Stage Cluster Sampling Research Articles

Eco-Friendliness and Cost-Effectiveness of Reusable Sanitary Pads for Rural Women: A Model for Menstrual Hygiene Management in Low Resource Settings

Background Menstrual Hygiene Management (MHM) is fundamental to women’s health, well-being, and gender equality. The study aimed to assess the cost-effectiveness and acceptability of reusable sanitary pads among rural women in Pakistan, proposing a scalable model for improving MHM practices in low-income countries. Methods A cross-sectional study was conducted using Multi- Stage Cluster sampling to accomplish a sample size of 340 childbearing-age women from the rural areas of Sindh, Pakistan. The data was collected using a standard questionnaire regarding the affordability and accessibility of reusable versus disposable sanitary pads; further information was also gathered from Market surveys for MHM products. The biodegradability of the pads was assessed using a soil burial test. The data was analyzed using SPSS version 27. Results Our research found a significant preference for reusable sanitary pads. The biodegradability tests demonstrated that reusable pads had a superior degradation rate (1.88%) to disposable pads (1.59%) over four months. Economic assessments showed a low utilization of commercial pads (12.5%) due to affordability issues, with 87.5% using reusable cloths. Despite 70% awareness of menstrual hygiene, 48% of women showed interest in creating sanitary solutions, underscoring the feasibility of implementing locally sourced, cost-effective products across similar socio-economic landscapes. Conclusion The present study underscores the universal applicability of affordable, sustainable MHM solutions in rural communities of low-income countries, advocating for broader implementation of such models to address global menstrual hygiene challenges. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1030-1037

Level of awareness on the sustainable development goals among Indian youth: Empirical evidence from Northern India

In India, government has made many policies and plans to contribute in the attainment of SDGs but being a developing nation with a large population and vast geographical expanse, the attainment of SDGs is a big task. In the 2022 Global Index of SDGs, India ranked 121 out of 163 countries. The present research's objective was to measure the awareness among universities students. Two stage cluster sampling was used for sample selection. In the first stage, 4 cities from the Northern part of India were selected and in second stage, from each city, selection of subjects was done. 546 subjects were contacted, and 335 participated. Survey was conducted using questionnaires (Odoom, Mensah, Dick‑Sagoe, Lee, Opoku & Obeng‑Baah, 2024). The scale has questions related to all the SDGs. Results showed that subjects had moderate awareness about SDG5, SDG6, SDG7, SDG9, SDG13 and SDG15 with the respective mean score (Mean 3.32, 3.77, 3.80, 3.27, 3.79, & 3.27) and had low awareness for SDG10, SDG11, SDG16, and SDG17 with the respective mean score (Mean 2.95, 2.86, 2.95, & 2.86). Results showed significant difference in the SDGs awareness among male and female. For SDG2, SDG3, SDG4, SDG9, SDG14, SDG15 and SDG17, the awareness was higher in male (respective mean rank score182.80, 181.76, 176.29, 181.80, 217.26, 184.95, 194.08) than female (respective mean rank score 152.01, 153.12, 159.04, 153.09, 122.42, 149.68, 139.81). For SDG5, SDG6, SDG7, SDG10, SDG11, SDG12, SDG13, SDG16, the awareness was higher in female (respective mean score 224.19, 224.19, 196.48, 198.99, 211.51, 205.13, 219.52, 205.25) in comparison to male (respective mean score 116.01, 115.01, 141.65, 139.32, 127.74, 133.64, 120.33, 133.53). Results of the present research also imply the role of social structure in SDGs awareness and highlight the need to introduce some programs to promote the discussion on SDGs in every classroom.

