The findings highlight a significant gap between awareness and use of SRH services among adolescents, emphasising the need for targeted interventions to improve awareness and access to SRH services for adolescents in Arsi Zone, Ethiopia.
Key Findings
Results
Having an existing STI or SRH problem was the strongest predictor of SRH service utilisation among adolescents.
Presence of an SRH problem such as a sexually transmitted infection was strongly associated with SRH service utilisation (AOR = 4.88; 95% CI: 2.26–10.54)
This was the highest adjusted odds ratio among all significant predictors identified in the multivariable logistic regression model
Study population was 651 randomly selected adolescents aged 15–19 years in six districts of Arsi Zone, Oromia, Ethiopia
Data were collected from 01 January 2024 to 29 February 2024 using a self-administered structured questionnaire
Results
Perceived convenience of SRH service operating hours was significantly associated with higher SRH service utilisation.
Convenient service operating hours were associated with higher utilisation (AOR = 3.19; 95% CI: 1.57–6.52)
This was the second strongest predictor after presence of an SRH problem
Finding suggests structural/logistical factors play an important role in adolescent access to services
Results
Involvement in SRH discussions with trusted individuals was significantly associated with SRH service utilisation.
Being involved in SRH discussions with trusted individuals was associated with better odds of SRH service use (AOR = 2.12; 95% CI: 1.22–3.67)
This suggests that social support and communication networks influence adolescents' health-seeking behaviour
A school-based cross-sectional design was used with multivariable logistic regression analysis
Results
Absence of fear when seeking care was significantly associated with higher utilisation of SRH services.
Absence of fear when seeking care was significantly associated with higher SRH service utilisation (AOR = 2.07; 95% CI: 1.12–3.83)
This finding implies that fear is a meaningful barrier to adolescents seeking SRH services
Fear-related barriers likely reflect sociocultural stigma and concerns about confidentiality
Results
A significant gap exists between awareness and actual use of SRH services among adolescents in Arsi Zone, Ethiopia.
The study was conducted among 651 randomly selected adolescents aged 15–19 years across six districts of Arsi Zone
Despite adolescents having some awareness of SRH services, utilisation remained low
The study identified both structural barriers (operating hours) and sociocultural barriers (fear, lack of trusted discussion partners) as contributing to the gap
Authors note this gap emphasises the need for targeted interventions to improve awareness and access
Discussion
The study provides empirical evidence on structural and sociocultural barriers to adolescent SRH service access in Ethiopia.
Study was school-based and cross-sectional, conducted in six districts of Arsi Zone, Oromia, Ethiopia
Measures of association were expressed as adjusted odds ratios (AORs) with corresponding 95% confidence intervals using multivariable logistic regression
Authors state findings offer 'actionable insights for designing, implementing and evaluating adolescent SRH policies and programmes'
The study addresses gaps in service access, structural and sociocultural barriers, and service use in an Ethiopian context
What This Means
This research examined why adolescents in the Arsi Zone of Ethiopia are not using sexual and reproductive health (SRH) services even when they are aware those services exist. Surveying 651 students aged 15–19 across six districts, researchers found that several specific factors were linked to whether or not young people actually sought out these services. Adolescents were much more likely to seek care if they already had an obvious health problem like a sexually transmitted infection, if they felt comfortable talking about SRH topics with someone they trusted, if they were not afraid to seek care, and if the clinic hours were convenient for them.
The study found that fear and inconvenient service hours were meaningful barriers keeping adolescents away from care, suggesting that both social stigma and practical logistics play important roles. The largest single predictor of service use was already having an SRH problem — meaning many adolescents only sought care when they had no other choice, rather than seeking preventive or routine services. This points to a gap between knowing that services exist and actually feeling willing or able to use them.
This research suggests that simply making adolescents aware of SRH services is not enough to increase their use. Programmes that create safe spaces for young people to discuss sexual health with trusted adults, reduce stigma and fear around care-seeking, and adjust service hours to be more accessible could help bridge this gap. The findings are intended to guide health policy and programme design in Ethiopia and similar settings where adolescent SRH service use remains low despite available services.
Demissie D, Mmusi-Phetoe R. (2026). Awareness, service use and barriers to sexual and reproductive health among adolescents in the Arsi Zone, Oromia, Ethiopia.. African journal of primary health care & family medicine. https://doi.org/10.4102/phcfm.v18i1.5500