Adolescents in urban and rural communities in Rivers state, Nigeria: Factors influencing access and utilization of reproductive health services

Abstract

Introduction: Reproductive health services (RHS) are used and accessed differently in rural and urban areas, though to what extent is unknown. In Rivers State, Nigeria, we identified and examined the characteristics impacting adolescents' access to and use of RHS in rural and urban areas. Methods: A cross-sectional comparative study design was employed, five hundred and seven adolescents—255 from urban and 252 from rural communities—were surveyed. Access and utilization were measured and using adjusted odd ratios in multivariate logistic regression models, predictors of access and utilization were identified. Results: The corresponding median ages and interquartile ranges were 16.0 (14–19) and 14.0 (12–16) years, respectively. RHS utilization was low, with 57 (22.6 percent) in rural areas and 65 (25.5 percent) in urban areas. There was also a lack of access to services; only 8 (3.17 percent) rural and 81 (31.76 percent) urban residents had economic access to RHS. Access and utilization were predicted by age, level of education, awareness of RHS, sexual experience in both communities, beliefs that condoms can prevent STIs/ HIV, and exposure to mass and socio-media influenced access and utilization of RHS. Specifically, age group (15-19 years) of respondents was found to be a significant predictor of utilization of RHS for both urban (cOR=4.32, 95% CI; 0.82-22.69, p=0.001) and rural (aOR=7.65, 95% CI; 1.99-29.40, p=0.003) adolescents. Conclusion: Adolescents in urban areas have more access (3 in 10) and utilization of RHS compared with their rural (3 in 100) counterparts. There is a need to promote information and education on RHS among adolescents, especially in rural areas.

Keywords

• Access
• Utilization
• Reproductive Health Service
• Adolescents
• Rivers State