INCIDENCE OF HYPERTENSION IN ADOLESCENTS IN THE WORKING AREA OF PACCERAKKANG HEALTH CENTER AND SUDIANG HEALTH CENTER, MAKASSAR CITY

Hypertension generally occurs in advanced age, but some studies suggest that hypertension can appear as early as adolescence and its prevalence has increased over the past few decades. However, many do not realize that it is the cause of hypertension in adults and the elderly. This study aims to determine the prevalence of hypertension in adolescents at the Sudiang Raya Health Center, Makassar City. The method used is carried out by observation with a Cross Sectional approach. The research sample was 147 adolescents using Two Stage Cluster Sampling. Data collection using questionnaires, measurements of weight, height and blood pressure. The data were analyzed univariately using a frequency distribution table. The results of the study obtained 73 male respondents (49.7%) and 74 female respondents (50.3%). Most (77.6%) of the respondents had a moderate level of knowledge. The results of blood pressure measurements showed that as many as 9 people (6.1%) were in the stage 2 hypertension category, as many as 18 people (12.2%) were in the stage 1 hypertension category, as many as 22 people (15.0%) were in the pre-hypertension category and as many as 98 people (66.7%) had normal blood pressure. Conclusion: The results showed that one-third of the respondents already had hypertension.

Maternal health care services utilization and associated factors among women in Zoba Maekel, Eritrea 2022: a community based study

Introduction: Studies reveal that regular utilization of maternal health care services reduces maternal morbidity and mortality in which these services are affected by complex factors which may be similar across populations. Methods: A community based cross sectional study was conducted from February to May of 2022. A total of 607 women who gave birth in the last 2 years and residing in the area for at least 6 months were selected by two stage cluster sampling technique. A predesigned and pretested questionnaire was used to collect data via face to face interview technique. Chi-square test and multivariable logistic regression were used for data analysis using SPSS (Version 26). Results: Magnitude of maternal health care services utilization was found as; attending antenatal care 99.9%, institutional delivery 99.3% and postnatal care 91.4%. The majority (91.4%) were aware of postnatal care. The proportion (91.5%) of women who utilized postnatal care among those with awareness about it was significantly greater (p<0.001) than the proportion of women who utilized it and with no awareness (63.5%). The nationwide lockdown due to COVID- 19, sudden onset of labor, feeling well were barriers to attending antenatal care, institutional delivery and postnatal care services respectively. Conclusion: Prevalence of antenatal care, institutional delivery and postnatal care services was higher than the national estimate. Improving the quality of care around the time of pregnancy, birth and postpartum is recommended to continuously sensitize the community about the services and further increase the utilization.

A simulation study of sampling in difficult settings: Statistical superiority of a little-used method

Taking a representative sample to determine prevalence of variables such as disease or vaccination in a population presents challenges, especially when little is known about the population. Several methods have been proposed for second stage cluster sampling. They include random sampling in small areas (the approach used in several international surveys), random walks within a specified geographic area, and using a grid superimposed on a map. We constructed 50 virtual populations with varying characteristics, such as overall prevalence of disease and variability of population density across towns. Each population comprised about a million people spread over 300 towns. We applied ten sampling methods to each. In 1,000 simulations, with different sample sizes per cluster, we estimated the prevalence of disease and the relative risk of disease given an exposure and calculated the Root Mean Squared Error (RMSE) of these estimates. We compared the sampling methods using the RMSEs. In our simulations a grid method was the best statistically in the great majority of circumstances. It showed less susceptibility to clustering effects, likely because it sampled over a much wider area than the other methods. We discuss the findings in relation to practical sampling issues.

Measuring socioeconomic inequalities in postnatal health checks for newborns in Ethiopia: a decomposition analysis.

