Availability, accessibility, and quality of adolescent Sexual and Reproductive Health (SRH) services in urban health facilities of Rwanda: a survey among social and healthcare providers

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.

Factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown: An online cross-sectional survey

“…It is apparent that the lockdown further compounded an already poor access to health services in Uganda. In Lao People's Democratic Republic, geographical accessibility was one of the barriers to access SRH [34] although this was not the case in Rwanda where geographical accessibility to SRH services was not seen as a negative factor in uencing access among the young people [36]. However geographical challenges to access were not reported in our study.…”

Access to information and use of adolescent sexual reproductive health services: Qualitative exploration of barriers and facilitators in Kisumu and Kakamega, Kenya

“…Studies in other countries have found similar barriers to access to ASRH services and information. A study in Rwanda on availability, accessibility, and quality of ASRH services found that a majority of adolescents had to travel more than 30 minutes to access SRH services and that only half of the facilities offered low-cost services for adolescents [ 22 ]. In Nepal, adolescents were unwilling to visit health facilities because of the lack of availability of SRH items and medicines that are free of cost but are often out of stock, which required adolescents to purchase supplies from private pharmacies [ 23 ].…”

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

“…1 It is also expressed as a persons with the age group of 10 to 19 years and it is one of the most fascinating and complex life stages. 2 This period is characterized by fast development of physical, emotional, mental and social welfare 2,3 and also a stage in life when adolescents are susceptible to many risks, particularly in relation to their sexuality; they often not have access to sufficient information, counseling, and services on issues crucial to their development needs. [3][4][5] When adolescents are not in primary or secondary education at the age of schooling in some case when adolescents in pre-primary education or non-formal education are considered as out of school.…”