Availability and Utilization of Sexual Reproductive Health Services among adolescents in boarding secondary schools in Soroti District
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Background: Adolescence represents a period of transition from childhood to adulthood. During this period, adolescents are exploring, highly active and are willing to take risks including sexual experimentation. Therefore, exposing them to reproductive health risks yet adolescent are less informed and they utilize less of the few available Sexual Reproductive Health (SRH) services. This study determined what SRH services are available for adolescents in boarding secondary schools in Soroti district, the level of utilization of SRH services and factors associated with utilization. The study further explored adolescents’ experiences while they seek and utilize SRH services in boarding secondary schools. Methods: This was a cross-sectional study among 451 adolescents aged 15-19 years conducted from 15th April to 26th April 2019 in seven boarding secondary schools of Soroti district. FGDs were used to collect qualitative data which was analyzed using thematic analysis. Quantitative data was collected using interviewer administered questionnaires and check lists, captured using EPI info 7 and analyzed using STATA 14. Summary statistics were generated to describe availability and utilization of SRH services. Modified Poisson regression with robust standard error was used to identify factors associated with utilization of SRH services. Results: More than half 114 (77.6%) of the 147 (44%) sexually active adolescents utilized at least one of the three SRH services as follows: a half 86 (58.5%) used HCT, 78 (53%) used FP and 25 (17%) used STI screening and treatment. Among the 7 schools, the most available SRH service was STI treatment (7/7 schools) followed by HCT (3/7) and FP information was available in 2/7 schools. Knowing where to find SRH service [APR 0.60, CI (0.40-0.91)], perceiving risk of pregnancy or infection [APR 0.61, CI (0.43-0.86)] and person lived with during holidays [APR 0.60, CI (0.64-0.83)] were independently associated with utilization of SRH services. Adolescents experienced, lack of confidentiality, delayed access to SRH service, stigmatization and support while seeking and using SRH services. Conclusion: SRH services are inadequately available in boarding secondary schools of Soroti. Most adolescents receive SRH services from public and private health facilities. This represents a need for schools to establish relevant linkages with providers of SRH services to ensure their availability. The level of SRH utilization is suboptimal; the factors associated with utilization are: age, being in a sexual relationship, knowing where to find services and perceiving risk of STIs and pregnancies. Furthermore, adolescent experiences in boarding schools are generally. unfavorable; there is need for school administrators to be intentional in making school environment favorable for adolescents with SRH problems.