Reproductive Health Services: Expectations and Experiences Among in-school and Out-of-school Adolescents in Nigeria

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Despite the growing adolescent population, they have limited access to health services. In Nigeria, one in three children are out-of-school. Therefore, this study aimed to compare reproductive health service expectations and experiences among in-school and out-of-school adolescents. Methods: This was a comparative cross-sectional study among adolescents aged 10-19 years. In-school adolescents were selected via a multistage sampling technique, whereas out-of-school adolescents in the mapped area were selected. A WHO illustrative questionnaire for interviews with young people was used to collect data. The SERVQUAL tool was used to measure the gap between expectations and perceptions of the services delivered. Results: Six hundred forty adolescents were recruited. More in-school adolescents (80.6%) than out-of-school adolescents (63.4%) were aware of ARHS (p<0.001). The mean ARHS expectations score of out-of-school adolescents was higher than that of in-school adolescents (t=2.824; p=0.005). A greater proportion of out-of-school compared with in-school adolescents expected to receive ARHS from a young and same-sex health professional (p<0.001). More in-school adolescents (52.8%) than out-of-school adolescents (18.8%) had ARHS experiences (p<0.001). More out-of-school adolescents than in-school adolescents received warmth and empathy from from health professionals (p=0.025). A greater proportion of out-of-school adolescents than in-school adolescents considered the ARHS satisfactory (p=0.017). Conclusions: Increased expectations of ARHS among out-of-school adolescents do not translate to increased utilisation of ARHS. This, therefore, calls for more community outreach to out-of-school adolescents. Sexual & Reproductive Medicine Expectations Experiences In-school adolescents Out-of-school adolescents Reproductive health services Figures Figure 1 Figure 2 BACKGROUND Reproductive health encompasses all aspects of an individual's physical, mental, and social well-being and is not limited to the lack of disease or infirmity concerning the reproductive system, its functions, or its processes. 1 Reproductive health services include sexuality and reproductive health information; sexual abuse counselling; HIV testing, counselling, and treatment; STI testing and counselling; contraception counselling and provision (family planning services); maternal health services; postabortion care (within the extent of the law); sexual and gender-based violence counselling; harmful traditional practice prevention; and referral services (including legal and social services). 2 , 3 Adolescents are aged ten to nineteen years, a phase in which rapid physical and cognitive growth occurs. 4 During this period, a sense of self-awareness and emotional independence occurs. 4 Adolescence is a crucial stage when personal responsibilities develop on the basis of exposure and experience, and it is not without its fragility. The adolescent population is increasing; approximately 1.2 billion of the 7.3 billion people in the world are adolescents, 85% of whom live in developing countries. 5 , 6 In Nepal, adolescents and young people constitute approximately 24% and 33% of the population, respectively. 7 This figure is similar to that of the Nigerian population, which is estimated at 200 million, with 22% of the population being adolescents and 31% being young. 8 , 9 Despite the growing population, adolescents in developing countries have little access to medical care or education, with a high prevalence of poverty and cultural and sexual norms. 7 Adolescents have unique health needs that require specific and appropriate reproductive health services. 2 While adolescent reproductive health services are a significant part of adolescent health, unfortunately, many adolescents are unaware of the sexual and reproductive health information and services available. Therefore, they could not benefit from them. In a study in Nigeria, only 13.1% of the adolescents were aware of adolescent reproductive health services, whereas 7.8% had ever used the service. 10 One of the concerted efforts is establishing adolescent and youth-friendly health services (AYFHSs), adapted to address the barriers adolescents face in having quality reproductive health (RH) services. 11 The AYFHS has standalone service delivery with a growing ability to make existing health services youth friendly. 11 However, most adolescents are unaware and lack substantial knowledge about the AYFHS, and sadly, they also encounter obstacles and challenges in obtaining quality services and information. 12 A study in Sri Lanka revealed that only girls were aware of the availability of RH services, whereas no single male adolescent knew about the RH services available to them. 13 This is contrary to a study performed in Nepal, where male adolescents had better knowledge of SRH issues than female adolescents did. 14 A study in Brazil showed that most adolescents are unaware of existing reproductive health services. 15 A study in Oyo State, Nigeria, revealed a low level of awareness of adolescent reproductive health services (ARHS), with 13.1% being aware of ARHS and only 7.8% utilising ARHS. 10 The low patronage was because they did not know where to go. The provision of the AYFHS may not be sufficient to increase adolescent use of services; hence, there is a need to harness the expectations of adolescents, which is a way of strengthening the participatory rights of adolescents. These expectations will help support the high-quality services of adolescent RHs through multiple channels to reach in-school and out-of-school adolescents. 16 There are studies related to reproductive health and sexual behaviours carried out among in-school adolescents. 17 – 19 Studies on the differences in reproductive health services between rural and urban in-school adolescents abound. 10 , 20 Nevertheless, studies on adolescent expectations and experiences of reproductive health services, particularly among out-of-school adolescents, are scarce. 10 , 21 There were 12.4 million children who never went to school and 5.9 million who left early. 22 Nigeria’s out-of-school adolescent population accounts for 15% of the global total; one in three adolescents eligible for senior secondary school attend. 22 The needs of out-of-school adolescents are similar to those of other in-school adolescents; however, the sexual and reproductive health needs of out-of-school adolescents may vary depending on their circumstances and hence the need for reproductive health services. This study was conducted to determine the expectations and experiences of reproductive health services among in-school and out-of-school adolescents in the Owo Local Government Area (LGA) of Ondo state and the differences between their reproductive health expectations and experiences. This study will help improve RH care for in-school and out-of-school adolescents and propose ways to reach out-of-school adolescents. It will also provide necessary information for policymakers, opinion leaders, organisations, and governments to guide the development of effective and comprehensive reproductive health services for in-school and out-of-school adolescents in Nigeria to help achieve sustainable development goals. METHODS Study area This study was conducted among secondary school and out-of-school adolescents in Owo Local Government Area (LGA), Ondo State, southwestern Nigeria. The population of Owo, according to the 2006 population census, was 218,886, of which approximately 30% were adolescents and young people. 23 There were 34 secondary schools (comprising 18 public and 16 private) with an estimated 13,500 secondary school students in Owo LGA. Health institutions offer adolescent reproductive health services but do not have designated adolescent/youth-friendly, out-of-school adolescents engaged in menial jobs such as bus conducting, street hawking, petty trading, loitering, learning trades in artisan workshops (mechanics, tailor, vulcaniser, electrical), and even begging for alms in the streets. They tend to congregate in public spaces such as motor parks, markets and artisan workshops. 24 Study design This was a comparative cross-sectional study. Study population Adolescents aged 10–19 years in public and private secondary schools in Owo LGA (in-school adolescents) and adolescents aged 10–19 years who attended primary school but did not proceed to secondary school or who did not complete their secondary school education and were found in public places such as in motor parks, on the street, in shops such as artisans and marketplaces during regular school hours (out-of-school adolescents) were recruited. Adolescents who could not provide the information needed due to ill health, who were married, and out-of-school adolescents who were enrolled in afternoon school classes or enrolled in adult class education were excluded. Sample size determination The sample size was calculated via the following formula for comparing two groups: 25 $$\:N=\frac{2{\left(z\alpha\:+z\beta\:\right)}^{2}{P}_{0}\left(1-{P}_{0}\right)}{{d}^{2}}$$ where N = Minimum sample size Zα = Standard normal deviation, usually set at 1.96 (95% level of significance) Zβ = Standard normal deviation corresponding to the power of 1-β set as 0.84 (at 80% power) P 0 = Mean of the two prevalences in the two comparison groups, i.e., (P2 + P1)/2 P1 was 19.2% in a study in Nigeria on the prevalence of risky sexual behaviour reported among in-school adolescents. 26 𝑁= 2 (1.96 + 0.84) 2 × 0.242 × 0.758/0.1 2 2 × 7.84 × 0.1834/0.01 = 288 respondents A 10% nonresponse rate = The minimum sample size is 320 respondents of in-school and 320 out-of-school adolescents. Sampling technique This study was both a school-based and community-based comparative cross-sectional study. A multistage sampling technique was employed to select the study population of in-school adolescents, and all consenting out-of-school adolescents in the mapped area were selected. Stage 1 was the selection of wards, of which four wards out of the six wards with public and private secondary schools were selected by simple random sampling by balloting. Stage 2 was the selection of schools from the selected wards. Two schools (one private and one public) were selected via a simple random sampling method through balloting from each ward. Eight secondary schools were chosen in total, comprising four public schools and four private secondary schools. Stage 3 was the selection of arms from classes in each selected school. All the classes were involved. In classes with more than one arm, one arm was randomly selected by balloting from the classes. Stage 4 involved the selection of in-school adolescents from the selected arms. Individual students within the selected classes were selected via systematic sampling. A list of all the class students was obtained from the class teachers’ register. The sampling fraction was achieved by dividing the total number of students in the class by the total number in the school and multiplying it by the desired number of respondents in that school, as shown below Sampling fraction= \(\:\frac{Number\:of\:students\:in\:the\:class\:\times\:Desired\:number\:of\:respondents\:in\:the\:class\:\left(40\right)}{Total\:number\:of\:students}\) Individual students were selected within the classes via systematic sampling via a list of all the students in the classes obtained from the class teachers' register. For the selection of out-of-school adolescents, in the same four wards selected for the in-school adolescents, out-of-school adolescents in markets, motor parks, car wash service centres, automobile repair shops, streets, and shops as artisans were identified and mapped. All consenting out-of-school adolescents in the mapped areas were recruited. Study instruments : An interviewer-administered questionnaire was used for in-school and out-of-school adolescents. Some questions were adapted from the WHO illustrative questionnaire for interviews with young people. 27 The questionnaire was divided into five sections to collect relevant information as follows: Section A: Sociodemographic characteristics; Section B: Family structure and consistency; Section C: Awareness of reproductive health services; Section D: Expectations of adolescents concerning reproductive health services; and Section E: Experiences and challenges of adolescent reproductive health services. The questionnaire was pretested among adolescents in similar settings in another ward not selected for the study. This approach helped address the questionnaire's ambiguity and the feasibility of the designed data collection procedure and analysis. Necessary modifications and corrections were made. The reliability coefficient of the Expectation of Reproductive Health Services Care Scale was 72%. The questionnaire was translated into Yoruba and back-translated to English by an expert translator to ensure that the original meaning was retained. The translation was for the benefit of some out-of-school adolescents who did not understand English. Expectations of adolescents’ reproductive health : Adolescent reproductive health services were categorised via the fourteen items concerning respondents’ expectations based on five factors in this study, adapted from the SERVQUAL tool. 28 The SERVQUAL tool measures the gap between expectations and perceptions of services delivered to patients. The modified SERVQUAL scores of adolescents’ reproductive health services (ARHS) expectations were grouped into five levels in this study, and their means were calculated: the expectation level for assurance, measuring health workers' knowledge, courtesy, and ability to offer trust and confidence, had three questions; the expectation level for tangibles, which measured the appearance of personnel and communication materials, had four questions; the expectation level of responsiveness, which measured the willingness to help adolescents, was assigned two questions; the expectation level for reliability, which measured dependability and accuracy, was assigned two questions; and three questions were assigned to the expectation level of empathy, which measured the providers' caring and individualised attention. This study modified the SERVQUAL tool for the respondents' expectations concerning the ARHS, using an odd Likert scale that asked about the order of importance of the questions. The scores for the order of importance were as follows: Very important – 3; Important – 2; Not important – 1. A minimum score of 14 points and a possible maximum score of 42 points were given, which was converted to a percentage and categorised as follows: high expectations—greater than or equal to 70%; minimum acceptable expectations—50–69%; and low expectations—<50%. Experiences of adolescents’ reproductive health services Experiences with reproductive health services were assessed in adolescents who had utilised or used reproductive health services at least once. Therefore, the experience of adolescent reproductive health services was categorised into ‘present’ or ‘absent’ depending on whether the adolescent had ‘ever used’ or ‘never used’ reproductive health services, respectively. Among those who have ever utilised or experienced adolescent reproductive health services, other questions were assessed, including the opening time of the health facility, availability of trained staff, availability of drugs and equipment, long waiting period, and satisfactory services. 29 Other questions addressed among those who had ever utilised reproductive health services included being shouted at, discriminated against, poor attention from health workers, and being mocked for being pregnant at a young age or having STIs. 29 Socioeconomic class The socioeconomic class of the respondents in this study was classified into three social classes, high, middle and low, on the basis of Oyedeji's social class classification. For occupation, the score ranges from 1 (the highest occupational group – professionals) to 5 (the lowest occupational group – unemployed individuals). For educational level, the score ranges from 1 to 5 (1 for tertiary education to 5 for nonliterate individuals). The occupations and educational levels of the mothers and fathers were scored, and the means of the four scores were used as score measures, with scores ranging from 1–5. Respondents with scores of 1–2 were classified as high social class, three as middle social class and 4–5 as low social class. 30 Data analysis The questionnaires were screened for errors after each field day to correct the errors promptly. The data were entered into IBM SPSS statistics 27.0 software for data cleaning and analysis. Frequencies, proportions and percentages were used to summarise categorical variables of interest, such as the age of the respondents and their living status. Appropriate tables and charts were used to display the results. The quantitative variables were summarised in terms of means and standard deviations. Univariate analysis was used to determine the awareness of ARHS, level of expectations for ARHS and experiences of ARHS. This study compared adolescents who were in school with out-of-school adolescents. A p value of less than 0.05 was set as the level of significance. RESULTS A total of 653 adolescents were recruited for the study, and 640 were analysed because the questionnaires were not completely filled out, resulting in a response rate of 98%. There were 320 respondents each of in-school and out-of-school adolescents, with a ratio of 1:1. Table 1 shows the sociodemographic profile of the adolescents. Middle adolescents were predominant among the in-school adolescents (154, 48.1%), whereas 131 (40.9%) out-of-school adolescents were predominant. The difference in the age group between in-school and out-of-school adolescents was statistically significant (p < 0.001). The mean age of the out-of-school adolescents (15.27 ± 2.410 years) was significantly greater than that of the in-school adolescents (13.98 ± 2.028 years) (p < 0.001). A significantly greater percentage (58.4%) of out-of-school adolescents than in-school adolescents (50.3%) were males (p = 0.039). There were more Christians among in-school (86.6%) than out-of-school (63.4%) adolescents (p < 0.001). The Yoruba ethnic group was more predominant (75.0%) among in-school adolescents than 48.8% among out-of-school adolescents (p < 0.001). A significantly greater percentage (37.2%) of in-school adolescent parents were in the high social class than did 5.3% of out-of-school adolescents (p < 0.001). More in-school (65.6%) than out-of-school (36.6%) adolescents lived with both parents (p < 0.001). Table 1 Sociodemographic characteristics of in-school and out-of-school adolescents Variables In-school adolescents N = 320 n (%) Out-of-school adolescents N = 320 n (%) χ² P Value Age (years) 10–13 (Early adolescence) 132 (41.2) 79 (24.7) 55.280 0.001 14–16 (Middle adolescence) 154 (48.2) 131 (40.9) 17–19 (Late adolescence) 34 (10.6) 110 (34.4) Sex Male 161 (50.3) 187 (58.4) 4.258 0.039 Female 159 (49.7) 133 (41.6) Religion Christianity 277 (86.6) 203 (63.4) 45.633 0.001 Islam 43 (13.4) 117 (36.6) Ethnicity Yoruba 240 (75.0) 156 (48.8) 59.437 0.001 Igbo 31(9.7) 58 (18.1) Hausa 4 (1.2) 40 (12.5) Others* 45 (14.1) 66 (20.6) Social class of parents High social class 119 (37.2) 17 (5.3) 130.846 0.001 Middle social class 149 (46.6) 144 (45.0) Low social class 52 (16.2) 159 (49.7) Currently live with Both parents 210 (65.6) 117 (36.6) 58.533 0.001 Single parent 68 (21.2) 99 (30.9) Other family/nonfamily caregivers** 42 (13.1) 104 (32.5) *Other ethnicities include the Ebira, Edo, Idoma and Igala ethnic groups **Other family/nonfamily caregivers include grandparents, uncle, aunty, elder sibling, boss at work, proprietor or teacher in school Among the in-school adolescent classes, SSS 2 was the highest (26.6%), and JSS 2 accounted for 23.1% of the selected schools. In contrast, for the out-of-school adolescents, the in-shop artisans accounted for the highest identified areas (28.4%), the market area (20.6%), and the carwash area (6.9%). Figure 1 shows the classes and aggregation area. The respondents’ awareness of ARHS is shown in Table 2 . More in-school adolescents (80.6%) than 63.4% of out-of-school adolescents were aware of ARHS (p < 0.001). With respect to awareness of where ARHS can be obtained, a significantly greater percentage (57.6%) of out-of-school adolescents than 28.3% of in-school adolescents were aware of where to obtain HIV treatment (p < 0.001). More of the in-school adolescents (82.6%) than the out-of-school adolescents (25.1%) were aware of where to obtain sexual education (p < 0.001). Compared with 8.9% of out-of-school adolescents, 62.0% reported sex education in school as a source of information by in-school adolescents (p < 0.001). A significantly greater percentage (58.1%) of out-of-school adolescents reported peers/friends as their source of information than did 22.5% of in-school adolescents (p < 0.001). More in-school adolescents (43.0%) than 21.7% of out-of-school adolescents were aware that private hospitals rendered ARHS (p < 0.001). A significantly greater percentage (85.7%) of in-school adolescents were aware that hospitals rendered ARHS than 77.3% of out-of-school adolescents did (p = 0.021). The majority (48.1%) of the in-school adolescents, compared with 43.8% of the out-of-school adolescents, reported that government health institutions were the most reliable health facility where they were not deprived of ARHS (p < 0.001). Table 2 Respondents’ awareness of adolescents’ reproductive health vervices Variables In-school adolescents n (%) Out-of-school adolescents n (%) χ² P Value Awareness of any ARHS (N i = 320, N o = 320) Yes 258 (80.6) 203 (63.4) 23.461 < 0.001 No 62 (19.4) 117 (36.6) Awareness of where the following ARHS can be obtained* (N = 461) Contraceptives 86 (33.3) 120 (59.1) 30.547 < 0.001 Sexually transmitted infections treatment 74 (28.7) 107 (52.7) 27.503 < 0.001 HIV treatment 73 (28.3) 117 (57.6) 40.363 < 0.001 Sexual education 213 (82.6) 51 (25.1) 153.144 < 0.001 Source of information* (N = 461) Television 93 (36.0) 41 (20.2) 13.842 < 0.001 Radio 76 (29.5) 41 (20.2) 5.144 0.023 Parents 69 (26.7) 55 (27.1) 0.007 0.933 Sex education in school 160 (62.0) 18 (8.9) 135.392 < 0.001 Peers/Friends 58 (22.5) 118 (58.1) 61.167 < 0.001 Internet 68 (26.4) 44 (21.7) 1.354 0.245 Doctors/Nurses 93 (36.0) 34 (16.7) 21.197 < 0.001 Awareness of where ARHS can be rendered* (N = 461) Private clinic 111 (43.0) 44 (21.7) 23.200 < 0.001 School 20 (7.8) 4 (2.0) 7.695 0.006 Hospital 221 (85.7) 157 (77.3) 5.326 0.021 Pharmacies 59 (22.9) 44 (21.7) 0.093 0.760 Nowhere 11 (4.3) 3 (1.5) 2.994 0.084 Facilities adolescents visit and are not deprived of RHS (N i = 258, N o = 203) Government health institution 124 (48.1) 89 (43.8) 30.740 < 0.001 Private hospitals 85 (32.9) 46 (22.7) Pharmacies 28 (10.9) 61 (30.0) Youth-friendly centre 21 (8.1) 7 (3.4) *Multiple responses allowed N i and N o = subsamples of in- and out-of-school respondents, respectively Table 3 shows the respondents' expectations concerning reproductive health services using adapted SERVQUAL scores. A greater proportion (75.0%) of the out-of-school adolescents had high expectations concerning the ARHS than did 63.4% of the in-school adolescents (p = 0.006). The mean ARHS expectation score of the out-of-school adolescents (31.92 ± 5.082) was higher than that of the in-school adolescents (30.74 ± 5.464) (p = 0.005). The modified SERVQUAL scores of the ARHS expectation levels for assurance (p < 0.001), tangibles (p = 0.022), responsiveness (p = 0.027), and reliability (p = 0.003) were significantly higher among out-of-school adolescents than among in-school adolescents. The mean expectation level of reliability for out-of-school adolescents was lower than that for in-school adolescents (p = 0.003). However, there was no statistically significant association in the expectation level of empathy between in-school and out-of-school adolescents. Table 3 Expectations concerning reproductive health services among the respondents using adapted SERVQUAL scores Variables In-school adolescents N = 320 n (%) Out-of-school adolescents N = 320 n (%) Test statistics P Value Level of expectations for ARHS High expectations (70–100%) 203 (63.4) 240 (75.0) χ²= 10.242 0.006 Minimum acceptable expectations (50–69%) 98 (30.7) 65 (20.3) Low expectations (< 50%) 19 (5.9) 15 (4.7) ARHS expectations score 30.74 ± 5.464 31.92 ± 5.082 t= -2.824 0.005 Modified SERVQUAL scores of ARHS expectation Expectation level on assurance 5.75 ± 1.348 6.36 ± 1.214 t= -6.010 < 0.001 Expectation level on tangibles 8.84 ± 2.138 9.22 ± 1.970 t= -2.288 0.022 Expectation level of responsiveness 4.77 ± 1.248 4.97 ± 1.060 t= -2.219 0.027 Expectation level of reliability 4.90 ± 1.183 4.64 ± 1.019 t = 2.935 0.003 Expectation level of empathy 6.48 ± 1.740 6.73 ± 1.561 t= -1.913 0.056 The respondents’ expectations concerning reproductive health services are shown in Table 4 . A significantly greater percentage (45.0%) of out-of-school adolescents than 34.1% of in-school adolescents considered ages 10–13 years appropriate for accessing ARHS (p < 0.001). More out-of-school adolescents (89.1%) than in-school adolescents (71.2%) expected the facilities rendering ARHSs open all day (p < 0.001). Regarding the expected days for ARHS availability, the majority (34.7%) of out-of-school adolescents, compared with in-school adolescents (16.9%), expected the ARHS to be available from Monday to Friday (p < 0.001). A significantly greater percentage (41.6%) of in-school adolescents than 23.7% of out-of-school adolescents expected mature and same-sex health professionals to render ARHS to them (p < 0.001). There was no statistically significant association in the expected distance of ARHS to the respondents’ residence between in-school and out-of-school adolescents. Table 4 Expectations concerning reproductive health services among the respondents Variables In-school adolescents N = 320 n (%) Out-of-school adolescents N = 320 n (%) χ² P Value Expected age considered appropriate for accessing ARHS Before 10 years old 30 (9.4) 8 (2.5) 21.056 < 0.001 Between 10–13 years old 109 (34.1) 144 (45.0) Between 14–19 years old 101 (31.6) 109 (34.1) Above 20 years old 80 (25.0) 59 (18.4) Expected time for a place rendering ARHS to open All day 228 (71.2) 285 (89.1) 39.686 < 0.001 After schooltime 73 (22.8) 18 (5.6) During schooltime 19 (5.9) 17 (5.3) Expected days ARHS be available Monday-Friday 54 (16.9) 111 (34.7) 56.479 < 0.001 Monday-Saturday 59 (18.4) 92 (28.8) Saturday-Sunday 41 (12.8) 36 (11.2) Every day 166 (51.9) 81 (25.3) Expected health professional to receive ARHS from Young and of the same sex 63 (19.7) 103 (32.2) 26.388 < 0.001 Young and any sex 45 (14.0) 54 (16.9) Matured and same sex 133 (41.6) 76 (23.7) Matured and any sex 79 (24.7) 87 (27.2) Expected distance of ARHS to respondent's residence Near the place of residency area 209 (65.3) 208 (65.0) 0.007 0.934 Outside place of residency area 111 (34.7) 112 (35.0) ARHS = Adolescents’ reproductive health services. Table 5 shows the components of services and fees expected to be rendered in an ARHS centre. A significantly greater percentage (84.7%) of out-of-school adolescents expected life skills to be rendered at the ARHS centre than did 63.8% of in-school adolescents (p < 0.001). Compared with in-school adolescents, more out-of-school adolescents expected HIV testing (p < 0.001), contraceptive use (p = 0.024), and counselling (p = 0.006) to be offered at the ARHS center. A significantly greater percentage (28.8%) of in-school adolescents than 17.5% of out-of-school adolescents expected SRH information to be incorporated into the school curriculum (p < 0.001). Compared with out-of-school adolescents (58.4%), the majority (63.8%) of in-school adolescents expected ARHS to be free of charge for adolescents (p < 0.001). However, there was no statistically significant association in SRH information inclusion in mass media between in-school and out-of-school adolescents. Table 5 Components of services and fees expected to be rendered in an adolescent reproductive health services centre Variables In-school adolescents n (%) Out-of-school adolescents n (%) χ² P Value Expected services to be rendered to adolescents* (N-640) Life skills 204 (63.8) 271 (84.7) 36.657 < 0.001 HIV testing 68 (21.2) 108 (33.8) 12.539 < 0.001 Abortion services 45 (14.1) 55 (17.2) 1.185 0.276 Contraceptives 54 (16.9) 77 (24.1) 5.077 0.024 Counselling 172 (53.8) 137 (42.8) 7.665 0.006 SRH information included in mass media 68 (21.2) 66 (20.6) 0.038 0.846 SRH information to be incorporated into the school curriculum 92 (28.8) 56 (17.5) 11.391 < 0.001 Expected service fees for ARHS (N i = 320, N o = 320) Free of charge for adolescents 204 (63.8) 187 (58.4) 52.105 < 0.001 At a subsidised rate for adolescents 37 (11.6) 102 (31.9) Standard rate applicable for adult 32 (10.0) 12 (3.8) Do not know 47 (14.7) 19 (5.9) *Multiple responses allowed, SRH- Sexual reproductive health N i and N o = subsamples of in- and out-of-school respondents, respectively Figure 2 shows the respondents' expected location for ARHS provision by gender. The majority of in-school male adolescents expected the ARHS provision to be located in special rooms within existing services (38.5%), and the least expected location was pharmacies (5.0%). Most out-of-school male adolescents expected the ARHS provision to be located in special adolescent health institutions (31.0%), and the least expected location was pharmacies (7.0%). With respect to in-school female adolescents, the highest proportion (35.2%) expected the ARHS provision to be located in special adolescent health institutions, and the least expected place was pharmacies (2.5%). Most out-of-school female adolescents expected the ARHS provision to be located in special adolescent health institutions (29.3%). The experiences of ARHS among the respondents are shown in Table 6 . A significantly greater percentage (52.8%) of the in-school adolescents than 18.8% of the out-of-school adolescents had ever used the ARHS (p < 0.001). A significantly greater percentage (18.3%) of out-of-school adolescents than 4.1% of in-school adolescents visited the ARHS facility for pregnancy tests (p < 0.001). More in-school adolescents (74.6%) than out-of-school adolescents (58.3%) visited the ARHS facility for the treatment of common illnesses (p = 0.018). There was no statistically significant association in the types of facilities visited between in-school and out-of-school adolescents. Table 6 Experiences of adolescent reproductive health services among respondents Variables In-school adolescents n (%) Out-of-school adolescents n (%) χ² P Value Ever used ARHS (N i = 320, N o = 320) Yes 169 (52.8) 60 (18.8) 80.790 < 0.001 No 151 (47.2) 260 (81.2) Types of facility visited (N i = 169, N o = 60) Government-owned hospital 101 (59.8) 31 (51.7) 2.620 0.454 Privately owned hospital 65 (38.5) 29 (48.3) Traditional 2 (1.2) 0 (0.0) Pharmacy 1 (0.6) 0 (0.0) Reasons for visit* (N = 229) Counselling 30 (17.8) 8 (13.3) 0.625 0.429 Information 20 (11.8) 5 (8.3) 0.558 0.455 Training 14 (8.3) 2 (3.3) 1.670 0.196 Family planning 7 (4.1) 6 (10.0) 2.838 0.092 Breast examination 2 (1.2) 3 (5.0) 3.020 0.082 Pregnancy test 7 (4.1) 11 (18.3) 12.313 < 0.001 Treatment of common illnesses 126 (74.6) 35 (58.3) 5.582 0.018 STI treatment 6 (3.6) 6 (10.0) 3.709 0.054 Immunisation 18 (10.7) 1 (1.7) 4.697 0.030 Recreation 1 (0.6) 0 (0.0) 0.357 0.550 HIV testing 8 (4.7) 2 (3.3) 0.208 0.648 *Multiple responses allowed; N i and N o = subtotal samples of in- and out-of-school respondents, respectively More of the in-school adolescents (39.1%) than the out-of-school adolescents (8.4%) had utilised the ARHS in the last six months (p < 0.001). A greater percentage (44.0%) of out-of-school adolescents than 17.9% of in-school adolescents provided reasons for not visiting the ARHS facility in the last six months did not know where to visit (p < 0.001). More in-school (16.4%) than out-of-school (3.4%) adolescents were too busy for revisiting (p < 0.001). A significantly greater percentage (19.5%) of in-school adolescents than out-of-school adolescents’ reason for not visiting in the past six months was fear of being seen by parents/guardians (p < 0.001), as shown in Table 7 a. Table 7 a: Respondents’ current experiences with reproductive health services Variables In-school adolescents n (%) Out-of-school adolescents n (%) χ² P Value Visited ARHS facility in last six months (N i = 320, N o = 320) Yes 125 (39.1) 27 (8.4) 82.865 < 0.001 No 195 (60.9) 293 (91.6) Reason for not visiting in the last 6 months* (N = 488) Did not know where to go 35 (17.9) 129 (44.0) 35.686 < 0.001 Did not have money 29 (14.9) 46 (15.7) 0.062 0.804 Too busy 32 (16.4) 10 (3.4) 25.145 < 0.001 Services are not available 22 (11.3) 35 (11.9) 0.050 0.823 Parents refused 27 (13.8) 7 (2.4) 23.710 < 0.001 Fear of being seen by parents/guardian 38 (19.5) 16 (5.5) 23.406 < 0.001 Embarrassment at needing ARHS 24 (12.3) 48 (16.4) 1.545 0.214 Providers are judgmental 13 (6.7) 47 (16.0) 9.541 0.002 The time of service is not convenient 37 (15.4) 10 (3.4) 22.299 < 0.001 I don’t need the services 37 (19.0) 27 (9.2) 9.786 0.002 ARHS = Adolescents’ reproductive health services *Multiple responses allowed; N i and N o = subsamples of in- and out-of-school respondents, respectively Table 7 b shows the respondents' experiences with ARHS. A greater percentage (48.1%) of the out-of-school adolescents than 45.6% of the in-school adolescents perceived that health professionals understood them (p = 0.025). There was no statistically significant association in the type of health worker seen at the facility between the in-school and out-of-school adolescents, although the majority of the respondents were seen by a doctor. More out-of-school adolescents (66.7%) than in-school adolescents (40.0%) experienced friendly and polite providers (p = 0.011). A significantly greater percentage (92.6%) of the out-of-school adolescents than 70.4% of the in-school adolescents considered the ARHS offered at the centres satisfactory (p = 0.017). More out-of-school adolescents (77.8%) than 36.0% of the in-school adolescents reported that no one else was listening when they were being attended to (p < 0.001). More in-school adolescents (8.1%) than 1.6% of out-of-school adolescents had ever denied ARHS (p < 0.001). Table 7 b: Respondents’ current experiences with reproductive health services Variables In-school adolescents n (%) Out-of-school adolescents n (%) χ² P Value Reception at the facility (N i = 125, N o = 27) With warmth and empathy 28 (22.4) 12 (44.5) 9.354 0.025 With understanding 57 (45.6) 13 (48.1) With indifference 25 (20.0) 2 (7.4) With reservation/coldness 15 (12.0) 0 (0.0) Type of health worker seen at the facility (N i = 125, N o = 27) Doctor 84 (67.2) 14 (51.9) 3.181 0.365 Nurse 30 (24.0) 11 (40.7) Health aid 5 (4.0) 1 (3.7) Peer educator/counsellor 6 (4.8) 1 (3.7) Experience with the provider* (N = 152) Was the provider knowledgeable and qualified 67 (53.6) 20 (74.1) 3.803 0.051 Friendly and polite 50 (40.0) 18 (66.7) 6.387 0.011 Interested in you and your problem 35 (28.0) 13 (48.1) 4.172 0.041 A good communicator 51 (40.8) 14 (51.9) 1.108 0.293 Respectful 54 (43.2) 12 (44.4) 0.014 0.906 Concerned about your privacy 30 (24.0) 13 (48.1) 6.382 0.012 Honest and direct 56 (44.8) 10 (37.0) 0.545 0.461 A good listener 48 (38.4) 13 (48.1) 0.878 0.349 Able to help 48 (38.4) 10 (37.0) 0.017 0.895 Considered the services offered at the centre satisfactory (N i = 125, N o = 27) Yes 88 (70.4) 25 (92.6) 5.733 0.017 No 37 (29.6) 2 (7.4) Anyone else listening when you were being attended to (N i = 125, N o = 27) Yes 35 (28.0) 3 (11.1) 15.814 < 0.001 No 45 (36.0) 21 (77.8) I don’t know 45 (36.0) 3 (11.1) Interrupted when you were being attended to (N i = 125, N o = 27) Yes 36 (28.8) 4 (14.8) 2.240 0.135 No 89 (71.2) 23 (85.2) You or any of your friends have ever been denied ARHS (N i = 320, N o = 320) Yes 26 (8.1) 5 (1.6) 18.769 < 0.001 No 135 (42.2) 120 (37.5) I don’t know 159 (49.7) 195 (60.9) *Multiple responses allowed; N i and N o = subsamples of in- and out-of-school respondents, respectively DISCUSSION This study was conducted to assess and compare in-school and out-of-school adolescents' reproductive health problems and their expectations and experiences with reproductive health services in Owo, Ondo State. Awareness of the existence and uptake of reproductive health services can help overcome the rising challenges in the reproductive health and sexual behaviours of adolescents. 31 The level of awareness firmly determines the utilisation of ARHS. 32 In this study, the level of awareness of ARHS was greater among in-school adolescents than among their out-of-school counterparts. The level of awareness was higher than that reported in studies performed in Nigeria and Sri Lanka. 10 , 13 The difference in the reports could be because the Sri Lankan study was qualitative only. However, it was similar to studies in Nepal and Ghana, where adolescents were highly aware of ARHS. 33 The high level of awareness of ARHS could be because of the sexual education taught in secondary schools. Unsurprisingly, out-of-school adolescents do not have access to sexuality education available to in-school adolescents. Additionally, ARHS may mean different things to different adolescents, and the actual meaning may be taken out of context. In this study, more out-of-school adolescents than in-school adolescents knew where to access contraceptives and receive treatment for STIs, including HIV. However, they claimed not to know about ARHS. There is indeed a significant discrepancy between awareness and knowledge of ARHS, as evidenced in this study. Accessing ARHS in early life could help delay sexual debut, prevent unwanted pregnancy, and prevent STIs. Unlike the study in Ethiopia, where health workers were the primary source of ARHS information, 16 the main source of ARHS information found in this study was school teachers among in-school adolescents and peers/friends among out-of-school adolescents. This situation was consistent with studies conducted among in-school adolescents in India18 and Ghana, 34 where schoolteachers were the major source of information. The study in Ethiopia was conducted in a health facility, whereas the current study and the study conducted in Ghana were community-based. Among the out-of-school adolescents, the source of ARHS information is similar to that used in other studies performed in Nigeria and Uganda, where friends/peers were the main sources of information. 35 , 36 The means of disseminating information differ across regions and locations; what is essential is ensuring that the information is transmitted to the people. In this study, most out-of-school adolescents (75.0%) had significantly higher expectations than did in-school adolescents (63.4%), and a significantly greater proportion of out-of-school compared with in-school adolescents, those aged 14–19 years were appropriate for accessing ARHS. This finding is similar to that of a study in Nigeria, where most in-school adolescents deemed 15 years of age appropriate to access ARHS. 10 The findings of the present study are different from those of a study conducted in Botswana, where adolescents aged ten years were considered appropriate for accessing the ARHS. 37 This difference could be attributed to the fact that in Nigeria, society and culture, teaching adolescent sexual issues early in life may lead to promiscuity. It may be culturally different in Botswana, where it is believed that reproductive health and sex education will aid in reducing the risk of unwanted pregnancies. 38 Concerning the days of the week expected for ARHS to be made available, most in-school adolescents wanted ARHS to be provided at all times every day. In contrast, the out-of-school adolescents wanted ARHS to be provided Monday to Friday, exempting the weekends but at all times of the day. This finding is different from other studies among in-school adolescents carried out in Nigeria 10 and Ethiopia, 16 where most of the adolescents expected to be able to access ARHS during school hours. A study in India revealed that in-school adolescents expected the ARHS to be rescheduled to weekends, which would not interfere with their schooling. 