Abstract:
Background:Adolescence is a period in which rapid physical, social and psychological 
development takes place. It is a critical developmental period as a significant portion of the 
disease and injury burden encountered, implying something different must be done to 
respond to the needs of adolescents. In Ethiopia, there were many initiatives that support 
adolescent service utilization, but limited evidence exists on service utilization and 
associated factors in the study area. 
Objective:This study aimed to assess the magnitude of sexual and reproductive health 
services utilization and associated factors among secondary school students in Meta 
district, Eastern Ethiopia, from May 2–14, 2023. 
Methods:A school-based cross-sectional study design was used with 475 randomly 
selected secondary school students. Simple random sampling technique was used to select 
the study participants. A structured, pre-tested, self-administered questionnaire was used. 
Collected data was entered to Epi data version 3.1 and analyzed by SPSS version 26. Both 
descriptive and analytical statistics was performed. Bivariate and multivariable logistic 
regression analyses were executed.Variables with a P-value <0.05 and adjusted odd 
ratiowith a 95% confidence interval was used to declare the presence of a statistically 
significant association between the outcome and independent variables. 
Result:This study found the magnitude of sexual and reproductive health services 
utilization among the study participant was 26.7% (95% CI: 22.7%-30.9%). Adolescents 
who were in grade 12 (AOR = 4.33, 95% CI: 2.12-8.87), being urban residents (AOR = 
2.47, 95% CI: 1.36-4.48), engaged in sexual activity (AOR = 2.67, 95% CI: 1.55-4.59), 
exposure to SRH information(AOR = 2.25, 95% CI: 1.06-4.77), discussions of SRH issues 
with someone else (AOR = 2.58, 95% CI: 1.45–4.61) and proximity to the health facility 
(AOR = 2.39, 95% CI: 1.03-5.56) were significantly associated with high school 
adolescent’s sexual and reproductive health services utilization. 
Conclusion:This study found that the magnitude of sexual and reproductive health services 
utilization among secondary school adolescents was 26.7% which is relatively 
low.Adolescents' use of services can be increased by expanding educational opportunities, 
distributing information about the services, encouraging open discussion about sexual 
issues, and enhancing the geographic accessibility of service providing facilities.