Addis Ababa University College of Health Sciences

School of Public Health

Assessment of the Availability and Utilization of Reproductive

Health Service in Youth Centers, Addis Ababa, Ethiopia

By: Anewar Hulegicho (BSc.)

Advisor: Dr. Mesfin Addissie (MD, MPH)

Thesis Submitted to Addis Ababa University, School of Public Health

in Partial Fulfillment of the Requirements for the Degree of Masters
in Public Health

May 2014

1
ACKNOWLEDGMENT

First and for most, I would like to thank Allah for his compassion and guidance for
accomplishment of the study. I lack words to thank and express my deepest gratitude to my
advisor Dr.Mesfine addissie for his unreserved support throughout the development of
proposal to finalizing this Research paper.

I have a great full acknowledgement to Addis Ababa Women, Youth and Children bureau
and heads of youth centers for their help in providing official data. I also extend my
appreciation to service providers and young people that participated in the study. My
acknowledgement also goes to Supervisors and data collectors who committed themselves
throughout the study period.

My special thanks forwarded to my beloved family for their moral and financial support.
Finally, to all you that could not I have mentioned but in one way or other played in part of
the fulfillment of this study I said thank you so much.

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 TABLE OF CONTENT

TITLE PAGE

Acknowledgement ……………………………………………………………………………I

Table of Content ……………………………………………………………………………..ii

List of Tables and Figures…....................................................................................................iii

List of Annexes ………………………………………………………….…………………...v

List of Abbreviations ……………………………………………………………………….IV

Abstract …………………………………………………………………………………….viii

1. Introduction ……………………………………………………………………………......1

1.1. Background ………………………………………………………………………......1

1.2. Statement of the Problem …………………………………………………..…….….3

1.3. Significance of the Study ……………………………………………………...……..5

2. Literature Review ………………………………………………..…………….……….…6

3. Objectives ……………………………………………………….…………….………......12

3.1. General Objective………………………………………………………….................12

3.2. Specific Objective………...………………………………………………...……......12

4. Methodology ………………………………………………………………………...…....13

5. Result ………………………………………………………………………………...…....20

6. Discussion ………………………………………………………………………….……..40

7. Strength and Limitation of the Study ………………………………………….…..……..44

8. Conclusion ………………………………………………………………………………...45

9. Recommendation …………………………………………………………………….........46

10. Reference ……………………………………………………………………...………....48

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 II

LIST OF TABLES

Table 1:- Socio Demographic Characteristics of Respondent, Addis Ababa, Ethiopia, June
2013………………………………….……...……………………………………….…….…27

Table 2:- Description of Parents by Education, Occupation, and Income of the Study
Population, Addis Ababa, Ethiopia, June 2013……………..………….……….…………..28

Table 3:- Knowledge, Preference and Utilization of Reproductive Health Service, Addis
Ababa, Ethiopia, June 2013…………………………………………………...………..……29

Table 4:- Staff Patterns of the Youth Centers Reproductive Health Clinics, Addis Ababa,
Ethiopia, June 2013……………………………………………………………….…………31

Table 5:- Types of Training that Service Providers Attended, Addis Ababa, Ethiopia, June
2013……………………………………………………………………………….……....….35

Table 6:- Utilization of Reproductive Health Service in Youth Center, Addis Ababa,
Ethiopia, June 2013…………………..………………..……………………………….…….38

Table 7:- Logistic Regression Analyses of Socio Demographic and other Variables over
Youth Center Reproductive Health Utilization, Addis Ababa, Ethiopia, June
2013………………………………………………………………………………...….....…..40

Table 8:- Factors that affect youth center RHS Utilization, Addis Ababa, Ethiopia, June
2013…………….…………………………………………………………………………….41

Table 9:- Visual Aid and Providers Approach to Young Clients, Addis Ababa, Ethiopia, June
2013…......................................................................................................................................42

Table 10:- Providers Reception and Communication to Young Clients, Addis Ababa,
Ethiopia, June 2013 ……………………………………………………………………….....43

Table 11- Preference of Young people to Reproductive Health Service, Addis Ababa,
Ethiopia, June 2013……………..………………………………………………................…45

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 III

LIST OF FIGURES

Figure 1: - Schematic Presentation of the Sampling Procedure………………….…………21

Figure 2:- Types of Training Service Providers Attended by Time, Addis Ababa, Ethiopia,
June 2013…………………………………………………..…………....................................

