Access to Sexual and Reproductive Health Information Among Adolescents With Hearing Disabilities in Rwanda

Access to Sexual and Reproductive Health Information Among Adolescents With Hearing Disabilities in Rwanda | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Access to Sexual and Reproductive Health Information Among Adolescents With Hearing Disabilities in Rwanda Uwera Yvonne, Twizere Celestin, Anne Kumurenzi, Sangano Bertrand This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7814335/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background Adolescents, defined as individuals aged 10–19 years, are a primary focus of sexual and reproductive health (SRH) programs. However, adolescents with disabilities, particularly those with hearing impairments, face heightened challenges due to societal discrimination and an increased risk of sexual abuse. A common misconception persists that persons with disabilities are asexual or do not require sexuality education. As a result, many are denied access to crucial SRH information, which increases their vulnerability to SRH-related issues, including unintended pregnancies, unsafe abortions, and sexually transmitted infections (STIs). While Rwanda has integrated SRH services into its healthcare system, little is known about the accessibility of these services for adolescents with hearing disabilities. There is a critical gap in research on this population’s access to SRH information and services. Objectives This study aimed to examine the factors influencing access to sexual and reproductive health information among adolescents with hearing disabilities in Rwanda. Methods A quantitative cross-sectional study design was employed, using a census strategy to recruit all eligible participants. Data were collected through structured questionnaires administered to adolescent students with hearing disabilities. Communication was facilitated using sign language interpreters. Results All participants (100%) reported having access to some form of SRH information. The most common source of information was schoolteachers, followed by peers, with mass media being the least cited. Key facilitators of access included inclusive education settings and the availability of SRH services in health facilities. Identified barriers included the lack of sign language proficiency among healthcare providers, stigma and discrimination within the community, and exclusionary education practices. Conclusion and Recommendations: Adolescents with hearing disabilities need inclusive, gender-sensitive, and accessible SRH education to ensure equitable access to essential information. Community sensitization and advocacy are vital to addressing harmful societal attitudes and promoting inclusion. Furthermore, strengthening the accessibility of SRH services especially through the integration of sign language interpretation is essential to meeting the needs of this underserved population, regardless of age or educational background. CHAPTER 1: INTRODUCTION Adolescents, defined as individuals aged 10 to 19, are a priority population in sexual and reproductive health (SRH) programs due to their increased vulnerability to adverse health outcomes ( 1 ). Unprotected sexual activity among adolescents is associated with unintended pregnancies, unsafe abortions, HIV and other sexually transmitted infections (STIs), infertility, gender-based violence, and long-term sexual health complications ( 5 ). Globally, over 10 million unintended pregnancies occur each year among adolescent girls aged 15–19 in low-income countries( 22 ). In addition, adolescents account for 41% of new HIV infections in individuals aged 15 and above, with over 800,000 new infections recorded annually 79% of which occur in sub-Saharan Africa ( 24 ). Despite significant efforts in Rwanda to educate young people about SRH, adolescent sexual health outcomes remain concerning. For instance, five percent of girls and 10% of boys report initiating sexual activity before the age of 15, and teenage pregnancies among school-aged girls remain a major national issue ( 9 ). Several structural and systemic barriers continue to hinder the effective implementation of SRH strategies for adolescents, particularly girls. These include insufficient SRH education, inadequate access to youth-friendly services, lack of autonomy in reproductive decision-making, and pervasive gender inequality ( 6 ). In many low-income settings, SRH services are not tailored to the specific needs of adolescents but are instead designed for married adult women. This mismatch leaves adolescents especially those in vulnerable groups underserved and at risk ( 26 ). Adolescents with disabilities face even greater challenges. They are more likely to encounter social exclusion, stigma, and discrimination, and have fewer opportunities to access information or services that are essential to their sexual health and rights. Young persons with disabilities (YPWD), including those with hearing impairments, often lack access to SRH information due to physical inaccessibility of clinics, lack of materials adapted for visual or hearing impairments, and healthcare providers’ limited capacity to communicate using sign language ( 7 ). Societal misconceptions frequently portray individuals with disabilities as asexual or incapable of engaging in intimate relationships, which further justifies the exclusion of these populations from comprehensive sexuality education. Consequently, many adolescents with disabilities are denied the right to accurate, timely, and inclusive SRH information ( 8 ). This marginalization exacerbates their vulnerability to sexual abuse, STIs, unintended pregnancies, and school dropout. Adolescents with hearing disabilities are particularly at risk due to barriers in both formal education and informal peer communication ( 20 ) and ( 23 ). The limited availability of youth- and disability-friendly SRH materials and services deepens these disparities. Although Rwanda has established supportive frameworks, including youth-friendly corners in schools and health facilities, and national SRH policies, the specific experiences of adolescents with disabilities especially those who are hearing-impaired remain largely undocumented. This lack of disaggregated data contributes to their continued exclusion from programming and policy development ( 21 ). While the global development agenda emphasizes universal access to SRH information, there is limited empirical evidence on how adolescents with hearing disabilities in low- and middle-income countries access such information ( 11 ). In Rwanda, research in this area is scarce. Yet, evidence indicates that access to SRH information is essential to improving knowledge, informed decision-making, and positive sexual health outcomes among adolescents ( 13 ). Understanding the extent to which adolescents with hearing disabilities can access SRH information and identifying the barriers and facilitators that shape this access is critical to designing inclusive, equitable, and effective health interventions ( 12 ). This study therefore aims to investigate the determinants of access to sexual and reproductive health information among adolescents with hearing disabilities in Rwanda. It seeks to quantify access levels, explore enabling and limiting factors, and generate evidence to inform more inclusive health education strategies. The findings are expected to support policymakers, educators, and healthcare providers in addressing the unique SRH needs of adolescents with hearing disabilities and promote more equitable health outcomes within this marginalized population. CHAPTER 2: METHODOLOGY This study was conducted among adolescents with hearing disabilities enrolled at HVP Gatagara schools in Rwanda during the 2023/2024 academic year. HVP Gatagara, with campuses in Nyanza and Huye districts, is a well-established institution offering inclusive education to children and adolescents with various disabilities, including hearing impairments. The schools were selected due to their long-standing role in supporting learners with disabilities from diverse regions across the country. A cross-sectional quantitative design was employed to explore the factors influencing access to sexual and reproductive health (SRH) information among adolescents with hearing disabilities. Given the relatively small and defined population of eligible students, a census approach was used, enabling the inclusion of all qualifying participants to maximize precision and representativeness. Participants were adolescents aged 10 to 19 years with documented hearing disabilities. Both male and female students were included, provided that parental consent was obtained for minors, or that the participants themselves gave informed consent if aged 18 or older. Students who had ever been pregnant or given birth were excluded to minimize bias, as they may have had prior exposure to SRH services through antenatal and postnatal care. Data collection took place in April 2024 following ethical clearance from the Institutional Review Board of the University of Rwanda. School administrators granted formal authorization after reviewing the study protocol. Prior to data collection, the study’s objectives, procedures, and voluntary nature were explained to participants in accessible formats, including through sign language interpretation. Questionnaires were distributed directly to the students, who completed them independently. An educator proficient in sign language supported the communication process as needed. The primary data collection instrument was a standardized SRH questionnaire adapted from the World Health Organization’s Sample Core Instrument, modified based on a pilot test conducted two weeks prior to the main study. This pilot study, involving five participants at a comparable institution (Centre des Jeunes Sourd-Muets), allowed for refinement of the questionnaire to improve clarity and relevance particularly in questions related to communication with healthcare providers. Throughout the data collection process, all questionnaires were reviewed daily for completeness and accuracy. Data were entered and analyzed using STATA software. Descriptive statistics, including frequencies and cross-tabulations, were generated to summarize demographic characteristics and levels of SRH information access. Binary logistic regression was performed to identify associations between sociodemographic variables and access to SRH information. Ethical considerations were strictly observed. Participation was voluntary, and all students were informed of their right to withdraw at any time without any negative consequences. To maintain confidentiality, responses were anonymized using coded identifiers. No risks were posed to participants, and no financial or material compensation was provided. Study results will be shared with participating schools to inform future programming and policy development in inclusive SRH education. “The study was conducted in accordance with the Declaration of Helsinki.” Clinical trial number: Not applicable. CHAPTER 3: RESULTS INTERPRETATION AND ANALYSIS This chapter presents the findings of the study using descriptive statistics, including frequencies and percentages. Results are displayed through tables and figures to facilitate interpretation. All 37 eligible participants completed the questionnaire, yielding a 100% response rate. 3.1. Socio-Demographic Characteristics Table 3.1 summarizes the socio-demographic characteristics of the participants. Slightly more than half were male (51.35%). The majority were aged over 16 years (56.76%), and nearly all participants (97.30%) reported the ability to