Socio-demographic characteristic of respondent
A total of 845 youth were involved in this study and provided a response rate of 100%. The age of participants ranged from 15–24. The mean age (in years) of the studypopulation was 17.02 ± 5.45 years.Gedeo was a dominant ethnic group, which accounted 36.9% (n = 312) See table1.
Knowledge and attitude towards reproductive health services
Majority 768 (90.8%) were understood that reproductive health service is important and most of the youth had information about reproductive health service from peer educators 204 (24.1), youth club 188 (22.2%) and school min-media 213(25.2%). Abortion (31.3 %), unintended pregnancy (28.7 %), unsafe sexual practice (17.6%), and STIs/HIV/AIDS (22.4%) were the major RH problems described by youths see fig 1.The reproductive health service known by youths were family planning (36.7%), abortion care (26.4%) and STIs including HIV/AIDS (31.4 %) and health education (5.5%). 186(22 %) were knowledgeable about reproductive health service given at the health institutions. Majority of the respondent had positive attitude. Response from the youths that using condom (32.4%) abstaining from sex (40.1% %) followed by faithfulness to partner (27.5 %) were the major modes of preventing HIV/AIDS reported by the youth.
Utilization of reproductive health services
The prevalence of reproductive health service utilization in Dilla town was 34%. During focu group discution youth described reasons why they visit reproductive health service and they described for support of family member for health care service, for other medical service.
43.7 % of youth were visits reproductive health service for the first time and (4.6% %) got counseling service, (14.3 %) were for contraceptive services, (3.8 %) were for pregnancy related servicesand post abortion careaccounts (1.1 %.).
Factors associated with utilization of reproductive health services
Peer educator [AOR = 3.12, 95 % CI (5.76, 8.3)], school min-media [AOR = 1.79, 95 % CI (1.00, 3.19)], youth club [AOR = 2.78,95 % CI (3.67, 9.11)] and approach of health care provider [AOR = 4.11, 95 % CI (5.54, 11.23)] as source of information were factors associated with reproductive health serviceutilization Table 2.
During the time of discussion, Facility readiness was repeatedly raised as a factor that prevented the youth from acquiring essential RH services. A 19- year male discussant said “while you seek reproductive health service and moved to health facilities, the service were not provided in separate room and we lost our confident and privacy so that we become ashamed of discussing our problem.”
A 17 year- old female discussant who visited the facility for abortion service described “while at the time of my visit the provider asked me how can I get pregnant and I told him that from my boyfriend and providers told me it is sin so that I ashamed and lost confident trough out the process." other
Moreover, an 18 years old male discussant indicated about setup of the facility "when he visits the health facilities the environment was not conducive so he was afraid of sawing community member and left the facilities before getting the service."
At the time of, in-depth interview they were asked about provision of the service, the respondent from public institutions explained that there is no specifically designed RH services room for the youth in their institutions as well RH services are offered for youths without giving them aspartate room so that they are treating them as adult clients.
Additionally, the respondents of the in-depth interview were asked whether they have been given training on RH and approaching the youths. The respondents reported that they have taken such trainings and are confident that they could respond to the needs of the youth.
Provider from the government institution said, “…. I have obtained trainingon how to provide the service, But I am assigned in another unit and am working in RH clinic as aback up so that which is not appropriate for me providing the service per standard.”