Figure 3:- Respondent Reason for Today Visit of the Youth Center, Adds Ababa, Ethiopia,
June 2013……………………………………………………………..…………….………...

Figure 4:- Factors Affecting Utilization of Youth Center Reproductive Health Service, Addis
Ababa, Ethiopia, June 2013………………………………………………………….

Figure 5:- The Quality of RH service provided in Youth Center Clinics According to
Respondent, Addis Ababa, Ethiopia, June 2013……….…………….….………..…………32

Figure 6:- Respondent Prefers to Sex and Age of Reproductive Health Service Provider,
Addis Ababa, Ethiopia, June 2013………………………………..…………………………34

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 IV

LIST OF ANNEXES

Annex 1:- English questioner……………………………….…………………………….…60

Annex 2:- Checklist……………………………...…………….………………………….…74

Annex 3:- Amharic questioner…………………………….….…………..…………………75

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 V

ABBREVIATIONS

AIDS - Acquired Immune Deficiency Syndrome.

ASRH - Adolescent Sexual and Reproductive Health.
BCC - Behavior Change Communication.
CI - Confidence Interval.
FGAE - Family Guidance Association of Ethiopia.
FGD - Focus Group Discussion.
FP - Family Planning.
HIV - Human Immunodeficiency Virus.
IEC - Information, Education and Communication.
KAP - Knowledge, Attitude and Practice.
MOH - Ministry of Health.
NGO - Non Governmental Organization.
NACP - National AIDS Control Program.
PE - Peer Educator.
RH - Reproductive Health.
SDP - Service Delivery Point .
SP - Service Provider.
SRH - Sexual and Reproductive Health.
STIs - Sexually Transmitted Infections.
VCT - Voluntary Counseling and Testing.
WHO - World Health Organization.
YC - Youth Centers.
YFS - Youth Friendly Service.
YRHS - Youth Reproductive Health Service.

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 VI

Abstract
Background: - Young People are, highly vulnerable for reproductive health problems. The
situation is aggravated by low level of awareness, poor availability of service and health
service seeking behavior of youths. Reproductive health services for young people in Addis
Ababa are emerging in varying extent such as in youth centers. Youth Centers are a social
and recreational center intended primarily for use by young people.

Objective: - To assess the availability and utilization of reproductive health services in youth
centers in Addis Ababa, Ethiopia.

Method: - A descriptive cross- sectional study conducted between January 2013 and June
2013 and in ten youth centers of Addis Ababa, representing all sub cities by selecting one
youth center from each using lottery method. The study subject includes 423 young people
ages 15-29 selected using systematic sampling and ten service providers. Interview using
structured and semi structured questioner and checklist were the main research tools used.
Data entered using EPi Info and analyzed using SPSS statistical packages. Odd Ratio and
95% CI applied to measure the associations of variables.

Result: - of the targeted 423 respondent 407 response obtained for structured questioner, 232
(57%) were male and 175(43%) female. age group 15 to 19 account highest 159 (39.12%).
Staff pattern of the study youth center indicate that there is 10(100%) nurse and 5(50%)
laboratory technicians. the type of service available were voluntary counseling and testing,
family planning, reproductive health counseling, condom distribution and peer education.
Nine clinics have VCT service, four clinics family planning, three clinics peer education, and
all provide reproductive counseling and condom distribution. Concerning utilization
172(42.6%) respondent ever visited youth center reproductive health clinics. The major
reason of ever visit was VCT and condom. Main factors that affect utilization were lack of
knowledge 145(35.62%), lack of confidence 106(26.04%) and fear of being seen by friends
or family 57(14%). Regarding preference 119(29.5%) respondent wish the clinics to open in
weekend and 150(36.9%) service provider to be young and the same sex.

Conclusion and recommendation: - The RH services available in youth center are very
limited as compared with other African countries youth center and there is poor utilization of
RH services. Although respondent are sexual active, only 5-10% of those visit the youth
center come to the RH service clinics. The major factor that affects utilization was the gap in
8
information so Information, education and communication to increase awareness about
reproductive health should cared out and working hour have to include weekend.

