Knowledge and Perceptions on Sexual Reproductive Health and Rights Among University of Rwanda Students: A Mixed-Method Study

Abstract

Background: Poor knowledge of sexual reproductive health and rights (SRHR) among university students has been constantly reported in low and middle-income countries. A study conducted on female students at the University of Rwanda (UR) about knowledge of emergency contraceptive method use revealed inadequate knowledge in family planning though they are sexually active. However, no study has assessed knowledge of SRHR in general among UR students. This study aims to explore the UR students’ knowledge and perspectives on SRHR. Methodology: This was a mixed-method study. An online survey was conducted among a convenient sample of 441 UR students. After reviewing the survey results, 12 structured interviews were conducted among a sample of UR students from each of the six colleges. In data collection, we used a validated questionnaire with 50 items on SRHR knowledge through Moodle online platform and physical in-depth interviews. SPSS version 25 was used for descriptive and logistic regression analysis, whereas N-vivo 12 was used for qualitative thematic analysis. A p-value <0.05 was considered significant. Results: The majority had insufficient knowledge (57%).Prior exposure to the SRHR course through YouTube (aOR 3.66; [1.01-13.17]) and SRHR prior exposure through Radio (aOR: 5.58; [1.50-20.75]) were associated with SRHR knowledge. In qualitative analysis, five themes emerged: 1) Prevention of unplanned pregnancies, 2) Knowledge of SRHR Services, 3) Knowledge of contraceptive methods, 4) Perceptions of sexual intercourse among youths before marriage, 5) Perceptions of safe abortion. Participants reported that they use condoms, pills and abstinence, feel ashamed to ask for SRHR information or share their experiences in public, fear the use of long-acting contraceptive methods, and have limited condom access. Conclusion and Recommendations: UR students do not have sufficient knowledge of SRHR. Every UR student should benefit from SRHR training from reliable sources to enable them to make effective choices regarding their reproductive health.