Young people in Sri Lanka face multiple barriers relating to availability, accessibility, and quality when accessing formal youth-friendly sexual and reproductive health services, with preferences for informal sources of information over formal healthcare providers and schools.
Key Findings
Results
Young women in Sri Lanka preferred to receive sexual and reproductive health (SRH) information from their mothers, while young men preferred to seek information from their peers.
This gender-differentiated pattern of preferred information sources was identified across included studies
Both young men and women were less likely to prefer formal sources such as teachers, school curricula, and trained healthcare providers
This finding reflects broader social norms and gendered patterns of communication in Sri Lanka
The preference for informal over formal sources has implications for the design of SRH education and outreach programs
Results
Young people in Sri Lanka face multiple barriers related to availability, accessibility, and quality when accessing formal youth-friendly SRH services.
Specific barriers identified included embarrassment, fear of stigma, and lack of knowledge about available services
These barriers were identified through thematic analysis of 16 included studies
The review included quantitative, qualitative, and mixed-methods studies on young people aged 10–24 years
The database search yielded 1,198 results, of which 16 papers met the inclusion criteria
Background
Sri Lankan health policy primarily conceptualizes and implements sexual and reproductive healthcare through the lens of family planning, resulting in gaps in addressing the diverse SRH needs of adolescents and young adults.
This framing is described as characteristic of many low-to-middle-income countries, not only Sri Lanka
The family planning lens has led to a lack of awareness about the broader SRH needs of the growing adolescent and young adult demographic
Sexual and reproductive health is described as 'a key component of young people's right to health during their development years'
The review was motivated in part by this policy gap
Results
Young people in included studies were less likely to prefer formal sources of SRH information and care, including school-based resources such as teachers and the curriculum, as well as trained healthcare providers.
This finding contrasts with the preference for informal sources (mothers for young women, peers for young men)
The underutilization of formal sources suggests that existing school-based and healthcare-based channels are not meeting young people's needs or preferences
This was identified through thematic analysis across the 16 included studies
Studies covered young people aged 10–24 years in Sri Lanka
Results
Potential strategies to improve SRH information and services in Sri Lanka include education of parents and teachers, increased partnerships with young people to develop effective interventions, and tailored promotion of available youth-friendly resources.
These strategies were identified based on synthesized findings from the 16 included papers
Engaging parents as SRH information sources aligns with young women's expressed preference for receiving information from mothers
Partnerships with young people are recommended to ensure interventions are responsive to actual needs and preferences
The authors note that more research is needed on how SRH needs vary between young people from different socio-demographic groups
Methods
The systematic review followed PRISMA guidelines and included 16 papers from an initial database yield of 1,198 results across four electronic databases.
Databases searched included Ovid Medline, Ovid Embase, Ovid Global Health, and Ovid PsycInfo
Only peer-reviewed articles were included
Two authors independently conducted full-text screening, data extraction, and quality assessment
Studies included quantitative, qualitative, and mixed-methods designs, with participants aged 10–24 years
Data were extracted and analysed thematically
What This Means
This research synthesized evidence from 16 studies to understand what young people aged 10–24 in Sri Lanka know, need, and prefer when it comes to sexual and reproductive health (SRH) information and services. The review found that young people face significant obstacles in accessing formal SRH services, including feeling embarrassed, fearing judgment or stigma, and simply not knowing what services are available. These barriers mean that many young people do not get the health information or care they need during a critical period of their development.
The research also found clear differences in where young men and young women prefer to get SRH information. Young women were more likely to turn to their mothers, while young men tended to rely on their peers. Both groups were less likely to use formal sources like school teachers, the school curriculum, or trained healthcare workers — suggesting that current formal channels are not resonating with or meeting the needs of young people in Sri Lanka. This is compounded by the fact that Sri Lanka's health system has largely focused SRH services on family planning for adults, leaving adolescents underserved.
This research suggests that improving SRH outcomes for young Sri Lankans will require engaging parents and teachers as better-informed sources of information, working in partnership with young people themselves to design health programs, and better promoting existing youth-friendly services. The authors also highlight a gap in research on how SRH needs differ across various groups of young people — such as by gender, age, income, or location — which future studies should address to ensure no group is left behind.
Weerasinghe M, Mudunna C, Makleff S, Sastry J, Rajapaksa Hewageegana N, Varshney K, et al.. (2025). Sexual and reproductive health information and service needs and preferences of adolescents and young adults in Sri Lanka: a systematic review.. BMC public health. https://doi.org/10.1186/s12889-025-24324-5