Reproductive health services: expectations and experiences among in-school and out-of-school adolescents in Owo, Ondo State, Nigeria

Abstract

BACKGROUND: Adolescents have specific health needs that require access to appropriate reproductive health services (RHS). Unfortunately, many adolescents are unaware of the reproductive health information available, especially in developing countries where there is little access to medical care, with a high prevalence of poverty, and sexual norms that interfere with RHS. This study compared reproductive health service expectations and experiences among in-school and out-of-school adolescents. METHODS: This study employed a comparative cross-sectional design among adolescents aged 10-19 years. In-school adolescents were selected via a multistage sampling technique, whereas out-of-school adolescents in the mapped area were selected. A WHO illustrative questionnaire for young people was used to collect data. The SERVQUAL tool was used to measure the gap between expectations and perceptions of the services delivered. RESULTS: Six hundred forty adolescents were recruited. More in-school adolescents (80.6%) than out-of-school adolescents (63.4%) were aware of ARHS (p < 0.001). The mean adolescents' reproductive health services (ARHS) expectations score of out-of-school adolescents was higher than that of in-school adolescents (t = 2.824; p = 0.005). A greater proportion of out-of-school compared with in-school adolescents expected to receive ARHS from a young and same-sex health professional (p < 0.001). More in-school adolescents (52.8%) than out-of-school adolescents (18.8%) had ARHS experiences (p < 0.001), but a greater proportion of out-of-school adolescents than in-school adolescents considered the ARHS satisfactory (p = 0.017). CONCLUSIONS: The increased expectations of ARHS among out-of-school adolescents do not translate to increased utilisation of ARHS. This, therefore, calls for more community outreach to out-of-school adolescents.