9
Chapter One
1.1 Introduction

Reproductive health is a state of complete physical, mental, and social well-being and not
merely the absence of disease or infirmity, in all matters related to the reproductive system
and to its functions and process. Reproductive health addresses the human sexuality and
reproductive processes, functions and system at all stages of life and implies that people are
able to have a responsible, satisfying and safe sex life and that they have the capability to
reproduce and the freedom to decide if, when and how often to do so (1).

Reproductive health service components include preconception care, family life education,
family planning, antenatal care, nutrition, delivery, postnatal care, reproductive tract
infection care, STDs/HIV/AIDS, reproductive cancer treatment, prevention and treatment of
infertility; prevention and management of complications of unsafe abortion, safe abortion
services where not against the law, active discouragement of harmful practices, and referral
for additional services (1,2).

World Health Organization defines adolescents comprising age groups between 10-19 years,
youth as 15-24 and young people as 10-24. In Ethiopian context according to EFEDR
national youth police- young people defined as age 15-29. Young people currently accounts
over 30% of the world’s total population and trends are upwards, particularly in the urban
areas of developing countries (3, 4).Young people constitute more than one-third of the total
population in Ethiopia (6).

Due to the changing conditions of civilization, urbanization and life style, the health of
adolescents is increasingly at stake. Sexually transmitted diseases, HIV/AIDS and other
reproductive health problems are the greatest threats to their well-being. However, despite the
growing needs, there is no adequate health service or counseling specifically suitable for this
specific age group unlike children, mothers or adults (44).

The reproductive health problems of young people in Ethiopia are multifaceted and
interrelated. Forty-five percent of the total births in the country occur among adolescent girls
and young women, sexual violence and commercial sex work have become common
phenomena. As result, HIV/AIDS crisis and other reproductive health problems are spreading
throughout the country. The situation aggravated by the overall poor socioeconomic
environment and harmful traditional practices (5). Because of the complex nature of the
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problems, youth reproductive health strategies demand a multi spectral and integrated
approach (6).

Despite the growing need to RH and youth friendly services, it is recently that service begins
flourishing gradually in government and NGO health facilities to various degrees. Advocacy,
awareness and educational programs to support utilization of RH services are beginning
spreading. Some clinical records indicate that most young people are increasingly attending
RH clinics spatiality to access contraceptives and condoms. However, statistics show that
until now the rates of STIs and unwonted pregnancies among adolescent is still remain high
in Addis Ababa. (8)

Youth centers are social and recreational center intended primarily for use by young people.
The youth centers support opportunities for youth to develop their physical, social, emotional,
and cognitive abilities and help to experience achievement, leadership, enjoyment, friendship,
and recognition (5, 6). Youth centers divided into three according to the range of service they
provide. Comprehensive youth center are those provide at list eight full services including
highly organized educational and recreational programs, middle youth center are that have at
list five full service including partially full filled educational and recreational programs and
moderate youth center are those provide more than three services (6).

There are good polices and strategies regarding young people reproductive health in Ethiopia
but the implementation of this polices are week. Despite the construction and having,
different department youth centers are not will equip, staffed and supported. Only 46 of 76
youth centers have RH service centers, some of them have no full staff or facilities to operate
and from those are in service most of them suffer in lack of materials, poor Clint-providers
relationship, poor attraction and retention of users. The absence of mechanisms and strategy
on how to increasing utilization and youth participation is other challenges

Study reports and other literatures on young people reproductive health are very limited to
schools and not comprehensive, some studies tried to reveal the magnitude of sexual and
reproductive health problems of youth and tried to recommend to Governmental and
Nongovernmental organizations for intervention (6). To date, little known about the
reproductive health service available and it is utilization in youth center. Information on
affecting factors of the subject is not will studied. Hence undertaking a study in this area
believed to provide information that could help organizations to improve future reproductive
health services offered in youth centers.
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1.2 Statement of the Problem

Youth centers in Addis Ababa, although primarily organized for recreational purpose, they
are providing reproductive health service for young population visiting the centers. However,
there is limitation in the consistent availability of service in quantity and type, which hinder
youth from utilization of service based on their choice. Moreover, the reproductive health
clinics are poor in attracting, providing and retaining the young clients for regular utilization
(25, 26).