read. Most were enrolled at the secondary school level (78.38%). In terms of school site, 81.08% of participants were recruited from HVP Gatagara Nyanza (both primary and secondary levels), while the remaining 18.92% were from the Huye campus, all attending secondary school. Regarding religious affiliation, a significant proportion identified as Protestant (48.65%) Table 3.1 Socio-demographic characteristics of respondents VARIABLE FREQUENCY (N=37) PERCENTAGES (%) Gender of respondent Male Female 19 18 51.35 48.65 Age categories >=14 Between 15-17 Years old Above 17 years 7 19 11 18.92 51.35 29.73 Reading capacity No Yes 1 36 2.70 97.30 Education level Primary Secondary Technical 8 29 0 21.62 78.38 0 Schools HVP-Nyanza HVP-Huye 30 7 81.08 18.92 Religion Catholic Protestant Muslim Other None 13 18 2 4 0 35.14 48.65 5.41 10.81 0 Importance of religion Very important Important Not important 25 12 0 67.57 32.43 0 3.2. Parental Presence and Communication As table 3.2. shows most participants reported that their parents were present in their lives, with 81.08% indicating the presence of their fathers and 91.89% reporting the presence of their mothers. However, communication about sex-related matters remained limited. Only 35.14% of participants felt comfortable discussing such topics with their fathers, and 45.95% with their mothers, highlighting a gap between parental presence and open dialogue on sexual and reproductive health Table 3.2. Parental Presence and Communication Father alive Yes No 30 7 81.08 18.92 Father live in a same household Yes No 27 10 72.97 27.03 Talk with your father about things that are important Very difficult Difficult Easy Very easy I do not see him 3 7 8 11 8 8.11 18.92 21.62 29.73 21.62 Ever discussed about sex related matters with your father Yes No 13 24 35.14 64.86 If yes, Often Occasionally Rarely N/A 6 3 4 24 16.22 8.11 10.81 64.86 Mother alive Yes No 34 3 91.89 8.11 Mother live in a same household Yes No 33 4 89.19 10.81 Talk with your mother about things that are important Very difficult Difficult Average Easy Very easy I do not see her 2 7 1 9 15 3 5.41 18.92 2.70 24.32 40.54 8.11 Ever discussed about sex related matters with your mother Yes No 17 20 45.95 54.05 If yes, Often Occasionally Rarely N/A 10 5 2 20 27.03 13.51 5.41 54.05 3.3. Knowledge of SRH Information and Services As shown in Table 3.3, the majority of participants demonstrated a high level of awareness regarding key sexual and reproductive health topics. Nearly all participants (97.3%) reported knowledge of puberty, and 91.89% were familiar with the sexual and reproductive system. Similarly, 97.3% were informed about HIV/AIDS, while 70.27% had awareness of other sexually transmitted infections. When asked about preventive measures, 81.08% identified condoms as a method of protection against HIV, STIs, and pregnancy. Additionally, 62.16% reported knowing how to prevent pregnancy, and an equal proportion were aware of where young people can access contraceptive methods. Although 59.46% of participants knew that SRH services are available at health facilities, only 32.43% indicated that they had personal access to a health facility offering youth-friendly SRH services. Table 3.3. Knowledge of SRH Information and Services VARIABLE FREQUENCY (N) PERCENTAGES (%) Knowledge on puberty . Yes 36 97.3 No 1 2.7 Knowledge on sexual and reproductive systems of men and women Yes 34 91.89 No 3 8.11 Knowledge on HIV/AIDS Yes 36 97.30 No 1 2.70 Knowledge on other sexual transmitted diseases? Yes 26 70.27 No 11 29.73 Knowledge on condoms as a protective measure Yes 30 81.08 No 7 18.92 Knowledge on contraceptive methods for pregnancy Yes 23 62.16 No 14 37.84 Knowledge on a place to obtain contraceptive methods? Yes 24 62.16 No 13 37.84 Knowledge on where to receive services and information about contraception, pregnancy, abortion, sexual transmitted infections? Yes 22 59.46 No 15 40.54 Access to health facility that offer sexual and reproductive health services? Yes 12 32.43 No 25 67.57 3.5. Sources of SRH Information As presented in Table 3.4, the primary source of sexual and reproductive health (SRH) information for participants was schoolteachers, cited by an average of 49.90% of respondents. In contrast, mass media was the least common source, mentioned by only 6.90% of participants. These findings highlight the central role of schools—and particularly teachers—in delivering SRH education to adolescents with hearing disabilities. Table 3.4. Sources of SRH Information Source of Information/ SRH related Knowledge puberty pattern sexual and reproductive systems HIV/AIDS like mode of transmission, treatment other sexual transmitted diseases condoms are effective way of protecting against HIV, STI and pregnancy contraceptive place or person from where young people could obtain contraceptive methods health facility, youth can receive services and information access to health facility that offer sexual and reproductive health services. Average School Teacher 59.5 62.2 59.5 48.6 59.5 45.9 49.5 40.5 24.3 49.9 Father 21.6 13.5 10.8 13.5 5.4 10.8 5.4 10.8 2.7 10.5 Mother 43.2 40.5 35.1 27 16.6 13.5 16.2 18.9 8.1 24.3 Brother 35.1 24.3 13.5 10.8 10.8 8.1 13.5 13.5 10.8 15.6 Sister 29.7 29.7 27 24.3 8.1 13.5 13.5 16.2 8.1 18.9 Other Family member 24.3 16.2 16.2 5.4 10.8 10.8 18.9 10.8 13.5 14.1 Friends 70.3 56.8 59.5 43.2 59.5 48.6 35.1 43.2 18.9 48.3 Doctor/Nurse 29.7 29.7 32.4 18.9 35.1 27 27 24.3 10.8 26.1 Books/Magazine 24.3 29.7 21.6 18.9 29.7 8.1 13.5 18.9 13.5 19.8 Films/Videos 27 13.5 8.1 8.1 13.5 0 5.4 5.4 2.7 9.3 Television 27 32.4 21.6 21.6 16.2 13.5 8.1 10.8 5.4 17.4 Radio 0 0 0 0 0 0 0 0 0 0.0 Mass Media 8.1 5.4 5.4 8.1 8.1 2.7 8.1 13.5 2.7 6.9 N/A 2.7 8.1 2.7 29.7 18.9 37.8 37.8 40.5 67.9 27.3 3.5. Facilitators of Access to SRH Information As shown in Table 3.5, all participants reported having access to at least one source of SRH information. Inclusive education emerged as the most significant facilitator, with 81.08% of participants indicating that being in an inclusive school environment enhanced their access to sexual and reproductive health information. This underscores the importance of inclusive educational settings in promoting equitable access to SRH knowledge among adolescents with hearing disabilities. Table 3.5: Sources of sexual and reproductive health information among adolescents with hearing disabilities. VARIABLE FREQUENCY (N=37) PERCENTAGES (%) Access to sources of information Yes 37 100 No 0 0 Access to health facilities with SRH services YES 19 51.35 NO 18 48.63 Inclusive education YES 30 81.08 NO 7 18.92 Available communication technics with health professionals Yes 13 35.14 No 24 64.86 3.6. Barriers to access SRH information As shown in Table 3.6 , most participants reported limited access to SRH materials and also it shows that absence of sign language among health professionals is a barrier at 83.78%. Table 3.6 Barriers to access SRH information VARIABLE FREQUENCY (N) PERCENTAGE (%) No sign language among health professionals Yes 31 83.78 No 6 16.22 Exclusive education Yes 30 81.08 No 7 18.92 No available health facilities with SRH services for persons with disabilities Yes 21 56.76 No 16 43.24 Stigma and discrimination in the community Yes 25 67.57 No 12 37.43 3.7. Bivariate Analysis of Socio-Demographic Factors and Access to SRH Information Table 3.7 presents the bivariate analysis examining the relationship between socio-demographic characteristics and limitations in accessing SRH information sources. Among all variables assessed, only gender was significantly associated with access to SRH information (p = 0.030). Notably, all male participants reported no limitations in accessing SRH-related information, highlighting a gender disparity. Other factors, including age, educational level, religion, and parental status at the time of data collection, showed no statistically significant association with access to SRH information. Table 3.7. Bivariate Analysis of Socio-Demographic Factors and Access to SRH Information Variable Yes No P-value Gender Female Male 4 (22.22) 0 14 (77.78) 19 (100) 0.030 Age categories Less 14 Between 15-17 18 years 0 3(15.79) 1(9.09) 7(100) 16(84.21) 10(90.91) 0.504 Education Level Primary Secondary Technical 0 4(13.79) 0 8(100) 25(86.21) 0.266 Religion Catholic Muslim Protestants Other 1 (7.69) 0 3 (16.67) 0 12 (92.31) 2 (100) 15 (83.33) 4 (100) 0.683 3.8. Bivariate Analysis of Socio-Demographic Characteristics and Experience of Stigma Table 3.8 illustrates the relationship between socio-demographic factors and experiences of stigma and discrimination among adolescents with hearing disabilities. Age was significantly associated with stigma (p = 0.047), with younger adolescents (under 14 years) reporting fewer instances of stigmatization compared to those aged 15 years and above. Educational level was also a significant factor (p = 0.004); adolescents attending secondary school reported higher levels of community stigma and discrimination than those in primary school. Table 3.8. Bivariate Analysis of Socio-Demographic Characteristics and Experience of Stigma Variable Yes No P-value Gender Female Male 13 (72.22) 12 (63.16) 5 (27.78) 7 (36.84) 0.556 Age categories Less 14 Between 15-17 18 years 2(28.57) 15(78.95) 8(72.73) 5(71.43) 4(21.05) 3(27.27) 0.047 Education Level Primary Secondary Technical 2(25) 23(79.31) 0 6(75) 6(20.69) 0 0.004 Religion Catholic Muslim Protestants Other 9(69.23) 2(100) 10(55.56) 4(100) 4(30.77) 0 8(44.44) 0 0.253 Father Alive No Yes 5(71.43) 20 (66.67) 2(28.57) 10(33.33) 0.809 Mather alive No Yes 3(100) 22(64.71) 0 12(35.29) 0.211 CHAPTER 4: DISCUSSION This chapter interprets the study findings in relation to its objectives and existing literature, focusing on factors influencing access to sexual and reproductive health (SRH) information among adolescents with hearing disabilities in Rwanda, including facilitators and barriers. Knowledge about Sexual and Reproductive Health Information and Services The study reveals a generally good level of knowledge among participants regarding puberty, the reproductive system, HIV/AIDS, and condom use, reflecting the positive impact of comprehensive sexuality education programs. However, awareness of other sexually transmitted infections (STIs) and pregnancy prevention methods was less widespread, indicating gaps in the breadth of SRH education. Despite familiarity with contraception and service locations, many adolescents reported limited access to youth-friendly SRH services, highlighting a disconnect between knowledge and practical accessibility. Age and educational level were significantly associated with experiences of stigma and discrimination, with older adolescents (15 years and above) and those in secondary school facing greater social barriers. Gender also influenced access to SRH information, as male participants reported fewer limitations than females. These findings suggest that stigma and discrimination increase with age and educational progression, which may impede equitable access to SRH information and services. This disparity underscores the need not only for expanded and inclusive SRH education but also for improved accessibility and acceptability of health services that accommodate adolescents’ unique needs. Interventions must address systemic barriers to enable adolescents to translate knowledge into healthy behaviors and service utilization. Sources of Sexual and Reproductive Health Information Teachers and peers emerged as the primary sources of SRH information for adolescents with hearing disabilities, while parental involvement was minimal. This aligns with other research emphasizing the critical roles educators and peers play