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Published in: Reproductive Health 1/2015

Open Access 01-12-2015 | Research

Understanding sexual and reproductive health needs of adolescents: evidence from a formative evaluation in Wakiso district, Uganda

Authors: Lynn M Atuyambe, Simon P S Kibira, Justine Bukenya, Christine Muhumuza, Rebecca R Apolot, Edgar Mulogo

Published in: Reproductive Health | Issue 1/2015

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Abstract

Introduction

Adolescents are frequently reluctant to seek sexual and reproductive health services (SRH). In Uganda, adolescent health and development is constrained by translation of the relevant policies to practice. Recent studies done in central Uganda have shown that there is need for a critical assessment of adolescent friendly services (AFS) to gain insights on current practice and inform future interventions. This study aimed to assess the sexual reproductive health needs of the adolescents and explored their attitudes towards current services available.

Methods

A qualitative study was conducted in Wakiso district, central Uganda in September 2013.Twenty focus group discussions (FGDs) stratified by gender (10 out-of-school, and 10 in-school), were purposefully sampled. We used trained research assistants (moderator and note taker) who used a pretested FGD guide translated into the local language to collect data. All discussions were audio taped, and were transcribed verbatim before analysis. Thematic areas on; adolescent health problems, adolescent SRH needs, health seeking behaviour and attitudes towards services, and preferred services were explored. Data was analysed using atlas ti version 7 software.

Results

Our results clearly show that adolescents have real SRH issues that need to be addressed. In and out-of-school adolescents had sexuality problems such as unwanted pregnancies, sexually transmitted infections (STIs), defilement, rape, substance abuse. Unique to the females was the issue of sexual advances by older men and adolescents. We further highlight RH needs which would be solved by establishing adolescent friendly clinics with standard recommended characteristics (sexuality information, friendly health providers, a range of good clinical services such as post abortion care etc.). With regard to health seeking behaviour, most adolescents do not take any action at first until disease severity increase.