Despite the high needs in youth reproductive health, very few services were available and
provided in the past, which unmatched the centers service providing capacity. The women,
youth and children affairs office that are responsible for administering the youth center and
management of the youth centers gives attentions for improvement of service other than
reproductive health. There is limited effort and focus in improving the RH clinic achievement
and solving related problems.

The other thing that mentioned as limitation in the youth center RH clinics is the approach of
service providers. The life style and reactions of young people vary from those of adults. The
usual patient -physician relationship may not help health workers to understand their
problems. The health system should adapt a suitable strategy through restructuring and
formal training to make a more friendly and attractive environment for adolescents. (25)

The National Reproductive Health Needs Assessment showed that there are many gaps in
reproductive health services utilization. It indicates that young people are well aware of
family planning methods However, the utilization of family planning services was very low
and high rates of unwanted pregnancy and abortion complications demonstrated (12). this
study primarily focuses on identifying and assessing the extent of service availability in youth
centers and utilization by young peoples. In addition to this, it will also try to show the
possible factors that have been affecting service utilization and preference of youth towards
RH service.

Studies in young people sexual and reproductive health have been largely socio-behavioral in
nature and center mainly schools. It was recently that youth centers launched at woreda level
focusing on behavior culturing of youth and reproductive health service delivery. There has
been limited up-to-date research regarding availability and utilization of reproductive health

12
services in youth centers in Addis Ababa. It will fill the gap regarding to this and will serve
as groundwork for further research and investigation.

Information from this study will also help to re-orient RH services in youth centers, so that
they effectively meet the needs of young people and facilitate maximum utilization of
available services to protect their sexual and reproductive health. It does also explore the
factors that determine utilization of the services by young people

13
1.3 Significance of the study

Generally, most of the research on reproductive health that has done in our country primarily
focuses on school or in street children and Research done at the institution level commonly
focus on health institution like hospital and health center. Despite it is immense importance
there should be other mechanism to see out school youth to address the overall reproductive
health problem of young population.

Despite the contribution that youth centers playing in providing reproductive health service
and appearing to be alternative to the existing health institution still they are not able to
attract researcher’s attention. Researches ignored the reproductive health service binge given
in the youth centers some of them may mention indirectly, which does not address the whole
problem and phenomena as will. This research fill the gap regarding to this and contribute
allot to those who are interested in youth center reproductive health service.

The focus of this research was to gain deeper insight into youth reproductive health services
in terms of availability and utilization in youth centers. These studies also expose the extent
of available reproductive health service and utilization by target age group. That will help
concerned body to identify gapes and interfere in the best way to improve the centers
capacity.

It also Indicate some issues that are important youth center reproductive health service to
become more organized, attractive and comprehensive. It does promote the blooming of
youth reproductive health as part of youth centers where youths comes in mass, seeking of
different service. The research will also benefit Government, stakeholder’s, service providers
and program managers in developing plan to further improve the service availability in verity
extent in youth centers.

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Chapter Two
Literature Reviews
Adolescence is transitional period from childhood to adulthood, characterized by significant
physiological, psychological and social changes. WHO defines adolescents as those in the
age group of 10-19, youth 10-24 years and young population age between 15 and 24(23, 24).
According to EFDR Youth Policy young population defined as age group between 15 and 29.
Young people aged 10‐24 constitute about a quarter of the world’s population, with nearly
three‐quarters living in the developing world, and they suffer a disproportionate share of
unplanned pregnancies, STIs including HIV, and other reproductive health problems (15).

The adolescent population in Ethiopia has been increasing during the last few decades.
Currently, adolescents constitute about 24% while youth 10-29 years constitute about 35% of
the total population (3). Our world currently cares for a historic highest number of
adolescents; about 1.2 billion adolescents need proper education, health and other life skills
to ensure a better future for themselves and their countries (23, 24).

Young population places immense challenges for the country to provide the required social
services such as health service, education and economic opportunities (9, 10). The problems
the youth section of the society faced goes much deeper into different and complex issues and
the situations, including gender inequalities, sexual coercion, rape, and harmful traditional
practices like early marriage, abduction, female genital cutting and the like (13).

