Utilization of sexual and reproductive health services and associated factors among urban refugee adolescent girls and young women:A case study of Jesuit Refugee Service

Abstract

Background: Uganda continues to receive large numbers of refugees from the DRC and South Sudan, through the Southwestern and Northern boarders. Humanitarian crises and migration make urban refugee adolescent girls and young women more vulnerable to poor sexual and reproductive health (SRH) outcomes. Jesuit Refugee Service in partnership with government health facilities around Kampala have strived to provide SRH services. Nevertheless, there is still limited information on SRH outcomes and utilization of SRH services among urban refugee adolescent girls and young women. Objective: The study assessed utilization of sexual and reproductive health services and associated factors among urban refugee adolescent girls and young women. Methods The study employed a cross-sectional design incorporating both qualitative and quantitative approaches. Data was collected through a semi structured questionnaire administered to 404 urban refugee AGYW selected using simple random sampling. Additionally, four focus group discussions (FGDs) involving 32 participants and key informant interviews (KIIs) with health providers from four government hospitals (Kisenyi Health Centre IV, Kawempe Women’s Hospital, Mulago Hospital and Kiruddu Referral Hospital) were conducted. Poisson regression model with robust standard errors was used to determine factors independently associated to nonuse of the SRH services. In multivariate analysis, variables that had a p-value of <0.05 were statistically significant. For qualitative, Thematic analysis was done to identify patterns and themes within the interview data and the information was coded. Results: Sixty-nine-point one percent (69.1%) of the respondents were between the ages of 23-25 years with the median age being 24 years (IQR 22-25). Less than half of the participants 36% (145) had utilized at least one of the SRH services in the past twelve months. The prevalence of SRH utilization among those who were single was 1.14 times the prevalence of SRH utilization among those who are married (cPR1.14, p-value=0.400, CI=0.84-1.55). Conclusion: Health system factors play an important role in determining the uptake of SRH services among urban refugee adolescents and young women. Addressing issues related to accessibility, quality of care, affordability and confidentiality is essential for improving SRH service utilization