Sexual and reproductive health services utilization and its predictors among students in Ethiopia: A systematic review and meta-analysis
Background & Aim: Students are the most vulnerable group for reproductive health problems due to their inclination to be engaged in risky sexual behavior. The present study sought to determine the pooled prevalence of sexual and reproductive health service utilization and its determinant factors among students in Ethiopia.
Methods & Materials: PubMed, Web of Science, Google Scholar, EMBASE, and the Ethiopian University online library were searched. The review took place between November 15, 2022, and December 15, 2022. Data were extracted using Microsoft Excel and analyzed using STATA statistical software version 14. The pooled prevalence of sexual and reproductive health service utilization was computed with 95% CI, whereas a log odds ratio was used to declare the statistical significance between associated factors and sexual and reproductive health service utilization.
Results: There were 1520 research articles retrieved, but 18 articles with 12,338 participants were met the inclusion criteria and included in this systematic review and meta-analysis. The pooled estimates of sexual and reproductive health service utilization among students was 42.606% (95% CI: 32.917%–52.295%; I2 = 88.3%). Discussion with families/friends (OR=3.033, 95% CI=2.217-4.150, P-value<0.001, I2=75%) and knowledge (OR=2.215, 95%CI=1.105-4.515, P-value=0.025, I2= 85%) were predictors of sexual and reproductive health service utilization among students.
Conclusion: In relation to the data from the studies under analysis, below half percent of students in Ethiopia utilized sexual and reproductive health services. Further health education and communication are crucial to improving knowledge about sexual and reproductive health services among students in Ethiopia.
2. UNPFA. Sexual and Reproductive Health of Young People in Asia and the Pacific Burnet Institute Victoria, Australia, New YorkUSA, 2018. Available at https://asiapacific.unfpa.org/sites/default/files/pub-pdf/SRH%20of%20Ummarried%20Young%20People%20in%20Asia%20Pacific.
3. WHO. Adolescent Health and Development, Department of Child and Adolescent Health and Development; 2004.
4. World Health Organization. Promoting adolescent sexual and reproductive health through schools in low income countries: an information brief. World Health Organization; 2009.
5. Glasier A, Gülmezoglu AM, Schmid GP, Moreno CG, Van Look PF. Sexual and reproductive health: a matter of life and death. The Lancet. 2006 Nov 4;368(9547):1595-607.
6. Belachew T, Ch J, Nigussie S, Alemyehu M, Mengistie B, Egata G. Manual on reproductive health. Federal Democratic Republic of Ethiopia Ministry of Education and Ministry of Health. 2003 Aug.
7. Ingwersen R. Youth reproductive and sexual health in the developing world. Canberra: Development Studies Network. 2001.
8. Adefuye AS, Abiona TC, Balogun JA, Lukobo-Durrell M. HIV sexual risk behaviors and perception of risk among college students: implications for planning interventions. BMC Public Health. 2009 Dec;9(1):1-3.
9. World Health Organization. Sexually transmitted infections among adolescents: the need for adequate health services./Karl L. Dehne, Gabriele Riedner.2005.
10. De BruynMaP. Adolescents’ unwanted pregnancy and abortion. Policies, counseling, and clinical care. USA: IPAS; 2004.
11. Braeken D, Rondinelli I. Sexual and reproductive health needs of young people: matching needs with systems. International Journal of Gynecology & Obstetrics. 2012 Oct;119:S60-3.
12. Wood K, Aggleton P. Promoting young people’s sexual and reproductive health: stigma, discrimination and human rights. London: Department for International Development (DfID).2004.
13. Global Education Digest 2005. Paris, United Nations Educational, Scientific and Cultural Organization (UNESCO), 2005.
14. United Nations Educational, Scientific and Cultural Organization (UNESCO). Education for All by 2015: will we make it? Paris, , 2008
15. Kirby D, Short L, Collins J, Rugg D, Kolbe L, Howard M, Miller B, Sonenstein F, Zabin LS. School-based programs to reduce sexual risk behaviors: A review of effectiveness. Public Health Reports. 1994 May;109(3):339-60.
