Knowledge and Access to Sexual and Reproductive Health Services: a cross-sectional study of youths in Democratic Republic of the Congo

Knowledge and Access to Sexual and Reproductive Health Services: a cross-sectional study of youths in Democratic Republic of the Congo | 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 Knowledge and Access to Sexual and Reproductive Health Services: a cross-sectional study of youths in Democratic Republic of the Congo Chrys Promesse Kabuya Kaniki, Akinyinka Omigbodun, Justin Mikenji Biayi, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5966421/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background There is dearth of information on the sexual and reproductive health of youths in the Democratic Republic of the Congo (DRC). Demographic and Health Surveys conducted over the years focused only on maternal and child health issues. This study was conducted to ascertain the barriers for young people seeking access to Sexual and Reproductive Health (SRH) services. Methods A community-based, cross-sectional survey was conducted among 519 youths, aged 15 to 24 years, using a questionnaire adapted from the Demographic and Health Survey II in the DRC. The questionnaire was uploaded on the software KoBo Collect for data collection. Data collected were transferred, processed and analyzed using Excel 2007 and IBM SPSS 25.0. Descriptive analysis was performed with frequencies, means, standard deviation and proportions while association between variables were determined using chi–square (χ2) tests, with statistical significance set at p < 0.05. Results The average age of the study participants was 19.38 ± 2.49 years, with those aged 18–20 years being the largest group (39.11%). Only 317 participants (61.1%) reported having ever heard about the term SRH. Majority of the participants interviewed had never participated in any health promotion activity related to SRH issues in their community. One hundred seventy-five (35%) participants reported SRH services not being geographically accessible to them. The overwhelming majority (82%) would use SRH services if they were nearby. Only 155 (29.9%) participants had ever visited health facilities for SRH services. Respondents who were older (> 20years), male, had at least secondary education, were currently students or were of the Christian faith were more likely to be aware of SRH services (p < 0.05). Conclusions There is a poor level of access to SRH services among the youth in DRC, which is linked to poor awareness, low participation in health promotion activities and a pessimistic view of care affordability. However, age, gender, education level, and occupation of the youths plays a role in their level of awareness of SRH services. Therefore, it is advisable for the DRC to work on improving awareness of young people towards SRH services and integrating these services into other routine services. Furthermore, the concept of young people’s participation in health promotion activities is crucial and must be put into practical action by associating young people as key stakeholders in any process of making policies since this is about their SRH. youths sexual health reproductive health health services health promotion health services accessibility Democratic Republic of the Congo (DRC) community survey Figures Figure 1 Figure 2 Plain English Summary There is a dearth of useful information about the challenges of the youth in accessing sexual and reproductive health services in Democratic Republic of Congo. This study investigated these challenges to ascertain the barriers for young people seeking access to sexual and reproductive health services, to make recommendations for policy and public health practice. Five hundred and nineteen (519) youths from DRC were interviewed using a questionnaire to collect data related to access to sexual and reproductive health services. The respondents have an average age of 19 years and only 61% have ever heard about the term SRH while only 29.9% have ever accessed SRH services in a health facility. Many of them have not benefited from in any health promotion activity about SRH in their community and about one-third reported that SRH services are not available in their community, but many (82%) agreed that they would use these services if they were available. Further analysis showed that respondents who are currently students, had at least secondary education, older (> 20years), or are Christians are more likely to be aware of SRH services. This study provides evidence of low access to SRH services in DRC communities especially due to poor awareness on SRH services, low participation in health promotion activities and a pessimistic view of care affordability. BACKGROUND Sexual and Reproductive Health (SRH) remains a concern for young people today. The youths are confronted with situations such as early and unwanted pregnancies, unsafe abortions and their complications, sexually transmitted infections (STIs) and risky sexual behaviours such as early initiation of sexual activity, multiple sexual partners, intergenerational sexual relationships and inconsistent or incorrect use of condoms and contraceptives that increase the risk of STIs, HIV and early or unwanted pregnancies among young people ( 1 ). Today, there are about 1.8 billion people between the ages of 10 and 24. In many countries, young people up to half of the population. Nearly 90% of the world's young people live in developing countries ( 2 , 3 ). In the Democratic Republic of the Congo (DRC), the total population is estimated at 85,281,024 people with 32% of the population aged 10–24 years ( 4 ).To thrive, young people need access to sexual and reproductive health care ( 5 ). In Africa, nearly 82% of young women and 91% of young men under the age of 25 are not sufficiently informed about sexual and reproductive health ( 6 ). Those who have the information have it either in a fragmentary way or from questionable sources. Young people often have less access to information, services and resources than those who are older. Health services are rarely designed specifically to meet their needs and health workers only occasionally receive specialized training in issues pertinent to sexual health of the youths. It is perhaps not surprising, therefore, that there are particularly low levels of health-seeking behaviour among young people. Similarly, young people in a variety of contexts have reported that access to contraception and condoms is difficult ( 6 , 7 ). The 1994 International Conference on Population Development (ICPD) in Cairo, Egypt, recognized adolescent-friendly reproductive health services as an appropriate and effective strategy to address the sexual and reproductive health needs of adolescents ( 8 ). Adolescence is a period of transition from childhood to adulthood during which adolescents develop biologically and psychologically and move towards independence ( 8 ). Although we may think of adolescents as a healthy group, many die prematurely and unnecessarily through accidents, suicide, violence and pregnancy-related complications. Some of the serious conditions of adulthood, for example, STIs (such as HIV/Aids) and tobacco use have their roots in adolescent behaviour. Young people often face difficulties in accessing health services. Interventions to improve young people’s general and reproductive health, and services to support these, should address the legal, policy, structural and systemic sociocultural barriers that limit their ability to access health care. Very young adolescents, those aged 10 to 14, acquire information, develop attitudes and adopt behaviours that will affect their present and future well-being. Before young people, regardless of age, become sexually active, they need appropriate information and opportunities to develop skills that support safe and responsible behaviour. Effective sexuality education and easy and facilitated access to sexual and reproductive health services provide young people with age-appropriate, culturally relevant, gender-related and scientifically accurate information. “It is often said a healthy people is a people with the potential for development”. Young people are the future of societies, and their needs should be addressed in order to have healthy and productive citizens. If the nation is to address its rapid population growth, it is crucial to acknowledge the importance of the reproductive health concerns of adolescents and young people, particularly in their decisions related to avoidance of unwanted pregnancy. Since youths are the future of nations in general, and of the DRC in particular, decision makers should focus on improving the health of young people to increase performance in several areas of life in order to enable the country take off, given that the age pyramid of the DRC is typical of developing countries ( 9 ). Previous sub-Saharan Africa Studies in Nigeria and Ethiopia revealed that over 80% of youths in Nigeria and 67.3% in Ethiopia are unaware of any youth-friendly reproductive health services available in their healthcare facilities ( 30 , 31 ). Similarly, research indicates that only 38.5% of adolescents in South Africa know about the types of youth-friendly sexual and reproductive health (YFSRH) services offered (29, 32). These findings are crucial because only youths who are aware of specific reproductive health services are likely to use them. Currently in the DRC, not only is there little information on the health of young people, but the information that exists is fragmented. The two Demographic and Health Surveys from DRC - DHS I in 2007 ( 10 ) and DHS II in 2013-14 ( 11 ) - only covered the subject of sexual and reproductive health (SRH) of adolescents and young people superficially. In the realm of reproductive health, they focused on maternal and child health issues, except for some information provided on the rate of HIV/AIDS and pregnancies among young people. These two surveys did not give enough information about access of young people to SRH services, availability and accessibility of the SRH services for the youth, factors facilitating and disabling young people from use, knowledge, attitudes and practices of youth toward SRH services, the views of the youth about existing services and those of the health care providers too. Appropriate sexual and reproductive health information, life experience training and appropriate health services can help young people make healthy choices about sexuality and reproduction. This study was conducted to ascertain the barriers between young people and access to sexual and reproductive health services in Kasai Oriental Province of the Democratic Republic of the Congo. METHODS Study Setting This study executed between February 16 to March 10, 2020 was conducted in Mbuji-Mayi, Province of Kasai Oriental in the DRC covering five of the ten Health Zones that make up the city of Mbuji-Mayi. Each health zone is subdivided into health areas and three health areas have been systematically drawn from each selected health zone. Thus 15 health areas were included in the study ( 12 , 13 ). Covering an area of 135.12 km², Mbuji-Mayi has an estimated population of almost 2,500,000 inhabitants ( 14 ). Mbuji-Mayi, the capital of the Province of Kasai Oriental, is considered the oldest of Congolese cities, with origins dating back to 1913, and was properly founded in 1914. It is now the second largest city in the country in terms of population, ahead of Lubumbashi. Mbuji-Mayi is administratively divided into five Local Government Areas: Bipemba, Diulu, Dibindi, Kanshi and Muya ( 12 , 13 ). Study design This study is a cross-sectional descriptive study which aims to understand youth knowledge and awareness of sexual and reproductive health (SRH) and to examine the relationship between youth characteristics and access to SRH services in the Democratic Republic of Congo. Data was collected using a structured questionnaire that assessed various characteristics, including socio-demographic factors, geographical location, economic status, and participation in health promotion and policy development programs. Survey tool and variables A self-administered questionnaire was utilized for this survey and some of the survey questions were adapted from the Demographic and Health Survey II implemented in the DRC ( 15 ). It included a series of closed-ended questions developed in French and English; and translated into Tshiluba. Assistance was provided by the study investigators to participants when needed especially related to clarification of a question for better understanding, but they were left to fill the questionnaire according to their views. The questionnaire have six sections: 1) study purpose and consent - which explained the reasons for the survey, how the survey data will be used and sought consent from participants; 2) participants’ socio-demography; 3) theoretical knowledge and perceptions of sexual and reproductive health, including youth participation in health promotion and policy development programmes on their sexual and reproductive health issues; 4) youth attitudes towards sexual and reproductive health; 5) availability of sexual and reproductive health services in the communities; and 6) youth practices regarding sexual and reproductive health. The questionnaire was evaluated by experts in the field of sexual and reproductive health, and pre-tested randomly with young people with the same characteristics in the city of Mbuji-Mayi and validated by the research team and external experts. The pre-testing was performed on 10% of the sample size in the HZs not selected for the study, among a similar set of participants in a similar setting, to ensure relevance, appropriateness and adequacy of all items in the instrument. Some corrections were made before the final instrument was administered. Internal consistency (Cron-bach's alpha of 0.7), test-retest reliability, and inter-rater reliability (Kappa statistic, K = 0.9) were used to test the final questionnaire for consistency before final validation and use. Study population and sample size The study population consisted of youths between 15 and 24 years of age, resident in Mbuji-Mayi, who had lived there for more than five years. The representative sample is drawn on the basis of Slovin’s formula with a confidence interval of 95%, and 5% margin of