Services ◽

Sexual And Reproductive Health ◽

Service Providers ◽

Healthcare Providers ◽

System Level ◽

Southern Ethiopia ◽

Reproductive Health Services ◽

African Countries ◽

Youth Friendly

Abstract Background: In Ethiopia, lowest utilization of adolescent friendly sexual and reproductive health services (AFSRHs) is recorded among Sub-Saharan African countries. Little is known why adolescents were not accessing the existing services to the side of healthcare providers. Objective: The aim of this study is to explore contextual perceived and actual barriers to accessing AFSRHs by adolescents in Southern Ethiopia.Methods: Phenomenological study design supplemented with observation was used to explore perceived and actual barriers to accessing AFSRHs in 2020. Criterion sampling was used to select study participants. In-depth interviews with key healthcare providers and non-specialist sexual and reproductive health providers were conducted. Transcribed interviews and observation were imported to Open Code 4.02 for coding, categorizing codes, and creating themes. Finally, barriers to assessing the services were explained using thematic analysis. Results: The study explores contextual barriers to accessing sexual and reproductive health services in five emergent themes. According to providers’ view, barriers include ranging from providers (e.g poor providers’ competency), health facility (e.g. supply constraints and unsupportive environment), adolescents (e.g perceived lack of information and attitude towards SRHs), community (e.g. lack of parental and social support), and broader health system (e.g. poor implementation and multi-sectorial engagement). Conclusion: As to providers, adolescents face multiple barriers to accessing youth friendly sexual and reproductive health services. Healthcare facilities and the health systems should implement varieties of approaches to increase access to the services for adolescents. The existing strategies should be re-evaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.

Download Full-text

What do service providers in Southern Ethiopia say about barriers to using youth-friendly sexual and reproductive health services for adolescents?: Qualitative study

10.21203/rs.3.rs-61064/v2 ◽

2021 ◽

Author(s):

Yitagesu Habtu ◽

Mirgissa Kaba ◽

Hussen Mekonnen

Keyword(s):

Reproductive Health ◽

Health Services ◽

Sexual And Reproductive Health ◽

Service Providers ◽

Healthcare Providers ◽

System Level ◽

Southern Ethiopia ◽

Reproductive Health Services ◽

African Countries ◽

Youth Friendly

Download Full-text

Youth Friendly Reproductive Health Services Among Students of Mizan-Tepi University, South-western Ethiopia

10.21203/rs.3.rs-96017/v1 ◽

2020 ◽

Author(s):

Samuel Getachew Zewudie ◽

Lema Abate Adulo ◽

Abel Mandefro Sirna ◽

Abiyot Asres

Keyword(s):

Logistic Regression ◽

Reproductive Health ◽

Health Services ◽

Descriptive Analysis ◽

Educational Background ◽

P Value ◽

Regression Result ◽

Reproductive Health Services ◽

Mothers And Fathers ◽

Youth Friendly

Abstract Background: Youth friendly reproductive health services are designed to entertain the unique needs of youth. Nevertheless, in developing countries like Ethiopia, knowledge, attitude and utilization of these services is very limited. This study was designed to assess the knowledge, attitude and the extent of utilization of youth friendly reproductive health services (YFRHS) and associated factors among students of Mizan-Tepi University, Southwestern, Ethiopia. Method: A public University-based cross-sectional study was conducted between October and January 2019. Simple random sampling technique was used to select participants from target population. Descriptive analysis, Chi-square test and logistic regression model were employed to identify the factors associated with YFRHS. Result: The results of descriptive analysis showed that about 55.4% of participants had no knowledge, 40.2% had negative attitudes and 61.2% had not practiced YFRHS. Majority 258(60.30%) of the respondents were females and 209(48.80%) were in the age group of 21-22 years. Most of the respondents lack basic information and knowledge, and have no any YFRHS in their surroundings 220(51.4%). Out of the 428 respondents, 57.9%, 59.3%, and 36.4% had never been practiced services related to VCT, family planning and contraception and treatment of sexually transmitted infections (STIs), respectively. The multivariable binary logistic regression result revealed that sex, age, religion, mother’s and father’s educational background, availability of YFRHS in the area and source of information had statistical significant effect on the knowledge, attitude and practices of students toward YFRHS. Male students were more likely to have knowledge and practicing experiences (OR = 1.847, p-value =0.015) and (OR=1.821, p-value = 0.017) respectively, however they had less likely positive attitudes (OR=0.519, p-value = 0.010) compared to their counterpart females. Students from primary and above educated mothers and fathers were more likely to have knowledge, attitude and practicing experience compared to students from uneducated mothers and fathers. Conclusion: The overall utilization, attitude and knowledge of YFRHS among study respondents’ are lower and therefore, further efforts like availability of YFRHS providers and improvement of facility, and education related to the service to all young groups and allocation of appropriate time of services is essential.

