Reproductive health service utilization and associated factors among secondary school students in Harari regional state, eastern Ethiopia, 2022: a multicenter study

(2023) 20:45 Sertsu et al. Reproductive Health https://doi.org/10.1186/s12978-023-01592-1 Reproductive Health Open Access COMMENT Reproductive health service utilization and associated factors among secondary school students in Harari regional state, eastern Ethiopia, 2022: a multicenter study Addisu Sertsu1, Addis Eyeberu1, Tilahun Bete1, Elias Yadeta1, Magarsa Lami1, Tegenu Balcha1, Bekelu Berhanu1, Ayichew Alemu1, Fentahun Meseret1, Hanan Mohammed1, Addisu Alemu2, Ahmed Mohammed Husen3, Fila Ahemed2, Abdi Birhanu3, Kabtamu Gemechu4, Adera Debella1, Tamirat Getachew1, Kabtamu Nigussie1, Shambel Nigussie5 and Abraham Negash1*    Abstract Introduction Reproductive health encompasses all conditions relating to the reproductive system and goes beyond simply being free from disease or infirmity. Several socioeconomic and socio-cultural factors affect reproductive health service utilization. Objectives To assess reproductive health service utilization and its associated factors among government secondary school students in Harari regional state, Eastern Ethiopia 2022. Methods A school-based cross-sectional study design was conducted among 1275 secondary school students in six randomly selected secondary schools in Harari Regional state, in eastern Ethiopia. The study participants were chosen using a simple random sampling method. Data was gathered using self-administered questionnaires, entered into Epi Data version 3.1, and exported to SPSS version 25 for cleaning and analysis. Descriptive statistics, bivariable, and multivariable logistic regression analyses were carried out to compute the frequency of each independent variable and the magnitude of the outcome variables, then to identify factors associated with the outcome variable, respectively. To declare a significant association, an adjusted odd ratio (AOR) with a 95% confidence interval and a p-value of 0.05 were used. Results Our finding indicated that 25.3% (95% CI:22.9, 27.7) of the secondary school students utilized reproductive health services. Being in grade 11–12 (AOR = 1.67, 95% CI: 1.18, 2.38), having a history of sexually transmitted infection (AOR = 6.11, 95% CI: 2.20, 16.99), presence of a health facility nearby (AOR = 1.49, 95% CI: 1.12, 1.99), discuss voluntary counseling and testing with family (AOR = 2.73, 95% CI: 1.90, 3.94), and discussing about contraceptive with friends (AOR = 1.22, 95% CI: 0.91, 1.65) were the elements that had a strong correlation with reproductive health service utilization. Conclusion In this study, only one-fourth of secondary school students utilized RH service during the past year. The student’s educational level, having a history of STI, the presence of a health facility nearby, and discussing RH service *Correspondence: Abraham Negash Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Sertsu et al. Reproductive Health (2023) 20:45 Page 2 of 8 with family/friends were the factors significantly associated with reproductive service utilization among secondary school students. Keywords Reproductive health, Service utilization, Secondary school, Harar, Ethiopia Introduction Reproductive health encompasses all conditions relating to the reproductive system’s physical, mental, and social well-being and goes beyond simply being free from disease or infirmity. This indicates that individuals can reproduce and have the flexibility to decide whether, when, and how often to do so [1, 2]. According to the World Health Organization, adolescents are young people between the ages of 10 and 19 [3, 4]. One of life’s most rapid and complex stages, marked by significant changes in the physical, cognitive, behavioral, social, and psychological domains, occurs during this age [5]. At this young age, they are vulnerable to risk and unintentional harm due to poor decisions and actions [6]. Around 1.2 billion adolescents are alive today, and more than half of them live in developing countries [7]. 33.8% of Ethiopia’s population is between the age of 10 to 24; 22% of this group are adolescents [8, 9]. Although young people are regarded as a country’s best hope for the future, their immaturity exposes them to unique risks such as unwanted pregnancy, STIs such as HIV, and unsafe abortion [10, 11]. Secondary school adolescents are particularly at risk for RH problems since they frequently engage in risky sexual activity [12]. The use of reproductive health services has been linked to several socio-demographic and socio-economic factors, including age, being a female adolescent, and parental communication. Maternal education, religious activities, maternal education, and media exposure are also important factors in the uptake of these services [13]. Utilization of SRH services varies widely across the country, ranging from 29.4% Hadiya zone South Ethiopia [14] to 63.8% in Harar [15]. Some evidence indicated that high school students were avoiding SRH facilities due to the unfavorable service hours, anxiety about being seen by others, long waiting times, and unwelcoming and judgmental staff members [16]. Even though it is not a regular event, schools are the primary source of information on reproductive health issues [17]. The Ethiopian government, in collaboration with several non-governmental organizations, has been actively encouraging programs including the institutionalization and scaling up of youth-friendly services [9, 18]. The results of all the initiatives, however, have not been seen in Ethiopian educational institutions, as evidenced by the enduring problems with young people’s reproductive health. For example, the prevalence of STIs, including HIV/AIDS (19.5%), is increasing, and abortion rates among students are 65 per 1,000 women, which is three times the national average for Ethiopia [12, 19]. In the study area and the country as a whole, there is a scarcity of recent evidence on the use (...truncated)