The freedom to choose how many children they want and when to have them are the rights of
men and women. The rights to be informed and have access to have safe, effective, affordable
and acceptable methods of family planning of their choice and the right of access to
appropriate health care services, that will enable women to go safely through pregnancy and
child birth and provide with the best chance of having a healthy infant (14).

Sexual Practice and need of RH (availability of RH)

A considerable proportion of the youth in country practice sex at early age and practice
unsafe sex consequently the majority of them are highly vulnerable to sexual and
reproductive health problems that include pregnancy and child bearing at early age,
complications of unsafe abortion, sexually transmitted infections and HIV/AIDS (13).

15
Youth having survived all childhood health problems, have been enjoying a relatively low
morbidity and mortality period in the past. At present, due to changing conditions due to
civilization, urbanization and life style, the health of adolescents is increasingly at stake.
Sexually transmitted infection, HIV/AIDS and other reproductive health problems are the
greatest threats to their well-being. However, despite the growing needs, there is no adequate
health service or counseling specifically suitable for this specific age group unlike children,
mothers or adults (25, 26).

Findings from 20 studies on youth RH provide important lessons about which interventions
are effective, what kind of impact is possible and what approaches have limited impact; they
quoted that Young people have limited access to reproductive health services that focus on
the special needs of adolescents. Inadequate knowledge about adolescent sexual behavior,
cultural influences, and the limited capacity of implementers hinder the provision of
reproductive health education and services to young people (15).

Youth reproductive health problem in Ethiopia

Young population health is a grossly neglected area in the public health agenda of the
developing countries like Ethiopia due to the traditional belief that adolescents having passed
through a high mortality childhood period they are among the healthiest in the society. This
traditional belief however largely undermined by recent changes in adolescent morbidity and
mortality trends observed worldwide (26).

Sexual activity among youth in Ethiopia, particularly those residing in urban areas, has
resulted in large numbers of unwanted pregnancies, and illegal abortions, which pose serious
health and social problems. Studies carried out in the country indicate that complications
from unsafe abortion accounted for almost 55 percent of all recorded maternal deaths, some
13 percent of which occur among women under the age of 20. The number of cases of
sexually transmitted disease (STD), including HIV/AIDS, is also Increasing (6). The same
study also indicated that about a quarter of adolescents believe that health services are neither
affordable nor accessible to adolescents (6).

A recent study in Addis Ababa conducted among high school students indicated that 22% are
sexually active; of which 8% had symptoms of STDs in the three months prior to the survey
and 6% of the girls had been pregnant, with 70% termination in abortion. About 40% of the
students reported the use of at least one of the common addictive substances (alcohol,

16
cigarette, chat or cannabis (marijuana); 52% had mental distress and 11% had attempted
suicide in the past (16).

Several other studies in different parts of the country have also shown that adolescents are
increasingly affected by reproductive health related problems, mental distress and substance
abuse due to changing social norms that increased their vulnerability and risk. The mean age
at first sexual debut reported to be between the ages of 15.3 and 19.0 (14). Unwanted
pregnancy prevalence among adolescents reported to be 15% in Harare, 30.1% in Gondar
(15) and 50% in Kola Diba (16) towns. STD prevalence of 6.5% in 1995 and 4% in 1998
among out of school adolescents reported from Hawassa. (17, 18).

The use of contraceptives among sexually active adolescents in many areas of the country is
very low in urban areas the consumption of alcohol, chat and tobacco by adolescents is quite
high and use starts early during the adolescence period (18). Mental distress and suicidal
attempts also reported among adolescent students. About 7% of adolescents in Addis Ababa
and Hawassa town reported mental distress while suicidal attempts varied greatly 14.3% in
Addis and 3.4% in Hawassa (17)

Youth friendly reproductive health service

Youth friendly health services can be freestanding clinics or attached to existing clinics or
recreational facilities. Ideally, they provide a full range of services and information to Young
people and are welcoming, confidentially, conveniently located and affordable. (17) In most
situations, actions needed on several different fronts if good quality health services that are
relevant to Young people's needs are make available and accessible to them, including
polices, organization of the services, and training of health workers and young people (1).

In addition to health promotion, health services for young people will, at a minimum need to
include emergency services, routine treatment of common diseases, and regular access to
non-judgmental listening and support guidance and regular access to the health supplies that
young people require. By fulfilling the preference of adolescents, Youth friendly services that
have polices and attributes that attract Youth; health facilities can provide comfortable and
appropriate services that meet the need of adolescents and retain them for follow up
successfully (20).

