Reproductive health knowledge and services utilization among rural adolescents in east Gojjam zone, Ethiopia: a community-based cross-sectional study

Abstract

BackgroundAccording to World Health Organization, adolescents are people between 10 and 19 years of age; one-fifth of Ethiopian population constitutes adolescents and four-fifth live in rural areas. Local evidence about adolescents’ reproductive health knowledge, services utilization and associated factors are relevant to design age-appropriate program interventions and strategies. Hence, this study assessed the level of reproductive health knowledge and services utilization among rural adolescents in Machakel district, Northwest Ethiopia.MethodsA community-based cross-sectional study was conducted to assess the level of reproductive health knowledge and services utilization of rural adolescents in Machakel district. The study employed both quantitative and qualitative methods. A systematic random sampling technique was used to select 415 adolescents from eligible households. Data were collected using pre-tested structured questionnaires and in-depth interview guides. The data were entered into Epi Info and analyzed by SPSS software for windows. Univariate, bivariate and multivariate analyses were done.ResultMore than two-third (67%) of the adolescents had knowledge about reproductive health. Age (AOR = 3.77, 95% CI: 3.1-8.98), living arrangement (AOR = 2.21, 95% CI: 1.81-6.04) and economic status (AOR = 3.37, 95% CI: 1.65-6.87) were associated with reproductive health knowledge. However, only one-fifth (21.5%) of the adolescents had ever used reproductive health services including family planning, sexually transmitted infections treatment and information, education and communication. Reproductive health services utilization was significantly associated with age (AOR = 2.18, 95% CI: 1.13-8.03) and knowledge for reproductive health (AOR = 1.23, 95% CI: 1.23-4.21). Parent disapproval, lack of basic information and pressure from partners were found to deter adolescents from accessing and using reproductive health services.ConclusionReproductive health knowledge and services utilization amongst rural adolescents remained low. Age and economic status were significantly associated with reproductive health knowledge; moreover, reproductive health services utilization was associated with age and respective knowledge for reproductive health. Community-conversation in line with adolescent-to-adolescent-counseling, peer education and parent-adolescent communication should address sensitive topics such as sex education and life skill development.

Knowledge, attitude and practice related to reproductive health among female adolescents

“…[ [36][37][38][39][40][41] Knowledge about female sterilization and male sterilization was poor, which is somewhat similar to a study done by Patanwar et al (2013) who reported that only 14.1% of adolescents had knowledge about female sterilization, and 7% had knowledge about male sterilization. [35] This result contradicts that of Gollakota et al's study (2015), who reported higher knowledge among female adolescents regarding female and male sterilization in their study.…”

“…This is consistent with the studies of Abiodun et al (2016), Patanwar et al (2013), and Gollakota et al (2015). [35][36][37][38][39][40][41][42] The adolscents in the current study were aware of STDs like Syphilis, Gonorrhea, and ulcer in the genital area. Although chlamydial infections are the major causes of pelvic inflammatory diseases, tubal occlusions, and infertility, only 10% of the students in the current study were aware of it.…”

Reproductive Health Service Utilization and Associated Factors Among Female Adolescents in Kachabirra District, South Ethiopia: A Community Based Cross Sectional Study

“…Female adolescents of age 15-19 years utilized RHS 3 times more likely than those of age 10-14 years, which was almost similar to that of Machakel district where adolescents of age 15-19 years utilized two times that of adolescents of age 10-19 years [21], which may be due to lack of awareness and feeling of shame and fear during the early adolescence.…”

Opinions of Health Professionals on Tailoring Reproductive Health Services to the Needs of Adolescents

“…In that study, less than half of adolescents used reproductive health services [25]. Another study by Abajobir and Seme (2013) in rural Ethiopia found only one-fifth of adolescents using reproductive health services [24]. The low levels of service utilization among adolescents could be as a result of the limited access to facilities and services [13, 15, 16].…”

“…In response to this call for moral propriety, adolescents face barriers in finding information and care regarding issues of sexual intercourse, STIs, pregnancy, contraception, among others [6, 22]. Hence only a few adolescents use reproductive health service [6, 24, 25]. Some adolescents actually refuse to utilize services in response to the negative attitudes from healthcare providers [26, 27].…”