A relatively high proportion of youths in major urban towns of Ethiopia exhibit low uptake of SRH and FP services, with a higher proportion exposed to high-risk sexual behaviour and unintended pregnancy, often linked to poor access to accurate and relevant SRH information.
Key Findings
Results
35% of surveyed youths in major urban towns of Ethiopia had engaged in high-risk sexual behaviour (HRSB).
The study included youths from community settings (n=1954) and higher education institutions (n=1261) across 13 major urban towns of Ethiopia.
HRSB was more prevalent among youths with no education, aged 18-19, who had not used SRH or FP services, and those with multiple social media accounts.
Community settings participants were selected from randomly selected eligible households.
Results
More than 14% of youths surveyed had experienced at least one unwanted pregnancy.
Unintended pregnancy among women was more common among those in higher education institutions.
Lacking comprehensive HIV knowledge was associated with higher rates of unintended pregnancy.
Engaging in HRSB was also associated with unintended pregnancy.
Results
Only 26.7% of youths had utilised sexual and reproductive health (SRH) services.
Uptake of SRH services was lower among unmarried youths.
Youths aged 18-19 had lower SRH service uptake compared to other age groups.
Individuals with no access to mass media and those who did not encounter SRH messages had lower uptake of SRH services.
Results
Only 26.4% of female youths currently used family planning (FP) services.
Non-use of FP services was associated with engagement in HRSB.
The study assessed current use of family planning services as a distinct outcome from general SRH service utilisation.
This finding reflects a broader pattern of low reproductive health service uptake among Ethiopian urban youth.
Results
Lack of access to mass media and absence of SRH messaging exposure were associated with lower SRH service utilisation.
Youths who did not encounter SRH messages had lower uptake of SRH services.
Barriers to SRH service utilisation were often linked to poor access to accurate and relevant SRH information.
The authors identified delivering targeted SRH-related messages through social media and mass media broadcasts as a potential intervention to address these gaps.
Having multiple social media accounts was associated with increased HRSB, suggesting complex and dual roles of social media in youth SRH outcomes.
Methods
The study was a cross-sectional formative assessment of the Integrated Youth Activity conducted across 13 major urban towns of Ethiopia.
A total of 1954 youths from community settings were included from randomly selected eligible households.
An additional 1261 students were included from higher education institutions.
The study assessed unwanted pregnancy, exposure to HRSB, SRH service utilisation, and current use of FP services as primary outcomes.
The study was designed as a cross-sectional study, limiting causal inference.
What This Means
This research surveyed over 3,200 young people living in 13 major cities in Ethiopia to understand how common sexual and reproductive health (SRH) problems are and how often young people use available health services. The study found that more than one-third of young people had engaged in risky sexual behaviors, more than 14% of youth had experienced an unwanted pregnancy, and fewer than 27% had ever used SRH services. Among young women, fewer than 27% were currently using any form of family planning.
The research suggests that young people who lacked access to mass media, had never encountered SRH-related health messages, were unmarried, or were in the 18-19 age group were least likely to use reproductive health services. Unwanted pregnancies were more common among young women in higher education who lacked knowledge about HIV and who engaged in risky sexual behaviors. Interestingly, having multiple social media accounts was linked to higher rates of risky sexual behavior, though the authors also point to social media as a potential tool for spreading accurate health information.
This research suggests that limited access to reliable and relevant sexual and reproductive health information is a key driver of both low service use and higher rates of risky behavior and unintended pregnancy among Ethiopian urban youth. The authors conclude that using mass media and social media platforms to deliver targeted, credible SRH messages could help bridge this information gap and improve young people's health knowledge and service-seeking behavior.
Dadi T, Medhin G, Fentaye F, Tadesse D, Tassew S, Wakene T, et al.. (2025). The state of youth sexual and reproductive health problems and service utilisation in major towns of Ethiopia: a cross-sectional study.. BMJ open. https://doi.org/10.1136/bmjopen-2024-087224