Download Full-text

Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review

Reproductive Health ◽

10.1186/s12978-021-01183-y ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Lesley Rose Ninsiima ◽

Isabel Kazanga Chiumia ◽

Rawlance Ndejjo

Keyword(s):

Reproductive Health ◽

Health Services ◽

Sexual And Reproductive Health ◽

Health Workers ◽

Sub Saharan Africa ◽

Inclusion Criteria ◽

Reproductive Health Services ◽

Factors Influencing ◽

Sub Saharan ◽

Youth Friendly

Abstract Background Despite the global agreements on adolescents’ sexual and reproductive health and rights, access to and utilisation of these services among the youth/adolescents remain unsatisfactory in low- and middle-income countries which are a significant barrier to progress in this area. This review established factors influencing access and utilisation of youth-friendly sexual and reproductive health services (YFSRHS) among the youth in sub-Saharan Africa to inform programmatic interventions. Methodology A systematic review of studies published between January 2009 and April 2019 using PubMed, Web of Science, EMBASE, Medline, and Cochrane Library, and Google Scholar databases was conducted. Studies were screened based on the inclusion criteria of barriers and facilitators of implementation of YFSRHS, existing national policies on provision of YFSRHS, and youth’s perspectives on these services. Findings A total of 23,400 studies were identified through database search and additional 5 studies from other sources. After the full-text screening, 20 studies from 7 countries met the inclusion criteria and were included in the final review. Structural barriers were the negative attitude of health workers and their being unskilled and individual barriers included lack of knowledge among youth regarding YFSRHS. Facilitators of utilisation of the services were mostly structural in nature which included community outreaches, health education, and policy recommendations to improve implementation of the quality of health services and clinics for adolescents/youth to fit their needs and preferences. Conclusion Stakeholder interventions focusing on implementing YFSRHS should aim at intensive training of health workers and put in place quality implementation standard guidelines in clinics to offer services according to youth’s needs and preferences. In addition, educating the youth through community outreaches and health education programs for those in schools can facilitate utilisation and scale up of the service.

Download Full-text

Disparities in utilization of sexual and reproductive health services among high school adolescents from youth friendly service implemented and non-implemented areas of Southern Ethiopia

10.21203/rs.2.22696/v5 ◽

2020 ◽

Author(s):

Bayu Haile ◽

Mulugeta Shegaze ◽

Tesfaye Feleke ◽

Mustefa Glagn ◽

Eshetu Andarge

Keyword(s):