In Ethiopia, young people get medical care through the existing network of health institutions
in the country (21). They are relative disadvantaged in their inability to access information

17
and services for their reproductive needs because of the absence of a youth – friendly service
delivery system. The service given by youth centers should be youth friendly that mains
accessible, acceptable Affordable, successful, safe and comfortable in place and times for
youths (22).

Peer pressure is the other important issue identified as the major factor resulting in risky
reproductive health related behavior among youth and adolescents. This is particularly so in
the context of the growing social acceptance of premarital sex, which influences decisions of
adolescents and other young people related to reproductive health. The influence of peer
pressure is also very high in the situation where the traditional parental control over
premarital sexual behavior of young people and role of family members is declining (28).

Exposing factor to reproductive health problem

It is widely recognized that young people are vulnerable to unwanted premature pregnancies
and abortions due to the following factors such as unfavorable social and cultural values,
gender bias, domestic violence, and early age at sexual initiation. Moreover, lack of
educational opportunities including sex education, economic reasons where women are
usually dependent on men, inaccessible and poor quality family planning and reproductive
health services, high-risk sexual behavior, lack of safe sex negotiating capacity and bias of
health care providers(6).

Factor affecting young people’s reproductive health utilization includes challenges that
expose them to making poor choices regarding their reproductive health such as Poor parental
guidance, homelessness, drugs, alcohol and substance abuse, limited survival options and
unemployment. In addition to that, inadequate RH/HIV/AIDS information, poor coping and
life skills, poverty, and high levels of stress which are a precursor for risk sexual behavior
resulting in early sexual involvement, STI infections and other reproductive issues including
HIV /AIDS are some of the factors that put young people at risk (27).

Factor Affecting RH service Utilization

The existing RH services are small scale and not well organized to meet the RH service needs
of young population. The existence of a clear mismatch between the available services and
RH needs of this section of the population observed. In this regard, most of the youth focused
reproductive health programs in the country reach youth in school. (29)

18
Other sub section of the youth population including street kids, young females, married
adolescent girls, youth who migrated to urban centers to escape early marriage or for
employment reasons including housemaids constitute the under-served section of the youth
who do not have access to proper information and counseling services. All of which as a
result suffers from poor decision-making on reproductive health choices, practices and lake
of accessible to service (29).

Generally, most of the research on reproductive health that has done in our country primarily
focuses on school or in street children and Research done at the institution level commonly
focus on health institution like hospital and health center. Despite it is immense importance
there should be other mechanism to see out school youth to adders the overall reproductive
health problem of young population.

The youth center offers structured and unstructured youth friendly service such as library,
counseling service, health education and reproduction health, first aid service, information
technology center, cafe and restaurant, indoor and outdoor games, shower service, club
meetings and so on (5). The services present in youth centers should be youth friendly that
Menes accessible, acceptable, affordable, successful, safe and comfortable in place and times
for youths (5, 6).

Despite the contribution that youth centers playing in providing reproductive health service
and appearing to be alternative to the existing health institution still they are not able to
attract researcher’s attention. Researches ignored the reproductive health service binge given
in the youth centers some of them may mention indirectly, which does not address the whole
problem and phenomena as will. This research fill the gap regarding to this and contribute
allot to those who are interested in youth center reproductive health service.

19
Chapter Three
Objective
2.1 General Objectives

To assess the availability and utilization of reproductive health services in youth centers in
Addis Ababa, Ethiopia.

2.2 Specific Objectives

1) To assess the types of reproductive health services available in youth centers in Addis
Ababa, Ethiopia.

2) To assess the extent of utilization of reproductive health service in the youth centers

3) To assess factors affecting the utilization of reproductive health service in youth centers.

4) To explore the perception and preference of young people towards the sexual and
reproductive health services provided in youth centers.