18 The difference could be because of the study population and location; the Nigerian study was conducted among in-school adolescents only, and the Ethiopian study was conducted in rural areas. The availability of the ARHS at all times of the day allows them to visit the ARHS at their convenience so that they do not need any particular excuse from their parents or guardians. It is still to buttress the point that they may be afraid of what their parents or other adults may think when they see them accessing such services. Four of the ten in-school adolescents in this study expected the health professional they would like to meet at the ARHS facility to be mature and same-sex. This expectation is in accordance with a study in Nigeria, 10 where in-school adolescents expected mature and same-sex health professionals to attend to them. However, this is contrary to the out-of-school adolescents’ expectations in this study, where young and same-sex health professionals were expected to visit them at the ARHS facility. The differences in the health professionals expected to visit them in the ARHS facility is an issue of adolescents' preference, and the Nigerian study was conducted among in-school adolescents only. However, it is expected by both in-school and out-of-school adolescents that health professionals should be skilled and competent in counselling, maintain confidentiality, listen to clients carefully, be friendly and have no negative attitudes, and be gender specific. 39 The proximity of the ARHS facility has been suggested to be paramount in the utilisation of ARHS. 32 In this study, approximately two-thirds of both in-school and out-of-school adolescents expected the ARHS to be close to their residence, although the difference was not statistically significant. The finding about adolescents’ expectations concerning proximity in ARHS services to the residence is similar to studies in Nigeria 10 and Ghana, 40 where proximity to the residence was a determining factor of optimal utilisation of ARHS. This expectation is anticipated, as it provides ample opportunities for adolescents to access ARHS any time they feel without any economic barriers, such as transport fare. 13 This expectation, however, may also negate the principles of citing youth-friendly centres in convenient locations where adolescents will have free access to youth-friendly services without fear, stigma, discrimination or any penalty for doing so because of a lack of privacy and confidentiality. This finding was similar to that of a study in Malaysia, where confidentiality was the major reason that adolescents would not access services. 41 With respect to expectations of services to be rendered, most adolescents mentioned life skills, although they were more highly expressed by the out-of-school adolescents. This finding was closely followed by counselling. The report on life skills as an expected service is in tandem with other studies conducted in Nigeria, 10 and Nepal. 42 This finding corroborates that gaining life skills enables adolescents to translate their knowledge, attitudes, and values into healthy behaviour and make thoughtful decisions when faced with challenges. In this study, approximately one-third of the adolescents wanted ARHS to be provided in a unique adolescent health institution, with a greater proportion of out-of-school adolescents. This finding is similar to those of studies conducted in India, Bangladesh, and a United Nations Population Fund report. 18 , 39 The reports show that adolescents' expectation was the establishment of a one-stop ARHS centre so that adolescents could obtain information, services and counselling in one setting. This shows that the existing facilities were not yet youth friendly in structure. Hence, adolescents desire to have a place separate from that of adults. In actual sense, this could afford them the privacy they wanted and would allow them to access reproductive health services even when they visit for other medical problems. It also might help eliminate the supposed shame that may be associated with adolescents accessing reproductive health services, as no one would know what such an adolescent has come for. This study revealed a significant difference in the expected service fees for ARHS, as more than half of the adolescents, predominantly in-school adolescents, wanted free service. This expectation is consistent with another study in Africa, where most adolescents wanted ARHS to be given free of charge. 40 However, a greater proportion of out-of-school than in-school adolescents expected a subsidised rate for the ARHS. It revealed how much the out-of-school adolescents wanted the ARHS to be made available at an affordable cost. The utilisation experience of the ARHS in this study was unsatisfactory; approximately half of the in-school adolescents had ever used the ARHS, whereas only one-fifth of the out-of-school adolescents had ever used the ARHS. This finding corroborated the findings of another study in Nigeria, 10 where only one-tenth of the adolescents had ever accessed the ARHS. This situation is, however, better than what was obtained in a study in Sri Lanka, 13 where none of the adolescents had ever accessed the ARHS. This differs from the survey in Ethiopia, 41 where more than three-quarters have used ARHS. The difference may be because the Ethiopian study targeted adolescents aged 15–19 years, whereas the current study included all the adolescents in all age ranges. Surprisingly, there was low utilisation experience of ARHS in this study despite the high level of awareness of ARHS; this is worrisome. The low utilisation in this study could be because the ARHS is not yet fully integrated into the existing primary health care centres in Nigeria, and the out-of-school adolescents are left out of the programme because they are out of reach and highly mobile. Additionally, this could be because of the challenge with implementation and misconception of the ARHS information. Overall, there is a need for concerted efforts to ensure the utilisation of ARHS. The major reason for not visiting the ARHS in this study was that the out-of-school adolescents did not know where to visit. This finding is consistent with other studies in Nigeria, 10 , 43 where the adolescents did not know where to seek ARHS, preventing adolescents from utilising ARHS. Among in-school adolescents, the fear of being seen by parents/guardians was the major reason preventing the use of ARHS. This finding is similar to that in Nepal, where the fear of being seen by parents was a barrier for adolescents seeking ARHS. 44 Treatment of common diseases was the major reason for the adolescents visiting the ARHS facility in this study and the predominant reason among in-school adolescents. This situation is different from another study conducted in Uganda, where the major reason for visiting ARHS was related to the treatment of sexually transmitted diseases. 45 The difference could be due to the difference in research methods, in which the Ugandan study was a synthesis of evidence from the literature. The type of facility where the in-school and out-of-school adolescents received the ARHS in this study was the government-owned hospital. This finding is similar to that of another study in Nigeria, where the facility primarily visited for ARHS was a government health facility. 46 This could be because the Nigerian government mainly provided ARHS through maternal and child health/family planning programmes (MCH/FP). 47 In this study, most of the adolescents reported their experience with healthcare workers in the ARHS facility as being understood. Approximately one-tenth of in-school and none of the out-of-school adolescents were given reservations/coldness. This approach is highly encouraging and should be continued and improved upon. This differs from studies in India, 18 where most adolescents were embarrassed, or Ethiopia, 48 where the adolescents felt uncomfortable and unwanted. The differences in the reports could be due to the study location and design, as the Indian study was conducted in a health facility, and the Ethiopian study was qualitative only. The major health professionals who attended the adolescents at the facility were the doctors who were knowledgeable and qualified. This finding is similar to those of studies in Nigeria 10 and Ethiopia, 42 where qualified doctors attended adolescents who visited the ARHS. Fewer than half (48.1%) of the out-of-school adolescents and approximately one-quarter of the in-school adolescents in this study reported that the providers at the ARHS facility were concerned about their privacy. This finding differs from the findings in Ethiopia, where 45% of the in-school adolescents reported not having enough privacy. 49 The Ethiopian study was conducted in a rural and urban setting, unlike the current study, which was carried out in an urban setting. This could account for the difference in the reports. Approximately three-quarters of the in-school adolescents and almost all (92.6%) of the out-of-school adolescents in this study considered the ARHS offered at the facility satisfactory. This finding is corroborated by the findings of other studies in Nigeria 10 and Ethiopia, 42 where almost all the adolescents considered the ARHS satisfactory. The limitation of this study was that the expectations and experiences were assessed via self-report questionnaires, which are prone to recall bias. This was reduced by the use of detailed probe questions that provide more information on exposure events, and the researcher was available to provide proper guidance to the respondents. Additionally, the selection of out-of-school adolescents may not be representative, as the various groups are heterogeneous; some, such as house help, were not considered in the sampling technique. In conclusion, in-school adolescents are more aware of the ARHS than are out-of-school adolescents. Despite the higher level of expectations for ARHS among out-of-school adolescents than among in-school adolescents, fewer out-of-school adolescents than in-school adolescents have utilised ARHS. The major reason for visiting the ARHS was the treatment of common illnesses, although this was more common among in-school adolescents. The main reasons for not visiting were that they did not know where to visit, which was reported more among out-of-school adolescents, and that more in-school adolescents feared being seen by parents/guardians. For those who had utilised the ARHS, more out-of-school adolescents had satisfactory experiences than did in-school adolescents. It is therefore recommended that policymakers recognise the distinct needs of in-school and out-of-school adolescents and formulate policies that bridge the gaps in accessing reproductive health services and that the ARHS should be free or discounted for adolescents to motivate them to use these services. The government should design health education and promotion programs to increase awareness of the ARHS, primarily through mass media, social media, artisans, union leaders, religious leaders, and schools. Similarly, schools should provide comprehensive ARHS information and awareness, which can be a lifelong protective benefit to adolescents. Declarations Ethical approval and consent to participate: Ethical approval was obtained from the Health Research Ethics Committee of the Federal Medical Centre, Owo, Ondo State with number FMC/OW/380/VOL.CXLVIII/200. Permission to conduct the study was obtained from the Ondo State Ministry of Education. Verbal consent was obtained from the school authorities and the local trade union leaders in the study area. The consent of parents/guardians was obtained. In addition, consent/assent was obtained from each of the participating adolescents, following the provision of a detailed explanation of the study objectives, information about the benefits and risks and assurance of the freedom to participate or otherwise without any threat of sanction or unfavourable treatment. The data collection instrument had no personal identification information. All participants were identified using only serial numbers. Data were secured by password protection of the research-related data. Consent for publication: The consent for publication has been obtained. Availability of data and materials : The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interest – The authors declare that they have no competing interests. Funding – There was no financial support of any kind, either in terms of grants or equipment or otherwise. Authors’ contribution: KAO, KAJ: Concept and design of the study, acquisition of data, analysis of data, interpretation of data, drafting the article, and final approval of the version to be published. AAM, AOO: Concept and design of the study, interpretation of data, drafting the article, revising it critically for important intellectual content, and final approval of the version to be published. AAJ, FDT, AIF,OKO, AOO, FIO,ALA: The acquisition of data, interpretation of data, drafting the article, revising it critically for important intellectual content, and final approval of the version to be published. Acknowledgements: We acknowledged the resident doctors in the Department of Community Health of Federal Medical Centre, Owo, Nigeria who helped in the recruitment of the participants. Authors' information: KAO: Consultant/specialist Community Health Physician in reproductive health; Fellow of the West African College of Physician (comm Health), Master of Public Health, Bachelor of Surgery; Bachelor of Medicine (MBChB). KAJ: Consultant/specialist Paediatrician; Fellow Medical College of Paediatrics, Master of Public Health, Bachelor of Surgery Bachelor of Medicine (MBChB). AAM: Professor of Community Medicine (University of Ibadan, Nigeria); Consultant/specialist Community Health Physician in school health and reproductive health; Fellow of the West African College of Physician (comm Health), Master of Public Health, Bachelor of Surgery; Bachelor of Medicine (MBBS). AOO: Consultant/specialist Community Health Physician; Fellow of the West African College of Physician (comm Health), Master of Public Health, Bachelor of Surgery; Bachelor of Medicine (MBBS). FIO: Consultant/specialist Paediatrician; Fellow of the West African College of Physician (Paediatrics), Bachelor of Surgery Bachelor of Medicine (MBChB). ALA: Consultant/specialist Family Medicine Physician; Fellow of the West African College of Physician (Family Medicine), Bachelor of Surgery Bachelor of Medicine (MBBS). References ICPD. International Conference on Population and Development (1994) Available from: https://www.unfpa.org/events/international-conference-population-and-development-icpd . 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Sci J Public Health 2(3):17 Ndyanabangi B, Kipp W, Diesfeld HJ (2017) Reproductive Health Behaviour among In-School and Out-of-School Youth in Kabarole District, Uganda. Afr J Reprod Health 8(3):249–252 Seloilwe E, Magowe M, Dithole K, St. Lawrence J (2015) Parent and Youth Communication Patterns on HIV and AIDS, STIs and Sexual Matters: Opportunities and Challenges. J Child Adolesc Behav 3(3):1–6 Barchi F, Ntshebe O, Apps H, Ramaphane P (2022) Contraceptive Literacy among School-going Adolescents in Botswana. Int Nurs Rev 69(1):86–94 Yunus S, Sharmin S, Huq NL, Haseen F, Imam MA, Nahar Q (2018) Expectations of Adolescents to Receive Reproductive Health Information and Services from Health Service System: A Qualitative Study in Bangladesh. South East Asia J Public Health 7(2):19–26 Biddlecom AE, Munthali A, Singh S, Woog V (2007) Adolescents’ Views of and Preferences for Sexual and Reproductive Health Services in Burkina Faso, Ghana, Malawi and Uganda. Afr J Reprod Health 11(3):99 Feleke SA, Koye DN, Demssie AF, Mengesha ZB (2013) Reproductive Health Service Utilisation and Associated Factors among Adolescents (15–19 years old) in Gondar Town, Northwest Ethiopia. BMC Health Serv Res 13(1):1–9 Bam K, Haseen F, BC RK, Newman MS, Chaudhary AH, Thapa R et al (2015) Perceived Sexual and Reproductive Health Needs and Service Utilisation among Higher Secondary School Students in Urban Nepal. Am J Public Health Res 3(2):36–45 Ekong I (2016) Adequacy of Adolescent Healthcare Services Available for Adolescent girls in a Southern Nigerian Environment. Int Res J Med Biomedical Sci 1(2):23–28 Adhikari N, Uddin S, Sapakota K, Adhikari S (2020) Sexual and Reproductive Health Needs and Service Utilisation among Adolescents in Nepal. Am J Public Health Res 8(2):47–53 Neema S, Musisi N, Kibombo R (2006) Adolescent Sexual and Reproductive Health in Uganda: A Synthesis of Research Evidence. Occasional Reeport No 14. Available from: . Accessed January 10, 2025 Nnebue CC (2016) Sexual Behaviour and Practices among Secondary School Adolescents in Anambra State, Nigeria. Afrimedic J 1:22–27 Federal Ministry of Health Nigeria. Assessment Report of the National Response to Young People’s Sexual and Reproductive Health in Nigeria. Federal Ministry of Health Nigeria (2009) Available from: . Accessed January 12, 2025 Munea AM, Alene GD, Debelew GT, Sibhat KA (2022) Sociocultural Context of Adolescent Sexuality and Youth Friendly Service Intervention in West Gojjam Zone, Northwest Ethiopia: A Qualitative Study. BMC Public Health. ;22(1) Abdurahman C, Oljira L, Hailu S, Mengesha MM (2022) Sexual and Reproductive Health Services Utilisation and Associated Factors among Adolescents Attending Secondary Schools. Reprod Health 19(1):1–10 Additional Declarations The authors declare no competing interests. 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Kareem","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIiWNgGAWjYBACA2YGBgkGhgQIL+GHDZBkbDxAvJaHPWkgLQ34tTAgaWF8wHYYzMCrxZyd+eBt3h1p8ubtzUc3JPCct1vbfhhoS41NNC4tls1syda8Z3IM55w5lnYjweJ28rYziUAtx9JyG3A57DCPmTRvWwXjDIkcsxsJPLeTzQ4AtTA2HCaoxX6G/PtvNxLYziWbnX9IlJacxBkSPGxALQfszG4QsAXkF8u5bWnJM3jSgIp7khPMbgBtScDjF3P+wwdvvG1Ltp3BfvjZzR8/7OzNzqc/fPChxganFgyQCFaZQKxyELAnRfEoGAWjYBSMDAAAOChkCLS8I3MAAAAASUVORK5CYII=","orcid":"","institution":"Federal Medical centre, owo, Nigeria","correspondingAuthor":true,"prefix":"","firstName":"Abiodun","middleName":"John","lastName":"Kareem","suffix":""},{"id":485996825,"identity":"cebe36d6-408c-472c-a52b-044d07faf491","order_by":2,"name":"Ayodeji Mathew Adebayo","email":"","orcid":"","institution":"University College Hospital, Ibadan, Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Ayodeji","middleName":"Mathew","lastName":"Adebayo","suffix":""},{"id":485996826,"identity":"41275d52-a358-4e8d-abb8-a9f8bb32c080","order_by":3,"name":"Oludele Oluwafemi Ayodeji","email":"","orcid":"","institution":"Federal Medical centre, owo, Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Oludele","middleName":"Oluwafemi","lastName":"Ayodeji","suffix":""},{"id":485996827,"identity":"cdd2fc40-fb75-42ec-b762-14c255a8331a","order_by":4,"name":"Adewale Johnson Aro","email":"","orcid":"","institution":"Federal Medical centre, owo, Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Adewale","middleName":"Johnson","lastName":"Aro","suffix":""},{"id":485996828,"identity":"21182e4f-e4fc-47cf-b815-c5e25dff0c1d","order_by":5,"name":"Darlington Tolutope Falana","email":"","orcid":"","institution":"Federal Medical centre, owo, 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Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Opeyemi","middleName":"Omolade","lastName":"Akinmadelo","suffix":""},{"id":485996832,"identity":"c49057d2-413e-4bff-b075-bac4d1e3944d","order_by":9,"name":"Ifedayo Olabisi Fasoranti","email":"","orcid":"","institution":"Federal Medical centre, owo, Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Ifedayo","middleName":"Olabisi","lastName":"Fasoranti","suffix":""},{"id":485996833,"identity":"e162696d-ea51-44b4-95ea-3cc11e0eb631","order_by":10,"name":"Liasu Adeagbo Ahmed","email":"","orcid":"","institution":"Federal Medical centre, owo, Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Liasu","middleName":"Adeagbo","lastName":"Ahmed","suffix":""}],"badges":[],"createdAt":"2025-07-15 23:09:55","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7134310/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7134310/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87053979,"identity":"a8bf8e0a-eabc-49c3-aef8-84ef52507b55","added_by":"auto","created_at":"2025-07-18 15:20:52","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":315239,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eClasses and aggregation areas of the respondents\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7134310/v1/6e79cceeef5fd10daa0082d0.jpeg"},{"id":87053447,"identity":"88791f8a-c99c-4f65-8fb3-82d26862e787","added_by":"auto","created_at":"2025-07-18 15:12:52","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":98100,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eRespondents’ expected location for ARHS provision by gender\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7134310/v1/5316d50624cda67bb0105742.png"},{"id":87054794,"identity":"2c618472-1114-4828-a9e9-e0956eaca5c3","added_by":"auto","created_at":"2025-07-18 15:28:54","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2551420,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7134310/v1/8b1fdd0d-a847-4342-9d0b-be891ec0a95c.