Navigating reproductive health: Drivers of youth-friendly service utilization among secondary school students in Yeka Sub-City, Addis Ababa, Ethiopia

Abstract

Introduction: Accurate global statistics on reproductive health challenges within schools are difficult to obtain due to variations in data collection and dissemination across countries. Nevertheless, these issues significantly impact the development and well-being of young people worldwide. Objective: This study assessed the utilization of youth-friendly reproductive health services (YFRHS) and associated factors by secondary school students in Yeka Sub-City, Addis Ababa, Ethiopia. Method: An institution-based cross-sectional survey was conducted from May 20-24, 2024, among 415 randomly selected students from 15 secondary schools in Yeka Sub-City, Addis Ababa, to examine YFRHS utilization. Data were collected using a standardized, self-administered questionnaire and analyzed using SPSS version 27. Binary logistic regression identified factors associated with YFRHS use. Variables with p < 0.25 in the bivariate analyses were included in multivariable logistic regression. Statistical significance was determined at p ≤ 0.05, with adjusted odds ratios (AOR) and 95% confidence intervals (CI) used to evaluate the strength of associations. Results: YFRHS utilization was 18.8% (95% CI: 0.154-0.227). Having a sexual partner (AOR = 3.8; 95% CI: 1.7-8.4), parental communication (AOR = 2.2; 95% CI: 1.20-4.02), proximity to YFRHS facilities (AOR = 5.1; 95% CI: 2.5-10.3), and believing that seeking such services improves youth health (AOR = 4.6; 95% CI: 1.50-14.04) were significantly associated with YFRHS utilization. Conclusion: Approximately one in five school-aged youth utilized YFRHS. Utilization was significantly associated with having a sexual partner, positive perceptions regarding the benefits of seeking services, parental communication, and proximity to YFRHS facilities.