in disseminating SRH information, especially for young people with disabilities. Communication challenges and cultural taboos likely contribute to parents’ limited engagement in these discussions. These findings highlight the importance of strengthening inclusive school-based SRH education and training educators to deliver accessible, disability-sensitive content. Additionally, fostering open communication between parents and their children with hearing disabilities is essential to support comprehensive SRH knowledge and healthy attitudes at home. Facilitators and Barriers to Accessing SRH Information While inclusive education was recognized as a key facilitator, enabling many adolescents to access SRH information, significant barriers persist. A notable proportion of participants reported a lack of health facilities offering SRH services tailored to their needs, especially the absence of sign language interpretation—a critical gap that hinders effective communication and service utilization. Stigma and discrimination remain pervasive in communities, further limiting access and reinforcing social exclusion. These obstacles call for a multifaceted approach that combines inclusive educational policies, accessible health services, and community-level interventions to shift societal attitudes. In summary, despite encouraging levels of SRH knowledge facilitated by inclusive education and school environments, adolescents with hearing disabilities face notable challenges in accessing supportive services and overcoming stigma. Strengthening the roles of educators and peers, increasing parental engagement, improving service accessibility, and addressing societal barriers are vital steps toward empowering these adolescents to make informed SRH decisions. CONCLUSION AND RECOMMENDATIONS This study demonstrates that gender, age, and educational level significantly influence adolescents with hearing disabilities’ access to SRH information and experiences of stigma and discrimination. Females face greater challenges in accessing SRH information compared to males. Older adolescents and those in secondary schools experience more stigma and discrimination than their younger or primary-level peers, underscoring the need for targeted interventions. Addressing these intersecting factors requires gender-sensitive, inclusive education strategies and community engagement to challenge harmful perceptions of disability. Ensuring equitable access to SRH information and services, free from stigma and discrimination, is essential for promoting the health and rights of adolescents with hearing disabilities. Recommendations To the Ministry of Education: Implement gender-sensitive SRH education programs tailored to the needs of females with hearing disabilities to promote equitable information access. Foster inclusive educational environments, especially in secondary schools, that support students with disabilities and reduce stigma. To the Ministry of Health and Rwanda Biomedical Centre: 3. Launch community awareness campaigns and advocacy initiatives to challenge negative societal attitudes toward disability and promote inclusion. 4. Ensure SRH services are accessible, including provision of sign language interpretation, to facilitate equitable healthcare access regardless of age or education level. Declarations Acknowledgments This special acknowledgment goes to the Government of Rwanda for his support of my study. support of the Centre of Excellence for Biomedical Engineering and e-Health during the research. I also appreciate my supervisor Prof. Twizere Celestin and Dr. Kumurenzi Anne for his guidance in this study. Another special thanks is given to all SPH lecturers, and my heartfelt thanks go to Mr. Sangano Bertrand for her great contribution to the statistical analysis. Authors’ contributions UY contributed to the entire study from the beginning of the study to the writing of the manuscript. TC, KA and SB contributed to the review of the research proposal, data analysis and interpretation of the results. They also contributed to the review of the study manuscript. All the authors have agreed and approved the final manuscript for publication. Funding The study did not receive funding for manuscript publication. However, it is prepared from a master’s dissertation that was conducted to fulfill the requirements of a master’s degree that was funded by the Centre of Excellence for Biomedical Engineering and e-Health, College of Medicine and Health Sciences, University of Rwanda. Ethics approval and consent to participate This study was approved by the University of Rwanda College of Medicine and Health Science Institution Review Board (UR-CMHS-IRB) (reference number: CMHS/IRB/508/2023). GROUPE SCOLAIRE HVP GATAGARA HUYE and GROUPE SCOLAIRE HVP GATAGARA.NYANZA The participants were informed about the study, including that participation was voluntary and that they had the right to withdraw at any time. The participants were duly informed that there are no associated risks or harm related to their involvement in the study, that they possess the option to engage in the study voluntarily and that all information submitted would be maintained privately and confidentially. Furthermore, all participants provided written informed consent for their participation. Data availability The data used and analyzed during the study are available from the corresponding author upon reasonable request. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Author details School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda. References Janighorban M, Boroumandfar Z, Pourkazemi R, Mostafavi F. Barriers to vulnerable adolescent girls ’ access to sexual and reproductive health. BMC Public Health [Internet]. 2022;1–16. Available from: https://doi.org/10.1186/s12889-022-14687-4 Denno DM, H MP, Hoopes AJ, D M, Chandra-mouli V, Sc M. Effective Strategies to Provide Adolescent Sexual and Reproductive Health Services and to Increase Demand and Community Support. J Adolesc Heal [Internet]. 2015;56(1):S22–41. Available from: http://dx.doi.org/10.1016/j.jadohealth.2014.09.012 Mbarushimana V, Conco DN, Goldstein S. “ Such conversations are not had in the families ”: a qualitative study of the determinants of young adolescents ’ access to sexual and reproductive health and rights information in Rwanda. BMC Public Health [Internet]. 2022;1–14. Available from: https://doi.org/10.1186/s12889-022-14256-9 Kassa TA, Luck T, Bekele A, Riedel-Heller SG. Sexual and reproductive health of young people with disability in Ethiopia: A study on knowledge, attitude and practice: A cross-sectional study. Global Health [Internet]. 2016;12(1):1–11. Available from: http://dx.doi.org/10.1186/s12992-016-0142-3 Access O. with disabilities. 2019;8688:1–11. Kwadwo Mprah W. Perceptions about barriers to sexual and reproductive health information and services among deaf people in Ghana. Asia Pacific Disabil Rehabil J. 2013;24(3):21–36. Ndayishimiye P, Uwase R, Kubwimana I, De J, Niyonzima C, Dine RD, et al. Availability , accessibility , and quality of adolescent Sexual and Reproductive Health ( SRH ) services in urban health facilities of Rwanda : a survey among social and healthcare providers. 2020;0:1–11. Soule O, Sonko D. Examining access to sexual and reproductive health services and information for young women with disabilities in Senegal : a qualitative study Examining access to sexual and reproductive health services and qualitative study. 2022; Available from: https://doi.org/10.1080/26410397.2022.2105965 I. Introduction. 2009;(October):1–21. Survey H. Rwanda. 2019. Mji G, Braathen SH, Vergunst R, Scheffler E, Kritzinger J, Mannan H, et al. Exploring the interaction of activity limitations with context , systems , community and personal factors in accessing public health care services : A presentation of South African case studies. 2017;1–9. Ndayishimiye P, Dine RD, Dukuze A, Kubwimana I, Nyandwi JB, Biracyaza E. Perceptions and barriers toward sexual reproductive health services accessibility, availability and quality among adolescents in selected cities of Rwanda. 2020;1–23. Cressey S, Gupta R, Li M, Palavajjhala R. Policy brief Policy: Adolescent pregancy and sexual reproductive health and rights in Rwanda. Gend Adolesc Glob Evid [Internet]. 2020;1(2):16. Available from: https://www.gage.odi.org/wp-content/uploads/2020/08/Adolescent-pregnancy-and-sexual-reproductive-health-and-rights-in-Rwanda.pdf Abbott P, Rwirahira J, Mugisha R, Mutesi L, Tuyishime C, Vuningoma L. Lifestyle and Sexual and Reproductive Health in Rwanda : Findings from a Purposive Qualitative Study Lifestyle and Sexual and Reproductive Health in Rwanda : Findings from a Purposive Qualitative Study Pamela Abbott , John Rwirahira , Roger Mugisha , Lill. 2014;(May). Coast E, Jones N, Francoise UM, Yadete W, Isimbi R, Gezahegne K, et al. Adolescent Sexual and Reproductive Health in Ethiopia and Rwanda: A Qualitative Exploration of the Role of Social Norms. SAGE Open. 2019;9(1). Schulze M. Understanding The UN Convention On The Rights Of Persons With Disabilities. 2010. Id HC, Baumann A, Ogba P, Banfield L, Diliberto D. PLOS GLOBAL PUBLIC HEALTH Exploring adolescent engagement in sexual and reproductive health research in Kenya , Rwanda , Tanzania , and Uganda : A scoping review. 2022;1–13. Available from: http://dx.doi.org/10.1371/journal.pgph.0000208 Carroll A. World report on disability. Ir Med J. 2012;105(5). National T, Centre R, Education I, Support W, United T, Population N, et al. Knowledge , Attitudes and Practices ( KAP ) Study on the Sexual and Reproductive Health Of Hearing Impaired Adolescents And Adults in Belize. Nkurikiye JB. Sexual and Reproductive Health Among Rural Adolescents in Kamonyi District, Southern Province of Rwanda. SSRN Electron J. 2020;2010. Etikan I. Sampling and Sampling Methods. Biometrics Biostat Int J. 2017;5(6):215–7. Cleland J, Ingham R, Stone N, Cleland J. Asking young people about sexual and reproductive behaviours : Illustrative Core Instruments. 2001; Ydo Y. Inclusive education: Global priority, collective responsibility. Prospects [Internet]. 2020;49(3–4):97–101. Available from: https://doi.org/10.1007/s11125-020-09520-y WHO Recommendations On Adolescent Sexual and Reproductive Health and Rights. 2018. Who E. Executive summary. 2023;8–15. Report GEM, Monitoring GE, Education G, Report M, South G, Report TGEM, et al. GEM Report summary on disabilities and education Most countries have committed to protect the right to education for people with disabilities , which offers a basis for accountability Monitoring compliance of the right to education for people with disabil. 