Logistic Regression ◽

Reproductive Health ◽

Service Utilization ◽

Sexual And Reproductive Health ◽

Reproductive Health Services ◽

Services Utilization ◽

Significant Difference ◽

Open Discussion ◽

Youth Friendly Service ◽

Youth Friendly

Abstract Background: In recent years, much effort was made to improve access to sexual and reproductive health services (SRH) to adolescents and youths in Ethiopia particularly through establishment of youth friendly service (YFS) corners as part of the existing health care facilities. The existing evidences focused on investigating the utilization of SRH services at YFS established areas alone. There is a dearth of evidence which compares the SRH service use between the YFS implemented and non-implemented areas so that evidences can be drawn to suggest on the successes of the expansion of youth friendly corners. Methods: A school-based comparative cross-sectional study was conducted by employing a multistage cluster sampling method. A pre-tested self-administered questionnaire was used to collect data and the collected data were entered in to Epidata version 4.4.1 software and then exported to SPSS version 20 for analysis. χ2 test was used to see a significant difference in SRH service utilization among adolescents from YFS implemented and non-implanted areas. The association between the SRH services utilization and the independent variables were examined using binary logistic regression. Finally, variables having p-value less than or equal to 0.05 in the multivariable logistic regression model were considered as statistically significant.Results: There were a significant difference in the rate of SRH service utilization between YFS implemented (33.8%) and YFS non- implemented (9.9%) areas (χ2=37.49, p<0.001). Higher educational status of mothers (AOR=2.588, 95 % CI: 1.220, 5.491), having open discussion with family (AOR=3.175, 95%CI: 1.624, 6.206), having good knowledge (AOR= 4.511, 95% CI: 2.458, 8.278) and having positive attitude (AOR= 5.084, 95% CI: 2.764, 9.352) were factors positively associated with SRH services utilization.Conclusion: Compared with high schools from YFS implemented areas, the SRH service utilization was significantly lower among students from high schools where health facilities did not implement YFS. There is a need for enhancing efforts to establish YFS corners by the stakeholders at different hierarchies at places where the centers were not established so that SRH service uptake would be improved. In addition, it is better to promote open discussion with adolescents at the family level, and emphasis should be given for women education in the broad sense. Furthermore, wide-range awareness creation strategies should be used to address poor knowledge and negative attitude.

Download Full-text

Disparities in utilization of sexual and reproductive health services among high school adolescents from youth friendly service implemented and non-implemented areas of Southern Ethiopia

Archives of Public Health ◽

10.1186/s13690-020-00508-w ◽

2020 ◽

Vol 78 (1) ◽

Author(s):

Bayu Haile ◽

Mulugeta Shegaze ◽

Tesfaye Feleke ◽

Mustefa Glagn ◽

Eshetu Andarge

Keyword(s):

Logistic Regression ◽

Reproductive Health ◽

Service Utilization ◽

Sexual And Reproductive Health ◽

Reproductive Health Services ◽

Services Utilization ◽

Significant Difference ◽

Open Discussion ◽

Youth Friendly Service ◽

Youth Friendly

Abstract Background In recent years, much effort was made to improve access to sexual and reproductive health services (SRH) to adolescents and youths in Ethiopia particularly through establishment of youth friendly service (YFS) corners as part of the existing health care facilities. The existing evidences focused on investigating the utilization of SRH services at YFS established areas alone. There is a dearth of evidence which compares the SRH service use between the YFS implemented and non-implemented areas so that evidences can be drawn to suggest on the successes of the expansion of youth friendly corners. Methods A school-based comparative cross-sectional study was conducted by employing a multistage cluster sampling method. A pre-tested self-administered questionnaire was used to collect data and the collected data were entered in to Epidata version 4.4.1 software and then exported to SPSS version 20 for analysis. χ2 test was used to see a significant difference in SRH service utilization among adolescents from YFS implemented and non-implanted areas. The association between the SRH services utilization and the independent variables were examined using binary logistic regression. Finally, variables having p-value less than or equal to 0.05 in the multivariable logistic regression model were considered as statistically significant. Results There were a significant difference in the rate of SRH service utilization between YFS implemented (33.8%) and YFS non- implemented (9.9%) areas (χ2 = 37.49, p < 0.001). Higher educational status of mothers (AOR = 2.588, 95% CI: 1.220, 5.491), having open discussion with family (AOR = 3.175, 95%CI: 1.624, 6.206), having good knowledge (AOR = 4.511, 95% CI: 2.458, 8.278) and having positive attitude (AOR = 5.084, 95% CI: 2.764, 9.352) were factors positively associated with SRH services utilization. Conclusion Compared with high schools from YFS implemented areas, the SRH service utilization was significantly lower among students from high schools where health facilities did not implement YFS. There is a need for enhancing efforts to establish YFS corners by the stakeholders at different hierarchies at places where the centers were not established so that SRH service uptake would be improved. In addition, it is better to promote open discussion with adolescents at the family level, and emphasis should be given for women education in the broad sense. Furthermore, wide-range awareness creation strategies should be used to address poor knowledge and negative attitude.

Download Full-text