Background: Adolescents are still getting pregnant and contracting Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs) in Rwanda as elsewhere. Quality and comprehensive SRH services and information for adolescents is valuable for adolescents' wellbeing. This study aimed at understanding SRH services providers' viewpoints on accessibility, availability, and quality of SRH services provided to adolescents in selected cities of Rwanda. Method: The study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach. A checklist was used to collect data from 159 conveniently selected SRH services providers. The survey tool was validated. SPSS version 20 was used to describe quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically. Results: Qualitatively, health care providers reported that the availability of adolescent SRHS are satisfactory with access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV services, and counselling. However, the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Religious leaders and family members may hinder adolescents from health-seeking behavior by promoting abstinence and discouraging use of protective means. Quantitatively, we found that 94.3% of health facilities provide information to adolescents on SRH services that were available and 51.6% affirmed delivering services at a low cost. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities.

Background: Adolescents are still getting pregnant and contracting Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs) in Rwanda as elsewhere. Quality and comprehensive SRH services and information for adolescents is valuable for adolescents’ wellbeing. This study aimed at understanding SRH services providers’ viewpoints on accessibility, availability, and quality of SRH services provided to adolescents in selected cities of Rwanda. Method: The study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach. A checklist was used to collect data from 159 conveniently selected SRH services providers. The survey tool was validated. SPSS version 20 was used to describe quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically.Results: Qualitatively, health care providers reported that the availability of adolescent SRHS are satisfactory with access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV services, and counselling. However, the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Religious leaders and family members may hinder adolescents from health-seeking behavior by promoting abstinence and discouraging use of protective means. Quantitatively, we found that 94.3% of health facilities provide information to adolescents on SRH services that were available and 51.6% affirmed delivering services at a low cost. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities.Conclusion: SRH services in Rwanda are available for the general population and are not specifically designed for adolescents. These SRH services seem to be fairly accessible to adolescents with insufficient quality as adolescents themselves do not get to be fully involved in service provision among other aspects of quality SRH as stated by the World Health Organization (WHO). Therefore, there is a need to improve the present quality of these services to meet adolescents’ needs in an urban setting.

Abstract Background: Adolescents are still getting pregnant and contracting Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs) in Rwanda as elsewhere. Quality and comprehensive SRH services and information for adolescents is valuable for adolescents’ wellbeing. This study aimed at understanding SRH services providers’ viewpoints on accessibility, availability, and quality of SRH services provided to adolescents in selected cities of Rwanda. Method: The study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach. A checklist was used to collect data from 159 conveniently selected SRH services providers. The survey tool was validated. SPSS version 20 was used to describe quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically.Results: Qualitatively, health care providers reported that the availability of adolescent SRHS are satisfactory with access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV services, and counselling. However, the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Religious leaders and family members may hinder adolescents from health-seeking behavior by promoting abstinence and discouraging use of protective means. Quantitatively, we found that 94.3% of health facilities provide information to adolescents on SRH services that were available and 51.6% affirmed delivering services at a low cost. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities.Conclusion: SRH services in Rwanda are available for the general population and are not specifically designed for adolescents. These SRH services seem to be fairly accessible to adolescents with insufficient quality as adolescents themselves do not get to be fully involved in service provision among other aspects of quality SRH as stated by the World Health Organization (WHO). Therefore, there is a need to improve the present quality of these services to meet adolescents’ needs in an urban setting.