2020; Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 27 Jan, 2026 Reviews received at journal 27 Jan, 2026 Reviewers agreed at journal 27 Jan, 2026 Reviewers agreed at journal 16 Jan, 2026 Reviewers agreed at journal 16 Jan, 2026 Editor invited by journal 01 Dec, 2025 Reviewers invited by journal 12 Nov, 2025 Editor assigned by journal 29 Oct, 2025 Submission checks completed at journal 29 Oct, 2025 First submitted to journal 09 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7814335","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":549101321,"identity":"24a61ebe-71c1-4189-a428-a417a020cdce","order_by":0,"name":"Uwera Yvonne","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/ElEQVRIiWNgGAWjYFAD9saGw38qgAxm5gYitfAcPniA5wxICyOxWiTSkg/wtoFYBLQY3Eg+Js1TcSePnyHH4IDkvNpo/naglh8V2/BoSUuT5jnzrFiy4YzBAcNtx3NnHGZsYOw5cxu3lts5ZpIz2w4nbjjYY3Agcdux3AagFmbGNnxa8r+Btew/zGNw4OCcY7nzCWvJYZP4CLKFjS3hYGNDTe4GQlok7z8ztvhw5nDijDPMBw4zHDuQuxGo5SA+v/CdOfzwRkLF4cT++Q+bPzPU1OXOO3/44IMfFbi1AAGLBBLnMJg8gE89EDB/QOLUEVA8CkbBKBgFIxEAAIPQaEwj2ILyAAAAAElFTkSuQmCC","orcid":"","institution":"University of Rwanda","correspondingAuthor":true,"prefix":"","firstName":"Uwera","middleName":"","lastName":"Yvonne","suffix":""},{"id":549101322,"identity":"88f0e09d-28ed-4b8c-a5b5-657fe9277178","order_by":1,"name":"Twizere Celestin","email":"","orcid":"","institution":"University of Rwanda","correspondingAuthor":false,"prefix":"","firstName":"Twizere","middleName":"","lastName":"Celestin","suffix":""},{"id":549101323,"identity":"e38cd94e-68d5-4efa-9896-12b04e6793b0","order_by":2,"name":"Anne Kumurenzi","email":"","orcid":"","institution":"University of Rwanda","correspondingAuthor":false,"prefix":"","firstName":"Anne","middleName":"","lastName":"Kumurenzi","suffix":""},{"id":549101324,"identity":"a488adf3-d06b-4a18-bf08-c21a1699c25f","order_by":3,"name":"Sangano Bertrand","email":"","orcid":"","institution":"University of Rwanda","correspondingAuthor":false,"prefix":"","firstName":"Sangano","middleName":"","lastName":"Bertrand","suffix":""}],"badges":[],"createdAt":"2025-10-09 07:38:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7814335/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7814335/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":96612359,"identity":"3c99dfb4-219b-4849-9ee7-5bbb0c62ce04","added_by":"auto","created_at":"2025-11-24 09:39:10","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":55106,"visible":true,"origin":"","legend":"","description":"","filename":"ACCESSTOSEXUALANDREPRODUCTIVEHEALTHINFORMATIONAMONGADOLESCENTSWITHHEARINGDISABILITIESINRWANDAV.4.docx","url":"https://assets-eu.researchsquare.com/files/rs-7814335/v1/f5b44164c642c747d26dcdf6.docx"},{"id":96612356,"identity":"c745a438-d633-4f58-9abd-fa032b323a6d","added_by":"auto","created_at":"2025-11-24 09:39:10","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":7652,"visible":true,"origin":"","legend":"","description":"","filename":"b158f9b68260409fadcc6266f4ae2377.json","url":"https://assets-eu.researchsquare.com/files/rs-7814335/v1/428e2351d6e9a9f52c9dd6bf.json"},{"id":96708154,"identity":"cc95ad89-6bdd-457a-93a9-de4a362df744","added_by":"auto","created_at":"2025-11-25 09:58:17","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":106899,"visible":true,"origin":"","legend":"","description":"","filename":"b158f9b68260409fadcc6266f4ae23771enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7814335/v1/8b48c6fcaa4b5658a5826ba9.xml"},{"id":96612363,"identity":"818627f2-4eb9-4613-b5ac-8f98de333e6a","added_by":"auto","created_at":"2025-11-24 09:39:10","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":101896,"visible":true,"origin":"","legend":"","description":"","filename":"b158f9b68260409fadcc6266f4ae23771structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7814335/v1/29b53150eb237f2b52bd1ee8.xml"},{"id":96612357,"identity":"d08a6b0f-8592-40a1-b4dc-0d7d3456399b","added_by":"auto","created_at":"2025-11-24 09:39:10","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":114524,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7814335/v1/88b198561c1f10c8017b61d3.html"},{"id":97135900,"identity":"809f0721-f5d9-4f04-a48b-49c71953efe0","added_by":"auto","created_at":"2025-12-01 09:54:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1776085,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7814335/v1/aab12ced-42da-46c2-b8b3-10cf935e4160.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eAccess to Sexual and Reproductive Health Information Among Adolescents With Hearing Disabilities in Rwanda\u003c/p\u003e","fulltext":[{"header":"CHAPTER 1: INTRODUCTION","content":"\u003cp\u003eAdolescents, defined as individuals aged 10 to 19, are a priority population in sexual and reproductive health (SRH) programs due to their increased vulnerability to adverse health outcomes (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Unprotected sexual activity among adolescents is associated with unintended pregnancies, unsafe abortions, HIV and other sexually transmitted infections (STIs), infertility, gender-based violence, and long-term sexual health complications (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Globally, over 10\u0026nbsp;million unintended pregnancies occur each year among adolescent girls aged 15\u0026ndash;19 in low-income countries(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). In addition, adolescents account for 41% of new HIV infections in individuals aged 15 and above, with over 800,000 new infections recorded annually 79% of which occur in sub-Saharan Africa (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDespite significant efforts in Rwanda to educate young people about SRH, adolescent sexual health outcomes remain concerning. For instance, five percent of girls and 10% of boys report initiating sexual activity before the age of 15, and teenage pregnancies among school-aged girls remain a major national issue (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Several structural and systemic barriers continue to hinder the effective implementation of SRH strategies for adolescents, particularly girls. These include insufficient SRH education, inadequate access to youth-friendly services, lack of autonomy in reproductive decision-making, and pervasive gender inequality (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). In many low-income settings, SRH services are not tailored to the specific needs of adolescents but are instead designed for married adult women. This mismatch leaves adolescents especially those in vulnerable groups underserved and at risk (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAdolescents with disabilities face even greater challenges. They are more likely to encounter social exclusion, stigma, and discrimination, and have fewer opportunities to access information or services that are essential to their sexual health and rights. Young persons with disabilities (YPWD), including those with hearing impairments, often lack access to SRH information due to physical inaccessibility of clinics, lack of materials adapted for visual or hearing impairments, and healthcare providers\u0026rsquo; limited capacity to communicate using sign language (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Societal misconceptions frequently portray individuals with disabilities as asexual or incapable of engaging in intimate relationships, which further justifies the exclusion of these populations from comprehensive sexuality education. Consequently, many adolescents with disabilities are denied the right to accurate, timely, and inclusive SRH information (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis marginalization exacerbates their vulnerability to sexual abuse, STIs, unintended pregnancies, and school dropout. Adolescents with hearing disabilities are particularly at risk due to barriers in both formal education and informal peer communication (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). The limited availability of youth- and disability-friendly SRH materials and services deepens these disparities. Although Rwanda has established supportive frameworks, including youth-friendly corners in schools and health facilities, and national SRH policies, the specific experiences of adolescents with disabilities especially those who are hearing-impaired remain largely undocumented. This lack of disaggregated data contributes to their continued exclusion from programming and policy development (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eWhile the global development agenda emphasizes universal access to SRH information, there is limited empirical evidence on how adolescents with hearing disabilities in low- and middle-income countries access such information (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). In Rwanda, research in this area is scarce. Yet, evidence indicates that access to SRH information is essential to improving knowledge, informed decision-making, and positive sexual health outcomes among adolescents (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Understanding the extent to which adolescents with hearing disabilities can access SRH information and identifying the barriers and facilitators that shape this access is critical to designing inclusive, equitable, and effective health interventions (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis study therefore aims to investigate the determinants of access to sexual and reproductive health information among adolescents with hearing disabilities in Rwanda. It seeks to quantify access levels, explore enabling and limiting factors, and generate evidence to inform more inclusive health education strategies. The findings are expected to support policymakers, educators, and healthcare providers in addressing the unique SRH needs of adolescents with hearing disabilities and promote more equitable health outcomes within this marginalized population.\u003c/p\u003e"},{"header":"CHAPTER 2: METHODOLOGY","content":"\u003cp\u003eThis study was conducted among adolescents with hearing disabilities enrolled at HVP Gatagara schools in Rwanda during the 2023/2024 academic year. HVP Gatagara, with campuses in Nyanza and Huye districts, is a well-established institution offering inclusive education to children and adolescents with various disabilities, including hearing impairments. The schools were selected due to their long-standing role in supporting learners with disabilities from diverse regions across the country.\u003c/p\u003e\n\u003cp\u003eA cross-sectional quantitative design was employed to explore the factors influencing access to sexual and reproductive health (SRH) information among adolescents with hearing disabilities. Given the relatively small and defined population of eligible students, a census approach was used, enabling the inclusion of all qualifying participants to maximize precision and representativeness.\u003c/p\u003e\n\u003cp\u003eParticipants were adolescents aged 10 to 19 years with documented hearing disabilities. Both male and female students were included, provided that parental consent was obtained for minors, or that the participants themselves gave informed consent if aged 18 or older. Students who had ever been pregnant or given birth were excluded to minimize bias, as they may have had prior exposure to SRH services through antenatal and postnatal care.\u003c/p\u003e\n\u003cp\u003eData collection took place in April 2024 following ethical clearance from the Institutional Review Board of the University of Rwanda. School administrators granted formal authorization after reviewing the study protocol. Prior to data collection, the study\u0026rsquo;s objectives, procedures, and voluntary nature were explained to participants in accessible formats, including through sign language interpretation. Questionnaires were distributed directly to the students, who completed them independently. An educator proficient in sign language supported the communication process as needed.\u003c/p\u003e\n\u003cp\u003eThe primary data collection instrument was a standardized SRH questionnaire adapted from the World Health Organization\u0026rsquo;s Sample Core Instrument, modified based on a pilot test conducted two weeks prior to the main study. This pilot study, involving five participants at a comparable institution (Centre des Jeunes Sourd-Muets), allowed for refinement of the questionnaire to improve clarity and relevance particularly in questions related to communication with healthcare providers.