Accessibility to sexual and reproductive health and rights education among marginalized youth in selected districts of Tanzania.

INTRODUCTION: Access to information, education and services is central in the promotion of sexual and reproductive health and rights (SRHR) among young people. It enables young people make informed choices on sexuality matters, hence reduce teenage pregnancies and sexually transmitted infections (STIs). This study assessed accessibility of SRH rights' information among marginalized young people in three municipalities of Iringa, Ilala and Kinondoni in Tanzania. METHODS: A cross-sectional study design using mixed methods was conducted in 2013 in three selected districts of Tanzania. We randomly selected 398 young people including those with disabilities to partake in quantitative survey while 48 community members were purposely selected for qualitative part. Quantitative data analysis was done using descriptive statistics and chi square test with the assistance of the Statistical Package for Social Science(SPSS) version 20, while qualitative data was thematically analyzed. RESULTS: There were 396 (99%) participants (144 Males and 251 females), with a mean age of 20.1years. The majority were out of school female, cohabiting and had completed secondary education. Overall, 317 (79.6%) had SRH rights knowledge. The leading sources of SRH rights information were peer educators (36.7%) and radio (22.8%). Awareness regarding laws and policies related to SRH right was 55.1%. However, young people living with HIV and school truants had more access to SRHR education and services than the other youth groups(χ2 30.69, p< 0.0001). The qualitative study revealed that parents and teachers perceived themselves to be incompetent in providing SRH information to their youngsters despite of being mostly trusted. CONCLUSION: Access to SRH rights information is high but decreases when it is disaggregated across different age groups. There is a need for diversified approach for reaching specific groups of young people depending on their needs and circumstances.

Barriers to sexual reproductive health services and rights among young people in Mtwara district, Tanzania: a qualitative study.

BACKGROUND: In Tanzania over 1/3 of the population is under 24 years. Nationwide 23% of teenagers have started childbearing. However, Mtwara Region has the highest percentage (25.5%) of teenagers who begin childbearing early. Mtwara District has a teenage pregnancy rate of 11% with young people utilizing sexual reproductive health services (SRHS) less frequently than adults.This study aimed at gaining insights on barriers to the utilization of SRHS in Mtwara district. METHODS: A qualitative study was carried out using focus group discussions, facility assessment interviews and case studies. A total of nine focus group discussions (comprising 8 to 10 persons per group) were conducted among girls (10-18 years), community leaders and adults. Data was transcribed using pattern matching methods then merged into relevant themes for analysis and interpretation. RESULTS: The study revealed that a good number of health facilities do not have skilled service providers (SPs) on sexual reproductive health rights. Girls start sexual intercourse between 9 and 12 years. Services sought included; education, family planning and voluntary counseling and testing. However, the services were inaccessible due to lack of privacy, confidentiality, equipments and negative attitudes from SPs. Initiation ceremonies, early marriages and gender disparities were mentioned as social-cultural barriers to SRH rights. CONCLUSION: This study has demonstrated that factors such as lack of youth friendly services, gender disparity and unfavorable socio-cultural practices may create barriers to accessing adolescent SRHS and rights. Therefore, there is a need to integrate youth friendly services in health facilities and advocate for behavior change.