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eReproductive Health Services: Expectations and Experiences Among in-school and Out-of-school Adolescents in Nigeria\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eReproductive health encompasses all aspects of an individual's physical, mental, and social well-being and is not limited to the lack of disease or infirmity concerning the reproductive system, its functions, or its processes.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e Reproductive health services include sexuality and reproductive health information; sexual abuse counselling; HIV testing, counselling, and treatment; STI testing and counselling; contraception counselling and provision (family planning services); maternal health services; postabortion care (within the extent of the law); sexual and gender-based violence counselling; harmful traditional practice prevention; and referral services (including legal and social services).\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eAdolescents are aged ten to nineteen years, a phase in which rapid physical and cognitive growth occurs.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e During this period, a sense of self-awareness and emotional independence occurs.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e Adolescence is a crucial stage when personal responsibilities develop on the basis of exposure and experience, and it is not without its fragility. The adolescent population is increasing; approximately 1.2\u0026nbsp;billion of the 7.3\u0026nbsp;billion people in the world are adolescents, 85% of whom live in developing countries.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e In Nepal, adolescents and young people constitute approximately 24% and 33% of the population, respectively.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e This figure is similar to that of the Nigerian population, which is estimated at 200\u0026nbsp;million, with 22% of the population being adolescents and 31% being young.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eDespite the growing population, adolescents in developing countries have little access to medical care or education, with a high prevalence of poverty and cultural and sexual norms.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e Adolescents have unique health needs that require specific and appropriate reproductive health services.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e While adolescent reproductive health services are a significant part of adolescent health, unfortunately, many adolescents are unaware of the sexual and reproductive health information and services available. Therefore, they could not benefit from them. In a study in Nigeria, only 13.1% of the adolescents were aware of adolescent reproductive health services, whereas 7.8% had ever used the service.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eOne of the concerted efforts is establishing adolescent and youth-friendly health services (AYFHSs), adapted to address the barriers adolescents face in having quality reproductive health (RH) services.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e The AYFHS has standalone service delivery with a growing ability to make existing health services youth friendly.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e However, most adolescents are unaware and lack substantial knowledge about the AYFHS, and sadly, they also encounter obstacles and challenges in obtaining quality services and information.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eA study in Sri Lanka revealed that only girls were aware of the availability of RH services, whereas no single male adolescent knew about the RH services available to them.\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e This is contrary to a study performed in Nepal, where male adolescents had better knowledge of SRH issues than female adolescents did.\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e A study in Brazil showed that most adolescents are unaware of existing reproductive health services.\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e A study in Oyo State, Nigeria, revealed a low level of awareness of adolescent reproductive health services (ARHS), with 13.1% being aware of ARHS and only 7.8% utilising ARHS.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e The low patronage was because they did not know where to go.\u003c/p\u003e\u003cp\u003eThe provision of the AYFHS may not be sufficient to increase adolescent use of services; hence, there is a need to harness the expectations of adolescents, which is a way of strengthening the participatory rights of adolescents. These expectations will help support the high-quality services of adolescent RHs through multiple channels to reach in-school and out-of-school adolescents.\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThere are studies related to reproductive health and sexual behaviours carried out among in-school adolescents.\u003csup\u003e\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e–\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e Studies on the differences in reproductive health services between rural and urban in-school adolescents abound.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e Nevertheless, studies on adolescent expectations and experiences of reproductive health services, particularly among out-of-school adolescents, are scarce.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e There were 12.4\u0026nbsp;million children who never went to school and 5.9\u0026nbsp;million who left early.\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e Nigeria’s out-of-school adolescent population accounts for 15% of the global total; one in three adolescents eligible for senior secondary school attend.\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThe needs of out-of-school adolescents are similar to those of other in-school adolescents; however, the sexual and reproductive health needs of out-of-school adolescents may vary depending on their circumstances and hence the need for reproductive health services.\u003c/p\u003e\u003cp\u003eThis study was conducted to determine the expectations and experiences of reproductive health services among in-school and out-of-school adolescents in the Owo Local Government Area (LGA) of Ondo state and the differences between their reproductive health expectations and experiences. This study will help improve RH care for in-school and out-of-school adolescents and propose ways to reach out-of-school adolescents. It will also provide necessary information for policymakers, opinion leaders, organisations, and governments to guide the development of effective and comprehensive reproductive health services for in-school and out-of-school adolescents in Nigeria to help achieve sustainable development goals.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003eStudy area\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e This study was conducted among secondary school and out-of-school adolescents in Owo Local Government Area (LGA), Ondo State, southwestern Nigeria. The population of Owo, according to the 2006 population census, was 218,886, of which approximately 30% were adolescents and young people.\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e There were 34 secondary schools (comprising 18 public and 16 private) with an estimated 13,500 secondary school students in Owo LGA. Health institutions offer adolescent reproductive health services but do not have designated adolescent/youth-friendly, out-of-school adolescents engaged in menial jobs such as bus conducting, street hawking, petty trading, loitering, learning trades in artisan workshops (mechanics, tailor, vulcaniser, electrical), and even begging for alms in the streets. They tend to congregate in public spaces such as motor parks, markets and artisan workshops.\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThis was a comparative cross-sectional study.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eStudy population\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eAdolescents aged 10–19 years in public and private secondary schools in Owo LGA (in-school adolescents) and adolescents aged 10–19 years who attended primary school but did not proceed to secondary school or who did not complete their secondary school education and were found in public places such as in motor parks, on the street, in shops such as artisans and marketplaces during regular school hours (out-of-school adolescents) were recruited. Adolescents who could not provide the information needed due to ill health, who were married, and out-of-school adolescents who were enrolled in afternoon school classes or enrolled in adult class education were excluded.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eSample size determination\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe sample size was calculated via the following formula for comparing two groups:\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$\\:N=\\frac{2{\\left(z\\alpha\\:+z\\beta\\:\\right)}^{2}{P}_{0}\\left(1-{P}_{0}\\right)}{{d}^{2}}$$\u003c/div\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003ewhere\u003c/p\u003e\u003cp\u003eN = Minimum sample size\u003c/p\u003e\u003cp\u003eZα = Standard normal deviation, usually set at 1.96 (95% level of significance)\u003c/p\u003e\u003cp\u003eZβ = Standard normal deviation corresponding to the power of 1-β set as 0.84 (at 80% power)\u003c/p\u003e\u003cp\u003eP\u003csub\u003e0\u003c/sub\u003e = Mean of the two prevalences in the two comparison groups, i.e., (P2 + P1)/2\u003c/p\u003e\u003cp\u003eP1 was 19.2% in a study in Nigeria on the prevalence of risky sexual behaviour reported among in-school adolescents.\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e𝑁= 2 (1.96 + 0.84)\u003csup\u003e2\u003c/sup\u003e × 0.242 × 0.758/0.1\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e2 × 7.84 × 0.1834/0.01 = 288 respondents\u003c/p\u003e\u003cp\u003eA 10% nonresponse rate = The minimum sample size is 320 respondents of in-school and 320 out-of-school adolescents.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eSampling technique\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThis study was both a school-based and community-based comparative cross-sectional study. A multistage sampling technique was employed to select the study population of in-school adolescents, and all consenting out-of-school adolescents in the mapped area were selected. Stage 1 was the selection of wards, of which four wards out of the six wards with public and private secondary schools were selected by simple random sampling by balloting. Stage 2 was the selection of schools from the selected wards. Two schools (one private and one public) were selected via a simple random sampling method through balloting from each ward. Eight secondary schools were chosen in total, comprising four public schools and four private secondary schools. Stage 3 was the selection of arms from classes in each selected school. All the classes were involved. In classes with more than one arm, one arm was randomly selected by balloting from the classes. Stage 4 involved the selection of in-school adolescents from the selected arms. Individual students within the selected classes were selected via systematic sampling. A list of all the class students was obtained from the class teachers’ register. The sampling fraction was achieved by dividing the total number of students in the class by the total number in the school and multiplying it by the desired number of respondents in that school, as shown below\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eSampling fraction=\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{Number\\:of\\:students\\:in\\:the\\:class\\:\\times\\:Desired\\:number\\:of\\:respondents\\:in\\:the\\:class\\:\\left(40\\right)}{Total\\:number\\:of\\:students}\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\u003cp\u003eIndividual students were selected within the classes via systematic sampling via a list of all the students in the classes obtained from the class teachers' register.\u003c/p\u003e\u003cp\u003eFor the selection of out-of-school adolescents, in the same four wards selected for the in-school adolescents, out-of-school adolescents in markets, motor parks, car wash service centres, automobile repair shops, streets, and shops as artisans were identified and mapped. All consenting out-of-school adolescents in the mapped areas were recruited.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy instruments\u003c/b\u003e: An interviewer-administered questionnaire was used for in-school and out-of-school adolescents. Some questions were adapted from the WHO illustrative questionnaire for interviews with young people.\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e The questionnaire was divided into five sections to collect relevant information as follows: Section A: Sociodemographic characteristics; Section B: Family structure and consistency; Section C: Awareness of reproductive health services; Section D: Expectations of adolescents concerning reproductive health services; and Section E: Experiences and challenges of adolescent reproductive health services.\u003c/p\u003e\u003cp\u003eThe questionnaire was pretested among adolescents in similar settings in another ward not selected for the study. This approach helped address the questionnaire's ambiguity and the feasibility of the designed data collection procedure and analysis. Necessary modifications and corrections were made. The reliability coefficient of the Expectation of Reproductive Health Services Care Scale was 72%. The questionnaire was translated into Yoruba and back-translated to English by an expert translator to ensure that the original meaning was retained. The translation was for the benefit of some out-of-school adolescents who did not understand English.\u003c/p\u003e\u003cp\u003e\u003cb\u003eExpectations of adolescents’ reproductive health\u003c/b\u003e: Adolescent reproductive health services were categorised via the fourteen items concerning respondents’ expectations based on five factors in this study, adapted from the SERVQUAL tool.\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e The SERVQUAL tool measures the gap between expectations and perceptions of services delivered to patients. The modified SERVQUAL scores of adolescents’ reproductive health services (ARHS) expectations were grouped into five levels in this study, and their means were calculated: the expectation level for assurance, measuring health workers' knowledge, courtesy, and ability to offer trust and confidence, had three questions; the expectation level for tangibles, which measured the appearance of personnel and communication materials, had four questions; the expectation level of responsiveness, which measured the willingness to help adolescents, was assigned two questions; the expectation level for reliability, which measured dependability and accuracy, was assigned two questions; and three questions were assigned to the expectation level of empathy, which measured the providers' caring and individualised attention.\u003c/p\u003e\u003cp\u003eThis study modified the SERVQUAL tool for the respondents' expectations concerning the ARHS, using an odd Likert scale that asked about the order of importance of the questions.\u003c/p\u003e\u003cp\u003eThe scores for the order of importance were as follows: Very important – 3; Important – 2; Not important – 1. A minimum score of 14 points and a possible maximum score of 42 points were given, which was converted to a percentage and categorised as follows: high expectations—greater than or equal to 70%; minimum acceptable expectations—50–69%; and low expectations—\u0026lt;50%.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eExperiences of adolescents’ reproductive health services\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eExperiences with reproductive health services were assessed in adolescents who had utilised or used reproductive health services at least once. Therefore, the experience of adolescent reproductive health services was categorised into ‘present’ or ‘absent’ depending on whether the adolescent had ‘ever used’ or ‘never used’ reproductive health services, respectively. Among those who have ever utilised or experienced adolescent reproductive health services, other questions were assessed, including the opening time of the health facility, availability of trained staff, availability of drugs and equipment, long waiting period, and satisfactory services.\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e Other questions addressed among those who had ever utilised reproductive health services included being shouted at, discriminated against, poor attention from health workers, and being mocked for being pregnant at a young age or having STIs.\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eSocioeconomic class\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThe socioeconomic class of the respondents in this study was classified into three social classes, high, middle and low, on the basis of Oyedeji's social class classification. For occupation, the score ranges from 1 (the highest occupational group – professionals) to 5 (the lowest occupational group – unemployed individuals). For educational level, the score ranges from 1 to 5 (1 for tertiary education to 5 for nonliterate individuals). The occupations and educational levels of the mothers and fathers were scored, and the means of the four scores were used as score measures, with scores ranging from 1–5. Respondents with scores of 1–2 were classified as high social class, three as middle social class and 4–5 as low social class.\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eData analysis\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThe questionnaires were screened for errors after each field day to correct the errors promptly. The data were entered into IBM SPSS statistics 27.0 software for data cleaning and analysis. Frequencies, proportions and percentages were used to summarise categorical variables of interest, such as the age of the respondents and their living status. Appropriate tables and charts were used to display the results. The quantitative variables were summarised in terms of means and standard deviations. Univariate analysis was used to determine the awareness of ARHS, level of expectations for ARHS and experiences of ARHS. This study compared adolescents who were in school with out-of-school adolescents. A p value of less than 0.05 was set as the level of significance.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eA total of 653 adolescents were recruited for the study, and 640 were analysed because the questionnaires were not completely filled out, resulting in a response rate of 98%. There were 320 respondents each of in-school and out-of-school adolescents, with a ratio of 1:1.