Conclusions

Adolescents in Uganda have multiple sexual and reproductive health needs that require special focus through adolescent friendly services. This calls for resource support in terms of health provider training, information education and communication materials as well as involvement of key stakeholders that include parents, teachers and legislators.
Literature
1.
go back to reference UNFPA: Generation of Change: Young People and Culture. Youth Supplement to UNFPA’s State of the World Population Report New York 2008. UNFPA: Generation of Change: Young People and Culture. Youth Supplement to UNFPA’s State of the World Population Report New York 2008.
2.
go back to reference UNFPA. United Nations Population Fund (UNFPA), State of the World Population 2003: Investing in Adolescents’ Health and Rights. New York: UNFPA; 2003. UNFPA. United Nations Population Fund (UNFPA), State of the World Population 2003: Investing in Adolescents’ Health and Rights. New York: UNFPA; 2003.
3.
go back to reference World Health Organisation. Health for the Worlds Adolescents A second Chancein the Second Decade. Geneva: World Health Organisation; 2014. World Health Organisation. Health for the Worlds Adolescents A second Chancein the Second Decade. Geneva: World Health Organisation; 2014.
4.
go back to reference Breinbauer C, Maddaleno M. Youth: Choices and Change. Health Behaviours in Adolescents. Washington, D C: PAHO; 2005. Breinbauer C, Maddaleno M. Youth: Choices and Change. Health Behaviours in Adolescents. Washington, D C: PAHO; 2005.
5.
go back to reference Green G, Pool R, Harrison S, Hart GJ, Wilkinson J, Nyanzi S, et al. Female control of sexuality: illusion or reality? Use of vaginal products in south west Uganda. Soc Sci Med. 2001;52(4):585–98.CrossRefPubMed Green G, Pool R, Harrison S, Hart GJ, Wilkinson J, Nyanzi S, et al. Female control of sexuality: illusion or reality? Use of vaginal products in south west Uganda. Soc Sci Med. 2001;52(4):585–98.CrossRefPubMed
6.
go back to reference Nyanzi S, Pool R, Kinsman J. The negotiation of sexual relationships among school pupils in south-western Uganda. AIDS Care. 2001;13(1):83–98.CrossRefPubMed Nyanzi S, Pool R, Kinsman J. The negotiation of sexual relationships among school pupils in south-western Uganda. AIDS Care. 2001;13(1):83–98.CrossRefPubMed
7.
go back to reference Nzioka C. Perspectives of adolescent boys on the risks of unwanted pregnancy and sexually transmitted infections: Kenya. Reprod Health Matters. 2001;9(17):108–17.CrossRefPubMed Nzioka C. Perspectives of adolescent boys on the risks of unwanted pregnancy and sexually transmitted infections: Kenya. Reprod Health Matters. 2001;9(17):108–17.CrossRefPubMed
8.
go back to reference Lema VM, Mpanga V, Makanani BS. Socio-demographic characteristics of adolescent post-abortion patients in Blantyre. Malawi East Afr Med J. 2002;79(6):306–10.PubMed Lema VM, Mpanga V, Makanani BS. Socio-demographic characteristics of adolescent post-abortion patients in Blantyre. Malawi East Afr Med J. 2002;79(6):306–10.PubMed
9.
go back to reference Soderberg H, Andersson C, Janzon L, Sjoberg NO. Continued pregnancy among abortion applications. A study of women having a change of mind. Acta Obstet Gynecol Scand. 1997;76(10):942–7.CrossRefPubMed Soderberg H, Andersson C, Janzon L, Sjoberg NO. Continued pregnancy among abortion applications. A study of women having a change of mind. Acta Obstet Gynecol Scand. 1997;76(10):942–7.CrossRefPubMed
10.
go back to reference Felice ME, Feinstein RA, Fisher MM, Kaplan DW, Olmedo LF, Rome ES, et al. Adolescent pregnancy–current trends and issues: 1998 American Academy of Pediatrics Committee on Adolescence, 1998–1999. Pediatrics. 1999;103(2):516–20.CrossRefPubMed Felice ME, Feinstein RA, Fisher MM, Kaplan DW, Olmedo LF, Rome ES, et al. Adolescent pregnancy–current trends and issues: 1998 American Academy of Pediatrics Committee on Adolescence, 1998–1999. Pediatrics. 1999;103(2):516–20.CrossRefPubMed
11.
