Patterns of utilization of sexual and reproductive health services by secondary school-going adolescents in Gaborone, Botswana, 2012.

Abstract

Background: Adolescents in Botswana, especially women, face many sexual and reproductive health (SRH) challenges including high maternal mortality, sexually transmitted infections (STIs) including HIV, and unintended pregnancies, despite available SRH services. The youth friendly service (YFS) concept has been initiated and various strategies developed to address adolescents concerns. However, services remain underutilized and barriers to accessing services still exist. Aim: The aim of this study was to determine patterns of utilization of sexual and reproductive health services by adolescents attending senior secondary schools in Gaborone in 2012. The specific objectives were to: identify SRH services utilized by adolescents in the district; identify factors associated with adolescent utilization of YFS in the district; and determine barriers and facilitators to utilization of available YFS by adolescents. Design: This was a health systems research, which was conducted through an observational study, with descriptive and analytic components. Methods: 506 adolescents attending at the three (3) senior secondary schools in Gaborone were sampled through a simple random sampling strategy in each school. Parental consent and assent from participants was requested before respondents completed a self-administered questionnaire which was designed for the data collection. The questionnaire was pilot tested prior to the study. SPSS version 16 was used to analyse the data. A chi-squared test and logistic regression were used investigate association, and a p-value <0.05 was considered as statistically significant. Results: The findings of this study revealed that utilization of SRH by adolescents was low and the level of awareness of youth friendly services was also low. The study revealed that utilization of SRH was higher among female adolescents compared to their male counterparts. The study identified factors which hinder adolescents YFS utilization, which include: location of the facility, no interest in YFS, staff attitudes and behaviours, and inconvenient hours of operation. Conclusion: Identifying patterns of utilization of SRH services by adolescents attending senior secondary schools in Gaborone can help strengthen programmes at all levels of service delivery and the country at large. The Botswana Ministries of Health, and Education and Skills Development can re-orientate, or develop new initiatives that will deal with barriers to access and assist adolescents to fully utilize the available services.