error: \(\:n=\:\frac{N}{1+\:{Ne}^{2}}\) . N = Population size and e = margin of error. Mbuji-Mayi has an estimated population of about 2,500,000 inhabitants ( 14 ). Thus, the minimum calculated sample size for the study is 400 as shown below. Sample size: n = \(\:\frac{2500000}{1+2500000\:{\left(0.05\right)}^{2}}=\:\frac{2500000}{1+6250}=399.94\:(\approx\:400)\) To prevent non-respondents, transcription errors and missing responses an attrition factor of 20% was added to the target population, making the sample size be 480. Sampling Procedures A multistage sampling technique was used for selecting the participants. In the first stage, five HZs were randomly selected from the ten HZs available in Mbuji-Mayi. Then, three HAs were drawn from each of the five randomly selected HZs, bringing them to 15 HAs included in this study. Using simple random sampling, specific households recruited for the study were identified. The survey questions were addressed to the youths found in the households and able to answer the survey. The investigators started with a randomly selected household and continued the survey with the closest household using a sampling step of 118. The sampling step (survey interval) had been calculated by taking the number of households from each HA divided by the calculated sample size. The sampling step (survey interval) was obtained according to the formula: Sample step = \(\:\frac{Number\:of\:HZ\:households}{sample\:size}=\:\frac{56696}{480}=118.12\:(\approx\:118)\) During the collection of data, efforts were made to have an approximately equal sample of males and females when recruiting participants from the households. Data collection, processing, and analysis The questionnaire was uploaded on a web-based software - KoBo Collect - for data collection between February and March 2020. They were administered to all consenting young people in the selected households. There were four investigators per HZ (one of them was the team supervisor while each of the other three worked in one of the three selected HAs). Data collected from the software were transferred to Excel 2007, cleaned and analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA). Descriptive analysis was performed with frequencies, means, standard deviation and proportions while association between variables were determined using chi–square (χ2) tests, with statistical significance set at p < 0.05. Also, binary logistic regression was used to determine significant predictor variables of knowledge and awareness of SRH among the youths of DRC. Youth access to SRH services in Mbuji-Mayi, which was dichotomous, was considered the dependent variable for this study, while other variables were considered independent, including age, sex, educational level, religion, culture, family size, occupation, geographic accessibility to SRH services, financial accessibility to SRH services, knowledge and impression about SRH services, and participation in health promotion and policy development programmes on SRH issues. RESULTS Participant distribution The Health Zone of Dibindi which is the biggest Health Zone of Mbuji-Mayi, had the largest sample (33.72%) in the study population (Fig. 1 ), while CAMED and AS du CHPM had the largest samples in the health areas (Fig. 2 ). General characteristics and socio-demography of participants The sociodemographic characteristics of the respondents are shown in Table 1 . Out of the 519 participants 51.8% were in the 15–19 years’ age group. The mean age was 19.38 years (SD: 2.716). years. There were 254 (48.9%) male and 265 (51.1%) female responders. Majority of those interviewed (364 participants – 70.1%) had at least secondary school education and 54.1% of these (197 participants) were above the age of 18 years. Less than 20% had a State Diploma (young people that reached the university level) and nearly 3% reported having no formal education. Females were 32% of the participants who had reached the university level and 71.4% of those without formal education. Most of the participants (> 85%) were unmarried. In terms of the educational attainment of participants' parents, more than 85% of fathers and 65% of mothers had at least a high school education, while 10% of fathers and nearly 20% of mothers were reported as having no formal education. Table 1 Socio-demographics of the participants in the 15 health areas Variables Frequency Percentage Age range of participants 15–19 269 51.83 20–24 250 48.17 Total 519 100.00 Gender/Sex Male 254 48.94 Female 265 51.06 Total 519 100.00 Education level of participants Primary 52 10.02 Secondary 364 70.13 Tertiary 89 17.15 None 14 2.70 Total 519 100 Marital status of participants Single without kid 448 86.32 Single with kids 16 3.08 Married 54 10.40 Divorced/Widow 1 0.19 Total 519 100 Living status With both parents 289 55.68 Family members 80 15.41 Alone 29 5.59 Husband/wife 47 9.06 Friends 35 6.74 One of the parents (Father) 11 2.12 One of the parents (Mother) 28 5.39 Total 519 100 Religion of participants Christianity 467 89.98 Islam 6 1.16 Others 46 8.86 Total 519 100 Importance of Religion Very important 379 73.03 Important 131 25.34 Undecided (I don’t know) 9 1.73 Total 519 100 Importance of Tradition Very important 254 48.94 Important 188 36.22 Undecided (I don’t know) 77 14.84 Total 519 100 Occupation of participants Student 316 60.89 Employee/owner 65 12.52 None/unemployed 138 26.59 Total 519 100 Father’s education level Primary 20 3.85 Secondary 309 59.54 Tertiary 138 26.59 None 52 10.02 Total 519 100 Mother’s education level Primary 81 15.61 Secondary 307 59.15 Tertiary 33 6.36 None 98 18.88 Total 519 100 Youth knowledge on SRH services Among the responders, 202 (38.9%) had never heard the term “sexual and reproductive health” and their knowledge about SRH services are seen in Table 2 . Services such as “Testing, Treatment & Information on STIs, HIV and STDs” and “Information or Classes on Sexuality Matters” were known by more than 70% of youth participants whereas services such as “Pregnancy Test” and “Prenatal and Postnatal Care, Safe Delivery” were known only to about one-third. Only about one in five knew about “Safe Abortion and Post-Abortion Care” (Table 3 ). Table 4 shows the relationship between the socio-demographic characteristics of the participants and their knowledge of the term SRH. Male, older youth who had at least secondary education and identified as Christians, especially if they were still students, were more likely to know about SRH. Table 2 Participants’ knowledge of the term ‘Sexual and Reproductive Health (SRH)’ Variables Frequency Percentage Have you ever heard about Sexual and Reproductive Health? Yes 317 61.08 No 202 38.92 Total 519 100.00 Table 3 Knowledge of SRH services among the participants Variables Frequency Percentage Testing, Treatment & information on STIs, HIV and STDs 430 82.9 Information or classes on Sexuality matters 386 74.4 Information on sexual relationships and premarital preparation 360 69.4 Contraceptives (+ condoms) and instruction for use 290 55.9 Counselling and sexual violence and abuse service 278 53.6 Family Planning 251 48.4 Psychosocial care and support 243 46.8 Pregnancy test 191 36.8 Prenatal and postnatal care, safe delivery 182 35.1 Safe abortion and post-abortion care 106 20.4 Binary logistic regression models. The results from the logistic regression analysis show that age, religion, and current occupation play significant roles in predicting individuals' awareness of Sexual and Reproductive Health (SRH) (p < 0.001). Specifically, an increase in age by one unit is associated with a 1.296-fold increase in the likelihood of being aware of SRH. Additionally, identifying as Christian significantly increases the likelihood of SRH awareness by a factor of 2.826 compared to other religious affiliations. Various occupation categories demonstrate significant associations with SRH awareness, with individuals in “Clerk / trader / businessman / public servant” and “others” being notably more likely to have knowledge of SRH compared to the reference category. However, gender and highest level of education do not significantly contribute to the prediction of SRH awareness. B Wald Df Sig. Exp(B) Step 1 a 2. How old are you? 0.259 29.713 1 .000 1.296 3. Gender? (1) -0.339 2.752 1 .097 .712 4. What is your highest level of education? 6.670 3 .083 4. What is your highest level of education? (1) -0.973 1.068 1 .301 .378 4. What is your highest level of education? (2) 0.389 .562 1 .454 1.475 4. What is your highest level of education? (3) 0.695 2.709 1 .100 2.003 7. What religion are you? 9.467 2 .009 7. What religion are you? (1) 1.039 7.501 1 .006 2.826 7. What religion are you? (2) − .354 .129 1 .719 .702 10. What is your current main occupation? 14.717 4 .005 10. What is your current main occupation? (1) -1.448 8.290 1 .004 .235 10. What is your current main occupation? (2) -2.029 7.517 1 .006 .131 10. What is your current main occupation? (3) − .535 1.209 1 .271 .585 10. What is your current main occupation? (4) − .831 3.172 1 .075 .436 Constant -5.112 20.656 1 .000 .006 Frequency Parameter coding (1) (2) (3) (4) What is your current main occupation? Clerk/trader/businessman/public servant 50 1.000 .000 .000 .000 Other 15 .000 1.000 .000 .000 Secondary school student 236 .000 .000 1.000 .000 Unemployed 138 .000 .000 .000 1.000 University or Higher Institute Student 80 .000 .000 .000 .000 What is your highest level of education? No formal education 14 1.000 .000 .000 Primary 52 .000 1.000 .000 Secondary 364 .000 .000 1.000 University 89 .000 .000 .000 What religion are you? Christianity 467 1.000 .000 Islam 6 .000 1.000 Other 46 .000 .000 Gender? Female 265 1.000 Male 254 .000 Categorical variables coding Youth participation in health promotion and development program Table 5 shows the level of participation of the youth in health promotion and policy development programmes. More than 80% (430) had attended school classes on SRH and relationships between boys and girls. About 55% of them thought that more classes on these topics should be provided. Majority (84%) of the participants interviewed reported that they had never participated in any health promotion activity involving policy development on youth SRH issues in their community, but approximately two-thirds of these young people were keenly interested in participating in such programmes. Table 5 Youth participation in health promotion and policy development programmes Variables Frequency Percentage Have you ever attended school classes on SRH and Systems and relationships between boys and girls? Yes 430 82.85 No 89 17.15 Total 519 100.00 Have you ever been involved in a sexual health promotion programme in your community? Yes 83 15.99 No 436 84.01 Total 519 100.00 Are youths involved in policy development programmes on adolescent and youth SRH issues in your community? Yes 104 20.04 No 415 79.96 Total 519 100.00 Do you think youth opinions value when developing health promotion policy and programmes on youth SRH problems? Yes 349 67.24 No 170 32.76 Total 519 100.00 How do you think young people should be involved in these programmes? At concept level (first level of brainstorming) 104 20.04 During discussions on SRH issues 116 22.35 At implementation level (programmes implementation) 55 10.60 At All levels 207 39.88 None 37 07.13 Total 519 100.00 Do you think that young people should be involved and listened to in that kind of discussions? Yes 393 75.72 No 126 24.28 Total 519 100.00 Youth access to SRH services The distribution of participants according to the accessibility of SRH Services for young people shows that out of 519 participants interviewed, approximatively 35% reported that in their community, SRH services are not easily geographically accessible. However, they also reported that they would use SRH services if they are close to them (82%). Again, more than 55% of the participants reported that these services are not affordable in term of the cost they have to pay. But if affordable for them, they would use them (75%) (Table 6). Table 6 Accessibility to Sexual and Reproductive Health Services for young people Variables Frequency Percentage Are SRH Services geographically accessible? (distance from your home to SRH Services) Yes 344 66.28 No 113 21.77 Undecided 62 11.95 Total 519 100.00 If SRH services were close by in the community, would youth use them? Yes 429 82.66 No 53 10.21 Undecided 37 7.13 Total 519 100.00 Are SRH Services affordable? (cost of SRH services) Yes 215 41.43 No 180 34.68 Undecided 124 23.89 Total 519 100.00 If SRH services were affordable in the community, would youth use them? (cost of SRH services) Yes 389 74.95 No 73 14.07 Undecided 57 10.98 Total 519 100.00 Are SRH services culturally or socially accessible? (judgement of others on the use of SRH services by youth) Yes 308 59.34 No 108 20.81 Undecided 103 19.85 Total 519 100.00 Youth impression after visiting or using SRH services The study revealed that 29.87% of the respondents have used SRH services in their community (data not shown). 