go back to reference Atuyambe L. Health care seeking behavior for sexually transmitted infections among adolescents in Rakai District, Uganda. In: Master of Public Health. Kampala: Makerere University. Dissertation; 1998. Atuyambe L. Health care seeking behavior for sexually transmitted infections among adolescents in Rakai District, Uganda. In: Master of Public Health. Kampala: Makerere University. Dissertation; 1998.
12.
go back to reference Okonofua FE. Factors associated with adolescent pregnancy in rural Nigeria. J Youth Adolesc. 1995;24(4):419–38.CrossRefPubMed Okonofua FE. Factors associated with adolescent pregnancy in rural Nigeria. J Youth Adolesc. 1995;24(4):419–38.CrossRefPubMed
13.
go back to reference Amooti-Kaguna B, Nuwaha F. Factors influencing choice of delivery sites in Rakai district of Uganda. Soc Sci Med. 2000;50(2):203–13.CrossRefPubMed Amooti-Kaguna B, Nuwaha F. Factors influencing choice of delivery sites in Rakai district of Uganda. Soc Sci Med. 2000;50(2):203–13.CrossRefPubMed
14.
go back to reference Vijay Grover OA. Reproductive health problems of female Adolescents-an overview in Pediatric and Adolescent Gynecology. New Delhi: Jaypee Brothers New Delhi; 2003. p. 206–16. Vijay Grover OA. Reproductive health problems of female Adolescents-an overview in Pediatric and Adolescent Gynecology. New Delhi: Jaypee Brothers New Delhi; 2003. p. 206–16.
15.
go back to reference MoH. The National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights. Reproductive Health Division, Department of Community Health, Ministry of Health Uganda. Thirdth ed. 2011. MoH. The National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights. Reproductive Health Division, Department of Community Health, Ministry of Health Uganda. Thirdth ed. 2011.
16.
go back to reference UBOS and ICF International: Uganda Demographic and Health Survey 2011. In. Kampala, Uganda and Calverton, Maryland: Uganda Bureau of Statistics (UBOS) and ICF International Inc.; 2012. UBOS and ICF International: Uganda Demographic and Health Survey 2011. In. Kampala, Uganda and Calverton, Maryland: Uganda Bureau of Statistics (UBOS) and ICF International Inc.; 2012.
17.
go back to reference Uganda Bureau of Statistics (UBOS) and Macro International Inc. Uganda Demographic and Health Survey 2006. Calverton, Maryland, USA: UBOS and Macro International Inc; 2007. Uganda Bureau of Statistics (UBOS) and Macro International Inc. Uganda Demographic and Health Survey 2006. Calverton, Maryland, USA: UBOS and Macro International Inc; 2007.
18.
go back to reference Lankoande J, Ouedraogo CM, Ouedraogo A, Tieba B, Akotionga M, Sanou J, et al. [Maternal mortality in adolescents at the university hospital of Ouagadougu]. Rev Med Brux. 1999;20(2):87–9.PubMed Lankoande J, Ouedraogo CM, Ouedraogo A, Tieba B, Akotionga M, Sanou J, et al. [Maternal mortality in adolescents at the university hospital of Ouagadougu]. Rev Med Brux. 1999;20(2):87–9.PubMed
19.
go back to reference Isaranurug S, Mo-Suwan L, Choprapawon C. Differences in socio-economic status, service utilization, and pregnancy outcomes between teenage and adult mothers. J Med Assoc Thai. 2006;89(2):145–51.PubMed Isaranurug S, Mo-Suwan L, Choprapawon C. Differences in socio-economic status, service utilization, and pregnancy outcomes between teenage and adult mothers. J Med Assoc Thai. 2006;89(2):145–51.PubMed
20.
go back to reference Soula O, Carles G, Largeaud M, El Guindi W, Montoya Y. [Pregnancy and delivery among adolescents under 15: a study of 181 cases in French Guiana]. J De Gynecologie, Obstetriqueet Biol De la Reprod. 2006;35(1):53–61.CrossRef Soula O, Carles G, Largeaud M, El Guindi W, Montoya Y. [Pregnancy and delivery among adolescents under 15: a study of 181 cases in French Guiana]. J De Gynecologie, Obstetriqueet Biol De la Reprod. 2006;35(1):53–61.CrossRef
21.
go back to reference Alene DG, Wheeler JG, Grosskurth H. Adolescent reproductive health and awareness of HIV among rural high school students, North Western Ethiopia. AIDS Care. 2004;16(1):57–68.CrossRefPubMed Alene DG, Wheeler JG, Grosskurth H. Adolescent reproductive health and awareness of HIV among rural high school students, North Western Ethiopia. AIDS Care. 2004;16(1):57–68.CrossRefPubMed
22.
