Adolescent's access to and use of reproductive health services in Ndola urban
Mutati, Christine M.
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Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system. Until now, many health aspects of reproduction were dealt with through public health approaches. The reproductive health needs of young people and adolescents have been brought to the fore front as requiring urgent and special attention. Providing information and reproductive health services to adolescents will better their lives and postpone sexual activity. This study aimed at determining utilisation patterns of and access to RHS by adolescents and factors that could influence utilisation in Ndola, Zambia. A cross sectional survey was conducted on a sample of 202 adolescents aged between 10-19 randomly selected from 10 residential areas of Ndola using cluster sampling methods. Data was collected using a structured questionnaire, interview schedule and checklist for the health facility. This study revealed that majority of the respondents were in their late adolescence (79.8%). The proportion of utilising RHS between male and female was 43.1% and 56.9% respectively. In addition it was found that age and education had a significant effect on utilisation. Age (p = 0.004) Education (p = 0.031). The majority of the study subjects were found to reside in high density areas. However, this had no association with utilisation of services. The ratio of utilisation of RHS between the two residential areas ,that is, high and low density was 2:1. This difference is attributed to the fact that most of the health facilities are located in high density residential areas. The level of knowledge on reproductive health was very low (82.2%). However knowledge of reproductive health had no association with utilisation (p = 0.092). Despite low knowledge level, most of the respondents were able to mention reproductive health problems. This suggests that there exists a gap between knowledge of reproductive health and practice among adolescents. The major source of information on reproductive health was peer educator for those who have used RHS (51.4%) and media for those who have not used (39.8%). the striking finding was the perception by adolescents that one requires a consent to obtain RHS. This could be seen as a deterrent factor in providing RHS to adolescents The level of sexual activity was quite high with over half of the respondents (62.4%) having had an experience of sex. Sadly by age 9 (3%) some have already engaged into sex and majority (53.7%) of those who are sexually active have multiple sexual partners, thereby making themselves more vulnerable to STD and HIV/AIDS. The reasons for engaging into sex were: Peer pressure (54%); Curiosity (21.4%); Marriage (15.1%); and Rape (9.5%). Majority of them had also utilised RHS and services used most were for STD (34.9%) and family planning (29.4%). level. These findings show presence of bad sexual behaviour beginning at age 9 when most of these children are still trainable. It was therefore recommended that primary preventive strategies should be commenced in lower primary school before a child reaches age 9. These preventive measures should be implemented on the basis of available legislation aimed at reducing the prevalence of HIV/AIDS among adolescents hence reducing the disease burden Nationally.
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