65% (102 respondents) reported that they were comfortable enough to ask and answer questions while 73% (114 respondents) said they were satisfied and that the consultation went well. The study also revealed that 65% (337 respondents) of the participants agreed that health care providers were available to listen, consult, and counsel youth on SRH issues when they visited the health facilities. Also, the willingness to use the SRH services in the community is very high, almost 90% of the respondents said they are willing to use SRH Services (Table 7). Table 7 Youth impression after visiting/using SRH services available at health facilities in the community. Variables Frequency Percentage Did you feel comfortable enough to ask and answer questions? Yes, totally 102 65.81 Yes, somehow 43 27.74 Not at all 10 6.45 Were you satisfied with the answers to your questions during the consultation? Yes, totally 114 73.54 Yes, somehow 36 23.23 Not at all 5 3.23 Are service providers available to listen, consult, and counsel youth about SRH issues in health facilities? Yes, they are available 337 64.93 I am undecided / I don't know 96 18.5 No, they are not available 86 16.57 Are you willing to use the SRH services available in your community or not? Yes 466 89.76 No 53 10.21 Would you like to take courses/education on Sexual and Reproductive Health (CSE and reproductive health literacy)? Yes 497 95.76 No 11 2.12 I don’t know / it depends 11 2.12 DISCUSSION Our study provided several insights into factors that are associated with access to SRH Services for young people in DRC. The findings supported that the majority of young people were more likely to have poor access to SRH Services since they had poor knowledge of SRH term and related services, had low participation in health promotion activities and policy development programmes, and were more pessimistic view of care affordability (financial and geographical accessibility). However, those who had the chance to visit the services self-reported receiving adequate professional support and information to manage their conditions and that care providers were available for them. In line with this finding, several studies done in different areas have revealed similar findings ( 9 , 16 , 17 ). A survey conducted among social and healthcare providers in Rwanda reported that health facilities are providing information to adolescents on SRH services that were available and at a low cost. This survey emphasized that SRH services seemed to be only fairly accessible to adolescents with insufficient quality as adolescents themselves do not get to be fully involved in service provision among other aspects of quality SRH as stated by the World Health Organization. However, in this study, some of respondents mentioned that adolescents were involved in designing the feedback mechanisms at their facilities ( 15 ). A school based cross-sectional study done in Ethiopia in 2016 showed that discussions with health providers, previous history of perceived STIs symptoms, being ever sexually experienced and exposure to information from schoolteachers were associated with SRH services utilization among secondary school youths. Inconvenient times, culture, religion, lack of privacy, and fear of their parent were also cited as barriers to SRH service uptake by the school youths ( 18 ). However, the findings of our study revealed that there is a significant association between age, gender, education level and occupation with the knowledge of the participants and their access to SRH Services. The study also revealed that five out of the ten services in the SRH package available are less known by youths. According to the proportion of knowledge among respondents, knowledge in the population was weighted as “good” for services such as “Testing, Treatment & information on STIs, HIV and STDs”, “Information or classes on Sexuality matters”, “Information on sexual relationships and premarital preparation”, “Contraceptives and instruction for use” and “Counselling and sexual violence and abuse service” while it was weighted as "low” or “bad" for the remaining service. These rates show how dangerously young people are exposed to consequences for not having access to all SRH services available. Our study showed that participants who are 20–24 years old, male, single without kid, and went at least at secondary school have good knowledge of the SRH term. Further analysis reveals that age, gender, education level and occupation are significantly associated with knowledge about SRH. Logistic regression analysis show that age, religion, and current occupation are significant predictors of individuals' awareness of Sexual and Reproductive Health (SRH) (p < 0.001). Specifically, an increase in age by one unit is associated with a 1.296-fold increase in the likelihood of being aware of SRH, while identifying as Christian significantly increases the likelihood of SRH awareness by a factor of 2.826 compared to other religious affiliations. In this study, majority of the participants reported that they never participated in any health promotion activity involving policy development programmes on youth SRH issues in their community, but approximately two-thirds of these young people were keenly interested in participating in such programmes. Almost 40% of participants have reported they never heard of the term “Sexual and Reproductive Health”. This highlights the lack of information on comprehensive sexuality education among young people. Hence, interventions to avert this situation need to be intensified. As stated in the article on ‘ensuring youth's right to participation and promotion of youth leadership in the development of SRH policies and programmes’ ( 19 ), more research and documentation as well as the adoption of innovative practices for involving youth in SRH programs are needed. Youth participation in program and policy development should still be a priority. This allows for a sense of ownership and understanding of the programmes, since their own views on SRH will be captured. Therefore, a commitment to young people’s participation in activities related to health promotion, policy making and programmes development are greatly needed ( 20 ). The ICPD and ICPD + 5 emphasize involving young people in programme design and implementation as a way to increase the relevance and effectiveness of programme interventions ( 8 ). The concept of young people’s participation has tremendous potential if concrete ways are devised to put it into practical action. Obstacles to young people’s involvement can assume various forms. Cultural norms may favour hierarchical relationships between adults and young people. Young people may be considered as recipients of services and not active partners. Adult stakeholders, like parents and teachers, and policymakers may have biases and fears about working with young people (and vice versa). The study’s findings showed that health care providers are available to listen, consult, and counsel youth on SRH issues when they visit health facilities; and that the willingness to use the SRH services in the community was very high. The youth’s impression on service providers and SRH services at health facilities were quite good. On the policy level, as recommended in other studies ( 17 , 21 ); prioritization of adolescents’ SRH services requires attention. To the question of accessibility and cost of SRH care services, the findings show that these services are not easily geographically accessible for young people. However, it’s reported that young people would like to use SRH services if they are closed to them. It was also reported that the cost to pay for these services is not easy to cover for many of participants. These results emphasize the evidence why young people don’t really use or visit SRH Services even though they may be available in their community. This finding was supported by other studies done in Ethiopia ( 22 ) and Kenya ( 23 ) where young people who their nearby health facilities were health centers were more likely to utilize SRH services. Conversely, a study conducted in Enugu state, Nigeria on the SRH services for adolescents reported that the services were generally physically available ( 24 ). We found that the SRH services were available in the community but were geographically and financially not accessible to young people. This may be because these services were not specifically for the adolescents and therefore, may hinder their access as well as utilization. Previous studies ( 25 , 26 ) also reported low utilization of SRH services among young people. We suggest that adolescent-friendly SRH services (corners and spaces) should be made available and accessible within healthcare centers. The utilization of SRH services among young people is essential to reduce the prevalence of SRH problems ( 27 , 28 ). Determining the factors that make young people use or not to use SRH services remains very important in designing interventions to promote young people’s SRH service utilization. CONCLUSION & RECOMMENDATION This study reveals that young people in the Democratic Republic of Congo (DRC) have limited access to sexual and reproductive health (SRH) services. This issue stems from several key factors: poor awareness of these services, low participation in health promotion activities and policy development programmes, and a pessimistic view of the affordability of care. The research identifies age, gender, education level, religion, and current occupation as significant predictors of youths' knowledge and awareness of SRH services. Therefore, it is advisable for the DRC to work on improving awareness of young people towards SRH services and integrating these services into other routine services. Special focus should be given by providing affordable, accessible, acceptable, and friendly SRH Services corners. Furthermore, the concept of young people’s participation in health promotion activities is crucial and must be put into practical action by associating young people as key stakeholders in any process of making policies since this is about their SRH. Declarations Ethical approval Ethical clearance was obtained from the Research Ethics Committee of the University of Ibadan/University College Hospital with an IRB approval number: UI/EC/20/0010. A support letter was equally obtained from the Director of PAULESI to the Mayor of Mbuji-Mayi City and health authorities in charge of health facilities to allow the investigators access to the study area. Human Ethics and Consent to Participate declarations Written consent was obtained from each eligible study participant and/or parent or guardian of participants below the age of 18 years. All the necessary information regarding the study (objectives, requirements of the participants and duration of the study) were given to the prospective study participants on an information sheet in French version, and explained in Tshiluba translation for those who were not able to read or understand French. Ethical notions such as discretion, confidentiality, free consent of the interviewees as well as beneficence and non-maleficence to participants were scrupulously respected. Identifying information were not included in the questionnaire to ensure privacy and confidentiality. The right of an individual not to participate in the study was also respected. Consent for publication: Not applicable. Clinical trial number Not applicable. Availability of data and materials The data sets used and analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding The African Union Commission through PAULESI funded this study. The Grant Number is PAU0103003MB . We are grateful for the generous funding. The funder did not have any responsibility or contribution in the design of the study, collection, analysis, interpretation of data and writing of this manuscript. Authors' contributions CPKK was involved in conceptualization, literature review, study design, data collection, investigation, methodology, project administration, supervision, analysis, interpretation, writing—original draft, and writing—review and editing. MJB was involved in study design, methodology, supervision of data collection. AO and AOA were involved in conceptualization, methodology, supervision, manuscript review and editing. All authors read and approved the final manuscript. MJB is now deceased. Acknowledgements We are very grateful to the Directorate of the Pan African University Life and Earth Sciences Institute, the Mayor of the Mbuji-Mayi City and all the health authorities in the concerned health entities for the facilitation of the necessary research processes including approval and support letters. We thank all the study participants from all the health areas visited during the study period for their consent and cooperation to participate in the study. We also acknowledge the scientific and mentorship support received from the research supervisors during the conceptualization of this study. We also acknowledge the great support received from all research assistants during the data collection. References The Partnership for Maternal, Newborn and Childhealth. Advocating for Change for Adolescents! A Practical Toolkit for Young People to Advocate for Improved Adolescent Health and Well-being. The Partnership for Maternal, Newborn & Child Health (the Partnership), Women Deliver. [Internet]. Geneva: World Health Organization; 2018. 104 p. Available from: https://womendeliver.org/wp-content/uploads/2018/04/AdolescentAdvocacyToolkit_120318_DIGITAL.pdf Adolescent and Youth Reproductive Health: Introduction to Adolescent and Youth Reproductive Health (AYRH). [Internet]. [cited 2022 Feb 15]. Available from: https://www.open.edu/openlearncreate/mod/oucontent/view.php?id=62&printable=1 Cunningham J. Global Health E-learning. 2014 [cited 2022 Mar 15]. Santé Sexuelle et Reproductive de la Jeunesse. Available from: https://www.globalhealthlearning.org/fr/course/youth-sexual-and-reproductive-health UNESCO Institute for Statistics. Democratic Republic of the Congo, UNESCO UIS [Internet]. [cited 2022 Mar 5]. Available from: http://uis.unesco.org/en/country/cd UNESCO Digital Library. YOUNG PEOPLE TODAY. 2013 [cited 2022 Mar 23]. Time to Act now: Why adolescents and young people need comprehensive sexuality education and sexual and reproductive health services in Eastern and Southern Africa. Available from: https://unesdoc.unesco.org/ark:/48223/pf0000223447 World Health Organisation. Adolescent job aid: a handy desk reference tool for primary level health workers. [Internet]. Geneva: World Health Organization; 2010. 182 p. Available from: https://apps.who.int/iris/handle/10665/44387 UNAIDS. UNAIDS terminology guidelines 2015 [Internet]. 2015 [cited 2022 Mar 14]. Available from: www.unaids.org/en/resources/documents/2015/2015/terminologyguidelines Tilahun T, Bekuma TT, Getachew M, Seme A. Assessment of access and utilization of adolescent and youth sexual and reproductive health services in western Ethiopia. Reprod Health. 2021 Dec;18(1):85. Kwete D, Binanga A, Mukaba T, Nemuandjare T, Mbadu MF, Kyungu MT, et al. Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges. Glob Health Sci Pract. 