Background: A fifth of the global population is made up of adolescents. Sexual reproductive health needs for young people is largely ignored by existing health, education and other social programs. In Rwanda, there is still an increase in teen pregnancies, HIV/ STIs as well as reports on the lack of access to accurate SRH information. The study aimed to explore the perceptions and barriers toward sexual reproductive health services accessibility, availability and quality among adolescents in the second cities of Rwanda.Methods: Cross-sectional study was conducted in six selected cities of Rwanda. In-depth interviews were conducted using semi-structured questionnaires among 121 adolescents aged 10-19 years old living in six selected cities.Results : Majority of the participants were female 62.8% and aged between 15-17 years old 32.8%. Females adolescents were more aware, and adolescents with primary school level 62.5% were not aware about SRH services provision at health facilities. Adolescents were mostly aware about the availability of HIV testing and circumcision services at 102 ( 86.4%). Results indicate that utilization of SRH services remains low (34.7%) among adolescents. A recent utilization of a particular service was linked to a use in the past: “I am aware of my HIV status because I was tested when I was going to receive a transfusion at a hospital” (Female participant, Rwamagana). Family, socio-cultural, religious influences and lack of privacy, high costs for the services, unavailability of some services at private facilities as well as lack of comfortable separated rooms, were the barriers reported by adolescents that prevented them from utilising SRH services.Conclusion : Accessibility to SRH services for adolescents remains low and SRH services provision doesn’t offer confidentiality to adolescents who seek services at health facilities. Family influences, socio-cultural stigma and religious barriers remain a burden to adolescents’ SRH services utilization. Increasing community outreach and adolescent’s engagement is needed to enable access to accurate SRH information. Multidisciplinary stakeholders should collaborate and cooperate to address the stigma associated with access to SRH services for adolescents.

Background: Access and utilization of quality and comprehensive sexual and reproductive health services (SRHS) is crucial for the health of young adolescents worldwide. This study assessed the quality of SRHS provided to Rwandan adolescents in urban health facilities in terms of availability, accessibility, cost, and counseling, with particular emphasis on HIV and family planning-related education.Method: The study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach, including semi-structured questionnaire administration and in-depth interviews with 159 conveniently selected SRH services providers. All survey tools had been previously validated. SPSS version 20 was used for descriptive statistical analysis of quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically.Results: Overall, the availability of adolescent SRHS is satisfactory in more than 80% of health facilities surveyed, including access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV, and counselling. However the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. In-depth interviews revealed that 94.3% of centers provide information to adolescents on SRHS available and 51.6% affirmed delivering services at a low cost. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Private health facilities offer HIV testing for free, but for treatment and other services, they channel adolescents to public health facilities. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities. Religious leaders and family members may hinder adolescents from seeking behavior by promoting only abstinence and discouraging using protective means.Conclusion: SRHS were generally available for distribution to adolescents at most of the facilities but limited in access. Adolescents were said to face structural and social challenges towards accessing services. There is a need to improve the accessibility of SRH services delivery sites while considering innovative methods to broaden access to services.

Background : Access and utilization of quality and comprehensive sexual and reproductive health services (SRHS) is a very crucial point for young adolescents worldwide. This study assessed the quality of SRHS provided to Rwandan adolescents in urban health facilities in terms of availability, accessibility, cost, counseling, with particular emphasis on HIV and family planning-related cases. Method : The study was a descriptive cross-sectional survey conducted during the year 2019 in six selected cities of Rwanda using a mixed-methods approach, including s emi-structured questionnaire administration and in-depth interviews with social and healthcare workers. The study sample consisted of 159 social and healthcare providers ( 54.5 % men and 45.5% women) enrolled by convenience based on their responsibilities in the selected entities. All survey tools were pre-tested. SPSS version 20 served for descriptive statistics analysis of quantitative data, whereas ATLAS TI version 5.2 helped to code and analyze the qualitative data thematically. Results : Overall, the availability of adolescents sexual reproductive health services is satisfactory in more than 80% of health facilities surveyed, but the accessibility is a little bit low for some services. According to the respondents dire, some products available like female condoms are less demanded and often expire unused. In-depth interviews revealed that 94.3% of centers provide information to adolescents on SRHS available, and 51.6% affirmed delivering services at a low cost. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Private health facilities offer HIV testing for free, but for treatment and other services, they channel adolescents to public health facilities. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities. Religious leaders and family members may hinder adolescents from seeking behavior. Conclusion : SRHS were generally physically available at most of the facilities but limited in access as not all facilities were allowed to deliver some services. Adolescents were said to face structural and social challenges towards accessing services. There is a need to improve the accessibility of SRH services delivery sites while considering innovative methods to broaden access to services.