go back to reference Korra A, Mesfin H. Sexual behaviour and level of awareness on reproductive health among youths: Evidence from Harar, Eastern Ethiopia. Ethiop J Health Dev. 1999;13(2):107–13. Korra A, Mesfin H. Sexual behaviour and level of awareness on reproductive health among youths: Evidence from Harar, Eastern Ethiopia. Ethiop J Health Dev. 1999;13(2):107–13.
23.
go back to reference Mueller D-R. How young is “too young”? comparative perspectives on adolescent sexual, marital, and reproductive transitions, Studies in Family Planning. 39. 2008;4:247–62. Mueller D-R. How young is “too young”? comparative perspectives on adolescent sexual, marital, and reproductive transitions, Studies in Family Planning. 39. 2008;4:247–62.
24.
go back to reference Tylee A, Haller DM, Graham T, Churchill R, Sanci LA. Youth-friendly primary-care services: how are we doing and what more needs to be done? Lancet. 2007;369(9572):1565–73.CrossRefPubMed Tylee A, Haller DM, Graham T, Churchill R, Sanci LA. Youth-friendly primary-care services: how are we doing and what more needs to be done? Lancet. 2007;369(9572):1565–73.CrossRefPubMed
25.
go back to reference Bearinger LH, Sieving RE, Ferguson J, Sharma V. Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential. Lancet. 2007;369(9568):1220–31.CrossRefPubMed Bearinger LH, Sieving RE, Ferguson J, Sharma V. Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential. Lancet. 2007;369(9568):1220–31.CrossRefPubMed
26.
go back to reference Warenius L. Sexual and Reproductive Health Services for Young People in Kenya and Zambia. Providers’ attitudes young people’s needs and experiences. Stockholm: Karolinska Institutet; 2008. Warenius L. Sexual and Reproductive Health Services for Young People in Kenya and Zambia. Providers’ attitudes young people’s needs and experiences. Stockholm: Karolinska Institutet; 2008.
27.
go back to reference MoH. Adolescent Health Policy Guidelines and Services Standards. In: Kampala Uganda: The Reproductive Health Division. 3rd ed. Uganda: Department of Community Health, Ministry of Health; 2012. MoH. Adolescent Health Policy Guidelines and Services Standards. In: Kampala Uganda: The Reproductive Health Division. 3rd ed. Uganda: Department of Community Health, Ministry of Health; 2012.
28.
go back to reference Ministry of Health [Uganda]. Uganda National Health Policy. Kampala: MoH; 1999. Ministry of Health [Uganda]. Uganda National Health Policy. Kampala: MoH; 1999.
29.
go back to reference Atuyambe Muhimbuura L. Adolescent Motherhood in Uganda: Dilemmas, Health Seeking Behaviour and Coping Responses. Stockholm: Karolinska Institutet and Makerere University; 2008. Atuyambe Muhimbuura L. Adolescent Motherhood in Uganda: Dilemmas, Health Seeking Behaviour and Coping Responses. Stockholm: Karolinska Institutet and Makerere University; 2008.
30.
go back to reference Okumu MI, Chege IN, Pat Y, Oranga HO. Female adolescent health and sexuality in Kenyan secondary schools: a survey report. Nairobi: AMREF; 1994. Okumu MI, Chege IN, Pat Y, Oranga HO. Female adolescent health and sexuality in Kenyan secondary schools: a survey report. Nairobi: AMREF; 1994.
31.
go back to reference Uganda Bureau of Statistics: Projections of demographic trends in Uganda 2007-2017. In., vol. Volume I. Kampala: UBOS; 2007. Uganda Bureau of Statistics: Projections of demographic trends in Uganda 2007-2017. In., vol. Volume I. Kampala: UBOS; 2007.
32.
go back to reference Ndyanabangi B, Kipp W, Diesfeld HJ. Reproductive health behaviour among in-school and out-of-school youth in Kabarole District, Uganda. Afr J Reprod Health. 2004;8(3):55–67.CrossRefPubMed Ndyanabangi B, Kipp W, Diesfeld HJ. Reproductive health behaviour among in-school and out-of-school youth in Kabarole District, Uganda. Afr J Reprod Health. 2004;8(3):55–67.CrossRefPubMed
33.
go back to reference Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.CrossRefPubMed Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.CrossRefPubMed
34.
35.
go back to reference Rondini S, Krugu JK. Knowledge, attitude and practices study on reproductive health among secondary school students in Bolgatanga, upper east region. Ghana Afr J Reprod Health. 2009;13(4):51–66.PubMed Rondini S, Krugu JK. Knowledge, attitude and practices study on reproductive health among secondary school students in Bolgatanga, upper east region. Ghana Afr J Reprod Health. 2009;13(4):51–66.PubMed