2018 Mar 21;6(1):40–54. Ministère du Plan et Macro International. (2008). Enquête Démographique et de Santé, République Démocratique du Congo 2007. Calverton, Maryland, U.S.A: Ministère du Plan et Macro International. [Internet]. Ministère du Plan et Macro International.; 2008 [cited 2022 May 8]. Available from: https://dhsprogram.com/pubs/pdf/FR208/FR208.pdf Ministère du Plan et SMRM, Ministère de la, ICF International. Enquête Démographique et de Santé en République Démocratique du Congo 2013-2014. [Internet]. MPSMRM, MSP et ICF International.; 2014 [cited 2022 May 12]. Available from: https://www.unicef.org/drcongo/media/1046/file/EDS-RDC%20II%202013-2014.pdf Congo T. Tourisme RDCongo. [cited 2019 Dec 12]. Mbujimayi. Available from: http://www.congo-tourisme.org/visiter-la-rdc/kasai-occidental/mbuji-mayi/?lang=en World Population Review. World Population Review. [cited 2019 Oct 22]. Mbuji Mayi Population 2019. Available from: http://worldpopulationreview.com/world-cities/mbuji-mayi-population/ CAID.cd. Ville de Mbuji-Mayi [Internet]. [cited 2019 Dec 18]. Available from: https://www.caid.cd/index.php/donnees-par-villes/ville-de-mbuji-mayi/?domaine=fiche Ndayishimiye P, Uwase R, Kubwimana I, Niyonzima J de la C, Dzekem Dine R, Nyandwi JB, 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. BMC Health Serv Res. 2020 Jul 29;20(1):697. Jonas K, Crutzen R, Krumeich A, Roman N, Van Den Borne B, Reddy P. Healthcare workers’ beliefs, motivations and behaviours affecting adequate provision of sexual and reproductive healthcare services to adolescents in Cape Town, South Africa: a qualitative study. BMC Health Serv Res. 2018 Dec;18(1):109. Binu W, Marama T, Gerbaba M, Sinaga M. Sexual and reproductive health services utilization and associated factors among secondary school students in Nekemte town, Ethiopia. Reprod Health. 2018 Dec;15(1):64. Villa-Torres L, Svanemyr J. Ensuring Youth’s Right to Participation and Promotion of Youth Leadership in the Development of Sexual and Reproductive Health Policies and Programs. J Adolesc Health. 2015 Jan;56(1):S51–7. UNFPA. Reproductive Rights and Sexual and Reproductive Health Framework, “Making Reproductive Rights And Sexual And Reproductive Health A Reality For All” [Internet]. UNFPA; 2008 [cited 2020 Feb 12]. Available from: https://www.unfpa.org/sites/default/files/pub-pdf/SRH_Framework.pdf Jonas K, Reddy P, Van Den Borne B, Sewpaul R, Nyembezi A, Naidoo P, et al. Predictors of nurses’ and midwives’ intentions to provide maternal and child healthcare services to adolescents in South Africa. BMC Health Serv Res. 2016 Dec;16(1):658. Ayehu A, Kassaw T, Hailu G. Level of Young People Sexual and Reproductive Health Service Utilization and Its Associated Factors among Young People in Awabel District, Northwest Ethiopia. Ciccozzi M, editor. PLOS ONE. 2016 Mar 18;11(3):e0151613. Godia PM, Olenja JM, Lavussa JA, Quinney D, Hofman JJ, Van Den Broek N. Sexual reproductive health service provision to young people in Kenya; health service providers’ experiences. BMC Health Serv Res. 2013 Dec;13(1):476. Odo AN, Samuel ES, Nwagu EN, Nnamani PO, Atama CS. Sexual and reproductive health services (SRHS) for adolescents in Enugu state, Nigeria: a mixed methods approach. BMC Health Serv Res. 2018 Feb 8;18(1):92. Abebe M, Awoke W. Utilization of Youth Reproductive Health Services and Associated Factors among High School Students in Bahir Dar, Amhara Regional State, Ethiopia. Open J Epidemiol. 2014;04(02):69–75. Feleke SA, Koye DN, Demssie AF, Mengesha ZB. Reproductive health service utilization and associated factors among adolescents (15–19 years old) in Gondar town, Northwest Ethiopia. BMC Health Serv Res. 2013 Dec;13(1):294. Williamson LM, Parkes A, Wight D, Petticrew M, Hart GJ. Limits to modern contraceptive use among young women in developing countries: a systematic review of qualitative research. Reprod Health. 2009 Dec;6(1):3. Bearinger LH, Sieving RE, Ferguson J, Sharma V. Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential. The Lancet. 2007 Apr;369(9568):1220–31. Ministère du Plan et Suivi de la Mise en œuvre de la Révolution de la Modernité, Ministère de la Santé Publique, ICF International. Enquête Démographique et de Santé en République Démocratique du Congo 2013-2014. Rockville, Maryland, USA: MPSMRM, MSP, and ICF International; 2014. Francis, E., & Gabriel, V. C. (2019). Barriers limiting youth access to reproductive health services by primary health care facilities in Nigeria. Universal Journal of Public Health, 7(1), 36–43. Ayehu, A., Kassaw, T., & Hailu, G. (2016). Young people’s parental discussion about sexual and reproductive health issues and its associated factors in Awabel Woreda, Northwest Ethiopia. Reproductive Health. Ajike, S. O. (2016). Adolescent/youth utilization of reproductive health services: Knowledge still a barrier. Journal of Family Medicine and Health Care, 2(3), 17. Geary, R. S., Gómez-Olivé, F. X., Kahn, K., Tollman, S., & Norris, S. A. (2014). Barriers to and facilitators of the provision of a youth-friendly health services programme in rural South Africa. BMC Health Services Research, 14(1), 1–8. Table 4 Table 4 is available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Table4.docx Cite Share Download PDF Status: Posted Version 1 posted 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-5966421","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":423817134,"identity":"3977bc69-af56-4fc9-bbde-7e77ece1a863","order_by":0,"name":"Chrys Promesse Kabuya Kaniki","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4ElEQVRIiWNgGAWjYFACNiA2SOBhY28+AGRJyBCvhZ/nWAJICw+RWhgSGCRn5BiAWIS1mLMfS/xcUJAmY3Ag5/OrGzUWPAzsh49uwKfFsiftsPQMgxwegwNnt1nnHAM6jCct7QY+LQY32BukeQwqeAwO9m4zzmEDapHgMSOkpfk3WMthnmfGOf+I0sJ2DGhLDo9kGw/z49w2IrQA/ZJmzWOQBgxkNjPm3D4JHjZCfgGGmPFtnj/J9mzyjx9/zvlWJ8fPfvgYfochsdkkwCQ+5ehamD8QUj0KRsEoGAUjEwAAvhhBHhFOcVIAAAAASUVORK5CYII=","orcid":"","institution":"Pan African University Life and Earth Sciences Institute (Including Health and Agriculture), PAULESI, University of Ibadan","correspondingAuthor":true,"prefix":"","firstName":"Chrys","middleName":"Promesse Kabuya","lastName":"Kaniki","suffix":""},{"id":423817135,"identity":"904a5454-1a9c-41b0-9cf8-aa8edd3cef51","order_by":1,"name":"Akinyinka Omigbodun","email":"","orcid":"","institution":"University of Ibadan","correspondingAuthor":false,"prefix":"","firstName":"Akinyinka","middleName":"","lastName":"Omigbodun","suffix":""},{"id":423817136,"identity":"ca3afd71-8479-4b2d-9f40-5552f8105690","order_by":2,"name":"Justin Mikenji Biayi","email":"","orcid":"","institution":"Unnivesity of Mbuji Mayi","correspondingAuthor":false,"prefix":"","firstName":"Justin","middleName":"Mikenji","lastName":"Biayi","suffix":""},{"id":423817141,"identity":"18a7fba6-d9ef-49f4-9c4e-4d01d254da4e","order_by":3,"name":"Ayodele Arowojolu","email":"","orcid":"","institution":"University of Ibadan","correspondingAuthor":false,"prefix":"","firstName":"Ayodele","middleName":"","lastName":"Arowojolu","suffix":""}],"badges":[],"createdAt":"2025-02-05 14:08:40","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5966421/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5966421/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":78244428,"identity":"e6e58d06-dc86-45e7-a7e1-74e2b9137af0","added_by":"auto","created_at":"2025-03-11 09:18:44","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":299072,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution and proportions of the sample by health zones\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5966421/v1/4c7df062aeafcab56160b624.jpg"},{"id":78244417,"identity":"c5b104cc-4a28-4931-b3b5-b71a48c93d2a","added_by":"auto","created_at":"2025-03-11 09:18:44","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":294723,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution and proportions of the sample by health areas\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5966421/v1/608d612914504682b825dde2.jpg"},{"id":93049656,"identity":"a67ca6de-36b4-4252-9b9c-0a0ebbdc2940","added_by":"auto","created_at":"2025-10-08 14:02:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2654806,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5966421/v1/5e5606ed-2a3e-4ac5-8972-7d904e3db76b.pdf"},{"id":78244416,"identity":"a667950d-6bf1-4a08-a524-55f8b83d4ff2","added_by":"auto","created_at":"2025-03-11 09:18:44","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":34554,"visible":true,"origin":"","legend":"","description":"","filename":"Table4.docx","url":"https://assets-eu.researchsquare.com/files/rs-5966421/v1/6dc2ba663e3d22f590bcb340.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Knowledge and Access to Sexual and Reproductive Health Services: a cross-sectional study of youths in Democratic Republic of the Congo","fulltext":[{"header":"Plain English Summary","content":"\u003cp\u003eThere is a dearth of useful information about the challenges of the youth in accessing sexual and reproductive health services in Democratic Republic of Congo. This study investigated these challenges to ascertain the barriers for young people seeking access to sexual and reproductive health services, to make recommendations for policy and public health practice. \u0026nbsp;Five hundred and nineteen (519) youths from DRC were interviewed using a questionnaire to collect data related to access to sexual and reproductive health services. The respondents have an average age of 19 years and only 61% have ever heard about the term SRH while only 29.9% have ever accessed SRH services in a health facility. Many of them have not benefited from in any health promotion activity about SRH in their community and about one-third reported that SRH services are not available in their community, but many (82%) agreed that they would use these services if they were available. Further analysis showed that respondents who are currently students, had at least secondary education, older (\u0026gt; 20years), or are Christians are more likely to be aware of SRH services. This study provides evidence of low access to SRH services in DRC communities especially due to poor awareness on SRH services, low participation in health promotion activities and a pessimistic view of care affordability. \u0026nbsp;\u003c/p\u003e\n"},{"header":"BACKGROUND","content":"\u003cp\u003eSexual and Reproductive Health (SRH) remains a concern for young people today. The youths are confronted with situations such as early and unwanted pregnancies, unsafe abortions and their complications, sexually transmitted infections (STIs) and risky sexual behaviours such as early initiation of sexual activity, multiple sexual partners, intergenerational sexual relationships and inconsistent or incorrect use of condoms and contraceptives that increase the risk of STIs, HIV and early or unwanted pregnancies among young people (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eToday, there are about 1.8\u0026nbsp;billion people between the ages of 10 and 24. In many countries, young people up to half of the population. Nearly 90% of the world's young people live in developing countries (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). In the Democratic Republic of the Congo (DRC), the total population is estimated at 85,281,024 people with 32% of the population aged 10\u0026ndash;24 years (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).To thrive, young people need access to sexual and reproductive health care (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In Africa, nearly 82% of young women and 91% of young men under the age of 25 are not sufficiently informed about sexual and reproductive health (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Those who have the information have it either in a fragmentary way or from questionable sources. Young people often have less access to information, services and resources than those who are older. Health services are rarely designed specifically to meet their needs and health workers only occasionally receive specialized training in issues pertinent to sexual health of the youths. It is perhaps not surprising, therefore, that there are particularly low levels of health-seeking behaviour among young people. Similarly, young people in a variety of contexts have reported that access to contraception and condoms is difficult (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe 1994 International Conference on Population Development (ICPD) in Cairo, Egypt, recognized adolescent-friendly reproductive health services as an appropriate and effective strategy to address the sexual and reproductive health needs of adolescents (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Adolescence is a period of transition from childhood to adulthood during which adolescents develop biologically and psychologically and move towards independence (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Although we may think of adolescents as a healthy group, many die prematurely and unnecessarily through accidents, suicide, violence and pregnancy-related complications. Some of the serious conditions of adulthood, for example, STIs (such as HIV/Aids) and tobacco use have their roots in adolescent behaviour.\u003c/p\u003e \u003cp\u003eYoung people often face difficulties in accessing health services. Interventions to improve young people\u0026rsquo;s general and reproductive health, and services to support these, should address the legal, policy, structural and systemic sociocultural barriers that limit their ability to access health care.\u003c/p\u003e \u003cp\u003eVery young adolescents, those aged 10 to 14, acquire information, develop attitudes and adopt behaviours that will affect their present and future well-being. Before young people, regardless of age, become sexually active, they need appropriate information and opportunities to develop skills that support safe and responsible behaviour. Effective sexuality education and easy and facilitated access to sexual and reproductive health services provide young people with age-appropriate, culturally relevant, gender-related and scientifically accurate information.\u003c/p\u003e \u003cp\u003e\u0026ldquo;It is often said a healthy people is a people with the potential for development\u0026rdquo;. Young people are the future of societies, and their needs should be addressed in order to have healthy and productive citizens. If the nation is to address its rapid population growth, it is crucial to acknowledge the importance of the reproductive health concerns of adolescents and young people, particularly in their decisions related to avoidance of unwanted pregnancy. Since youths are the future of nations in general, and of the DRC in particular, decision makers should focus on improving the health of young people to increase performance in several areas of life in order to enable the country take off, given that the age pyramid of the DRC is typical of developing countries (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePrevious sub-Saharan Africa Studies in Nigeria and Ethiopia revealed that over 80% of youths in Nigeria and 67.3% in Ethiopia are unaware of any youth-friendly reproductive health services available in their healthcare facilities (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Similarly, research indicates that only 38.5% of adolescents in South Africa know about the types of youth-friendly sexual and reproductive health (YFSRH) services offered (29, 32). These findings are crucial because only youths who are aware of specific reproductive health services are likely to use them.