\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the sociodemographic profile of the adolescents. Middle adolescents were predominant among the in-school adolescents (154, 48.1%), whereas 131 (40.9%) out-of-school adolescents were predominant. The difference in the age group between in-school and out-of-school adolescents was statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The mean age of the out-of-school adolescents (15.27\u0026thinsp;\u0026plusmn;\u0026thinsp;2.410 years) was significantly greater than that of the in-school adolescents (13.98\u0026thinsp;\u0026plusmn;\u0026thinsp;2.028 years) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A significantly greater percentage (58.4%) of out-of-school adolescents than in-school adolescents (50.3%) were males (p\u0026thinsp;=\u0026thinsp;0.039). There were more Christians among in-school (86.6%) than out-of-school (63.4%) adolescents (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The Yoruba ethnic group was more predominant (75.0%) among in-school adolescents than 48.8% among out-of-school adolescents (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A significantly greater percentage (37.2%) of in-school adolescent parents were in the high social class than did 5.3% of out-of-school adolescents (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). More in-school (65.6%) than out-of-school (36.6%) adolescents lived with both parents (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\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\u003eSociodemographic characteristics of in-school and out-of-school adolescents\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\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\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\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\u003eIn-school adolescents\u003c/p\u003e\u003cp\u003eN\u0026thinsp;=\u0026thinsp;320\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOut-of-school adolescents\u003c/p\u003e\u003cp\u003eN\u0026thinsp;=\u0026thinsp;320\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eχ\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (years)\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\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e10\u0026ndash;13 (Early adolescence)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e132 (41.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e79 (24.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e55.280\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e14\u0026ndash;16 (Middle adolescence)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e154 (48.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e131 (40.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e17\u0026ndash;19 (Late adolescence)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e34 (10.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e110 (34.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex\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\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\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\u003e161 (50.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e187 (58.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.258\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.039\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\u003e159 (49.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e133 (41.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eReligion\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\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\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\u003e277 (86.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e203 (63.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e45.633\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\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\u003e43 (13.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e117 (36.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEthnicity\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\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYoruba\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e240 (75.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e156 (48.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e59.437\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIgbo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e31(9.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e58 (18.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHausa\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4 (1.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e40 (12.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\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\u003e45 (14.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e66 (20.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSocial class of parents\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\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh social class\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e119 (37.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17 (5.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e130.846\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMiddle social class\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e149 (46.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e144 (45.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow social class\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e52 (16.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e159 (49.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCurrently live with\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\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBoth parents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e210 (65.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e117 (36.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e58.533\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle parent\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e68 (21.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e99 (30.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther family/nonfamily caregivers**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e42 (13.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e104 (32.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003e*Other ethnicities include the Ebira, Edo, Idoma and Igala ethnic groups\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003e**Other family/nonfamily caregivers include grandparents, uncle, aunty, elder sibling, boss at work, proprietor or teacher in school\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAmong the in-school adolescent classes, SSS 2 was the highest (26.6%), and JSS 2 accounted for 23.1% of the selected schools. In contrast, for the out-of-school adolescents, the in-shop artisans accounted for the highest identified areas (28.4%), the market area (20.6%), and the carwash area (6.9%). Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the classes and aggregation area.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe respondents\u0026rsquo; awareness of ARHS is shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. More in-school adolescents (80.6%) than 63.4% of out-of-school adolescents were aware of ARHS (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). With respect to awareness of where ARHS can be obtained, a significantly greater percentage (57.6%) of out-of-school adolescents than 28.3% of in-school adolescents were aware of where to obtain HIV treatment (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). More of the in-school adolescents (82.6%) than the out-of-school adolescents (25.1%) were aware of where to obtain sexual education (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Compared with 8.9% of out-of-school adolescents, 62.0% reported sex education in school as a source of information by in-school adolescents (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A significantly greater percentage (58.1%) of out-of-school adolescents reported peers/friends as their source of information than did 22.5% of in-school adolescents (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). More in-school adolescents (43.0%) than 21.7% of out-of-school adolescents were aware that private hospitals rendered ARHS (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A significantly greater percentage (85.7%) of in-school adolescents were aware that hospitals rendered ARHS than 77.3% of out-of-school adolescents did (p\u0026thinsp;=\u0026thinsp;0.021). The majority (48.1%) of the in-school adolescents, compared with 43.8% of the out-of-school adolescents, reported that government health institutions were the most reliable health facility where they were not deprived of ARHS (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\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\u003eRespondents\u0026rsquo; awareness of adolescents\u0026rsquo; reproductive health vervices\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\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\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\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\u003eIn-school adolescents\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOut-of-school adolescents\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eχ\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eAwareness of any ARHS (N\u003csub\u003ei\u003c/sub\u003e = 320, N\u003csub\u003eo\u003c/sub\u003e = 320)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\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\u003e258 (80.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e203 (63.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23.461\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\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\u003e62 (19.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e117 (36.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAwareness of where the following ARHS can be obtained* (N\u0026thinsp;=\u0026thinsp;461)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eContraceptives\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e86 (33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e120 (59.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.547\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSexually transmitted infections treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e74 (28.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e107 (52.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.503\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHIV treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e73 (28.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e117 (57.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40.363\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSexual education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e213 (82.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51 (25.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e153.144\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSource of information* (N\u0026thinsp;=\u0026thinsp;461)\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\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTelevision\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e93 (36.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41 (20.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13.842\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRadio\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e76 (29.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41 (20.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.144\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.023\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e69 (26.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e55 (27.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.007\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.933\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex education in school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e160 (62.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 (8.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e135.392\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePeers/Friends\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e58 (22.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e118 (58.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61.167\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInternet\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e68 (26.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44 (21.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.354\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.245\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDoctors/Nurses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e93 (36.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34 (16.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21.197\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAwareness of where ARHS can be rendered* (N\u0026thinsp;=\u0026thinsp;461)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrivate clinic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e111 (43.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44 (21.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23.200\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSchool\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e20 (7.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (2.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.695\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.006\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e221 (85.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e157 (77.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.326\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.021\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePharmacies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e59 (22.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44 (21.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.093\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.760\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNowhere\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11 (4.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (1.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.994\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.084\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFacilities adolescents visit and are not deprived of RHS (N\u003c/b\u003e\u003csub\u003e\u003cb\u003ei\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 258, N\u003c/b\u003e\u003csub\u003e\u003cb\u003eo\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 203)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGovernment health institution\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e124 (48.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e89 (43.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.740\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrivate hospitals\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e85 (32.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46 (22.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePharmacies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e28 (10.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e61 (30.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYouth-friendly centre\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e21 (8.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 (3.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003e*Multiple responses allowed\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eN\u003c/em\u003e\u003csub\u003e\u003cem\u003ei\u003c/em\u003e\u003c/sub\u003e \u003cem\u003eand N\u003c/em\u003e\u003csub\u003e\u003cem\u003eo\u003c/em\u003e\u003c/sub\u003e \u003cem\u003e= subsamples of in- and out-of-school respondents, respectively\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the respondents' expectations concerning reproductive health services using adapted SERVQUAL scores. A greater proportion (75.0%) of the out-of-school adolescents had high expectations concerning the ARHS than did 63.4% of the in-school adolescents (p\u0026thinsp;=\u0026thinsp;0.006). The mean ARHS expectation score of the out-of-school adolescents (31.92\u0026thinsp;\u0026plusmn;\u0026thinsp;5.082) was higher than that of the in-school adolescents (30.74\u0026thinsp;\u0026plusmn;\u0026thinsp;5.464) (p\u0026thinsp;=\u0026thinsp;0.005). The modified SERVQUAL scores of the ARHS expectation levels for assurance (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), tangibles (p\u0026thinsp;=\u0026thinsp;0.022), responsiveness (p\u0026thinsp;=\u0026thinsp;0.027), and reliability (p\u0026thinsp;=\u0026thinsp;0.003) were significantly higher among out-of-school adolescents than among in-school adolescents. The mean expectation level of reliability for out-of-school adolescents was lower than that for in-school adolescents (p\u0026thinsp;=\u0026thinsp;0.003). However, there was no statistically significant association in the expectation level of empathy between in-school and out-of-school adolescents.\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\u003eExpectations concerning reproductive health services among the respondents using adapted SERVQUAL scores\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\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\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\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\u003eIn-school adolescents\u003c/p\u003e\u003cp\u003eN\u0026thinsp;=\u0026thinsp;320\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOut-of-school adolescents\u003c/p\u003e\u003cp\u003eN\u0026thinsp;=\u0026thinsp;320\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTest statistics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLevel of expectations for ARHS\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\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh expectations (70\u0026ndash;100%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e203 (63.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e240 (75.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eχ\u0026sup2;=\u003c/b\u003e10.242\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.006\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMinimum acceptable expectations (50\u0026ndash;69%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e98 (30.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e65 (20.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow expectations (\u0026lt;\u0026thinsp;50%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19 (5.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15 (4.