Addressing health inequity is a top priority for achieving sustainable development goals. The existing evidences in Ethiopia have shown that there are substantial inequalities in the use of health services among various socioeconomic strata. Therefore, the present study aimed to measure socioeconomic inequalities and the contributing factors in postnatal health checks for newborns in Ethiopia. We used a secondary data from the recent 2019 Ethiopia Mini Demographic and Health Survey dataset. The study includes a weighted sample of 2,105 women who gave birth in the 2 years preceding to the survey. The study participants were selected using two stage cluster sampling techniques. The socioeconomic inequality in postnatal health checks for newborns was measured using the Erreygers Normalized Concentration Index (ECI) and illustrated by the concentration curve. A decomposition analysis was done to identify factors contributing to the socioeconomic related inequality in postnatal health checks for newborns in Ethiopia. The concentration curve of postnatal health checks for newborns lay below the line of equality, and the Erreygers normalized concentration index was 0.133, with a standard error = 0.0333, and a p value <0.001; indicating that the postnatal health check for newborns was disproportionately concentrated among newborns with higher socioeconomic status. The decomposition analysis reported that antenatal care (ANC) visit (59.22%), household wealth index (34.43%), and educational level of the mother (8.58%) were the major contributors to the pro-rich socioeconomic inequalities in postnatal health checks for newborns. The finding revealed that there is a pro-rich inequality in postnatal health checks for newborns in Ethiopia. To reduce the observed socioeconomic health inequality, the government needs to improve ANC visits, implement strategies to access health service for economically disadvantaged groups, and increase educational attainment among women.

Knowledge and attitude on umbilical cord blood stem cell therapy among bachelor nursing students in Lalitpur Metropolitan City

Background: Stem cells are immature cells that have ability to mature into different types of functioning cells as needed by body. Umbilical cord blood is one of the richest sources of stem cells. It is vital for nurses to keep up-to-date of current advances in stem cell science and nurses can play crucial role in providing first-hand information to public about stem cell and umbilical cord blood banking. Therefore, this study is aimed to identify the knowledge and attitude regarding umbilical cord blood stem cell therapy among bachelor nursing students. Method: A descriptive cross sectional research design was used to assess the knowledge and attitude of 263 nurses studying bachelor in nursing science and post basic bachelor in nursing in different selected nursing college of Lalitpur metropolitan city. Multi stage cluster sampling was used to select respondents. Data was collected using self-developed self-administered google form questionnaire. Results: Most of the nurses had poor knowledge (49.4%) and few nurses had good knowledge (6.8%) however majority of nurses (93.9%) had favourable attitude regarding umbilical cord blood stem cell therapy. Regarding association between variable, there is no any association between knowledge level and attitude (p=0.224). Conclusion: Nurses had poor knowledge and favourable attitude regarding umbilical cord blood stem cell therapy. Keywords: Nurses,Stem cells, Umbilical cord blood

Effective Cataract Surgical Coverage in Four Large Districts in Telangana, India – Results from Rapid Assessment of Visual Impairment Study

ABSTRACT Purpose To report cataract surgical coverage (CSC) and effective Cataract Surgical Coverage (eCSC) from four districts in Telangana, India. Methods Individuals aged ≥40 years were recruited from Adilabad, Mahbubnagar, Warangal and Khammam districts using two stage cluster sampling methodology. All participants had detailed eye examinations including visual acuity assessment using a standard Snellen chart at a distance of six meters, anterior segment examination and fundus imaging by trained professionals. CSC and eCSC were calculated for persons using a 6/12 visual acuity cut-off. Results Of 12,150 individuals enumerated from four districts 11,238 (92.5%) were examined. The mean (standard deviation) age of the participants was 54.1 (±11.2) years (range: 40 to 102 years) and 54.6% (n = 6137) were women. Overall, the CSC (%) was 54.2%. It ranged from a highest of 59% in Khammam followed by 57.5% in Adilabad, 51.7% in Warangal, and a least of 49.7% in Mahbubnagar district. Overall, the eCSC (%) was 39.9%. It ranged from a highest of 46.1% in Adilabad followed by 43.2% in Khammam, 36.2% in Warangal district and a least of 35.8% in the Mahbubnagar district. Conclusions CSC and eCSC varied across the districts. A significant gap between CSC and eCSC is noted suggestive of challenges with quality of services. District-wise planning of cataract surgical services with a focus on quality care is recommended to improve coverage and contribute towards achieving the goal of universal eye health coverage in the Telangana State in India

IJCM_250A: Awareness and utilization of Ayushman Bharat Pradhan Mantri Jan Arogya Yojna in Chhattisgarh State - A cross Sectional study