\u003c/p\u003e \u003cp\u003eCurrently in the DRC, not only is there little information on the health of young people, but the information that exists is fragmented. The two Demographic and Health Surveys from DRC - DHS I in 2007 (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) and DHS II in 2013-14 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) - only covered the subject of sexual and reproductive health (SRH) of adolescents and young people superficially. In the realm of reproductive health, they focused on maternal and child health issues, except for some information provided on the rate of HIV/AIDS and pregnancies among young people. These two surveys did not give enough information about access of young people to SRH services, availability and accessibility of the SRH services for the youth, factors facilitating and disabling young people from use, knowledge, attitudes and practices of youth toward SRH services, the views of the youth about existing services and those of the health care providers too.\u003c/p\u003e \u003cp\u003eAppropriate sexual and reproductive health information, life experience training and appropriate health services can help young people make healthy choices about sexuality and reproduction. This study was conducted to ascertain the barriers between young people and access to sexual and reproductive health services in Kasai Oriental Province of the Democratic Republic of the Congo.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Setting\u003c/h2\u003e \u003cp\u003eThis study executed between February 16 to March 10, 2020 was conducted in Mbuji-Mayi, Province of Kasai Oriental in the DRC covering five of the ten Health Zones that make up the city of Mbuji-Mayi. Each health zone is subdivided into health areas and three health areas have been systematically drawn from each selected health zone. Thus 15 health areas were included in the study (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Covering an area of 135.12 km\u0026sup2;, Mbuji-Mayi has an estimated population of almost 2,500,000 inhabitants (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Mbuji-Mayi, the capital of the Province of Kasai Oriental, is considered the oldest of Congolese cities, with origins dating back to 1913, and was properly founded in 1914. It is now the second largest city in the country in terms of population, ahead of Lubumbashi. Mbuji-Mayi is administratively divided into five Local Government Areas: Bipemba, Diulu, Dibindi, Kanshi and Muya (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy design\u003c/h3\u003e\n\u003cp\u003eThis study is a cross-sectional descriptive study which aims to understand youth knowledge and awareness of sexual and reproductive health (SRH) and to examine the relationship between youth characteristics and access to SRH services in the Democratic Republic of Congo. Data was collected using a structured questionnaire that assessed various characteristics, including socio-demographic factors, geographical location, economic status, and participation in health promotion and policy development programs.\u003c/p\u003e\n\u003ch3\u003eSurvey tool and variables\u003c/h3\u003e\n\u003cp\u003eA self-administered questionnaire was utilized for this survey and some of the survey questions were adapted from the Demographic and Health Survey II implemented in the DRC (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). It included a series of closed-ended questions developed in French and English; and translated into Tshiluba. Assistance was provided by the study investigators to participants when needed especially related to clarification of a question for better understanding, but they were left to fill the questionnaire according to their views.\u003c/p\u003e \u003cp\u003eThe questionnaire have six sections: 1) study purpose and consent - which explained the reasons for the survey, how the survey data will be used and sought consent from participants; 2) participants\u0026rsquo; socio-demography; 3) theoretical knowledge and perceptions of sexual and reproductive health, including youth participation in health promotion and policy development programmes on their sexual and reproductive health issues; 4) youth attitudes towards sexual and reproductive health; 5) availability of sexual and reproductive health services in the communities; and 6) youth practices regarding sexual and reproductive health.\u003c/p\u003e \u003cp\u003eThe questionnaire was evaluated by experts in the field of sexual and reproductive health, and pre-tested randomly with young people with the same characteristics in the city of Mbuji-Mayi and validated by the research team and external experts. The pre-testing was performed on 10% of the sample size in the HZs not selected for the study, among a similar set of participants in a similar setting, to ensure relevance, appropriateness and adequacy of all items in the instrument. Some corrections were made before the final instrument was administered. Internal consistency (Cron-bach's alpha of 0.7), test-retest reliability, and inter-rater reliability (Kappa statistic, K\u0026thinsp;=\u0026thinsp;0.9) were used to test the final questionnaire for consistency before final validation and use.\u003c/p\u003e\n\u003ch3\u003eStudy population and sample size\u003c/h3\u003e\n\u003cp\u003eThe study population consisted of youths between 15 and 24 years of age, resident in Mbuji-Mayi, who had lived there for more than five years. The representative sample is drawn on the basis of Slovin\u0026rsquo;s formula with a confidence interval of 95%, and 5% margin of error: \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:n=\\:\\frac{N}{1+\\:{Ne}^{2}}\\)\u003c/span\u003e\u003c/span\u003e. N\u0026thinsp;=\u0026thinsp;Population size and e\u0026thinsp;=\u0026thinsp;margin of error. Mbuji-Mayi has an estimated population of about 2,500,000 inhabitants (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Thus, the minimum calculated sample size for the study is 400 as shown below.\u003c/p\u003e \u003cp\u003eSample size: n = \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{2500000}{1+2500000\\:{\\left(0.05\\right)}^{2}}=\\:\\frac{2500000}{1+6250}=399.94\\:(\\approx\\:400)\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003cp\u003eTo prevent non-respondents, transcription errors and missing responses an attrition factor of 20% was added to the target population, making the sample size be 480.\u003c/p\u003e\n\u003ch3\u003eSampling Procedures\u003c/h3\u003e\n\u003cp\u003eA multistage sampling technique was used for selecting the participants. In the first stage, five HZs were randomly selected from the ten HZs available in Mbuji-Mayi. Then, three HAs were drawn from each of the five randomly selected HZs, bringing them to 15 HAs included in this study. Using simple random sampling, specific households recruited for the study were identified. The survey questions were addressed to the youths found in the households and able to answer the survey. The investigators started with a randomly selected household and continued the survey with the closest household using a sampling step of 118. The sampling step (survey interval) had been calculated by taking the number of households from each HA divided by the calculated sample size. The sampling step (survey interval) was obtained according to the formula:\u003c/p\u003e \u003cp\u003eSample step = \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{Number\\:of\\:HZ\\:households}{sample\\:size}=\\:\\frac{56696}{480}=118.12\\:(\\approx\\:118)\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003cp\u003eDuring the collection of data, efforts were made to have an approximately equal sample of males and females when recruiting participants from the households.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection, processing, and analysis\u003c/h2\u003e \u003cp\u003eThe questionnaire was uploaded on a web-based software - KoBo Collect - for data collection between February and March 2020. They were administered to all consenting young people in the selected households. There were four investigators per HZ (one of them was the team supervisor while each of the other three worked in one of the three selected HAs). Data collected from the software were transferred to Excel 2007, cleaned and analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA). Descriptive analysis was performed with frequencies, means, standard deviation and proportions while association between variables were determined using chi\u0026ndash;square (χ2) tests, with statistical significance set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Also, binary logistic regression was used to determine significant predictor variables of knowledge and awareness of SRH among the youths of DRC. Youth access to SRH services in Mbuji-Mayi, which was dichotomous, was considered the dependent variable for this study, while other variables were considered independent, including age, sex, educational level, religion, culture, family size, occupation, geographic accessibility to SRH services, financial accessibility to SRH services, knowledge and impression about SRH services, and participation in health promotion and policy development programmes on SRH issues.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eParticipant distribution\u003c/h2\u003e \u003cp\u003eThe Health Zone of Dibindi which is the biggest Health Zone of Mbuji-Mayi, had the largest sample (33.72%) in the study population (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), while CAMED and AS du CHPM had the largest samples in the health areas (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eGeneral characteristics and socio-demography of participants\u003c/h2\u003e \u003cp\u003eThe sociodemographic characteristics of the respondents are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Out of the 519 participants 51.8% were in the 15\u0026ndash;19 years\u0026rsquo; age group. The mean age was 19.38 years (SD: 2.716). years. There were 254 (48.9%) male and 265 (51.1%) female responders. Majority of those interviewed (364 participants \u0026ndash; 70.1%) had at least secondary school education and 54.1% of these (197 participants) were above the age of 18 years. Less than 20% had a State Diploma (young people that reached the university level) and nearly 3% reported having no formal education. Females were 32% of the participants who had reached the university level and 71.4% of those without formal education. Most of the participants (\u0026gt;\u0026thinsp;85%) were unmarried. In terms of the educational attainment of participants' parents, more than 85% of fathers and 65% of mothers had at least a high school education, while 10% of fathers and nearly 20% of mothers were reported as having no formal education.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographics of the participants in the 15 health areas\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge range of participants\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51.83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender/Sex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e265\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation level of participants\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status of participants\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle without kid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e448\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle with kids\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced/Widow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLiving status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWith both parents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e289\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHusband/wife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFriends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOne of the parents (Father)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOne of the parents (Mother)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion of participants\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChristianity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e467\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e89.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eImportance of Religion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery important\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImportant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUndecided (I don\u0026rsquo;t know)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eImportance of Tradition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery important\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImportant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUndecided (I don\u0026rsquo;t know)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation of participants\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e316\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployee/owner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone/unemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFather\u0026rsquo;s education level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e309\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMother\u0026rsquo;s education level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.61\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eYouth knowledge on SRH services\u003c/h2\u003e \u003cp\u003eAmong the responders, 202 (38.9%) had never heard the term \u0026ldquo;sexual and reproductive health\u0026rdquo; and their knowledge about SRH services are seen in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Services such as \u0026ldquo;Testing, Treatment \u0026amp; Information on STIs, HIV and STDs\u0026rdquo; and \u0026ldquo;Information or Classes on Sexuality Matters\u0026rdquo; were known by more than 70% of youth participants whereas services such as \u0026ldquo;Pregnancy Test\u0026rdquo; and \u0026ldquo;Prenatal and Postnatal Care, Safe Delivery\u0026rdquo; were known only to about one-third. Only about one in five knew about \u0026ldquo;Safe Abortion and Post-Abortion Care\u0026rdquo; (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows the relationship between the socio-demographic characteristics of the participants and their knowledge of the term SRH. Male, older youth who had at least secondary education and identified as Christians, especially if they were still students, were more likely to know about SRH.