SEXUAL AND REPRODUCTIVE HEALTH SERVICE USE, PERCEPTION, BARRIERS, AND FACTORS ASSOCIATED WITH REPRODUCTIVE HEALTH SERVICE USE AMONG SECONDARY SCHOOL ADOLESCENT STUDENTS IN JIGJIGA TOWN SOMALI, ETHIOPIA: MIXED METHOD

Abstract

Background: Sexual and reproductive health involves the ability to prevent unintended pregnancies, unsafe abortions, sexually transmitted diseases, coercion, and sexual abuse, while ensuring mental and physical well-being. Lack of access to these services can lead to unwanted pregnancies, school dropouts, and life-threatening conditions like HIV/AIDS, reducing life expectancy. Despite efforts by the Ethiopian government to improve sexual and reproductive health services, there is limited information on adolescent usage and related issues in the Jigjiga Somali region. Objective: To assess sexual and reproductive health service use, perceptions, barriers, and factors associated with reproductive health service use among secondary school adolescent students in Jigjiga town Somali, Ethiopia 1-15 July 2024 Methods: A school-based cross-sectional study was conducted with 566 randomly selected secondary school adolescents in Jigjiga Town from 1-15 July 2024, using multistage sampling. Data were collected, entered EpiData version 3.1, and analyzed using Stata 17. Descriptive statistics and bivariable and multivariable logistic regression analyses were used. The association was reported using adjusted odds ratios with 95% confidence intervals, and statistical significance was declared at a P-value of less than 0.05. Result: A total of 566 adolescents were included in the study. Out of this, 19.96 % (95% CI: 16.7–23.5) utilized the sexual and reproductive health services. Discussion with family (AOR = 2.9; 95% C.I: 1.67-5.08), having sex (AOR = 5.8; 95% C.I: 3=11.4), Urban residence with family (AOR = 1.95; 95% C.I: 1.01-3.75), information exposure (AOR = 2.13; 95% C.I: 1.1- 4.08) and short distance (AOR = 4.3; 95% C.I: 1.79-10.4) were significantly associated with sexual and reproductive health service use. The qualitative revealed; distance, service hours, parental control, lack of privacy and sociocultural conditions to be barriers for service utilization. Conclusion: less than one in five adolescent sought sexual and reproductive health services. Factors such as family discussions, sexual activity, urban residence, exposure to information, and distance significantly influenced service utilization. Qualitative findings highlighted barriers like distance, inconvenient service hours, parental control, lack of privacy, and sociocultural norms as key challenges to accessing these services. A multifaceted intervention is recommended.