Factors influencing utilisation of adolescent reproductive health services in Iganga district

Abstract

INTRODUCTION AND BACKGROUND: Low utilization of Adolescent sexual reproductive health (ASRH) services is a global problem especially in the developing countries. Iganga district is one of the districts in Uganda where the ASRH services are not being fully utilized by the community. According to Iganga District Director of Health Services (DDHS) report, only 40% adolsescents are utilising the services. Reasons for the non utilisation of ASRH services in the district are not very clear. This study aimed at identifying the factors responsible for low utilisation of ASRH services in Iganga district. METHODOLOGY: This was a cross sectional survey. It was conducted in 24 randomly selected villages (clusters) in the district. Semi structured questionnaires were administered to adolescents to collect quantitative data on socio-demographic, knowledge, attitude and accessibility to ASRH services characteristics. The quantitative data was analyzed using Epi Info 2002 and SPSS 10.0. Qualitative data was collected from 4 focus group discussions and 17 key informant interviews; data was analyzed manually using a master sheet. RESULTS: A Total of 738 adolescents were interviewed. Factors that were associated with utilization of ASRH services included; Location of LC 1 vilage- ‘’urban of rural (OR=7.00, 95%C1: 2.04-24.04), whether respondent ever engaged in sexual activity (OR=28.82, 95%C1: 7.13-116.60), perception of providers (OR=4.51, 95%C1: 1.29-7.61), and being knowledgeable about ASRH services (OR=11.56, 95%C1: 3.54-37.76). Belief that utilization of ASRH services requires payment inhibited service utilization (OR=0.21, 95%C1 0.10-0.62). CONCLUSION: In Iganga district, the adolescents are not aware about existence of ASRH services and don’t know the importance of such services. Adolescents feel that the providers are rude and they think there are payments to be made before one accessed services. These factors are influencing utilization of the ASRH services. RECOMMENDATIONS: The Iganga District Health Team (DHT) should sensitize adolescents about ASRH services. The best strategy is through facilitation of health workers to disseminate ASRH education on Local FM radio stations and during outreaches. The DHT should train adolescent community peer educators, who will educate adolescents and mobolize them to utilze ASRH services. There is need to conduct further research to establish the reasons why these factors are present in the district and the ways of addressing them. DISSEMINATION AND USE OF RESULTS: The study findings will be disseminated to Makerere university school of Graduate studies, Makerere university school of public health, Iganga district Health team and any other interested party. Information generated by this study will be used by the DHT to plan and implement feasible strategies for improving utilization of ASRH services and address barriers.