\u003c/p\u003e\n\u003cp\u003eThroughout the data collection process, all questionnaires were reviewed daily for completeness and accuracy. Data were entered and analyzed using STATA software. Descriptive statistics, including frequencies and cross-tabulations, were generated to summarize demographic characteristics and levels of SRH information access. Binary logistic regression was performed to identify associations between sociodemographic variables and access to SRH information.\u003c/p\u003e\n\u003cp\u003eEthical considerations were strictly observed. Participation was voluntary, and all students were informed of their right to withdraw at any time without any negative consequences. To maintain confidentiality, responses were anonymized using coded identifiers. No risks were posed to participants, and no financial or material compensation was provided. Study results will be shared with participating schools to inform future programming and policy development in inclusive SRH education.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026ldquo;The study was conducted in accordance with the Declaration of Helsinki.\u0026rdquo;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u003c/strong\u003e Not applicable.\u003c/p\u003e"},{"header":"CHAPTER 3: RESULTS INTERPRETATION AND ANALYSIS","content":"\u003cp\u003eThis chapter presents the findings of the study using descriptive statistics, including frequencies and percentages. Results are displayed through tables and figures to facilitate interpretation. All 37 eligible participants completed the questionnaire, yielding a 100% response rate.\u003c/p\u003e\n\u003ch3\u003e3.1. Socio-Demographic Characteristics\u003c/h3\u003e\n\u003cp\u003eTable 3.1 summarizes the socio-demographic characteristics of the participants. Slightly more than half were male (51.35%). The majority were aged over 16 years (56.76%), and nearly all participants (97.30%) reported the ability to read. Most were enrolled at the secondary school level (78.38%). In terms of school site, 81.08% of participants were recruited from HVP Gatagara Nyanza (both primary and secondary levels), while the remaining 18.92% were from the Huye campus, all attending secondary school. Regarding religious affiliation, a significant proportion identified as Protestant (48.65%)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.1 Socio-demographic characteristics of respondents\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 338px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVARIABLE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFREQUENCY (N=37)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePERCENTAGES (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 338px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender of respondent\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e51.35\u003c/p\u003e\n \u003cp\u003e48.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 338px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge categories\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026gt;=14\u003c/p\u003e\n \u003cp\u003eBetween 15-17 Years old\u003c/p\u003e\n \u003cp\u003eAbove 17 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e18.92\u003c/p\u003e\n \u003cp\u003e51.35\u003c/p\u003e\n \u003cp\u003e29.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 338px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReading capacity\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.70\u003c/p\u003e\n \u003cp\u003e97.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 338px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003cp\u003eTechnical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e21.62\u003c/p\u003e\n \u003cp\u003e78.38\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 338px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSchools\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eHVP-Nyanza\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eHVP-Huye\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e81.08\u003c/p\u003e\n \u003cp\u003e18.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 338px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eCatholic\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eProtestant\u003c/p\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e35.14\u003c/p\u003e\n \u003cp\u003e48.65\u003c/p\u003e\n \u003cp\u003e5.41\u003c/p\u003e\n \u003cp\u003e10.81\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 338px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eImportance of religion\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eVery important\u003c/p\u003e\n \u003cp\u003eImportant\u003c/p\u003e\n \u003cp\u003eNot important\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e67.57\u003c/p\u003e\n \u003cp\u003e32.43\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch3\u003e3.2. Parental Presence and Communication\u003c/h3\u003e\n\u003cp\u003eAs table 3.2. shows most participants reported that their parents were present in their lives, with 81.08% indicating the presence of their fathers and 91.89% reporting the presence of their mothers. However, communication about sex-related matters remained limited. Only 35.14% of participants felt comfortable discussing such topics with their fathers, and 45.95% with their mothers, highlighting a gap between parental presence and open dialogue on sexual and reproductive health\u003c/p\u003e\n\u003cp\u003eTable 3.2. Parental Presence and Communication\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFather alive\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e81.08\u003c/p\u003e\n \u003cp\u003e18.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFather live in a same household\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e72.97\u003c/p\u003e\n \u003cp\u003e27.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTalk with your father about things that are important\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eVery difficult\u003c/p\u003e\n \u003cp\u003eDifficult\u003c/p\u003e\n \u003cp\u003eEasy\u003c/p\u003e\n \u003cp\u003eVery easy\u003c/p\u003e\n \u003cp\u003eI do not see him\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8.11\u003c/p\u003e\n \u003cp\u003e18.92\u003c/p\u003e\n \u003cp\u003e21.62\u003c/p\u003e\n \u003cp\u003e29.73\u003c/p\u003e\n \u003cp\u003e21.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver discussed about sex related matters with your father\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e35.14\u003c/p\u003e\n \u003cp\u003e64.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIf yes,\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eOften\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eOccasionally\u003c/p\u003e\n \u003cp\u003eRarely\u003c/p\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e16.22\u003c/p\u003e\n \u003cp\u003e8.11\u003c/p\u003e\n \u003cp\u003e10.81\u003c/p\u003e\n \u003cp\u003e64.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother alive\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e91.89\u003c/p\u003e\n \u003cp\u003e8.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother live in a same household\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e89.19\u003c/p\u003e\n \u003cp\u003e10.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTalk with your mother about things that are important\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eVery difficult\u003c/p\u003e\n \u003cp\u003eDifficult\u003c/p\u003e\n \u003cp\u003eAverage\u003c/p\u003e\n \u003cp\u003eEasy\u003c/p\u003e\n \u003cp\u003eVery easy\u003c/p\u003e\n \u003cp\u003eI do not see her\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5.41\u003c/p\u003e\n \u003cp\u003e18.92\u003c/p\u003e\n \u003cp\u003e2.70\u003c/p\u003e\n \u003cp\u003e24.32\u003c/p\u003e\n \u003cp\u003e40.54\u003c/p\u003e\n \u003cp\u003e8.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver discussed about sex related matters with your\u003c/strong\u003e mother\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e45.95\u003c/p\u003e\n \u003cp\u003e54.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIf yes,\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eOften\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eOccasionally\u003c/p\u003e\n \u003cp\u003eRarely\u003c/p\u003e\n \u003cp\u003eN/A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e27.03\u003c/p\u003e\n \u003cp\u003e13.51\u003c/p\u003e\n \u003cp\u003e5.41\u003c/p\u003e\n \u003cp\u003e54.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003e3.3. Knowledge of SRH Information and Services\u003c/h3\u003e\n\u003cp\u003eAs shown in Table 3.3, the majority of participants demonstrated a high level of awareness regarding key sexual and reproductive health topics. Nearly all participants (97.3%) reported knowledge of puberty, and 91.89% were familiar with the sexual and reproductive system. Similarly, 97.3% were informed about HIV/AIDS, while 70.27% had awareness of other sexually transmitted infections.\u003c/p\u003e\n\u003cp\u003eWhen asked about preventive measures, 81.08% identified condoms as a method of protection against HIV, STIs, and pregnancy. Additionally, 62.16% reported knowing how to prevent pregnancy, and an equal proportion were aware of where young people can access contraceptive methods. Although 59.46% of participants knew that SRH services are available at health facilities, only 32.43% indicated that they had personal access to a health facility offering youth-friendly SRH services.\u003c/p\u003e\n\u003ch3\u003eTable 3.3. Knowledge of SRH Information and Services\u003c/h3\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVARIABLE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFREQUENCY (N)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePERCENTAGES (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eKnowledge on \u003cstrong\u003epuberty\u003c/strong\u003e.\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e97.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eKnowledge on \u003cstrong\u003esexual and reproductive systems of men and women\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e91.89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e8.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eKnowledge on HIV/AIDS\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e97.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e2.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eKnowledge on other sexual transmitted diseases?\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e70.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e29.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eKnowledge on condoms as a protective measure\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e81.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e18.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eKnowledge on contraceptive methods for pregnancy\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e62.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e37.84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eKnowledge on a place to obtain contraceptive methods?\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e62.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e37.84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eKnowledge on where to receive services and information about contraception, pregnancy, abortion, sexual transmitted infections?\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e59.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e40.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eAccess to health facility that offer sexual and reproductive health services?\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e32.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 366px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e67.