36.
go back to reference Rassjo EB, Mirembe FM, Darj E. Vulnerability and risk factors for sexually transmitted infections and HIV among adolescents in Kampala, Uganda. AIDS Care. 2006;18(7):710–6.CrossRefPubMed Rassjo EB, Mirembe FM, Darj E. Vulnerability and risk factors for sexually transmitted infections and HIV among adolescents in Kampala, Uganda. AIDS Care. 2006;18(7):710–6.CrossRefPubMed
37.
go back to reference Lloyd CB, Mensch BS. Marriage and childbirth as factors in dropping out from school: an analysis of DHS data from sub-Saharan Africa. Popul Stud. 2008;62(1):1–13.CrossRef Lloyd CB, Mensch BS. Marriage and childbirth as factors in dropping out from school: an analysis of DHS data from sub-Saharan Africa. Popul Stud. 2008;62(1):1–13.CrossRef
38.
go back to reference Berhan Y, Berhan A: A meta-analysis of risky sexual behaviour among male youth in developing countries. AIDS research and treatment 2015, pp 1-9. Berhan Y, Berhan A: A meta-analysis of risky sexual behaviour among male youth in developing countries. AIDS research and treatment 2015, pp 1-9.
39.
go back to reference World Health Organisation: Making health services adolescent friendly: Developing national quality standards for adolescent friendly health services. In. Edited by Department of Maternal N, Child and Adolescent Health. Geneva, Switzerland; 2012. World Health Organisation: Making health services adolescent friendly: Developing national quality standards for adolescent friendly health services. In. Edited by Department of Maternal N, Child and Adolescent Health. Geneva, Switzerland; 2012.
40.
go back to reference Barua A, Kurz K. Reproductive health-seeking by married adolescent girls in Maharashtra, India. Reprod Health Matters. 2001;9(17):53–62.CrossRefPubMed Barua A, Kurz K. Reproductive health-seeking by married adolescent girls in Maharashtra, India. Reprod Health Matters. 2001;9(17):53–62.CrossRefPubMed
41.
go back to reference Biddlecom AE, Munthali A, Singh S, Woog V. Adolescents’ views of and preferences for sexual and reproductive health services in Burkina Faso, Ghana, Malawi and Uganda: original research article. Afr J Reprod Health. 2007;11(3):99–110.CrossRefPubMedPubMedCentral Biddlecom AE, Munthali A, Singh S, Woog V. Adolescents’ views of and preferences for sexual and reproductive health services in Burkina Faso, Ghana, Malawi and Uganda: original research article. Afr J Reprod Health. 2007;11(3):99–110.CrossRefPubMedPubMedCentral
42.
go back to reference Briefing Paper. A Technical Guide to Understanding the Legal and Policy Framework on Terminat ion of Pregnancy in Uganda. New York: Center for Reproductive Rights; 2012. Briefing Paper. A Technical Guide to Understanding the Legal and Policy Framework on Terminat ion of Pregnancy in Uganda. New York: Center for Reproductive Rights; 2012.
43.
go back to reference Lindberg C, Lewis-Spruill C, Crownover R. Barriers to sexual and reproductive health care: urban male adolescents speak out. Issues Compr Pediatr Nurs. 2006;29(2):73–88.CrossRefPubMed Lindberg C, Lewis-Spruill C, Crownover R. Barriers to sexual and reproductive health care: urban male adolescents speak out. Issues Compr Pediatr Nurs. 2006;29(2):73–88.CrossRefPubMed
44.
go back to reference Kipp W, Chacko S, Laing L, Kabagambe G. Adolescent reproductive health in Uganda: issues related to access and quality of care. Int J Adolesc Med Health. 2007;19(4):383–93.CrossRefPubMed Kipp W, Chacko S, Laing L, Kabagambe G. Adolescent reproductive health in Uganda: issues related to access and quality of care. Int J Adolesc Med Health. 2007;19(4):383–93.CrossRefPubMed
Metadata
Title
Understanding sexual and reproductive health needs of adolescents: evidence from a formative evaluation in Wakiso district, Uganda
Authors
Lynn M Atuyambe
Simon P S Kibira
Justine Bukenya
Christine Muhumuza
Rebecca R Apolot
Edgar Mulogo
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2015
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-015-0026-7

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