Sexual and reproductive health services utilization and associated factors among secondary school students in Nekemte town, Ethiopia

Binu et al. Reproductive Health (2018) 15:64 https://doi.org/10.1186/s12978-018-0501-z RESEARCH Open Access Sexual and reproductive health services utilization and associated factors among secondary school students in Nekemte town, Ethiopia Wakgari Binu1, Taklu Marama2*, Mulusew Gerbaba3 and Melese Sinaga3 Abstract Background: Despite policy actions and strategic efforts made to promote sexual and reproductive health service uptake of youths in Ethiopia, its utilization remains very low and little information was found on the extent to which school youths utilize available reproductive health services in Nekempt town. This study was aimed to assess utilization of Sexual and Reproduactive Health (SRH) services and its associated factors among secondary school students in Nekemte town, Ethiopia. Method: A school based cross-sectional study design was conducted from April 18 to 22, 2016. Multistage cluster sampling technique was used to select a total of 768 students who attended secondary schools. Sexual and reproductive health services utilization was measured using one item asking whether they had used either of sexual and reproductive health services components during the last one year or not. The data was entered using EpiData Manager with Entry Client and further analysis was done using SPSS version 21 software. Descriptive statistics, cross tabulations, biviarate and multivariate logistic regression analyses were used. All variables were set by p-values less than 0.05 and reported by Adjusted Odds Ratio with its 95%CI. Result: Out of the 768 study subjects, 739 participants underwent all the study components giving response rate of 96%. About 157 (21.2%) school youths reported that they utilized SRH services. On multivariable logistic regression analysis after adjusting for other variable, discussion with health workers (AOR 3.0, 95%CI [1.7–5.2]), previous history of perceived Sexually transmitted infections (STIs) symptoms (AOR 2.6, 95%CI [1.2–5.5]), being ever sexually experienced (AOR 5.9, 95%CI [3.4–10.2]) and exposure to information from school teachers (AOR 0.36, 95%CI [0.2–0. 6]) were found to be independent determinants of sexual and reproductive services utilization among secondary school youths. Inconvenient times, lack of privacy, religion, culture, and parent prohibition were barriers to SRH service uptake cited by the school youths. Conclusions: The overall utilization of sexual and reproductive services was low among school youths in the town. Discussion with health workers, history of perceived STIs symptoms, sexual experience and information were the association factors of sexual and reproductive service utilization among secondary school youths. * Correspondence: 2 Department of Midwifery, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia Full list of author information is available at the end of the article © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Binu et al. Reproductive Health (2018) 15:64 Plain English summary Even if policy actions and strategic efforts made to promote sexual and reproductive health service uptake of youths in Ethiopia, few literatures showed its utilization remains very low. So, this study was aimed to assess utilization of Sexual and reproductive Health (SRH) services and its associated factors among secondary school students in Nekemte town, Ethiopia. Students’ utilized as well as utilizing Sexual and reproductive Health services before and during April 18th to 22nd, 2016 are included in the study. Among 12 above grade 9 schools, two government and 2 non-government schools were selected using lottery methods. For this study, a total of 768 students were needed. To have these, students from each grade and sections were randomly selected from their attendance lists. On the day of data collection the randomly selected students were told to remain in their classes. Sexual and Reproductive Health services utilization was measured if the students utilized one of the six given components. To keep data quality first data was entered to EpiData Manager and exported to SPSS version 21 software to have the required output. The result was described in table and figures, and cross tabulated. Bivariate logistic regression model was used to see association between utilization and other factors. In this study, only 157 (21.2%) of students reported their utilization of Sexual and Reproduction Health services. Students who discussed with health workers, perceived history of Sexually transmitted infections (STIs) symptoms previously, experienced sex ever and exposed to information from school teachers were found to be better utilized Sexual and Reproductive Health services. When summarized, the overall utilization of SRH services was low among school youths in the town. Background There were 1.8 billion young people aged 10–24 years among which 1.2 billion youth aged 15–24 years globally in 2015, accounting for one out of every six people worldwide in which Africa comprises 19% (above 226 million) of the global youth population [1]. Young people make up the greatest proportion of the population in sub-Saharan Africa, with more than one-third of the population 10–24 ages [2], and 33.8% of the total population in Ethiopia is between the age of 10–24 [3]. Since the International Conference on Population and Development Key Informant Interview held in Cairo in 1994, governments have pledged to improve the SRH of adolescents by providing access to comprehensive, appropriate information and education and youth friendly health services. Most regions of the world however, still fall short of these commitments, especially for unmarried young people [4]. Page 2 of 10 Even though the comprehensive knowledge of HIV and other Reproductive Health (RH) problems is increasing around the world, many young people do not have the information or means to protect themselves from these problems [5]. Many health problems are contributed by adolescents and young people worldwide: 8.7 million abortions undergone, 41% of new HIV infection, high rate of early marriage and STIs, and high proportion of stillbirth and newborn deaths [6]. In Africa, 430,000 young people are infected with HIV per year; 2.6 million young people are living with HIV; teenage pregnancy rates still remain high and maternal mortality is among the leading causes of death for adolescent girl (...truncated)