Grace Okong'oCasper MasigaOngwae, Joshua2024-02-012024-02-012023-09https://ir-library.ku.ac.ke/handle/123456789/27370ArticleDespite the efforts universities are putting in place to address the sexual and reproductive health (SRH) concerns and needs of their students, the rate at which students are engaging in casual unprotected sex is reportedly high. This has resulted in increased rates of unintended pregnancies and unsafe abortions among the student population. It is against this background that this study sought to assess the determinants of utilization of sexual and reproductive health services among university students, Nairobi City County, Kenya. Universities provide the best avenue for training young people who will form a big part of Kenya’s future workforce and therefore, provide an opportunity for enhancing the students’ wellbeing by enhancing their utilization of SRH services. The objectives of the study were to: identify the SRH concerns, needs and priorities of young people in universities; examine the association between sexual behaviour, attitudes and university students’ (male and female) utilization of SRH services; determine awareness of SRH policy frameworks that impact on the provision and utilization of SRH services among university students (male and female); assess the relationship between SRH policy frameworks and utilization of SRH services in universities in Kenya; and identify strategies that will lead to increased awareness and implementation of SRH related policies and utilization of SRH services. The Social Economic Model (SEM) guided the study in understanding the problem while the Andersen and Newman Framework of Health Services Utilization guided the study in identifying possible solutions to the challenges identified. The targeted population was staff and students studying in universities with main campuses in Nairobi City County. Stratified random sampling was used to select the four public and private universities (Kenyatta University, Multimedia University of Kenya, United States International University - Africa and KCA University) which were part of the study from the six public and five private universities in Nairobi City County. The study was guided by cross-sectional and exploratory research designs. The target population was 192,193 students. Stratified random sampling was used to select the three hundred and seventy (370) students who completed the study questionnaires. Sixteen key informants were purposefully selected from staff and students to participate in-depth interviews while four focus group discussions (FGDs) of either gender of between 8 - 12 students in each FGD participated in the study. The tools for the study were questionnaires, key informant interview and FGD guides. Qualitative data was analysed according to themes while descriptive statistics was used to analyse quantitative data. Qualitative data was presented in narrative and verbatim forms. Reporting for quantitative data was done in both textual and visual formats such as diagrams, percentages, graphs and tables. The study established that university students are most concerned about getting infected with HIV/AIDS followed by getting pregnant or impregnating someone. The study established that what the students need the most is access to condoms, pills and contraceptives for pregnancy prevention and youth friendly services. Moreover, the findings revealed that university students prioritize confidentiality, the cost of SRH services and being attended by friendly healthcare providers in this order. Also, the results established that sexual behaviour determines utilization of SRH services. Further, the study found that there were low levels of awareness among university students of national and university SRH policy frameworks that impact on the provision of SRH services. The findings indicate no or negligible relationship between awareness of national SRH policies and services utilized. Based on the findings, the study made recommendations that included: universities to allocate resources for SRH programs, integrate gender and digitize SRH services and programming to improve service provision and utilization. It is expected that the adoption of the recommendations will lead to improved utilization of SRH services resulting to improved SRH outcomes for the students.enSexual and Reproductive Health ServicesUniversity StudentsNairobi City CountyKenyaThesis