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipants\u0026rsquo; knowledge of the term \u0026lsquo;Sexual and Reproductive Health (SRH)\u0026rsquo;\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHave you ever heard about Sexual and Reproductive Health?\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e317\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38.92\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKnowledge of SRH services among the participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTesting, Treatment \u0026amp; information on STIs, HIV and STDs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e430\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInformation or classes on Sexuality matters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e386\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInformation on sexual relationships and premarital preparation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e360\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContraceptives (+\u0026thinsp;condoms) and instruction for use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e290\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCounselling and sexual violence and abuse service\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e278\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily Planning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychosocial care and support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePregnancy test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrenatal and postnatal care, safe delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e182\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSafe abortion and post-abortion care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv\u003e\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eBinary logistic regression models.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results from the logistic regression analysis show that age, religion, and current occupation play significant roles in predicting individuals\u0026apos; awareness of Sexual and Reproductive Health (SRH) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Specifically, an increase in age by one unit is associated with a 1.296-fold increase in the likelihood of being aware of SRH. Additionally, identifying as Christian significantly increases the likelihood of SRH awareness by a factor of 2.826 compared to other religious affiliations. Various occupation categories demonstrate significant associations with SRH awareness, with individuals in \u0026ldquo;Clerk / trader / businessman / public servant\u0026rdquo; and \u0026ldquo;others\u0026rdquo; being notably more likely to have knowledge of SRH compared to the reference category. However, gender and highest level of education do not significantly contribute to the prediction of SRH awareness.\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable id=\"Taba\" border=\"1\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWald\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSig.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eExp(B)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"15\"\u003e\n \u003cp\u003eStep 1\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2. How old are you?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.259\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.713\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.296\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3. Gender? (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.339\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.752\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.712\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4. What is your highest level of education?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.670\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4. What is your highest level of education? (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-0.973\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.068\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.301\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.378\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4. What is your highest level of education? (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.389\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.562\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.454\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.475\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4. What is your highest level of education? (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.695\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.709\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7. What religion are you?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.467\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7. What religion are you? (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.501\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.826\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7. What religion are you? (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.354\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.719\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.702\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10. What is your current main occupation?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.717\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10. What is your current main occupation? (1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-1.448\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.290\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.235\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10. What is your current main occupation? (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-2.029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.517\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.131\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10. What is your current main occupation? (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.535\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.585\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10. What is your current main occupation? (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026minus;\u0026thinsp;.831\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.075\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.436\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-5.112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.656\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv\u003e\u003cbr\u003e\u003c/div\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eParameter coding\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e(2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e(4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eWhat is your current main occupation?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eClerk/trader/businessman/public servant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eSecondary school student\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eUniversity or Higher Institute Student\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eWhat is your highest level of education?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eNo formal education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\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: 27px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\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: 27px;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e364\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\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: 27px;\"\u003e\n \u003cp\u003eUniversity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eWhat religion are you?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eChristianity\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e467\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\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: 27px;\"\u003e\n \u003cp\u003eIslam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\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: 27px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eGender?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e265\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\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: 27px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCategorical variables coding\u003c/p\u003e\n\u003cdiv id=\"Sec13\"\u003e\n \u003ch2\u003eYouth participation in health promotion and development program\u003c/h2\u003e\n \u003cp\u003eTable 5 shows the level of participation of the youth in health promotion and policy development programmes. More than 80% (430) had attended school classes on SRH and relationships between boys and girls. About 55% of them thought that more classes on these topics should be provided. Majority (84%) of the participants interviewed reported that they had never participated in any health promotion activity involving policy development on youth SRH issues in their community, but approximately two-thirds of these young people were keenly interested in participating in such programmes.\u003c/p\u003e\n \u003cdiv\u003e\u0026nbsp;\u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 5\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eYouth participation in health promotion and policy development programmes\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eHave you ever attended school classes on SRH and Systems and relationships between boys and girls?\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e430\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you ever been involved in a sexual health promotion programme in your community?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e436\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAre youths involved in policy development programmes on adolescent and youth SRH issues in your community?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e415\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e79.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you think youth opinions value when developing health promotion policy and programmes on youth SRH problems?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e349\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e67.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e170\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHow do you think young people should be involved in these programmes?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAt concept level (first level of brainstorming)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuring discussions on SRH issues\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e22.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAt implementation level (programmes implementation)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAt All levels\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e07.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you think that young people should be involved and listened to in that kind of discussions?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e75.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\"\u003e\n \u003ch2\u003eYouth access to SRH services\u003c/h2\u003e\n \u003cp\u003eThe distribution of participants according to the accessibility of SRH Services for young people shows that out of 519 participants interviewed, approximatively 35% reported that in their community, SRH services are not easily geographically accessible. However, they also reported that they would use SRH services if they are close to them (82%). Again, more than 55% of the participants reported that these services are not affordable in term of the cost they have to pay. But if affordable for them, they would use them (75%) (Table 6).\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab6\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 6\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eAccessibility to Sexual and Reproductive Health Services for young people\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAre SRH Services geographically accessible? (distance from your home to SRH Services)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e344\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eIf SRH services were close by in the community, would youth use them?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e429\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAre SRH Services affordable? (cost of SRH services)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e215\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e34.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23.89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eIf SRH services were affordable in the community, would youth use them? (cost of SRH services)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e389\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e14.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAre SRH services culturally or socially accessible? (judgement of others on the use of SRH services by youth)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003eTotal\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e519\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e100.