Background: Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (PM-JAY) is the worlds largest health insurance/ assurance scheme fully financed by the government. It provides a cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization across public and private empaneled hospitals in India. Over 12 crore poor and vulnerable entitled families are eligible for these benefits. As of now, the total number of ration cards allotted to the people of Chhattisgarh are 57,14,798. Objective: To assess awareness and utilization of Ayushman Bharat Pradhan Mantri Jan Arogya Yojna in Chhattisgarh State. Methodology: This community based cross-sectional study was conducted among the eligible beneficiaries in Chhattisgarh state. Multis stage cluster sampling used to select eligible beneficiaries. One district each from all five divisions of Chhattisgarh will be selected then 5 clusters (3 urban and 2 rural area) will be selected from each district. Data was collected face to face interview by using semi structured questionnaire. Data was managed in MS- Excel and analysed using suitable statistical software (SPSS v21) and P Value Results: The study shows 300 (80.9%), and 68(18.3%) participants are BPL &amp; APL card holders respectively and 3(.8%) do not have any card. Out of 371 participants, 92(24.8%) are not enrolled in the scheme. Among study participants, only 90% were aware of the AB-PMJAY, and only 197 (53%) utilized the scheme and get benefitted. Conclusion: This study concluded that despite AB-PMJAY potentially providing cashless financial protection to beneficiaries, some of the study population is still unaware of AB-PMJAY. A quarter of the participants were not enrolled in the scheme, indicating potential gaps in the implementation or accessibility of the program.

Statistical Analysis of Regional Heterogeneity of Marital Dissolution Among Women in Ethiopia, EDHS 2016: Application of Multilevel Logistic Regression Model

Divorce is a major life stressor for the individuals involved, with potentially strong negative consequences for the mental and physical health of all members of the family. The aim of this study was to investigate the existence of regional heterogeneity marital dissolution among women in Ethiopia. The study used data from the 2016 Ethiopia Demographic and Health Survey which was a stratified two stage cluster sampling procedure was used. The researcher has been used (n=11405) of all married women from the selected population of study nested within nine regional states and two administrative cities in Ethiopia at time of interview. The Multilevel model were used to explore the major risk factors and regional variations of marital dissolution in Ethiopia using R statistical software. The descriptive result revealed that among eligible married women the proportion of marital dissolution was 9.91%. Among the three multilevel logistic models the random slope model found to be the best description of the data set and to evaluate the within and between regional heterogeneity of marital dissolution. Using this model variables that significantly affect the marital dissolution in Ethiopia were residence, education level of women, work status of women, duration of marriage, number of children, education level of husband and number of unions. The effects of the determinant variables are the same for each region, but the number of children and education level of husband were the two variables which varies within and between in each region. The other important result from this paper is that missing data analysis using appropriate imputation technique was performed to make better inferences.

Peran Internet di Saat Pandemi Covid-19 Terhadap Kinerja Guru SDN Wonosalam Demak

The study, entitled the use of the internet during the Covid-19 pandemic on the performance of elementary school teachers in Wonosalam sub-district, Demak district, aims to analyze the effect of internet use on the performance of primary school teachers in Wonosalam sub-district, Demak district. Using ex post facto research methods, with the sampling technique using cluster random sampling with two stage cluster sampling. The data analysis method used is descriptive statistical analysis, and by using a questionnaire to obtain data. The results showed that; 1) In general, it can be described that most of the respondents are familiar and familiar with using information technology facilities; 2) These variations in internet behavior are related to perceptions and understanding of the benefits of the internet which may vary between individuals; 3) Internet use has an influence on performance. The implication of this research can be concluded that to increase the role of the internet in teacher performance during the Covid-19 pandemic is to maximize quality network accessibility, improve IT infrastructure, use friendly and easy to apply (applicable) applications, socialize the use of applications in implementation. Teacher work. For further research, the sample can be reproduced to see patterns of Internet usage by a wider teacher. Future research can also be directed to look at usage patterns based on the life stages of the internet.