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eARHS expectations score\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30.74\u0026thinsp;\u0026plusmn;\u0026thinsp;5.464\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31.92\u0026thinsp;\u0026plusmn;\u0026thinsp;5.082\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et= -2.824\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.005\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eModified SERVQUAL scores of ARHS expectation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpectation level on assurance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5.75\u0026thinsp;\u0026plusmn;\u0026thinsp;1.348\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.36\u0026thinsp;\u0026plusmn;\u0026thinsp;1.214\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et= -6.010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpectation level on tangibles\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8.84\u0026thinsp;\u0026plusmn;\u0026thinsp;2.138\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.970\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et= -2.288\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.022\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpectation level of responsiveness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4.77\u0026thinsp;\u0026plusmn;\u0026thinsp;1.248\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.97\u0026thinsp;\u0026plusmn;\u0026thinsp;1.060\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et= -2.219\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.027\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpectation level of reliability\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e4.90\u0026thinsp;\u0026plusmn;\u0026thinsp;1.183\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.64\u0026thinsp;\u0026plusmn;\u0026thinsp;1.019\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;2.935\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpectation level of empathy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6.48\u0026thinsp;\u0026plusmn;\u0026thinsp;1.740\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.73\u0026thinsp;\u0026plusmn;\u0026thinsp;1.561\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003et= -1.913\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.056\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\u003eThe respondents\u0026rsquo; expectations concerning reproductive health services are shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. A significantly greater percentage (45.0%) of out-of-school adolescents than 34.1% of in-school adolescents considered ages 10\u0026ndash;13 years appropriate for accessing ARHS (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). More out-of-school adolescents (89.1%) than in-school adolescents (71.2%) expected the facilities rendering ARHSs open all day (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Regarding the expected days for ARHS availability, the majority (34.7%) of out-of-school adolescents, compared with in-school adolescents (16.9%), expected the ARHS to be available from Monday to Friday (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A significantly greater percentage (41.6%) of in-school adolescents than 23.7% of out-of-school adolescents expected mature and same-sex health professionals to render ARHS to them (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). There was no statistically significant association in the expected distance of ARHS to the respondents\u0026rsquo; residence between in-school and out-of-school adolescents.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eExpectations concerning reproductive health services among the respondents\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\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\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\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\u003eIn-school adolescents\u003c/p\u003e\u003cp\u003eN\u0026thinsp;=\u0026thinsp;320\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOut-of-school adolescents\u003c/p\u003e\u003cp\u003eN\u0026thinsp;=\u0026thinsp;320\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eχ\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eExpected age considered appropriate for accessing ARHS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBefore 10 years old\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30 (9.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8 (2.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21.056\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBetween 10\u0026ndash;13 years old\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e109 (34.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e144 (45.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBetween 14\u0026ndash;19 years old\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e101 (31.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e109 (34.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAbove 20 years old\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e80 (25.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e59 (18.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExpected time for a place rendering ARHS to open\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAll day\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e228 (71.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e285 (89.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e39.686\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAfter schooltime\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e73 (22.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18 (5.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDuring schooltime\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19 (5.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17 (5.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExpected days ARHS be available\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMonday-Friday\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e54 (16.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e111 (34.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e56.479\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMonday-Saturday\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e59 (18.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e92 (28.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSaturday-Sunday\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e41 (12.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36 (11.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEvery day\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e166 (51.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e81 (25.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExpected health professional to receive ARHS from\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYoung and of the same sex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e63 (19.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e103 (32.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e26.388\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYoung and any sex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e45 (14.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e54 (16.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMatured and same sex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e133 (41.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e76 (23.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMatured and any sex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e79 (24.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e87 (27.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExpected distance of ARHS to respondent's residence\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNear the place of residency area\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e209 (65.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e208 (65.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.007\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.934\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOutside place of residency area\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e111 (34.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e112 (35.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003eARHS\u0026thinsp;=\u0026thinsp;Adolescents\u0026rsquo; reproductive health services.\u003c/em\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows the components of services and fees expected to be rendered in an ARHS centre. A significantly greater percentage (84.7%) of out-of-school adolescents expected life skills to be rendered at the ARHS centre than did 63.8% of in-school adolescents (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Compared with in-school adolescents, more out-of-school adolescents expected HIV testing (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), contraceptive use (p\u0026thinsp;=\u0026thinsp;0.024), and counselling (p\u0026thinsp;=\u0026thinsp;0.006) to be offered at the ARHS center. A significantly greater percentage (28.8%) of in-school adolescents than 17.5% of out-of-school adolescents expected SRH information to be incorporated into the school curriculum (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Compared with out-of-school adolescents (58.4%), the majority (63.8%) of in-school adolescents expected ARHS to be free of charge for adolescents (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). However, there was no statistically significant association in SRH information inclusion in mass media between in-school and out-of-school adolescents.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComponents of services and fees expected to be rendered in an adolescent reproductive health services centre\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\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\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\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\u003eIn-school adolescents\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOut-of-school adolescents\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eχ\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eExpected services to be rendered to adolescents* (N-640)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLife skills\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e204 (63.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e271 (84.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e36.657\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHIV testing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e68 (21.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e108 (33.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12.539\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAbortion services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e45 (14.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e55 (17.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.185\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.276\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eContraceptives\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e54 (16.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e77 (24.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.024\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCounselling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e172 (53.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e137 (42.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.665\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.006\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSRH information included in mass media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e68 (21.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e66 (20.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.038\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.846\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSRH information to be incorporated into the school curriculum\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e92 (28.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e56 (17.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11.391\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExpected service fees for ARHS (N\u003c/b\u003e\u003csub\u003e\u003cb\u003ei\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 320, N\u003c/b\u003e\u003csub\u003e\u003cb\u003eo\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 320)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFree of charge for adolescents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e204 (63.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e187 (58.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e52.105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAt a subsidised rate for adolescents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e37 (11.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e102 (31.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStandard rate applicable for adult\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32 (10.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12 (3.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDo not know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e47 (14.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e19 (5.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003e*Multiple responses allowed, SRH- Sexual reproductive health\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eN\u003c/em\u003e\u003csub\u003e\u003cem\u003ei\u003c/em\u003e\u003c/sub\u003e \u003cem\u003eand N\u003c/em\u003e\u003csub\u003e\u003cem\u003eo\u003c/em\u003e\u003c/sub\u003e \u003cem\u003e= subsamples of in- and out-of-school respondents, respectively\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the respondents' expected location for ARHS provision by gender. The majority of in-school male adolescents expected the ARHS provision to be located in special rooms within existing services (38.5%), and the least expected location was pharmacies (5.0%). Most out-of-school male adolescents expected the ARHS provision to be located in special adolescent health institutions (31.0%), and the least expected location was pharmacies (7.0%).\u003c/p\u003e\u003cp\u003eWith respect to in-school female adolescents, the highest proportion (35.2%) expected the ARHS provision to be located in special adolescent health institutions, and the least expected place was pharmacies (2.5%). Most out-of-school female adolescents expected the ARHS provision to be located in special adolescent health institutions (29.3%).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe experiences of ARHS among the respondents are shown in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e. A significantly greater percentage (52.8%) of the in-school adolescents than 18.8% of the out-of-school adolescents had ever used the ARHS (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A significantly greater percentage (18.3%) of out-of-school adolescents than 4.1% of in-school adolescents visited the ARHS facility for pregnancy tests (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). More in-school adolescents (74.6%) than out-of-school adolescents (58.3%) visited the ARHS facility for the treatment of common illnesses (p\u0026thinsp;=\u0026thinsp;0.018). There was no statistically significant association in the types of facilities visited between in-school and out-of-school adolescents.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eExperiences of adolescent reproductive health services among respondents\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\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\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\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\u003eIn-school adolescents\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOut-of-school adolescents\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eχ\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEver used ARHS (N\u003csub\u003ei\u003c/sub\u003e = 320, N\u003csub\u003eo\u003c/sub\u003e = 320)\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\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\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\u003e169 (52.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e60 (18.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e80.790\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\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\u003e151 (47.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e260 (81.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTypes of facility visited (N\u003c/b\u003e\u003csub\u003e\u003cb\u003ei\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 169, N\u003c/b\u003e\u003csub\u003e\u003cb\u003eo\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 60)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGovernment-owned hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e101 (59.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31 (51.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.620\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.454\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrivately owned hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e65 (38.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e29 (48.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTraditional\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2 (1.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePharmacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1 (0.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eReasons for visit* (N\u0026thinsp;=\u0026thinsp;229)\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\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCounselling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30 (17.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8 (13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.625\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.429\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInformation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e20 (11.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e5 (8.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.558\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.455\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTraining\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14 (8.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2 (3.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.670\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.196\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\u003e7 (4.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6 (10.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.838\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.092\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBreast examination\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2 (1.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3 (5.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.020\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.082\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\u003e7 (4.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11 (18.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12.313\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTreatment of common illnesses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e126 (74.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e35 (58.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.582\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.018\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSTI treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6 (3.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6 (10.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.709\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.054\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eImmunisation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e18 (10.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1 (1.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.697\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.030\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRecreation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1 (0.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.357\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.550\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHIV testing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8 (4.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2 (3.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.208\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.648\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003e*Multiple responses allowed;\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eN\u003c/em\u003e\u003csub\u003e\u003cem\u003ei\u003c/em\u003e\u003c/sub\u003e \u003cem\u003eand N\u003c/em\u003e\u003csub\u003e\u003cem\u003eo\u003c/em\u003e\u003c/sub\u003e \u003cem\u003e= subtotal samples of in- and out-of-school respondents, respectively\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eMore of the in-school adolescents (39.1%) than the out-of-school adolescents (8.4%) had utilised the ARHS in the last six months (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A greater percentage (44.0%) of out-of-school adolescents than 17.9% of in-school adolescents provided reasons for not visiting the ARHS facility in the last six months did not know where to visit (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). More in-school (16.4%) than out-of-school (3.4%) adolescents were too busy for revisiting (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). A significantly greater percentage (19.5%) of in-school adolescents than out-of-school adolescents\u0026rsquo; reason for not visiting in the past six months was fear of being seen by parents/guardians (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e7\u003c/span\u003ea.