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec15\"\u003e\n \u003ch2\u003eYouth impression after visiting or using SRH services\u003c/h2\u003e\n \u003cdiv\u003e\n \u003cp\u003eThe study revealed that 29.87% of the respondents have used SRH services in their community (data not shown). 65% (102 respondents) reported that they were comfortable enough to ask and answer questions while 73% (114 respondents) said they were satisfied and that the consultation went well. The study also revealed that 65% (337 respondents) of the participants agreed that health care providers were available to listen, consult, and counsel youth on SRH issues when they visited the health facilities. Also, the willingness to use the SRH services in the community is very high, almost 90% of the respondents said they are willing to use SRH Services (Table 7).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab7\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 7\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eYouth impression after visiting/using SRH services available at health facilities in the community.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDid you feel comfortable enough to ask and answer questions?\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes, totally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e65.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes, somehow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNot at all\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eWere you satisfied with the answers to your questions during the consultation?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes, totally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e73.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes, somehow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e23.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNot at all\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAre service providers available to listen, consult, and counsel youth about SRH issues in health facilities?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes, they are available\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e337\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64.93\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI am undecided / I don\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo, they are not available\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAre you willing to use the SRH services available in your community or not?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e89.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eWould you like to take courses/education on Sexual and Reproductive Health (CSE and reproductive health literacy)?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e497\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e95.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eI don\u0026rsquo;t know / it depends\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eOur study provided several insights into factors that are associated with access to SRH Services for young people in DRC. The findings supported that the majority of young people were more likely to have poor access to SRH Services since they had poor knowledge of SRH term and related services, had low participation in health promotion activities and policy development programmes, and were more pessimistic view of care affordability (financial and geographical accessibility). However, those who had the chance to visit the services self-reported receiving adequate professional support and information to manage their conditions and that care providers were available for them.\u003c/p\u003e \u003cp\u003eIn line with this finding, several studies done in different areas have revealed similar findings (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). A survey conducted among social and healthcare providers in Rwanda reported that health facilities are providing information to adolescents on SRH services that were available and at a low cost. This survey emphasized that SRH services seemed to be only fairly accessible to adolescents with insufficient quality as adolescents themselves do not get to be fully involved in service provision among other aspects of quality SRH as stated by the World Health Organization. However, in this study, some of respondents mentioned that adolescents were involved in designing the feedback mechanisms at their facilities (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA school based cross-sectional study done in Ethiopia in 2016 showed that discussions with health providers, previous history of perceived STIs symptoms, being ever sexually experienced and exposure to information from schoolteachers were associated with SRH services utilization among secondary school youths. Inconvenient times, culture, religion, lack of privacy, and fear of their parent were also cited as barriers to SRH service uptake by the school youths (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). However, the findings of our study revealed that there is a significant association between age, gender, education level and occupation with the knowledge of the participants and their access to SRH Services.\u003c/p\u003e \u003cp\u003eThe study also revealed that five out of the ten services in the SRH package available are less known by youths. According to the proportion of knowledge among respondents, knowledge in the population was weighted as “good” for services such as “Testing, Treatment \u0026amp; information on STIs, HIV and STDs”, “Information or classes on Sexuality matters”, “Information on sexual relationships and premarital preparation”, “Contraceptives and instruction for use” and “Counselling and sexual violence and abuse service” while it was weighted as \"low” or “bad\" for the remaining service. These rates show how dangerously young people are exposed to consequences for not having access to all SRH services available. Our study showed that participants who are 20–24 years old, male, single without kid, and went at least at secondary school have good knowledge of the SRH term. Further analysis reveals that age, gender, education level and occupation are significantly associated with knowledge about SRH. Logistic regression analysis show that age, religion, and current occupation are significant predictors of individuals' awareness of Sexual and Reproductive Health (SRH) (p \u0026lt; 0.001). Specifically, an increase in age by one unit is associated with a 1.296-fold increase in the likelihood of being aware of SRH, while identifying as Christian significantly increases the likelihood of SRH awareness by a factor of 2.826 compared to other religious affiliations.\u003c/p\u003e \u003cp\u003eIn this study, majority of the participants reported that they never participated in any health promotion activity involving policy development programmes on youth SRH issues in their community, but approximately two-thirds of these young people were keenly interested in participating in such programmes. Almost 40% of participants have reported they never heard of the term “Sexual and Reproductive Health”. This highlights the lack of information on comprehensive sexuality education among young people. Hence, interventions to avert this situation need to be intensified. As stated in the article on ‘ensuring youth's right to participation and promotion of youth leadership in the development of SRH policies and programmes’ (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), more research and documentation as well as the adoption of innovative practices for involving youth in SRH programs are needed. Youth participation in program and policy development should still be a priority. This allows for a sense of ownership and understanding of the programmes, since their own views on SRH will be captured. Therefore, a commitment to young people’s participation in activities related to health promotion, policy making and programmes development are greatly needed (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe ICPD and ICPD + 5 emphasize involving young people in programme design and implementation as a way to increase the relevance and effectiveness of programme interventions (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). The concept of young people’s participation has tremendous potential if concrete ways are devised to put it into practical action. Obstacles to young people’s involvement can assume various forms. Cultural norms may favour hierarchical relationships between adults and young people. Young people may be considered as recipients of services and not active partners. Adult stakeholders, like parents and teachers, and policymakers may have biases and fears about working with young people (and vice versa).\u003c/p\u003e \u003cp\u003eThe study’s findings showed that health care providers are available to listen, consult, and counsel youth on SRH issues when they visit health facilities; and that the willingness to use the SRH services in the community was very high. The youth’s impression on service providers and SRH services at health facilities were quite good. On the policy level, as recommended in other studies (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e); prioritization of adolescents’ SRH services requires attention.\u003c/p\u003e \u003cp\u003eTo the question of accessibility and cost of SRH care services, the findings show that these services are not easily geographically accessible for young people. However, it’s reported that young people would like to use SRH services if they are closed to them. It was also reported that the cost to pay for these services is not easy to cover for many of participants. These results emphasize the evidence why young people don’t really use or visit SRH Services even though they may be available in their community. This finding was supported by other studies done in Ethiopia (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e) and Kenya (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) where young people who their nearby health facilities were health centers were more likely to utilize SRH services. Conversely, a study conducted in Enugu state, Nigeria on the SRH services for adolescents reported that the services were generally physically available (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). We found that the SRH services were available in the community but were geographically and financially not accessible to young people. This may be because these services were not specifically for the adolescents and therefore, may hinder their access as well as utilization. Previous studies (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) also reported low utilization of SRH services among young people. We suggest that adolescent-friendly SRH services (corners and spaces) should be made available and accessible within healthcare centers. The utilization of SRH services among young people is essential to reduce the prevalence of SRH problems (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Determining the factors that make young people use or not to use SRH services remains very important in designing interventions to promote young people’s SRH service utilization.\u003c/p\u003e "},{"header":"CONCLUSION \u0026 RECOMMENDATION","content":"\u003cp\u003eThis study reveals that young people in the Democratic Republic of Congo (DRC) have limited access to sexual and reproductive health (SRH) services. This issue stems from several key factors: poor awareness of these services, low participation in health promotion activities and policy development programmes, and a pessimistic view of the affordability of care. The research identifies age, gender, education level, religion, and current occupation as significant predictors of youths' knowledge and awareness of SRH services.\u003c/p\u003e\u003cp\u003eTherefore, it is advisable for the DRC to work on improving awareness of young people towards SRH services and integrating these services into other routine services. Special focus should be given by providing affordable, accessible, acceptable, and friendly SRH Services corners. Furthermore, the concept of young people’s participation in health promotion activities is crucial and must be put into practical action by associating young people as key stakeholders in any process of making policies since this is about their SRH.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical clearance was obtained from the Research Ethics Committee of the University of Ibadan/University College Hospital with an IRB approval number: UI/EC/20/0010. \u0026nbsp;A support letter was equally obtained from the Director of PAULESI to the Mayor of Mbuji-Mayi City and health authorities in charge of health facilities to allow the investigators access to the study area.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten consent was obtained from each eligible study participant and/or parent or guardian of participants below the age of 18 years. All the necessary information regarding the study (objectives, requirements of the participants and duration of the study) were given to the prospective study participants on an information sheet in French version, and explained in Tshiluba translation for those who were not able to read or understand French. Ethical notions such as discretion, confidentiality, free consent of the interviewees as well as beneficence and non-maleficence to participants were scrupulously respected. Identifying information were not included in the questionnaire to ensure privacy and confidentiality. The right of an individual not to participate in the study was also respected.\u0026nbsp;\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\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNot applicable.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data sets used and analyzed during the current study are available from the corresponding author on reasonable request.\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.