Young people's perceptions of access to sexual and reproductive health services in Manzini, Eswatini: a qualitative study.

Low health literacy was identified as a barrier to accessing sexual and reproductive health services among young people aged 10-24 in Manzini, Eswatini.

• Data collected through face-to-face in-depth semi-structured interviews with 14 participants
• Participants were seeking SRHR services at Family Life Association of Swaziland clinic in Manzini
• Interviews were conducted in October 2017 and audiotaped
• Colaizzi's seven steps of phenomenological data analysis was used to identify themes

Stigma was identified as a barrier to young people's access to and utilisation of sexual and reproductive health services.

• Study population included young people aged 10-24 years
• Convenience purposive sampling was used to recruit 14 participants
• Stigma was identified alongside low health literacy and privacy/confidentiality concerns as key barriers
• The qualitative design allowed for in-depth exploration of participants' perceptions

Privacy and confidentiality concerns were identified as barriers to young people accessing sexual and reproductive health services.

• Privacy and confidentiality emerged as a distinct barrier theme alongside stigma and low health literacy
• Findings are consistent with barriers reported in other low- and middle-income countries
• 14 participants were recruited from a single SRHR clinic in Manzini

Enablers of SRHR service utilisation among young people were mostly structural in nature, including community outreaches and health education.

• Community outreaches were identified as a structural enabler of service utilisation
• Health education was identified as another structural enabler
• The study found that enablers were predominantly structural rather than individual in nature
• The existing healthcare system was identified as a platform that presents an opportunity to be further optimised

Access to and utilisation of sexual and reproductive health services among young people including adolescents remains unsatisfactory in low- and middle-income countries including eSwatini, despite global agreements on adolescents' SRHR.

• The study was set in Manzini, Eswatini, a low- to middle-income country
• The target population was young people aged 10-24 years
• The study was conducted at the Family Life Association of Swaziland clinic
• The gap between global agreements and actual service access/utilisation motivated the study