Are Adolescents and Youth Programs Missing The Real Targets? Analysis of Socio-Cultural Factors Influencing Use of Sexual Reproductive Health Services by Young People in Swaziland

Abstract

Background: Access to reproductive health services by youth has received minimal attention given that Sexual Reproductive Health (SRH) service provision for many years has been tailored to meet the needs of the adult population. The youth have therefore been neglected partly due to cultural sensitivity that dictates what, when and how SRH information and services should be transmitted to them. The current study therefore sought to unveil and explore sociocultural factors influencing youth utilization of SRH services provided in health facilities. Methods: A mixed method approach was used to gain a comprehensive view of factors influencing utilization of adolescent sexual reproductive health (ASRH) services. Data were collected quantitatively by using semi-structured questionnaires and qualitatively through individual in-depth interviews and Focus Group Discussions (FDGs) among a total of 927 youth aged 15-24 years (222 out of school youth and 705 in-school youth). The study sample also comprised of 68 gate keepers who included: teachers, religious authorities, parents/guardians, traditional authorities and health professionals. Results: The study exposed factors underlying utilization of SRH services among Swazi youth. Such factors included the family, peers, religious and community values and norms. Youth who perceived their families, communities and peers to be liberating towards uptake of SRH services were more likely to utilize those services compared to youth who perceived the opposite. Conclusion: The results persuade optimistic youth programs determined to increase uptake of SRH services among youth to incorporate parental and community programs instead of exclusively focusing on youth in all interventions designed to propel protective sexual behaviour among youth at all service delivery levels. Recommendations: Parental, community, traditional and religious leadership involvement in the development and execution of youth program interventions should be prioritized.