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch3\u003e3.5. Sources of SRH Information\u003c/h3\u003e\n\u003cp\u003eAs presented in Table 3.4, the primary source of sexual and reproductive health (SRH) information for participants was schoolteachers, cited by an average of 49.90% of respondents. In contrast, mass media was the least common source, mentioned by only 6.90% of participants. These findings highlight the central role of schools\u0026mdash;and particularly teachers\u0026mdash;in delivering SRH education to adolescents with hearing disabilities.\u003c/p\u003e\n\u003cp\u003eTable 3.4. Sources of SRH Information\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"750\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSource of Information/ SRH related Knowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003cstrong\u003epuberty pattern\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003esexual and reproductive\u0026nbsp;\u003cbr\u003e\u0026nbsp;systems\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHIV/AIDS like mode of\u0026nbsp;\u003cbr\u003e\u0026nbsp;transmission, treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eother sexual transmitted\u003cbr\u003e\u0026nbsp; diseases\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003econdoms are effective way\u003cbr\u003e\u0026nbsp; of protecting against\u003cbr\u003e\u0026nbsp; HIV, STI \u0026nbsp;and pregnancy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003econtraceptive\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eplace or person from\u003cbr\u003e\u0026nbsp; where young people could\u0026nbsp;\u003cbr\u003e\u0026nbsp;obtain contraceptive methods\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ehealth facility, youth can\u003cbr\u003e\u0026nbsp; receive services and information\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eaccess to health facility\u0026nbsp;\u003cbr\u003e\u0026nbsp;that offer sexual and\u003cbr\u003e\u0026nbsp; reproductive health services.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAverage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSchool Teacher\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e59.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e62.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e59.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e48.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e59.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e45.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e49.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e40.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e24.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e49.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFather\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e21.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e43.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e40.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e35.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e16.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e16.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e24.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBrother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e35.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e24.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e15.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSister\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e24.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e16.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther Family member\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e24.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e16.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e16.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e14.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFriends\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e70.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e56.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e59.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e43.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e59.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e48.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e35.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e43.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e48.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDoctor/Nurse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e32.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e35.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e24.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e26.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBooks/Magazine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e24.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e21.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e19.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFilms/Videos\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTelevision\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e32.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e21.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e21.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e16.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e10.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e17.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRadio\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMass Media\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN/A\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 42px;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003e8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e37.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e37.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e40.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e67.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e27.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ch3\u003e3.5. Facilitators of Access to SRH Information\u003c/h3\u003e\n\u003cp\u003eAs shown in Table 3.5, all participants reported having access to at least one source of SRH information. Inclusive education emerged as the most significant facilitator, with 81.08% of participants indicating that being in an inclusive school environment enhanced their access to sexual and reproductive health information. This underscores the importance of inclusive educational settings in promoting equitable access to SRH knowledge among adolescents with hearing disabilities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.5:\u003c/strong\u003e Sources of sexual and reproductive health information among adolescents with hearing disabilities.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 347px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVARIABLE\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFREQUENCY (N=37)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePERCENTAGES (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 347px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAccess to sources of information\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 347px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 347px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAccess to health facilities with SRH services\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e51.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 347px;\"\u003e\n \u003cp\u003eNO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e48.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 347px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInclusive education\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e81.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 347px;\"\u003e\n \u003cp\u003eNO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e18.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 347px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvailable communication technics with health professionals\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e35.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 347px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e64.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch2 id=\"_Toc168946908\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/h2\u003e\n\u003ch2\u003e\u003cstrong\u003e3.6. Barriers to access SRH information\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eAs shown in \u003cstrong\u003eTable 3.6\u003c/strong\u003e, most participants reported limited access to SRH materials and also it shows that absence of sign language among health professionals is a barrier at 83.78%.\u003c/p\u003e\n\u003cp\u003eTable 3.6 Barriers to access SRH information\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 371px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVARIABLE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFREQUENCY (N)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePERCENTAGE (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 371px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo sign language among health professionals\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e83.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 371px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e16.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 371px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExclusive education\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e81.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 371px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e18.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 371px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo available health facilities with SRH services for persons with disabilities\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e56.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 371px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e43.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 371px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStigma and discrimination in the community\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e67.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 371px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e37.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch3\u003e3.7. Bivariate Analysis of Socio-Demographic Factors and Access to SRH Information\u003c/h3\u003e\n\u003cp\u003eTable 3.7 presents the bivariate analysis examining the relationship between socio-demographic characteristics and limitations in accessing SRH information sources. Among all variables assessed, only gender was significantly associated with access to SRH information (p = 0.030). Notably, all male participants reported no limitations in accessing SRH-related information, highlighting a gender disparity. Other factors, including age, educational level, religion, and parental status at the time of data collection, showed no statistically significant association with access to SRH information.\u003c/p\u003e\n\u003ch3\u003eTable 3.7.\u0026nbsp;Bivariate Analysis of Socio-Demographic Factors and Access to SRH Information\u003c/h3\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e4 (22.22)\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e14 (77.78)\u003c/p\u003e\n \u003cp\u003e19 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eAge categories\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eLess 14\u003c/p\u003e\n \u003cp\u003eBetween 15-17\u003c/p\u003e\n \u003cp\u003e18 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e3(15.79)\u003c/p\u003e\n \u003cp\u003e1(9.