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ea: Respondents\u0026rsquo; current experiences with reproductive health services\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\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\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\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\u003eIn-school adolescents\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOut-of-school adolescents\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eχ\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eVisited ARHS facility in last six months (N\u003csub\u003ei\u003c/sub\u003e = 320, N\u003csub\u003eo\u003c/sub\u003e = 320)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\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\u003e125 (39.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27 (8.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e82.865\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\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\u003e195 (60.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e293 (91.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eReason for not visiting in the last 6 months* (N\u0026thinsp;=\u0026thinsp;488)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDid not know where to go\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e35 (17.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e129 (44.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35.686\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDid not have money\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29 (14.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e46 (15.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.062\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.804\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eToo busy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32 (16.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10 (3.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25.145\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eServices are not available\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22 (11.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e35 (11.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.050\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.823\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParents refused\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e27 (13.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7 (2.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23.710\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFear of being seen by parents/guardian\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e38 (19.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16 (5.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23.406\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmbarrassment at needing ARHS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24 (12.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e48 (16.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.545\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.214\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProviders are judgmental\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13 (6.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e47 (16.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9.541\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe time of service is not convenient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e37 (15.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10 (3.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22.299\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI don\u0026rsquo;t need the services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e37 (19.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27 (9.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9.786\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eARHS\u0026thinsp;=\u003c/em\u003e\u0026thinsp;Adolescents\u0026rsquo; reproductive health services\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003e*Multiple responses allowed;\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eN\u003c/em\u003e\u003csub\u003e\u003cem\u003ei\u003c/em\u003e\u003c/sub\u003e \u003cem\u003eand N\u003c/em\u003e\u003csub\u003e\u003cem\u003eo\u003c/em\u003e\u003c/sub\u003e \u003cem\u003e= subsamples of in- and out-of-school respondents, respectively\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e7\u003c/span\u003eb shows the respondents' experiences with ARHS. A greater percentage (48.1%) of the out-of-school adolescents than 45.6% of the in-school adolescents perceived that health professionals understood them (p\u0026thinsp;=\u0026thinsp;0.025). There was no statistically significant association in the type of health worker seen at the facility between the in-school and out-of-school adolescents, although the majority of the respondents were seen by a doctor. More out-of-school adolescents (66.7%) than in-school adolescents (40.0%) experienced friendly and polite providers (p\u0026thinsp;=\u0026thinsp;0.011). A significantly greater percentage (92.6%) of the out-of-school adolescents than 70.4% of the in-school adolescents considered the ARHS offered at the centres satisfactory (p\u0026thinsp;=\u0026thinsp;0.017). More out-of-school adolescents (77.8%) than 36.0% of the in-school adolescents reported that no one else was listening when they were being attended to (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). More in-school adolescents (8.1%) than 1.6% of out-of-school adolescents had ever denied ARHS (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eb: Respondents\u0026rsquo; current experiences with reproductive health services\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\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\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\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\u003eIn-school adolescents\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOut-of-school adolescents\u003c/p\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eχ\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eReception at the facility (N\u003csub\u003ei\u003c/sub\u003e = 125, N\u003csub\u003eo\u003c/sub\u003e = 27)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWith warmth and empathy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e28 (22.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (44.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9.354\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.025\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWith understanding\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e57 (45.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13 (48.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWith indifference\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e25 (20.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (7.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWith reservation/coldness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e15 (12.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType of health worker seen at the facility (N\u003c/b\u003e\u003csub\u003e\u003cb\u003ei\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 125, N\u003c/b\u003e\u003csub\u003e\u003cb\u003eo\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 27)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDoctor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e84 (67.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (51.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.181\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.365\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30 (24.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11 (40.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHealth aid\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5 (4.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (3.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePeer educator/counsellor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6 (4.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (3.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExperience with the provider* (N\u0026thinsp;=\u0026thinsp;152)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWas the provider knowledgeable and qualified\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e67 (53.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20 (74.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.803\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.051\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFriendly and polite\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e50 (40.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 (66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.387\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.011\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInterested in you and your problem\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e35 (28.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13 (48.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.172\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.041\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA good communicator\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e51 (40.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (51.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.108\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.293\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRespectful\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e54 (43.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (44.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.014\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.906\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eConcerned about your privacy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e30 (24.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13 (48.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.382\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.012\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHonest and direct\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e56 (44.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (37.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.545\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.461\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA good listener\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e48 (38.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13 (48.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.878\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.349\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAble to help\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e48 (38.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (37.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.017\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.895\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eConsidered the services offered at the centre satisfactory (N\u003c/b\u003e\u003csub\u003e\u003cb\u003ei\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 125, N\u003c/b\u003e\u003csub\u003e\u003cb\u003eo\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 27)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\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\u003e88 (70.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25 (92.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.733\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.017\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\u003e37 (29.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (7.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAnyone else listening when you were being attended to (N\u003c/b\u003e\u003csub\u003e\u003cb\u003ei\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 125, N\u003c/b\u003e\u003csub\u003e\u003cb\u003eo\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 27)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\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\u003e35 (28.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (11.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15.814\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\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\u003e45 (36.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21 (77.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e45 (36.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (11.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eInterrupted when you were being attended to (N\u003c/b\u003e\u003csub\u003e\u003cb\u003ei\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 125, N\u003c/b\u003e\u003csub\u003e\u003cb\u003eo\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 27)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\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\u003e36 (28.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (14.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.240\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.135\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\u003e89 (71.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23 (85.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eYou or any of your friends have ever been denied ARHS (N\u003c/b\u003e\u003csub\u003e\u003cb\u003ei\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 320, N\u003c/b\u003e\u003csub\u003e\u003cb\u003eo\u003c/b\u003e\u003c/sub\u003e \u003cb\u003e= 320)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\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\u003e26 (8.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (1.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18.769\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\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\u003e135 (42.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e120 (37.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e159 (49.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e195 (60.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003e*Multiple responses allowed;\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eN\u003c/em\u003e\u003csub\u003e\u003cem\u003ei\u003c/em\u003e\u003c/sub\u003e \u003cem\u003eand N\u003c/em\u003e\u003csub\u003e\u003cem\u003eo\u003c/em\u003e\u003c/sub\u003e \u003cem\u003e= subsamples of in- and out-of-school respondents, respectively\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study was conducted to assess and compare in-school and out-of-school adolescents' reproductive health problems and their expectations and experiences with reproductive health services in Owo, Ondo State.\u003c/p\u003e\u003cp\u003eAwareness of the existence and uptake of reproductive health services can help overcome the rising challenges in the reproductive health and sexual behaviours of adolescents.\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e The level of awareness firmly determines the utilisation of ARHS.\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e In this study, the level of awareness of ARHS was greater among in-school adolescents than among their out-of-school counterparts. The level of awareness was higher than that reported in studies performed in Nigeria and Sri Lanka.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e The difference in the reports could be because the Sri Lankan study was qualitative only. However, it was similar to studies in Nepal and Ghana, where adolescents were highly aware of ARHS.\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e The high level of awareness of ARHS could be because of the sexual education taught in secondary schools. Unsurprisingly, out-of-school adolescents do not have access to sexuality education available to in-school adolescents. Additionally, ARHS may mean different things to different adolescents, and the actual meaning may be taken out of context. In this study, more out-of-school adolescents than in-school adolescents knew where to access contraceptives and receive treatment for STIs, including HIV. However, they claimed not to know about ARHS. There is indeed a significant discrepancy between awareness and knowledge of ARHS, as evidenced in this study. Accessing ARHS in early life could help delay sexual debut, prevent unwanted pregnancy, and prevent STIs.\u003c/p\u003e\u003cp\u003eUnlike the study in Ethiopia, where health workers were the primary source of ARHS information,\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e the main source of ARHS information found in this study was school teachers among in-school adolescents and peers/friends among out-of-school adolescents. This situation was consistent with studies conducted among in-school adolescents in \u003csup\u003eIndia18\u003c/sup\u003e and Ghana,\u003csup\u003e\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e where schoolteachers were the major source of information. The study in Ethiopia was conducted in a health facility, whereas the current study and the study conducted in Ghana were community-based. Among the out-of-school adolescents, the source of ARHS information is similar to that used in other studies performed in Nigeria and Uganda, where friends/peers were the main sources of information.\u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e,\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e The means of disseminating information differ across regions and locations; what is essential is ensuring that the information is transmitted to the people.\u003c/p\u003e\u003cp\u003eIn this study, most out-of-school adolescents (75.0%) had significantly higher expectations than did in-school adolescents (63.4%), and a significantly greater proportion of out-of-school compared with in-school adolescents, those aged 14\u0026ndash;19 years were appropriate for accessing ARHS. This finding is similar to that of a study in Nigeria, where most in-school adolescents deemed 15 years of age appropriate to access ARHS.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e The findings of the present study are different from those of a study conducted in Botswana, where adolescents aged ten years were considered appropriate for accessing the ARHS.\u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e This difference could be attributed to the fact that in Nigeria, society and culture, teaching adolescent sexual issues early in life may lead to promiscuity. It may be culturally different in Botswana, where it is believed that reproductive health and sex education will aid in reducing the risk of unwanted pregnancies.\u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eConcerning the days of the week expected for ARHS to be made available, most in-school adolescents wanted ARHS to be provided at all times every day. In contrast, the out-of-school adolescents wanted ARHS to be provided Monday to Friday, exempting the weekends but at all times of the day. This finding is different from other studies among in-school adolescents carried out in Nigeria\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e and Ethiopia,\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e where most of the adolescents expected to be able to access ARHS during school hours. A study in India revealed that in-school adolescents expected the ARHS to be rescheduled to weekends, which would not interfere with their schooling.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e The difference could be because of the study population and location; the Nigerian study was conducted among in-school adolescents only, and the Ethiopian study was conducted in rural areas. The availability of the ARHS at all times of the day allows them to visit the ARHS at their convenience so that they do not need any particular excuse from their parents or guardians. It is still to buttress the point that they may be afraid of what their parents or other adults may think when they see them accessing such services.