Determinants of Adolescent and Youth Sexual and Reproductive Health Service Utilization in Hard-To-Reach Communities of Amudat District, Uganda
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INTRODUCTION Uganda has one of the largest adolescent and youth populations globally and yet access and utilization of sexual and reproductive health services (SRH) among this population remains inadequate, especially in hard-to-reach communities. This study sought to establish the contextual determinants of service utilization in Amudat District, a hard-to-reach community in Karamoja, Uganda. MATERIALS AND METHODS A community based descriptive cross-sectional study was conducted using random sampling of 503 respondents recruited after informed consent. Data were collected using interviewer administered questionnaires, entered into epidata 3.1 and analysed using STATA version 12. For quantitative data, logistic regression analysis was used to determine factors associated with services utilization. Qualitative data were analysed by content analysis, for themes. RESULTS Older adolescents and youth out-of-school were more likely to utilise services, with religion and socially accepted norms additionally determining utilisation of services. CONCLUSION Strengthening social services that keep adolescents in school; supporting community engagement through youth gatekeepers particularly youth champions, religious and cultural leaders; while fostering family values that favour SRH discussions will increase access to and use of SRH services in hard-to-reach communities. RECOMMENDATIONS Promote culturally adapted sexuality education; prevent child marriage, and provide youth friendly SRH services aligned to need in Amudat and similar settings.