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7(100)\u003c/p\u003e\n \u003cp\u003e16(84.21)\u003c/p\u003e\n \u003cp\u003e10(90.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0.504\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eEducation Level\u003c/p\u003e\n \u003cp\u003ePrimary\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003cp\u003eTechnical\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e4(13.79)\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8(100)\u003c/p\u003e\n \u003cp\u003e25(86.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0.266\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003eReligion\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCatholic\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003cp\u003eProtestants\u003c/p\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1 (7.69)\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e3 (16.67)\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e12 (92.31)\u003c/p\u003e\n \u003cp\u003e2 (100)\u003c/p\u003e\n \u003cp\u003e15 (83.33)\u003c/p\u003e\n \u003cp\u003e4 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0.683\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch3\u003e3.8. Bivariate Analysis of Socio-Demographic Characteristics and Experience of Stigma\u003c/h3\u003e\n\u003cp\u003eTable 3.8 illustrates the relationship between socio-demographic factors and experiences of stigma and discrimination among adolescents with hearing disabilities. Age was significantly associated with stigma (p = 0.047), with younger adolescents (under 14 years) reporting fewer instances of stigmatization compared to those aged 15 years and above. Educational level was also a significant factor (p = 0.004); adolescents attending secondary school reported higher levels of community stigma and discrimination than those in primary school.\u003c/p\u003e\n\u003cp\u003eTable 3.8. Bivariate Analysis of Socio-Demographic Characteristics and Experience of Stigma\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eGender\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13 (72.22)\u003c/p\u003e\n \u003cp\u003e12 (63.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5 (27.78)\u003c/p\u003e\n \u003cp\u003e7 (36.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e0.556\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eAge categories\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eLess 14\u003c/p\u003e\n \u003cp\u003eBetween 15-17\u003c/p\u003e\n \u003cp\u003e18 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2(28.57)\u003c/p\u003e\n \u003cp\u003e15(78.95)\u003c/p\u003e\n \u003cp\u003e8(72.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5(71.43)\u003c/p\u003e\n \u003cp\u003e4(21.05)\u003c/p\u003e\n \u003cp\u003e3(27.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eEducation Level\u003c/p\u003e\n \u003cp\u003ePrimary\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003cp\u003eTechnical\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2(25)\u003c/p\u003e\n \u003cp\u003e23(79.31)\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6(75)\u003c/p\u003e\n \u003cp\u003e6(20.69)\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eReligion\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCatholic\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003cp\u003eProtestants\u003c/p\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e9(69.23)\u003c/p\u003e\n \u003cp\u003e2(100)\u003c/p\u003e\n \u003cp\u003e10(55.56)\u003c/p\u003e\n \u003cp\u003e4(100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e4(30.77)\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e8(44.44)\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e0.253\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eFather Alive\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5(71.43)\u003c/p\u003e\n \u003cp\u003e20 (66.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2(28.57)\u003c/p\u003e\n \u003cp\u003e10(33.33)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e0.809\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003eMather alive\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3(100)\u003c/p\u003e\n \u003cp\u003e22(64.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003cp\u003e12(35.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e0.211\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"CHAPTER 4: DISCUSSION","content":"\u003cp\u003eThis chapter interprets the study findings in relation to its objectives and existing literature, focusing on factors influencing access to sexual and reproductive health (SRH) information among adolescents with hearing disabilities in Rwanda, including facilitators and barriers.\u003c/p\u003e\n\u003ch3\u003eKnowledge about Sexual and Reproductive Health Information and Services\u003c/h3\u003e\n\u003cp\u003eThe study reveals a generally good level of knowledge among participants regarding puberty, the reproductive system, HIV/AIDS, and condom use, reflecting the positive impact of comprehensive sexuality education programs. However, awareness of other sexually transmitted infections (STIs) and pregnancy prevention methods was less widespread, indicating gaps in the breadth of SRH education. Despite familiarity with contraception and service locations, many adolescents reported limited access to youth-friendly SRH services, highlighting a disconnect between knowledge and practical accessibility.\u003c/p\u003e\n\u003cp\u003eAge and educational level were significantly associated with experiences of stigma and discrimination, with older adolescents (15 years and above) and those in secondary school facing greater social barriers. Gender also influenced access to SRH information, as male participants reported fewer limitations than females. These findings suggest that stigma and discrimination increase with age and educational progression, which may impede equitable access to SRH information and services.\u003c/p\u003e\n\u003cp\u003eThis disparity underscores the need not only for expanded and inclusive SRH education but also for improved accessibility and acceptability of health services that accommodate adolescents\u0026rsquo; unique needs. Interventions must address systemic barriers to enable adolescents to translate knowledge into healthy behaviors and service utilization.\u003c/p\u003e\n\u003ch3\u003eSources of Sexual and Reproductive Health Information\u003c/h3\u003e\n\u003cp\u003eTeachers and peers emerged as the primary sources of SRH information for adolescents with hearing disabilities, while parental involvement was minimal. This aligns with other research emphasizing the critical roles educators and peers play in disseminating SRH information, especially for young people with disabilities. Communication challenges and cultural taboos likely contribute to parents\u0026rsquo; limited engagement in these discussions.\u003c/p\u003e\n\u003cp\u003eThese findings highlight the importance of strengthening inclusive school-based SRH education and training educators to deliver accessible, disability-sensitive content. Additionally, fostering open communication between parents and their children with hearing disabilities is essential to support comprehensive SRH knowledge and healthy attitudes at home.\u003c/p\u003e\n\u003ch3\u003eFacilitators and Barriers to Accessing SRH Information\u003c/h3\u003e\n\u003cp\u003eWhile inclusive education was recognized as a key facilitator, enabling many adolescents to access SRH information, significant barriers persist. A notable proportion of participants reported a lack of health facilities offering SRH services tailored to their needs, especially the absence of sign language interpretation\u0026mdash;a critical gap that hinders effective communication and service utilization.\u003c/p\u003e\n\u003cp\u003eStigma and discrimination remain pervasive in communities, further limiting access and reinforcing social exclusion. These obstacles call for a multifaceted approach that combines inclusive educational policies, accessible health services, and community-level interventions to shift societal attitudes.\u003c/p\u003e\n\u003cp\u003eIn summary, despite encouraging levels of SRH knowledge facilitated by inclusive education and school environments, adolescents with hearing disabilities face notable challenges in accessing supportive services and overcoming stigma. Strengthening the roles of educators and peers, increasing parental engagement, improving service accessibility, and addressing societal barriers are vital steps toward empowering these adolescents to make informed SRH decisions.\u003c/p\u003e"},{"header":"CONCLUSION AND RECOMMENDATIONS","content":"\u003cp\u003eThis study demonstrates that gender, age, and educational level significantly influence adolescents with hearing disabilities\u0026rsquo; access to SRH information and experiences of stigma and discrimination. Females face greater challenges in accessing SRH information compared to males. Older adolescents and those in secondary schools experience more stigma and discrimination than their younger or primary-level peers, underscoring the need for targeted interventions.\u003c/p\u003e\n\u003cp\u003eAddressing these intersecting factors requires gender-sensitive, inclusive education strategies and community engagement to challenge harmful perceptions of disability. Ensuring equitable access to SRH information and services, free from stigma and discrimination, is essential for promoting the health and rights of adolescents with hearing disabilities.\u003c/p\u003e\n\u003ch3\u003eRecommendations\u003c/h3\u003e\n\u003cp\u003e\u003cstrong\u003eTo the Ministry of Education:\u003c/strong\u003e\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eImplement gender-sensitive SRH education programs tailored to the needs of females with hearing disabilities to promote equitable information access.\u003c/li\u003e\n \u003cli\u003eFoster inclusive educational environments, especially in secondary schools, that support students with disabilities and reduce stigma.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eTo the Ministry of Health and Rwanda Biomedical Centre:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;3. Launch community awareness campaigns and advocacy initiatives to challenge negative societal attitudes toward disability and promote inclusion.\u003cbr\u003e\u0026nbsp;4. Ensure SRH services are accessible, including provision of sign language interpretation, to facilitate equitable healthcare access regardless of age or education level.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis special acknowledgment goes to the Government of Rwanda for his support of my study. support of the Centre of Excellence for Biomedical Engineering and e-Health during the research. I also appreciate my supervisor Prof. Twizere Celestin and Dr. Kumurenzi Anne for his guidance in this study. Another special thanks is given to all SPH lecturers, and my heartfelt thanks go to Mr. Sangano Bertrand for her great contribution to the statistical analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUY contributed to the entire study from the beginning of the study to the writing of the manuscript. TC, KA and SB contributed to the review of the research proposal, data analysis and interpretation of the results. They also contributed to the review of the study manuscript. All the authors have agreed and approved the final manuscript for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study did not receive funding for manuscript publication. However, it is prepared from a master\u0026rsquo;s dissertation that was conducted to fulfill the requirements of a master\u0026rsquo;s degree that was funded by the Centre of Excellence for Biomedical Engineering and e-Health, College of Medicine and Health Sciences, University of Rwanda.