\u003c/p\u003e\u003cp\u003eFour of the ten in-school adolescents in this study expected the health professional they would like to meet at the ARHS facility to be mature and same-sex. This expectation is in accordance with a study in Nigeria,\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e where in-school adolescents expected mature and same-sex health professionals to attend to them. However, this is contrary to the out-of-school adolescents\u0026rsquo; expectations in this study, where young and same-sex health professionals were expected to visit them at the ARHS facility. The differences in the health professionals expected to visit them in the ARHS facility is an issue of adolescents' preference, and the Nigerian study was conducted among in-school adolescents only. However, it is expected by both in-school and out-of-school adolescents that health professionals should be skilled and competent in counselling, maintain confidentiality, listen to clients carefully, be friendly and have no negative attitudes, and be gender specific.\u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThe proximity of the ARHS facility has been suggested to be paramount in the utilisation of ARHS.\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e In this study, approximately two-thirds of both in-school and out-of-school adolescents expected the ARHS to be close to their residence, although the difference was not statistically significant. The finding about adolescents\u0026rsquo; expectations concerning proximity in ARHS services to the residence is similar to studies in Nigeria\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e and Ghana,\u003csup\u003e\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e where proximity to the residence was a determining factor of optimal utilisation of ARHS. This expectation is anticipated, as it provides ample opportunities for adolescents to access ARHS any time they feel without any economic barriers, such as transport fare.\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e This expectation, however, may also negate the principles of citing youth-friendly centres in convenient locations where adolescents will have free access to youth-friendly services without fear, stigma, discrimination or any penalty for doing so because of a lack of privacy and confidentiality. This finding was similar to that of a study in Malaysia, where confidentiality was the major reason that adolescents would not access services.\u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eWith respect to expectations of services to be rendered, most adolescents mentioned life skills, although they were more highly expressed by the out-of-school adolescents. This finding was closely followed by counselling. The report on life skills as an expected service is in tandem with other studies conducted in Nigeria,\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e and Nepal.\u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e This finding corroborates that gaining life skills enables adolescents to translate their knowledge, attitudes, and values into healthy behaviour and make thoughtful decisions when faced with challenges.\u003c/p\u003e\u003cp\u003eIn this study, approximately one-third of the adolescents wanted ARHS to be provided in a unique adolescent health institution, with a greater proportion of out-of-school adolescents. This finding is similar to those of studies conducted in India, Bangladesh, and a United Nations Population Fund report.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e The reports show that adolescents' expectation was the establishment of a one-stop ARHS centre so that adolescents could obtain information, services and counselling in one setting. This shows that the existing facilities were not yet youth friendly in structure. Hence, adolescents desire to have a place separate from that of adults. In actual sense, this could afford them the privacy they wanted and would allow them to access reproductive health services even when they visit for other medical problems. It also might help eliminate the supposed shame that may be associated with adolescents accessing reproductive health services, as no one would know what such an adolescent has come for.\u003c/p\u003e\u003cp\u003eThis study revealed a significant difference in the expected service fees for ARHS, as more than half of the adolescents, predominantly in-school adolescents, wanted free service. This expectation is consistent with another study in Africa, where most adolescents wanted ARHS to be given free of charge.\u003csup\u003e\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e However, a greater proportion of out-of-school than in-school adolescents expected a subsidised rate for the ARHS. It revealed how much the out-of-school adolescents wanted the ARHS to be made available at an affordable cost.\u003c/p\u003e\u003cp\u003eThe utilisation experience of the ARHS in this study was unsatisfactory; approximately half of the in-school adolescents had ever used the ARHS, whereas only one-fifth of the out-of-school adolescents had ever used the ARHS. This finding corroborated the findings of another study in Nigeria,\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e where only one-tenth of the adolescents had ever accessed the ARHS. This situation is, however, better than what was obtained in a study in Sri Lanka,\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e where none of the adolescents had ever accessed the ARHS. This differs from the survey in Ethiopia,\u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e where more than three-quarters have used ARHS. The difference may be because the Ethiopian study targeted adolescents aged 15\u0026ndash;19 years, whereas the current study included all the adolescents in all age ranges.\u003c/p\u003e\u003cp\u003eSurprisingly, there was low utilisation experience of ARHS in this study despite the high level of awareness of ARHS; this is worrisome. The low utilisation in this study could be because the ARHS is not yet fully integrated into the existing primary health care centres in Nigeria, and the out-of-school adolescents are left out of the programme because they are out of reach and highly mobile. Additionally, this could be because of the challenge with implementation and misconception of the ARHS information. Overall, there is a need for concerted efforts to ensure the utilisation of ARHS.\u003c/p\u003e\u003cp\u003eThe major reason for not visiting the ARHS in this study was that the out-of-school adolescents did not know where to visit. This finding is consistent with other studies in Nigeria,\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u003c/sup\u003e where the adolescents did not know where to seek ARHS, preventing adolescents from utilising ARHS. Among in-school adolescents, the fear of being seen by parents/guardians was the major reason preventing the use of ARHS. This finding is similar to that in Nepal, where the fear of being seen by parents was a barrier for adolescents seeking ARHS.\u003csup\u003e\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e Treatment of common diseases was the major reason for the adolescents visiting the ARHS facility in this study and the predominant reason among in-school adolescents. This situation is different from another study conducted in Uganda, where the major reason for visiting ARHS was related to the treatment of sexually transmitted diseases.\u003csup\u003e\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e The difference could be due to the difference in research methods, in which the Ugandan study was a synthesis of evidence from the literature. The type of facility where the in-school and out-of-school adolescents received the ARHS in this study was the government-owned hospital. This finding is similar to that of another study in Nigeria, where the facility primarily visited for ARHS was a government health facility.\u003csup\u003e\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u003c/sup\u003e This could be because the Nigerian government mainly provided ARHS through maternal and child health/family planning programmes (MCH/FP).\u003csup\u003e47\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eIn this study, most of the adolescents reported their experience with healthcare workers in the ARHS facility as being understood. Approximately one-tenth of in-school and none of the out-of-school adolescents were given reservations/coldness. This approach is highly encouraging and should be continued and improved upon. This differs from studies in India,\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e where most adolescents were embarrassed, or Ethiopia,\u003csup\u003e\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e where the adolescents felt uncomfortable and unwanted. The differences in the reports could be due to the study location and design, as the Indian study was conducted in a health facility, and the Ethiopian study was qualitative only.\u003c/p\u003e\u003cp\u003eThe major health professionals who attended the adolescents at the facility were the doctors who were knowledgeable and qualified. This finding is similar to those of studies in Nigeria\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e and Ethiopia,\u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e where qualified doctors attended adolescents who visited the ARHS. Fewer than half (48.1%) of the out-of-school adolescents and approximately one-quarter of the in-school adolescents in this study reported that the providers at the ARHS facility were concerned about their privacy. This finding differs from the findings in Ethiopia, where 45% of the in-school adolescents reported not having enough privacy.\u003csup\u003e\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e The Ethiopian study was conducted in a rural and urban setting, unlike the current study, which was carried out in an urban setting. This could account for the difference in the reports. Approximately three-quarters of the in-school adolescents and almost all (92.6%) of the out-of-school adolescents in this study considered the ARHS offered at the facility satisfactory. This finding is corroborated by the findings of other studies in Nigeria\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e and Ethiopia,\u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e where almost all the adolescents considered the ARHS satisfactory. The limitation of this study was that the expectations and experiences were assessed via self-report questionnaires, which are prone to recall bias. This was reduced by the use of detailed probe questions that provide more information on exposure events, and the researcher was available to provide proper guidance to the respondents. Additionally, the selection of out-of-school adolescents may not be representative, as the various groups are heterogeneous; some, such as house help, were not considered in the sampling technique.\u003c/p\u003e\u003cp\u003eIn conclusion, in-school adolescents are more aware of the ARHS than are out-of-school adolescents. Despite the higher level of expectations for ARHS among out-of-school adolescents than among in-school adolescents, fewer out-of-school adolescents than in-school adolescents have utilised ARHS. The major reason for visiting the ARHS was the treatment of common illnesses, although this was more common among in-school adolescents. The main reasons for not visiting were that they did not know where to visit, which was reported more among out-of-school adolescents, and that more in-school adolescents feared being seen by parents/guardians. For those who had utilised the ARHS, more out-of-school adolescents had satisfactory experiences than did in-school adolescents.\u003c/p\u003e\u003cp\u003eIt is therefore recommended that policymakers recognise the distinct needs of in-school and out-of-school adolescents and formulate policies that bridge the gaps in accessing reproductive health services and that the ARHS should be free or discounted for adolescents to motivate them to use these services. The government should design health education and promotion programs to increase awareness of the ARHS, primarily through mass media, social media, artisans, union leaders, religious leaders, and schools. Similarly, schools should provide comprehensive ARHS information and awareness, which can be a lifelong protective benefit to adolescents.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate:\u0026nbsp;\u003c/strong\u003eEthical approval was obtained from the Health Research Ethics Committee of the Federal Medical Centre, Owo, Ondo State with number FMC/OW/380/VOL.CXLVIII/200. Permission to conduct the study was obtained from the Ondo State Ministry of Education. Verbal consent was obtained from the school authorities and the local trade union leaders in the study area. The consent of parents/guardians was obtained. In addition, consent/assent was obtained from each of the participating adolescents, following the provision of a detailed explanation of the study objectives, information about the benefits and risks and assurance of the freedom to participate or otherwise without any threat of sanction or unfavourable treatment. The data collection instrument had no personal identification information. All participants were identified using only serial numbers. Data were secured by password protection of the research-related data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e The consent for publication has been obtained.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u003c/strong\u003e – The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding –\u0026nbsp;\u003c/strong\u003eThere was no financial support of any kind, either in terms of grants or equipment or otherwise.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contribution:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKAO, KAJ:\u0026nbsp;Concept and design of the study, acquisition of data, analysis of data, interpretation of data, drafting the article, and final approval of the version to be published.\u003c/p\u003e\n\u003cp\u003eAAM, AOO:\u0026nbsp;Concept and design of the study, interpretation of data, drafting the article, revising it critically for important intellectual content, and final approval of the version to be published.\u003c/p\u003e\n\u003cp\u003eAAJ, FDT, AIF,OKO, AOO, FIO,ALA: The acquisition of data, interpretation of data, drafting the article, revising it critically for important intellectual content, and final approval of the version to be published.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003eWe acknowledged the resident doctors in the Department of Community Health of Federal Medical Centre, Owo, Nigeria who helped in the recruitment of the participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' information:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKAO: Consultant/specialist Community Health Physician in reproductive health; Fellow of the West African College of Physician (comm Health), Master of Public Health, Bachelor of Surgery; Bachelor of Medicine (MBChB).\u003c/p\u003e\n\u003cp\u003eKAJ: Consultant/specialist Paediatrician; Fellow Medical College of Paediatrics, Master of Public Health, Bachelor of Surgery Bachelor of Medicine (MBChB).\u003c/p\u003e\n\u003cp\u003eAAM: Professor of Community Medicine (University of Ibadan, Nigeria); Consultant/specialist Community Health Physician in school health and reproductive health; Fellow of the West African College of Physician (comm Health), Master of Public Health, Bachelor of Surgery; Bachelor of Medicine (MBBS).\u003c/p\u003e\n\u003cp\u003eAOO: Consultant/specialist Community Health Physician; Fellow of the West African College of Physician (comm Health), Master of Public Health, Bachelor of Surgery; Bachelor of Medicine (MBBS).\u003c/p\u003e\n\u003cp\u003eFIO: Consultant/specialist Paediatrician; Fellow of the West African College of Physician (Paediatrics), Bachelor of Surgery Bachelor of Medicine (MBChB).\u003c/p\u003e\n\u003cp\u003eALA: Consultant/specialist Family Medicine Physician; Fellow of the West African College of Physician (Family Medicine), Bachelor of Surgery Bachelor of Medicine (MBBS).\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eICPD. 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Accessed January 12, 2025\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMunea AM, Alene GD, Debelew GT, Sibhat KA (2022) Sociocultural Context of Adolescent Sexuality and Youth Friendly Service Intervention in West Gojjam Zone, Northwest Ethiopia: A Qualitative Study. BMC Public Health. ;22(1)\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAbdurahman C, Oljira L, Hailu S, Mengesha MM (2022) Sexual and Reproductive Health Services Utilisation and Associated Factors among Adolescents Attending Secondary Schools. Reprod Health 19(1):1\u0026ndash;10\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Federal Medical Centre, Owo, Nigeria","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":"Expectations, Experiences, In-school adolescents, Out-of-school adolescents, Reproductive health services","lastPublishedDoi":"10.21203/rs.3.rs-7134310/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7134310/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Adolescents peculiar health needs require adolescent reproductive health services (ARHS). Despite the growing adolescent population, they have limited access to health services. In Nigeria, one in three children are out-of-school. Therefore, this study aimed to compare reproductive health service expectations and experiences among in-school and out-of-school adolescents.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This was a comparative cross-sectional study among adolescents aged 10-19 years. In-school adolescents were selected via a multistage sampling technique, whereas out-of-school adolescents in the mapped area were selected. A WHO illustrative questionnaire for interviews with young people was used to collect data. The SERVQUAL tool was used to measure the gap between expectations and perceptions of the services delivered.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Six hundred forty adolescents were recruited. More in-school adolescents (80.6%) than out-of-school adolescents (63.4%) were aware of ARHS (p\u0026lt;0.001). The mean ARHS expectations score of out-of-school adolescents was higher than that of in-school adolescents (t=2.824; p=0.005). A greater proportion of out-of-school compared with in-school adolescents expected to receive ARHS from a young and same-sex health professional (p\u0026lt;0.001). More in-school adolescents (52.8%) than out-of-school adolescents (18.8%) had ARHS experiences (p\u0026lt;0.001). More out-of-school adolescents than in-school adolescents received warmth and empathy from from health professionals (p=0.025). A greater proportion of out-of-school adolescents than in-school adolescents considered the ARHS satisfactory (p=0.017).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e Increased expectations of ARHS among out-of-school adolescents do not translate to increased utilisation of ARHS. This, therefore, calls for more community outreach to out-of-school adolescents.\u003c/p\u003e","manuscriptTitle":"Reproductive Health Services: Expectations and Experiences Among in-school and Out-of-school Adolescents in Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-18 15:04:47","doi":"10.21203/rs.3.rs-7134310/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":"a6e5c2cc-317e-4e64-a614-bc5273570c9b","owner":[],"postedDate":"July 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":51662964,"name":"Sexual \u0026 Reproductive Medicine"}],"tags":[],"updatedAt":"2025-07-18T15:04:47+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-18 15:04:47","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7134310","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7134310","identity":"rs-7134310","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}