Sexual and reproductive health service utilization and associated factors among rural adolescents in Dama District, Oromia Regional State, Ethiopia

Abstract

Background: Sexual and reproductive health (SRH) service utilization remains a significant public health issue which affecting millions of adolescents worldwide. Adolescents aged 15 to 19 are particularly vulnerable to unprotected sexual practices, increasing their risk of unwanted pregnancies and sexually transmitted infections (STIs). However, there is limited evidence on the utilization of SRH service and the associated factors among adolescents residing in rural areas. Thus, this study aimed to determine the utilization of SRH services and its associated factors among rural adolescents in Dama District, Guji Zone, Oromia Regional State, Ethiopia.

Methods: A mixed-methods study was conducted in Dama District from April to May 2022 involving 615 adolescents. A simple random sampling technique was employed to select participants for the quantitative portion, while a purposive sampling method was used for qualitative interviews. Quantitative data were collected using a structured questionnaire, and an interview guide was utilized for the qualitative study through in-depth interviews. The quantitative data were entered into Epi Data version 3.1 and analyzed using SPSS version 26. Descriptive statistics were used to summarize the characteristics of the participants, and a logistic regression model used to identify factors associated with SRH service utilization. Thematic analysis was conducted to assess barriers to SRH service utilization.

Results: The utilization of SRH service in the past twelve months was 18.2% (95% confidence interval: 15%–21.3%). Family planning was the most utilized service, with a rate of 71.4%. Not living with both parents (AOR = 2.7, 95% CI: 1.3–6.0), having discussions about family planning (AOR = 10, 95% CI: 6.0–19.0), engaging in discussions about voluntary counseling and testing (VCT) for HIV/AIDS (AOR = 2.6, 95% CI: 1.4–4.0), and possessing good knowledge of SRH (AOR = 3.4, 95% CI: 1.6–7.0) were significantly associated with SRH service utilization.

Conclusions: A considerable proportion of adolescents in rural areas are not utilizing SRH services. Enhancing discussions about family planning, VCT for HIV/AIDS, and increasing knowledge of SRH are crucial for improving service utilization among adolescents living in these areas.