# Availability and utilization of sexual and reproductive health services among adolescents of Godawari Municipality, Nepal: A cross-sectional study

## TL;DR

This study examines how well sexual and reproductive health services are available and used by adolescents in Nepal, finding that low awareness and poor service accessibility are major barriers.

## Contribution

The study provides insights into factors influencing adolescent use of reproductive health services in Nepal using a mixed-methods approach.

## Key findings

- Only 13.22% of adolescents had ever used adolescent-friendly sexual and reproductive health services.
- Lack of awareness and perceived need were the main reasons for not using the services.
- Health facilities did not meet adolescent-friendly criteria despite prior certification.

## Abstract

Adolescent sexual and reproductive health is getting due attention in developing countries because investing among adolescents can bring multiple benefits. This study aims to assess the availability and utilization of sexual and reproductive services (SRHS), and explore different factors affecting the utilization of SRHS by adolescents of Godawari Municipality. A cross-sectional, mixed-method study was conducted using Anderson’s model of health service utilization in three government secondary schools and three local health institutions in Godawari Municipality. A self-administered questionnaire was used with adolescents aged 15–19 (n = 416), and conducted Key Informants Interview (KII) and observation were conducted in health institutions. Quantitative data was analyzed in Statistical Package for Social Sciences (SPSS) version 16, and thematic analysis was done for qualitative data. The mean age of the respondents was 17.31 ± 0.99 years. Nearly one-third of them (30.63%) had not heard about Adolescent Friendly Health Services. Knowledge of ASRH and AFHS (AOR = 2.814, 95% C.I = 1.129-7.013) and conversation with parents (AOR = 2.069, 95% C.I = 1.094-3.912) and availability of ASRH (AOR = 2.801, 95% C.I = 0.810-9.687) had a significant relationship with utilization of health services. The adolescents’ perceived feeling of the need for ASRH services is significantly associated with the utilization of ASRH services (p < .001). Only 13.22% of them had ever used ASRH services, and the reasons for not using services were the lack of realization of the need for services (60.39%), while 14.55% of them felt that privacy was not maintained at all. The KII found the number of adolescents visiting Health Facility (HF) was very low, and those visiting for SRH-related services were rare. The observation showed none of the HF met the adolescent friendly criteria set by the government even when they were once certified. Knowledge of respondents and their parents, as well as availability of the services, had a significant role in the utilization of ASRH services by the adolescents. Awareness about the importance of health care services among adolescents and the availability of services is essential.