16. Moore KA, Papillo A, Manlove J, Franzetta K, Ikramullah E, Ryan S, Terry-Human E. Facts at a Glance, 2003.
17. Govindasamy P, Kidanu A, Bantayerga H. Youth reproductive health in Ethiopia. Calverton, Maryland: OCR Macro; 2002 Nov.
18. Adinew YM, Worku AG, Mengesha ZB. Knowledge of reproductive and sexual rights among University students in Ethiopia: institution-based cross-sectional. BMC international health and human rights. 2013 Dec;13:1-7.
19. Johnson S, Finger WR, Rivera R. Reproductive Health of Young Adults: Contraception, Pregnancy and Sexually Transmitted Diseases. Research Triangle Park, NC: Family Health International. 1997.
20. Federal Democratic Republic of Ethiopia Ministry of Health. National Adolescent and Youth Reproductive Health Strategy (2007–2015) Addis Ababa.2006. Available at https://extranet.who.int/countryplanningcycles/sites/default/files/planning_cycle_repository/ethiopia/ayrh_strategy.pdf
21. The federal democratic republic of Ethiopia Ministry of Health. Health sector transformation plan (2015) 2015/16–2019/20 (2008–2012 EFY). Avialable at https://www.medbox.org/pdf/5e148832db60a2044c2d40f6
22. Gelaye AA. KNT, and TM, Magnitude and risk factors of abortion among regular female students in Wolaita Sodo University, Ethiopia. BMC Womens Health. 2014;14(50):1–9.
23. UNFPA. People and possibilities in a world of 7 billion, state of world population 2011: UNFPA; 2011
24. Bam K, Haseen F, Bc RK, Newman MS, Chaudhary AH, Thapa R, Bhuyia I. Perceived sexual and reproductive health needs and service utilization among higher secondary school students in urban Nepal. American Journal of Public Health Research. 2015 May;3(2):36-45.
25. Othman S, Kong SZ, Mydin FM, Ng CJ. Knowledge, utilization, and barriers to primary care services for sexual and reproductive health among adolescents in secondary schools in Selangor, Malaysia. Malaysian family physician: the official journal of the Academy of Family Physicians of Malaysia. 2019;14(1):10.
26. Gurara AM, Gizaw AB, Ayalew AK, kediro Adem A. Reproductive health service utilization and associated factors among adolescents at public school in Adama town east Shewa Ethiopia, 2018. Nursing Practice Today. 2020 Jul 22;7(4):275-85.
27. Yonas FB, Chernet AA. Sexual and reproductive health service utilization and associated factors among high school learners in the Dawuro zone, Southwest Ethiopia. African Journal of Reproductive Health. 2022 Dec 5;26(9):48-54.
28. Gunta M, Tantu T, Wolka S, Meskele M, Ayza A, Duko B. Sexual and Reproductive Health Services Utilization among Wolaita Sodo University Students, Ethiopia: A Mixed Method Approach3. The Scientific World Journal. 2021 Dec 17;2021.
29. Aragie TG, Abate BB. Utilization of Reproductive Health Services and Associated Factors among Secondary School Students in Woldia Town, Northeast Ethiopia. Journal of Environmental and Public Health. 2021 Apr 20;2021.
30. Wachamo D, Tegene Y, Tibeso A, Washo A. Sexual and Reproductive Health Services Utilization and Associated Factors among College Students at West Arsi Zone in Oromia Region, Ethiopia. The Scientific World Journal. 2020 Aug 25;2020.
31. Diribsa T, Wakjira D, Atomsa G, Mekoya T, Mamo F, Fekecha B, Ebisa M, Teferi G. Determinant Factors of Sexual and Reproductive Health Service Utilization among In-School Adolescents with Disability in Jimma Zone, Southwest Ethiopia. International Journal of Reproductive Medicine. 2022 Aug 18;2022.
32. Liyeh TM, Goshu YA, Belay HG, Tasew HA, Mihiretie GN, Ayalew AB. Youth Reproductive Health Service Utilization and Associated Factors among Amhara Region Female Night Students, Ethiopia. BioMed Research International. 2021 Apr 8;2021.
33. Abebe M, Awoke W. Utilization of youth reproductive health services and associated factors among high school students in Bahir Dar, Amhara regional state, Ethiopia. Open Journal of Epidemiology. 2014 Mar 27;2014.
