Determinants of Utilization of Youth Friendly Reproductive Health Services among School and College Youth in Thika west district, Kiambu county, Kenya
Akinyi, Obonyo Perez
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This study was on Determinants of Utilization of Youth friendly Reproductive Health services (YFRHS) among school and college youth in Thika West District of Kiambu County, Kenya. The reproductive and sexual health of the youth remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. Sex and sexuality among the young people have remained a sacred area and few structures were in place to address it. After International Conference on Population and Development in 1994 countries started implementing adolescent reproductive health issues. The Government of Kenya together with partners in an attempt to address the reproductive health challenges came up with the Adolescent Reproductive Health and Development Policy (ARH&D) in 2003 whose guidelines were finalized in July 2005 and released for use by service providers. Despite these guidelines, the access and utilization of YFRHS among the school youth are dependent on many factors which include demographic, economic, school, socio-cultural and health system factors. The study examined how those factors determined or affected the utilization patterns of YFRHS by the youth. The study further explored ways of mitigating or addressing the barriers to scale up utilization of those services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 390 school and college youth in Thika West District from 9th January 2012 to 17thFebruary 2012.The key informants were mainly nurses who were working at the reproductive health service delivery area at the time of study and were interviewed using an interview guide. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) Version 18.0.Descriptive statistics and chi-square tests were performed to determine significant associations. The study established that sex, age, level of education, type of school and youth’s awareness about existence of reproductive health facility and services offered were significantly associated with utilization at p<0.05 while religion and parental employment status had association only to a few services. Ethnicity had no association to utilization of all YFRHS, p>0.05. Long queues, unfavorable working hours, mixing out of school youth and the school going youth and lack of money negatively affected utilization of YFRHS. Parents and teachers‟ involvement in passing RH information was found to be low as majority of the youth reported that they got information of these services from friends. The study concluded that the utilization of reproductive health services among the school and college youth was low largely due to unfriendliness of the reproductive health facilities to the youth and lack of awareness of RH services. In view of the findings, this study recommends need for the Government through the Ministry of Health and partners in health service provision to increase the number of YFRHS and ensure that the recommendations of Adolescent Health Policy guidelines are implemented fully with good evaluation strategies in place. Rigorous awareness drives to sensitize the youth about the available RHS through rigorous health education and increased involvement of both parents/guardians and teachers to scale up utilization are also recommended.