Sexual and reproductive health services (SRHS) for adolescents in Enugu state, Nigeria: a mixed methods approach

Abstract

BackgroundAvailability and accessibility of sexual and reproductive health services for adolescents are very crucial for prevention and control of sexual and reproductive health problems. These services also play vital roles in the promotion of adolescents’ sexual and reproductive health generally. The main purpose of the study was to determine the availability and accessibility (geographical and financial) of sexual and reproductive health services (SRHS) among adolescents in Enugu State, Nigeria.MethodsA mixed methods approach was adopted for the study. 192 health facilities were reached to check availability of SRH services. Randomly sampled 1447 adolescents (12–22 years) completed the questionnaire correctly. Twenty-seven interviews and 18 group discussions were conducted. Instruments for data collection consisted of a checklist, a questionnaire, a focus group discussion guide and an in-depth interview guide. All instruments were pre-tested. Quantitative data were analyzed using descriptive statistics and Chi-square tests. NVivo 11 Pro software was used to code and thematically analyze the qualitative data.ResultsA total of 1447 adolescents (between 12 and 22 years) completed the questionnaire correctly. Among these adolescents, males constituted 42.9% while females were 57.1%. The majority (86.7%) of the adolescents reported availability of safe motherhood services, and 67.5% reported availability of services for prevention and management of STIs and HIV and AIDS. The majority reported that these services were geographically accessible but few were financially accessible to adolescents. However, qualitative data revealed that available services were not specifically provided for adolescents but for general use. Age (p = ≤ .05), education (p = ≤ .05) and income (p = ≤ .05) were found to be significantly associated with access to SRHS.ConclusionSRHS were generally physically available but not financially accessible to adolescents. Adolescents’ clinics were not available and this could affect the access of SRHS by adolescents. Education and income were significantly associated with access to SRHS.

Availability, Accessibility, and Quality of Adolescent Sexual and Reproductive Health Services in Urban Health Facilities of Rwanda: A survey among social and healthcare providers

“…In addition to that, a predetermined health service package that is offered at a health facility as defined by the Rwanda Ministry of Health limit facilities at offering some SRH services. These results differ from findings in Nigeria, where they reported that female condoms were available in almost all health facilities included in their study (14).…”

“…Based on the study results, Rwanda is doing well in availing SRH services to help adolescents access them, but our results revealed that the SRH services provision were designed for the general population, without specialized adolescents SRH health providers and this comprehensive limit accessibility. Our results agree with previous studies conducted in Nigeria, Rwanda, and Kenya that also reported that SRH services were not mainly designed for adolescent's use (9,14,23). The study data reveals that some of the services are not available in health facilities due to being underutilized, such was the case with female condoms.…”

Sexual And Reproductive Health Needs Of Street-Involved Young People: Findings From A Baseline Survey In Southwest Nigeria

“…LARC requires a visit to the health facility for insertion and removal. The low utilization of clinics for uptake and use of contraception by adolescents and young persons in Nigeria [37][38][39] will likely be a barrier for LARC access by SIYP. Poor attention paid to the SRH needs of SIYP will further limit their use of healthcare services to address their SRH needs.…”

Availability, Accessibility, and Quality of Adolescent Sexual and Reproductive Health Services in Urban Health Facilities of Rwanda: A survey among social and healthcare providers

“…Like other most SSA countries, adolescents in Rwanda still face various challenges while seeking or trying to access SRH services such as limited availability or no specialized trained health care provider capable of catering adolescents' needs [14]. The government of Rwanda has been putting mechanisms and policies in place that would enable access to sexual and reproductive services for young adults since 2010 [15].…”

“…The government of Rwanda has been putting mechanisms and policies in place that would enable access to sexual and reproductive services for young adults since 2010 [15]. However, there is still evidence of increasing unwanted teen pregnancies, risky sexual behaviors, lack of comprehensive knowledge of SRH, and HIV risks among adolescents [14], [16], [17]. There is a gap in knowledge about provision of SRH services to adolescents in urban settings in Rwanda.…”