34. Binu W, Marama T, Gerbaba M, Sinaga M. Sexual and reproductive health services utilization and associated factors among secondary school students in Nekemte town, Ethiopia. Reproductive Health. 2018 Dec;15(1):64.
35. Abdurahman C, Oljira L, Hailu S, Mengesha MM. Sexual and reproductive health services utilization and associated factors among adolescents attending secondary schools. Reproductive Health. 2022 Dec;19(1):161.
36. Dida N, Darega B, Takele A. Reproductive health services utilization and its associated factors among Madawalabu University students, Southeast Ethiopia: A cross-sectional study. BMC Research Notes. 2015 Dec;8(1):1-8.
37. Abate AT, Ayisa AA. Reproductive health services utilization and its associated factors among secondary school youths in Woreta town, South Gondar, North West Ethiopia: a cross-sectional study. BMC Research Notes. 2019 Dec;12(1):1-7.
38. Atnafu A, Kebede A, AssefaTessema G, Emiru K, Berihun T, Asmamaw T, Habitu YA. Sexual and reproductive health services utilization and associated factors among university students, Northwest Ethiopia: a cross-sectional study. Journal of Gynecology and Women’s Health. 2019;15(555915):1-9.
39. Hunduma Dina, Desalegn Imana, Mebratu Demissie senbata and Simachew Kassa Limenh. Sexual and Reproductive Health Service Utilization Among High School Students in Assosa Zone: Western Ethiopia, 2021. Journal of Gynecology Reproductive Medicine. 2022; 6(2):71-9.
40. Takele Alemu Yadeta. Assessment of Youth Sexual and Reproductive Health Service Utilization and Associated Factors among High School Students in Bole Sub-city, Addis Ababa, Ethiopia: 2021
41. Tsegaab Temesgen. Current utilization of reproductive health services and the role of peer influence among undergraduate students of Wachamo University. 2017
42. Heaven Workineh. Assessment of factors affecting reproductive health service utilization among students in Bahir Dar University.2015.
43. Aklile Tebebe. Assessment of reproductive health service utilization by secondary school adolescents in Adis Ababa.2017.
44. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. International Journal of Surgery. 2021 Apr 1;88:105906.
45. Joanna Briggs Institute. Critical appraisal tools. 2017. Available at https://jbi.global/sites/default/files/2019-05/JBI_Critical_Appraisal-Checklist_for_Text_and_Opinion2017_0.pdf
46. Belay HG, Arage G, Degu A, Getnet B, Necho W, Dagnew E, Melkie A, Seid T, Bezie M, Nibret G, Worke MD. Youth-friendly sexual and reproductive health services utilization and its determinants in Ethiopia: A systematic review and meta-analysis. Heliyon. 2021 Dec 1;7(12):e08526.
47. Rutaremwa G, Kabagenyi A. Utilization of integrated HIV and sexual and reproductive health services among women in Uganda. BMC Health Services Research. 2016 Dec;16(1):1-9.
48. Diress G, Addisu A, Giza M. HIV testing service utilization and its association with HIV-related knowledge among students in higher education institutions in Ethiopia: systematic review and meta-analysis. Journal of Public Health. 2023 Apr;31(4):603-12.
49. Ninsiima LR, Chiumia IK, Ndejjo R. Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review. Reproductive Health. 2021 Dec;18(1):1-7.
50. Chawhanda C, Levin J, Ibisomi L. Factors associated with sexual and reproductive health service utilization in high migration communities in six Southern African countries. BMC Public Health. 2022 Dec;22(1):1-5.
51. Violita F, Hadi EN. Determinants of adolescent reproductive health service utilization by senior high school students in Makassar, Indonesia. BMC Public Health. 2019 Dec;19(1):1-7.
52. Abraham G, Yitbarek K, Morankar SN. Determinants of adolescents reproductive health service utilization in Ethiopia: a systematic review of quantitative evidence. Adolescent health, medicine, and therapeutics. 2019;10:49-58.
|Issue||Vol 10 No 3 (2023): Summer|
|sexual and reproductive health; services, students; school; Ethiopia|
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