Challenges Faced by Female Out-of-School Adolescents in Accessing and Utilizing Sexual and Reproductive Health Service: A Qualitative Exploratory Study in Southwest, Ethiopia

Abstract

Introduction Due to the limited access to sexual and reproductive health service, out-of-school-adolescents become at a higher risk for early marriage, early pregnancy early parenthood, and poor health outcomes over their life course. Hence, the aim of this study was to explore the challenges faced by female out-of-school adolescents in accessing sexual and reproductive health service in Bench-Sheko zone. Methods A community-based qualitative exploratory study was carried out from November 01/2020 to December 01/2020 among selected out-of-school adolescents residing in rural and urban districts of Bench-Sheko Zone, and healthcare professionals working in the local health centers. FGD participants and healthcare providers were purposely selected for this study. Eight focus group discussions and 8 in-depth interviews were conducted among female out-of-school adolescents, and health care professionals, respectively. Result The study revealed that out-of-school adolescents encounter several challenges in accessing sexual reproductive health service which includes socio-cultural barriers, health system barriers, perceived legal barrier, inadequate information regarding sexual reproductive health service, and low parent-adolescent communication. Conclusion The finding suggests the need to engage community influencers (religious leaders, community leaders, and elders) in overcoming the socio-cultural barriers. Program planners and policy makers have better make an effort to create adolescent friendly environments in SRH service areas. Furthermore, implementing community-based awareness raising programs, parental involvement in sexual reproductive health programs, and encouraging parent-adolescent communication on sexual reproductive health issues could improve sexual reproductive health service utilization by out-of-school adolescents in the study area.

Exploring Providers’ Perception Towards Provision of Sexual and Reproductive Health Services for Unmarried Adolescents in Gamo Zone, Southern Ethiopia: A Phenomenological Study

“…This finding is consistent with other findings in Ethiopia. 3,16 Similar to this study finding, the finding of a study conducted in DR Congo also shows stigma discouraged adolescents to access and utilized sexual and reproductive health services. 25 Another qualitative study in Tanzanian found that adolescents discouraged seeking SRH services due to community stigma.…”

“…Studies conducted in southern Ethiopia and southwest Ethiopia also support this study finding. 3 , 16 A qualitative study conducted in South Africa also shows that insufficient SRH skills and shortage of time to provide the necessary care hinder the provision of adequate SRH services to adolescents. 4 This study finding implies that health system barrier further contributes to the unfriendliness of the services environment to access and utilization of sexual and reproductive health services by unmarried adolescents.…”

“…28 Moreover, our study revealed that the healthcare providers were demotivated to provide SRH services for an unmarried adolescent when the adolescent repeatedly asked them for the same services. A qualitative study conducted in Southwest, Ethiopia 16 showed that most adolescents repeatedly asked for the same benefits due to lack of awareness, or it may be due to their peer influences. So, healthcare providers should give vital counseling to adolescents.…”

“… 15 However, access to sexual and reproductive health services by adolescents is still continuing to be a public health concern. 16 With the National Adolescent Reproductive Health Strategy, the government of Ethiopia has prioritized adolescents’ SRH to invest more resources and expand access to sexual and reproductive health services for adolescents through the Ethiopian health extension workers’ scheme. 17 In Ethiopia, sexual and reproductive health services for adolescents are commonly provided through two service delivery models: youth centers and integrated health services.…”

Impact of the COVID-19 Pandemic on Adolescents’ Sexual and Reproductive Health in Low- and Middle-Income Countries

“…In some countries or communities, introducing SRH services for adolescents in their homes could be a challenge. Discussion of topics pertaining to SRH has been mentioned to be restricted in some homes and communities [ 47 , 48 ] because it is unacceptable or frowned upon. Adolescents who are not exposed to the topic of SRH during this stage of their lives are likely to be naïve about the topic when they become adults.…”