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the University of Rwanda College of Medicine and Health Science Institution Review Board (UR-CMHS-IRB) (reference number: CMHS/IRB/508/2023). GROUPE SCOLAIRE HVP GATAGARA HUYE and GROUPE SCOLAIRE HVP GATAGARA.NYANZA The participants were informed about the study, including that participation was voluntary and that they had the right to withdraw at any time. The participants were duly informed that there are no associated risks or harm related to their involvement in the study, that they possess the option to engage in the study voluntarily and that all information submitted would be maintained privately and confidentially. Furthermore, all participants provided written informed consent for their participation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data used and analyzed during the study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSchool of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eJanighorban M, Boroumandfar Z, Pourkazemi R, Mostafavi F. Barriers to vulnerable adolescent girls \u0026rsquo; access to sexual and reproductive health. BMC Public Health [Internet]. 2022;1\u0026ndash;16. Available from: https://doi.org/10.1186/s12889-022-14687-4\u003c/li\u003e\n\u003cli\u003eDenno DM, H MP, Hoopes AJ, D M, Chandra-mouli V, Sc M. Effective Strategies to Provide Adolescent Sexual and Reproductive Health Services and to Increase Demand and Community Support. J Adolesc Heal [Internet]. 2015;56(1):S22\u0026ndash;41. Available from: http://dx.doi.org/10.1016/j.jadohealth.2014.09.012\u003c/li\u003e\n\u003cli\u003eMbarushimana V, Conco DN, Goldstein S. \u0026ldquo; Such conversations are not had in the families \u0026rdquo;: a qualitative study of the determinants of young adolescents \u0026rsquo; access to sexual and reproductive health and rights information in Rwanda. BMC Public Health [Internet]. 2022;1\u0026ndash;14. Available from: https://doi.org/10.1186/s12889-022-14256-9\u003c/li\u003e\n\u003cli\u003eKassa TA, Luck T, Bekele A, Riedel-Heller SG. Sexual and reproductive health of young people with disability in Ethiopia: A study on knowledge, attitude and practice: A cross-sectional study. Global Health [Internet]. 2016;12(1):1\u0026ndash;11. Available from: http://dx.doi.org/10.1186/s12992-016-0142-3\u003c/li\u003e\n\u003cli\u003eAccess O. with disabilities. 2019;8688:1\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eKwadwo Mprah W. Perceptions about barriers to sexual and reproductive health information and services among deaf people in Ghana. Asia Pacific Disabil Rehabil J. 2013;24(3):21\u0026ndash;36. \u003c/li\u003e\n\u003cli\u003eNdayishimiye P, Uwase R, Kubwimana I, De J, Niyonzima C, Dine RD, et al. Availability , accessibility , and quality of adolescent Sexual and Reproductive Health ( SRH ) services in urban health facilities of Rwanda : a survey among social and healthcare providers. 2020;0:1\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eSoule O, Sonko D. Examining access to sexual and reproductive health services and information for young women with disabilities in Senegal : a qualitative study Examining access to sexual and reproductive health services and qualitative study. 2022; Available from: https://doi.org/10.1080/26410397.2022.2105965\u003c/li\u003e\n\u003cli\u003eI. Introduction. 2009;(October):1\u0026ndash;21. \u003c/li\u003e\n\u003cli\u003eSurvey H. Rwanda. 2019. \u003c/li\u003e\n\u003cli\u003eMji G, Braathen SH, Vergunst R, Scheffler E, Kritzinger J, Mannan H, et al. Exploring the interaction of activity limitations with context , systems , community and personal factors in accessing public health care services : A presentation of South African case studies. 2017;1\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eNdayishimiye P, Dine RD, Dukuze A, Kubwimana I, Nyandwi JB, Biracyaza E. Perceptions and barriers toward sexual reproductive health services accessibility, availability and quality among adolescents in selected cities of Rwanda. 2020;1\u0026ndash;23. \u003c/li\u003e\n\u003cli\u003eCressey S, Gupta R, Li M, Palavajjhala R. Policy brief Policy: Adolescent pregancy and sexual reproductive health and rights in Rwanda. Gend Adolesc Glob Evid [Internet]. 2020;1(2):16. Available from: https://www.gage.odi.org/wp-content/uploads/2020/08/Adolescent-pregnancy-and-sexual-reproductive-health-and-rights-in-Rwanda.pdf\u003c/li\u003e\n\u003cli\u003eAbbott P, Rwirahira J, Mugisha R, Mutesi L, Tuyishime C, Vuningoma L. Lifestyle and Sexual and Reproductive Health in Rwanda : Findings from a Purposive Qualitative Study Lifestyle and Sexual and Reproductive Health in Rwanda : Findings from a Purposive Qualitative Study Pamela Abbott , John Rwirahira , Roger Mugisha , Lill. 2014;(May). \u003c/li\u003e\n\u003cli\u003eCoast E, Jones N, Francoise UM, Yadete W, Isimbi R, Gezahegne K, et al. Adolescent Sexual and Reproductive Health in Ethiopia and Rwanda: A Qualitative Exploration of the Role of Social Norms. SAGE Open. 2019;9(1). \u003c/li\u003e\n\u003cli\u003eSchulze M. Understanding The UN Convention On The Rights Of Persons With Disabilities. 2010. \u003c/li\u003e\n\u003cli\u003eId HC, Baumann A, Ogba P, Banfield L, Diliberto D. PLOS GLOBAL PUBLIC HEALTH Exploring adolescent engagement in sexual and reproductive health research in Kenya , Rwanda , Tanzania , and Uganda : A scoping review. 2022;1\u0026ndash;13. Available from: http://dx.doi.org/10.1371/journal.pgph.0000208\u003c/li\u003e\n\u003cli\u003eCarroll A. World report on disability. Ir Med J. 2012;105(5). \u003c/li\u003e\n\u003cli\u003eNational T, Centre R, Education I, Support W, United T, Population N, et al. Knowledge , Attitudes and Practices ( KAP ) Study on the Sexual and Reproductive Health Of Hearing Impaired Adolescents And Adults in Belize. \u003c/li\u003e\n\u003cli\u003eNkurikiye JB. Sexual and Reproductive Health Among Rural Adolescents in Kamonyi District, Southern Province of Rwanda. SSRN Electron J. 2020;2010. \u003c/li\u003e\n\u003cli\u003eEtikan I. Sampling and Sampling Methods. Biometrics Biostat Int J. 2017;5(6):215\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eCleland J, Ingham R, Stone N, Cleland J. Asking young people about sexual and reproductive behaviours : Illustrative Core Instruments. 2001; \u003c/li\u003e\n\u003cli\u003eYdo Y. Inclusive education: Global priority, collective responsibility. Prospects [Internet]. 2020;49(3\u0026ndash;4):97\u0026ndash;101. Available from: https://doi.org/10.1007/s11125-020-09520-y\u003c/li\u003e\n\u003cli\u003eWHO Recommendations On Adolescent Sexual and Reproductive Health and Rights. 2018. \u003c/li\u003e\n\u003cli\u003eWho E. Executive summary. 2023;8\u0026ndash;15. \u003c/li\u003e\n\u003cli\u003eReport GEM, Monitoring GE, Education G, Report M, South G, Report TGEM, et al. GEM Report summary on disabilities and education Most countries have committed to protect the right to education for people with disabilities , which offers a basis for accountability Monitoring compliance of the right to education for people with disabil. 2020; \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7814335/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7814335/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAdolescents, defined as individuals aged 10\u0026ndash;19 years, are a primary focus of sexual and reproductive health (SRH) programs. However, adolescents with disabilities, particularly those with hearing impairments, face heightened challenges due to societal discrimination and an increased risk of sexual abuse. A common misconception persists that persons with disabilities are asexual or do not require sexuality education. As a result, many are denied access to crucial SRH information, which increases their vulnerability to SRH-related issues, including unintended pregnancies, unsafe abortions, and sexually transmitted infections (STIs). While Rwanda has integrated SRH services into its healthcare system, little is known about the accessibility of these services for adolescents with hearing disabilities. There is a critical gap in research on this population\u0026rsquo;s access to SRH information and services.\u003c/p\u003e\u003cp\u003e\u003cb\u003eObjectives\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study aimed to examine the factors influencing access to sexual and reproductive health information among adolescents with hearing disabilities in Rwanda.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e\u003cp\u003eA quantitative cross-sectional study design was employed, using a census strategy to recruit all eligible participants. Data were collected through structured questionnaires administered to adolescent students with hearing disabilities. Communication was facilitated using sign language interpreters.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAll participants (100%) reported having access to some form of SRH information. The most common source of information was schoolteachers, followed by peers, with mass media being the least cited. Key facilitators of access included inclusive education settings and the availability of SRH services in health facilities. Identified barriers included the lack of sign language proficiency among healthcare providers, stigma and discrimination within the community, and exclusionary education practices.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion and Recommendations:\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAdolescents with hearing disabilities need inclusive, gender-sensitive, and accessible SRH education to ensure equitable access to essential information. Community sensitization and advocacy are vital to addressing harmful societal attitudes and promoting inclusion. Furthermore, strengthening the accessibility of SRH services especially through the integration of sign language interpretation is essential to meeting the needs of this underserved population, regardless of age or educational background.\u003c/p\u003e","manuscriptTitle":"Access to Sexual and Reproductive Health Information Among Adolescents With Hearing Disabilities in Rwanda","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-24 09:39:04","doi":"10.21203/rs.3.rs-7814335/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-01-27T13:17:58+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-27T08:55:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"59962617037302079185367143742906744024","date":"2026-01-27T07:58:57+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"316121205192479134488122267833295545915","date":"2026-01-16T11:57:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"63190055154786750634930967574652559800","date":"2026-01-16T05:26:39+00:00","index":"hide","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-01T10:46:55+00:00","index":"","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-12T10:14:43+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-29T05:40:34+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-29T05:39:50+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-10-09T07:23:14+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"36d5f4a6-f356-438a-8693-299dbb789e2e","owner":[],"postedDate":"November 24th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-24T09:39:04+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-24 09:39:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7814335","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7814335","identity":"rs-7814335","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}