Effects of Tiffin Practices on the Health of School Students in Makawanpur District, Nepal

The main goals of the study are to explore the existing tiffin practices among school students, and assess the effects of tiffin practices on their health. The study was conducted in 2023, among 100 students of four schools out of 65 community schools in Hetauda sub-metropolitan in Makawanpur district. Second stage cluster sampling method was adopted to select the study area and the students were selected with simple random sampling method from different grades (1-12) of the community schools of Hetauda sub-metropolitan. Semi-structured questionnaire and checklist were used to collect the data and information. Among them 66.00 % school students consumed packed food where only 21.00% of the students consumed homemade food as tiffin. Among the surveyed 64 students, 59.4% of students had faced stomachache, 29.7% students had faced vomiting, 4.7% encountered nausea and 6.3% underwent allergies. Chi-square test was employed to test the null hypothesis. Age, gender and grade were significantly associated with tiffin practices (p≤ .05). There was no significant association between packed food and health hazards (p= .347). Lack of time of the parents, imitation of the peers, taste of junk food, lack of awareness led the consumption of junk or packed food that caused various health hazards on school going children.

Residential inequalities in health-related quality of life among women of reproductive age in four regions of Ethiopia: a decomposition analysis

BackgroundEthiopian rural-urban disparities in key domains of health-related quality of life among women in reproductive age have been huge. However, sources of such inequalities were not studied well. Therefore, this study aimed to assess inequalities in health-related quality of life among women residing in urban and rural areas in four regions of Ethiopia.MethodsThis study used data extracted from the 2016 Ethiopian Demographic and Health Survey; collected at national level from January 18, 2016, to June 27, 2016. Stratified two stage cluster sampling method were used. The data collected from 2385 women in the age group 15–49 years who were living in four regions (Afar, Benishangul-Gumuz, Gambela, and Somali regions) of Ethiopia were used for this study. The outcome variable, Health-Related Quality of Life (HRQoL), was generated by Principal Component Analysis. Further, Multivariable Ordinary Least Square and Oaxaca decomposition threefold (interaction) were used in the analysis with a p-value less than 0.05 and 95% confidence interval to declare statistical significances.ResultsWomen education, region, religion, wealth index, and husband/partner education were identified as predictors of Health-Related Quality of Life. Women residing in rural areas had far lower health-related quality of life than those living in urban areas. The wealth index and educational level of women were the largest contributor of the inequality in health-related quality of life.ConclusionA substantial inequality in quality of life exist between women who reside in rural and urban areas in those four regions of Ethiopia. The socioeconomic factors more importantly wealth index and educational attainment explained the significant portion of the reported rural-urban disparities. Therefore, Policymakers and local administrators should pay more attention on interventions that promote education and narrowing gap in wealth in rural and urban settings.

Relationship between job stress and work-related quality of life among emergency medical technicians: a cross-sectional study

ObjectiveThis study was aimed to determine the relationship between job stress and work-related quality of life (WRQoL) among emergency medical technicians (EMTs) in Lorestan province, Western Iran.DesignThis was a cross-sectional...

Estimation and linkage between behavioral problems and social emotional competence among Pakistani young school children.

Behavioral problems are commonly occurring concerns in school children and if left unidentified can result in worse outcomes in any society. The research aims to explore the prevalence of behavioral problems and its association with social emotional competence in young school children from a community sample of Islamabad, Pakistan. The cross-sectional study was conducted from April to June 2021 in four public primary schools in Islamabad, Pakistan. Two stage cluster sampling was used to select study sites. The sample comprised 426 school children (males = 182, females = 195) aged 4-8 years (Mean age = 6.5, SD = 1.09), from three different grades kindergarten, 1, and 2, respectively. The Child Behavior Checklist (CBCL) and Social Emotional Development Assessment (SEDA) were used to screen behavioral problems and social emotional competences of children. Data were analyzed using Stata 17. Prevalence for overall behavioral problems accounted for 65.4% (4-6 years) and 36.2% (6-8 years) in the abnormal (borderline and clinical) ranges of total problems. Social emotional competence scores were found significantly negatively associated with behavioral problems of children. The high prevalence necessitates the provision of mental health care to school-aged children. The findings should be taken as a call to Pakistan's policymakers, clinicians, and researchers to develop proper screening and management protocols for early intervention.