\u003cstrong\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe African Union Commission through PAULESI funded this study. The Grant Number is \u003cstrong\u003ePAU0103003MB\u003c/strong\u003e. We are grateful for the generous funding. The funder did not have any responsibility or contribution in the design of the study, collection, analysis, interpretation of data and writing of this manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCPKK was involved in conceptualization, literature review, study design, data collection, investigation, methodology, project administration, supervision, analysis, interpretation, writing\u0026mdash;original draft, and writing\u0026mdash;review and editing. MJB was involved in study design, methodology, supervision of data collection. AO and AOA were involved in conceptualization, methodology, supervision, manuscript review and editing. All authors read and approved the final manuscript. MJB is now deceased.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are very grateful to the Directorate of the Pan African University Life and Earth Sciences Institute, the Mayor of the Mbuji-Mayi City and all the health authorities in the concerned health entities for the facilitation of the necessary research processes including approval and support letters.\u003c/p\u003e\n\u003cp\u003eWe thank all the study participants from all the health areas visited during the study period for their consent and cooperation to participate in the study. We also acknowledge the scientific and mentorship support received from the research supervisors during the conceptualization of this study. We also acknowledge the great support received from all research assistants during the data collection."},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eThe Partnership for Maternal, Newborn and Childhealth. Advocating for Change for Adolescents! A Practical Toolkit for Young People to Advocate for Improved Adolescent Health and Well-being. The Partnership for Maternal, Newborn \u0026amp; Child Health (the Partnership), Women Deliver. [Internet]. Geneva: World Health Organization; 2018. 104 p. Available from: https://womendeliver.org/wp-content/uploads/2018/04/AdolescentAdvocacyToolkit_120318_DIGITAL.pdf\u003c/li\u003e\n\u003cli\u003eAdolescent and Youth Reproductive Health: Introduction to Adolescent and Youth Reproductive Health (AYRH). [Internet]. [cited 2022 Feb 15]. Available from: https://www.open.edu/openlearncreate/mod/oucontent/view.php?id=62\u0026amp;printable=1 \u003c/li\u003e\n\u003cli\u003eCunningham J. Global Health E-learning. 2014 [cited 2022 Mar 15]. Sant\u0026eacute; Sexuelle et Reproductive de la Jeunesse. Available from: https://www.globalhealthlearning.org/fr/course/youth-sexual-and-reproductive-health\u003c/li\u003e\n\u003cli\u003eUNESCO Institute for Statistics. Democratic Republic of the Congo, UNESCO UIS [Internet]. [cited 2022 Mar 5]. Available from: http://uis.unesco.org/en/country/cd\u003c/li\u003e\n\u003cli\u003eUNESCO Digital Library. YOUNG PEOPLE TODAY. 2013 [cited 2022 Mar 23]. Time to Act now: Why adolescents and young people need comprehensive sexuality education and sexual and reproductive health services in Eastern and Southern Africa. Available from: https://unesdoc.unesco.org/ark:/48223/pf0000223447\u003c/li\u003e\n\u003cli\u003eWorld Health Organisation. Adolescent job aid: a handy desk reference tool for primary level health workers. [Internet]. Geneva: World Health Organization; 2010. 182 p. Available from: https://apps.who.int/iris/handle/10665/44387\u003c/li\u003e\n\u003cli\u003eUNAIDS. UNAIDS terminology guidelines 2015 [Internet]. 2015 [cited 2022 Mar 14]. Available from: www.unaids.org/en/resources/documents/2015/2015/terminologyguidelines\u003c/li\u003e\n\u003cli\u003eTilahun T, Bekuma TT, Getachew M, Seme A. Assessment of access and utilization of adolescent and youth sexual and reproductive health services in western Ethiopia. Reprod Health. 2021 Dec;18(1):85. \u003c/li\u003e\n\u003cli\u003eKwete D, Binanga A, Mukaba T, Nemuandjare T, Mbadu MF, Kyungu MT, et al. Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges. Glob Health Sci Pract. 2018 Mar 21;6(1):40\u0026ndash;54. \u003c/li\u003e\n\u003cli\u003eMinist\u0026egrave;re du Plan et Macro International. (2008). Enqu\u0026ecirc;te D\u0026eacute;mographique et de Sant\u0026eacute;, R\u0026eacute;publique D\u0026eacute;mocratique du Congo 2007. Calverton, Maryland, U.S.A: Minist\u0026egrave;re du Plan et Macro International. [Internet]. Minist\u0026egrave;re du Plan et Macro International.; 2008 [cited 2022 May 8]. Available from: https://dhsprogram.com/pubs/pdf/FR208/FR208.pdf\u003c/li\u003e\n\u003cli\u003eMinist\u0026egrave;re du Plan et SMRM, Minist\u0026egrave;re de la, ICF International. Enqu\u0026ecirc;te D\u0026eacute;mographique et de Sant\u0026eacute; en R\u0026eacute;publique D\u0026eacute;mocratique du Congo 2013-2014. [Internet]. MPSMRM, MSP et ICF International.; 2014 [cited 2022 May 12]. Available from: https://www.unicef.org/drcongo/media/1046/file/EDS-RDC%20II%202013-2014.pdf\u003c/li\u003e\n\u003cli\u003eCongo T. Tourisme RDCongo. [cited 2019 Dec 12]. Mbujimayi. Available from: http://www.congo-tourisme.org/visiter-la-rdc/kasai-occidental/mbuji-mayi/?lang=en\u003c/li\u003e\n\u003cli\u003eWorld Population Review. World Population Review. [cited 2019 Oct 22]. Mbuji Mayi Population 2019. Available from: http://worldpopulationreview.com/world-cities/mbuji-mayi-population/\u003c/li\u003e\n\u003cli\u003eCAID.cd. Ville de Mbuji-Mayi [Internet]. [cited 2019 Dec 18]. Available from: https://www.caid.cd/index.php/donnees-par-villes/ville-de-mbuji-mayi/?domaine=fiche\u003c/li\u003e\n\u003cli\u003eNdayishimiye P, Uwase R, Kubwimana I, Niyonzima J de la C, Dzekem Dine R, Nyandwi JB, 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. BMC Health Serv Res. 2020 Jul 29;20(1):697. \u003c/li\u003e\n\u003cli\u003eJonas K, Crutzen R, Krumeich A, Roman N, Van Den Borne B, Reddy P. Healthcare workers\u0026rsquo; beliefs, motivations and behaviours affecting adequate provision of sexual and reproductive healthcare services to adolescents in Cape Town, South Africa: a qualitative study. BMC Health Serv Res. 2018 Dec;18(1):109. \u003c/li\u003e\n\u003cli\u003eBinu W, Marama T, Gerbaba M, Sinaga M. Sexual and reproductive health services utilization and associated factors among secondary school students in Nekemte town, Ethiopia. Reprod Health. 2018 Dec;15(1):64. \u003c/li\u003e\n\u003cli\u003eVilla-Torres L, Svanemyr J. Ensuring Youth\u0026rsquo;s Right to Participation and Promotion of Youth Leadership in the Development of Sexual and Reproductive Health Policies and Programs. J Adolesc Health. 2015 Jan;56(1):S51\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eUNFPA. Reproductive Rights and Sexual and Reproductive Health Framework, \u0026ldquo;Making Reproductive Rights And Sexual And Reproductive Health A Reality For All\u0026rdquo; [Internet]. UNFPA; 2008 [cited 2020 Feb 12]. Available from: https://www.unfpa.org/sites/default/files/pub-pdf/SRH_Framework.pdf\u003c/li\u003e\n\u003cli\u003eJonas K, Reddy P, Van Den Borne B, Sewpaul R, Nyembezi A, Naidoo P, et al. Predictors of nurses\u0026rsquo; and midwives\u0026rsquo; intentions to provide maternal and child healthcare services to adolescents in South Africa. BMC Health Serv Res. 2016 Dec;16(1):658. \u003c/li\u003e\n\u003cli\u003eAyehu A, Kassaw T, Hailu G. Level of Young People Sexual and Reproductive Health Service Utilization and Its Associated Factors among Young People in Awabel District, Northwest Ethiopia. Ciccozzi M, editor. PLOS ONE. 2016 Mar 18;11(3):e0151613. \u003c/li\u003e\n\u003cli\u003eGodia PM, Olenja JM, Lavussa JA, Quinney D, Hofman JJ, Van Den Broek N. Sexual reproductive health service provision to young people in Kenya; health service providers\u0026rsquo; experiences. BMC Health Serv Res. 2013 Dec;13(1):476. \u003c/li\u003e\n\u003cli\u003eOdo AN, Samuel ES, Nwagu EN, Nnamani PO, Atama CS. Sexual and reproductive health services (SRHS) for adolescents in Enugu state, Nigeria: a mixed methods approach. BMC Health Serv Res. 2018 Feb 8;18(1):92. \u003c/li\u003e\n\u003cli\u003eAbebe M, Awoke W. Utilization of Youth Reproductive Health Services and Associated Factors among High School Students in Bahir Dar, Amhara Regional State, Ethiopia. Open J Epidemiol. 2014;04(02):69\u0026ndash;75. \u003c/li\u003e\n\u003cli\u003eFeleke SA, Koye DN, Demssie AF, Mengesha ZB. Reproductive health service utilization and associated factors among adolescents (15\u0026ndash;19 years old) in Gondar town, Northwest Ethiopia. BMC Health Serv Res. 2013 Dec;13(1):294. \u003c/li\u003e\n\u003cli\u003eWilliamson LM, Parkes A, Wight D, Petticrew M, Hart GJ. Limits to modern contraceptive use among young women in developing countries: a systematic review of qualitative research. Reprod Health. 2009 Dec;6(1):3. \u003c/li\u003e\n\u003cli\u003eBearinger LH, Sieving RE, Ferguson J, Sharma V. Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential. The Lancet. 2007 Apr;369(9568):1220\u0026ndash;31. \u003c/li\u003e\n\u003cli\u003eMinist\u0026egrave;re du Plan et Suivi de la Mise en \u0026oelig;uvre de la R\u0026eacute;volution de la Modernit\u0026eacute;, Minist\u0026egrave;re de la Sant\u0026eacute; Publique, ICF International. Enqu\u0026ecirc;te D\u0026eacute;mographique et de Sant\u0026eacute; en R\u0026eacute;publique D\u0026eacute;mocratique du Congo 2013-2014. Rockville, Maryland, USA: MPSMRM, MSP, and ICF International; 2014. \u003c/li\u003e\n\u003c/ol\u003e\n\u003col start=\"29\"\u003e\n\u003cli\u003eFrancis, E., \u0026amp; Gabriel, V. C. (2019). Barriers limiting youth access to reproductive health services by primary health care facilities in Nigeria. Universal Journal of Public Health, 7(1), 36\u0026ndash;43.\u003c/li\u003e\n\u003cli\u003eAyehu, A., Kassaw, T., \u0026amp; Hailu, G. (2016). Young people\u0026rsquo;s parental discussion about sexual and reproductive health issues and its associated factors in Awabel Woreda, Northwest Ethiopia. Reproductive Health.\u003c/li\u003e\n\u003cli\u003eAjike, S. O. (2016). Adolescent/youth utilization of reproductive health services: Knowledge still a barrier. Journal of Family Medicine and Health Care, 2(3), 17.\u003c/li\u003e\n\u003cli\u003eGeary, R. S., G\u0026oacute;mez-Oliv\u0026eacute;, F. X., Kahn, K., Tollman, S., \u0026amp; Norris, S. A. (2014). Barriers to and facilitators of the provision of a youth-friendly health services programme in rural South Africa. BMC Health Services Research, 14(1), 1\u0026ndash;8.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Table 4","content":"\u003cp\u003eTable 4 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"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":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"youths, sexual health, reproductive health, health services, health promotion, health services accessibility, Democratic Republic of the Congo (DRC), community survey","lastPublishedDoi":"10.21203/rs.3.rs-5966421/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5966421/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThere is dearth of information on the sexual and reproductive health of youths in the Democratic Republic of the Congo (DRC). Demographic and Health Surveys conducted over the years focused only on maternal and child health issues. This study was conducted to ascertain the barriers for young people seeking access to Sexual and Reproductive Health (SRH) services.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA community-based, cross-sectional survey was conducted among 519 youths, aged 15 to 24 years, using a questionnaire adapted from the Demographic and Health Survey II in the DRC. The questionnaire was uploaded on the software KoBo Collect for data collection. Data collected were transferred, processed and analyzed using Excel 2007 and IBM SPSS 25.0. Descriptive analysis was performed with frequencies, means, standard deviation and proportions while association between variables were determined using chi\u0026ndash;square (χ2) tests, with statistical significance set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe average age of the study participants was 19.38\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49 years, with those aged 18\u0026ndash;20 years being the largest group (39.11%). Only 317 participants (61.1%) reported having ever heard about the term SRH. Majority of the participants interviewed had never participated in any health promotion activity related to SRH issues in their community. One hundred seventy-five (35%) participants reported SRH services not being geographically accessible to them. The overwhelming majority (82%) would use SRH services if they were nearby. Only 155 (29.9%) participants had ever visited health facilities for SRH services. Respondents who were older (\u0026gt;\u0026thinsp;20years), male, had at least secondary education, were currently students or were of the Christian faith were more likely to be aware of SRH services (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThere is a poor level of access to SRH services among the youth in DRC, which is linked to poor awareness, low participation in health promotion activities and a pessimistic view of care affordability. However, age, gender, education level, and occupation of the youths plays a role in their level of awareness of SRH services. Therefore, it is advisable for the DRC to work on improving awareness of young people towards SRH services and integrating these services into other routine services. Furthermore, the concept of young people\u0026rsquo;s participation in health promotion activities is crucial and must be put into practical action by associating young people as key stakeholders in any process of making policies since this is about their SRH.\u003c/p\u003e","manuscriptTitle":"Knowledge and Access to Sexual and Reproductive Health Services: a cross-sectional study of youths in Democratic Republic of the Congo","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-11 09:18:39","doi":"10.21203/rs.3.rs-5966421/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"95d938b8-d57d-4b0c-946a-624d429d99f4","owner":[],"postedDate":"March 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-08T13:54:06+00:00","versionOfRecord":[],"versionCreatedAt":"2025-03-11 09:18:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5966421","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5966421","identity":"rs-5966421","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}