Athletic Trainers Value the Intrinsic Rewards of Specialty Certifications More than Barriers and Extrinsic Rewards

Purpose: Health care professionals may earn specialty certifications to recognize their advanced knowledge and skills. Athletic training has implemented specialties; however, it is unclear what athletic trainers (ATs) know and perceive about specialty certifications. We developed a survey to examine the following issues: (1) analyze what ATs know about specialty certifications; (2) rank the rewards and barriers ATs perceive to be associated with earning/pursuing specialty certifications; and (3) examine differences in these findings based on ATs state practice acts being more restrictive or less restrictive. Method: We utilized a nonequivalent group, cross-sectional survey design and collected data for one month using an online survey and e-mail recruitment process. We validated our instrument using the content validity index. We utilized qualitative data analysis techniques to group states as having more restrictive practice acts and less restrictive practice acts. Using a single stage cluster sampling process, we selected 3 more-restrictive states and 3 less-restrictive states and sent recruitment emails to 4,503 potential participants in these 6 states. We received 342 responses for a 7.6% response rate and an 87% completion rate. Results: Our analysis demonstrated practicing ATs have limited knowledge about specialty certifications. The differences in state practice act restrictions did not affect the perceived rewards or barriers for specialty certifications; however, the participants reported statistically significant differences in their agreement about the intrinsic rewards, barriers, and extrinsic rewards, respectively. Conclusions: ATs have limited knowledge about specialty certifications, and the level of state practice act restriction did not influence perceptions about their potential rewards and barriers. Participants ranked the proposed intrinsic rewards for earning a specialty certification highest, and the potential barriers for earning these credentials second highest. Participants perceived the potential extrinsic rewards of these credentials lowest.

Analisis Faktor yang Berhubungan dengan Kunjungan Ibu Balita di Posyandu Kelurahan Rejowinangun Utara Kecamatan Magelang Tengah Kota Magelang

Background: Toddler period experiences a process of rapid growth and increased nutritional needs, so mothers of toddlers are advised to visit Posyandu (Integrated Healthcare Center) to check the growth and development of toddlers, in order to anticipate if there are developmental disorders of toddlers that are not according to their age. North Rejowinangun Village experienced a decrease in the percentage of children under five compared to every year, in 2020 the achievement of toddlers was calculated to be 40.62% and in 2021 it was 22.53%. The purpose of this study was to determine the factors associated with the visit of mothers of children under five to the posyandu. Methods: This study used an analytic observational type with a cross sectional design. The number of samples was 91 respondents, the sampling technique used two stage cluster sampling and the data were analyzed by Chi Square test. Results: statistical tests showed that the variables were age (p = 0.096), education level (p = 0.0001), occupation (p = 0.041), knowledge (p = 0.0001), distance traveled (p = 0.0001), family support (p = 0.0001) and the role of cadres (p = 0.0001). Conclusion: there is a relationship between education level, level of knowledge, occupation, distance traveled, family support and the role of cadres with maternal visits to posyandu. There is no relationship between age and mother's visit to posyandu.

Prevalence and Factors Associated With Depression among School Going Adolescents in Bengaluru: A Cross-Sectional Study

Introduction: The period of adolescence involves a lot of emotional changes as it is a period of transition to adulthood demanding independence.Adolescents with depression are more likely to have anxiety, disruptive behavior disorder and substance abuse when compared to those who are not depressed. Objective: To estimate the prevalence of depression among school going adolescents and to assess the factors associated with depression among them. Method: A cross-sectional study was conducted among school going adolescents aged 13-16 years in the urban field practice area of a Medical College. Depression was assessed using Beck's depression inventory (BDI). Total 896 adolescents were included in this study. Single stage cluster sampling method was done in which schools were considered as clusters and students constituted the sampling units. Schools were selected by simple random sampling technique using lottery method. Results: In this study about 45.2% of the adolescents had depressive disorder, out of which mild depression was reported among 22.2% students, 12.4% moderately depressed and 10.6% severe depression. Factors like mother's education, lack of communication by father and mother with their children, lack of needs satisfied by the fathers of the adolescents (61.9%), father's role in adolescents' life (62%) and domestic violence in family (69.7%) were some of the important reasons for developing depression among adolescents. Adolescent whose parents were having conflict (69.2%) were found be depressed when compared to those adolescents whose parents had no conflicts this difference was statistically significant (p&lt;0.05). Conclusion: The prevalence of depression was found to be 45.2%. Finding of the study emphasizes the need for creating awareness about the early identification of behavioral changes leading to depression among adolescents by the parents and teachers. It is also important to emphasize to the parents on how their relationship and behavior towards the family affects the mental wellbeing of the adolescent.

Impact of nutritional status on hand grip strength among elderly population in India

Objectives: In the present study an attempt was made to find out the influence of sex and age on nutritional status and handgrip strength. Beside that relationship between nutritional status and hand grip strength was also evaluated irrespective of age and sex. Methods: Two stage cluster sampling method was employed for the study. 493 elderly subjects having the age range 51 and above were selected from different places of West Bengal state, India. Height, weight, Body mass index, Nutritional status (24-hour recall method) and hand grip strength were taken from the selected elderly population by standardized methods. Results: Hand grip strength found to be significantly higher in males than in females and so also it was significantly decreases with the advancement of age (p

Factors Associated With Utilization Of Adolescent-Friendly Health Services In Sunsari District Of Nepal

Objectives: Adolescent friendly health services are the tailored health services for adolescents in a friendly environment where adolescents can easily and comfortably access and enjoy sexual and reproductive health services. Utilization of such services helps to address sexual and reproductive health problems faced by adolescents and the status of adolescent sexual and reproductive health (SRH) in Nepal is alarming. However, limited studies have been conducted on utilization of Adolescent Friendly Health Services and its associated factors among school adolescents. Thus, this study was carried out to assess the factors associated with utilization of adolescent friendly health services in Sunsari district of Nepal. Methods: This study was a descriptive, cross-sectional study carried out among 502 secondary school adolescents of grade 9 and 10 studying either in public or private schools of Inaruwa Municipality Sunsari District, Nepal. Single stage cluster sampling was followed in this study. Data was collected through administration of pre-tested semi-structured questionnaire during the period of January to March, 2022. Results : Regarding socio-demographic characteristics, majority of the participants were female (56.2%) compared to male (43.8%). Mean age of the participants was 15 years with standard deviation of 1.359 years and most (92.8%) of them followed Hinduism. More than half of the participants (54.0%) belonged to Madhesi ethnicity and most (61.0%) of them were from nuclear family. Likewise, majority (90.6%) of the adolescents were unmarried whereas 5.6 % were in relationship. More than three-fourth of the participants (79.5%) were staying with their parents. Most participants (53.2%) reported having very close relationship with their family. Similarly, majority (70.9%) of the adolescents had not seen the logo of adolescent friendly health services but three fourth (75.5%) of them had heard about adolescent friendly health services. Only 38.5% of participants were known about the availability of adolescent friendly health institution in their locality and more than three fourth (79.9%) of participants said that the time required to reach health facility was less than 30 minutes. Less than one fourth (24.1%) of the participants had felt needs for sexual and reproductive health services. The utilization of adolescent friendly health services among adolescents was low i.e., 14.5% (CI: 0.115-0.176) and more than half (54.8%) of them had used counselling services. Regards of preference, 44.4% of the participants stated that they preferred private health facilities and most of them (79.3%) preferred the health facility nearby their residence. Conclusion: Based on the findings of the study, different intervention programs could be conducted to increase the awareness about adolescent friendly health services among adolescents which may increase its utilization.