20
Chapter Four
Methodology
4.1. The Study Area and Period
The study conducted in Addis Ababa City Administration. Addis Ababa is the capital city of
Ethiopia and the largest populated city in the country sharing boundaries with oromiya
Regional State. It covers an area of 530.1km². Administratively the city divided in to 10-sub
city and 116 woredas with total population of more than 2.73 million according to the 2007
population census, with annual growth rate of 3.8%. According to Addis Ababa, health office
the health service coverage of Addis Ababa is 67.5% in 2013. There are 6 regional hospitals,
50 health centers, 36 private hospitals, 700 private clinics and 529 private pharmacies that
providing health services.

A total of 77 youth centers have been constructed by targeting of building one youth centers
in each woredas. from the total 77 youth centers 35 of them give full service, 30 partially
service, 12 of them are not begin providing any service. Regarding to reproductive health
service 46 youth centers are providing service such as VCT, Family planning, Condom
distribution, RH counseling and others. The study period was from January to June 2013.

4.2. Study design

cross- sectional study having quantitative and qualitative methods conducted the qualitative
methods were used to verify data collected in quantitative method and to gain an in-depth
understanding of factor affecting availability and utilization.

4.3. Source population

The source populations were all young population aged between 15 and 29 years who reside
in Addis Ababa for more than two years. The age group range is according to the Ethiopian
youth police definition of young population.

4.4. Study population

The Study populations were those sampled young population, who reside in the woredas that
the selected youth centers belong, and have been visiting youth centers for different service at
the time of data collection.

1/ Inclusion criteria
- To minimize bias due to lake of knowledge and information the respondent was resident of

21
the selected woreda for more than 2 years.
2/ Exclusion criteria

- Youth who reside less than two years in the study area
- Who were critically sick at the time of study and unable to communicate
4.5. Sample size determination
The sample size was determined using single proportion formula. Assuming the proportion of
availability and utilization of reproductive health service is unknown and to be 50%, since
there is lake of data on proportion in comprehensive form. In addition, Significance level of
95% and 5% margin of error assumptions made. 10% added to compensate for non-responses
rate. Accordingly, 423 youth selected and interviewed.

n= (Zα/2)2P (1-p)

d2

n= the required sample size

z= standard score corresponding to 95%(1.96) confidence interval
p= the proportion of availability and utilization of reproductive health service to be 50%
d= the margin of error (precision) 5%
n=(1.96)2x(0.5x0.5)= 384.16+10% non response = 423

4.6. Sampling procedure

all youth centers considered in the sampling process for the selection of the study subject.
Primarily those youth center that provide reproductive health service stratified in to the sub
city they belong. Then using lottery method ten youth centers selected, one from each sub
city. The sample size distributed to each youth center with equal proportion. The study
subjects selected from each youth center using simple random sampling based on that, in
average more than 300 youth visit youth centers in a week for different service and it was
planned to collect the data within one week from each youth center. Based on this every six
youth who came to the center was selected as a sample and self administered questioner was
given by asking consent verbally and explaining the objective of the study in case of refusal,
the next sample taken. Those selected ten youth centers were
- Addis Ketema sub city, woreda 09 youth center.
- Akaki Kality sub city, wereda 01 youth center.
- Arada sub city, wereda 04 youth center.

22
- Bole sub city, wereda 06 youth center.
- Gulele sub city, wereda 05 youth center.
- Kirkose sub city, wereda 10 youth center.
- Kolfe keraniyo sub city, wereda 09 youth center.
- Ledeta sub city, wereda 03 youth center.
- Nefase selke lafeto sub city, wereda 08 youth center.
- Yeka sub city, wereda 08 youth center.

23
Figure 1: - Schematic presentation of the sampling procedure

Addis Ababa City Administration

Arada S/C 3,4,2,10 Worda 4 youth

Youth centers lottery method
center

Akaki Kality youth centers

1,2,3,4,8 lottery method Worda 1 youth
S/C center

Gulele S/C Youth centers 4,5,8,10 lottery method Worda 5 youth

center

Ledeta S/C 1,3,5,6,8, Woreda 3 youth

Youth centers lottery method center

Kolfi Keranio 3, 5, 6,8,10 Worda 10 youth

S/C Youth centers lottery method center

Nefas Selke 2,6,8,9,10 Woreda 6 youth

afto S/C center
Youth centers lottery method

Yeka S/C Youth centers 1,4,8,10 lottery method

Woreda 8 youth
center

Kirkose S/C 2,3,5,7,8 Woreda 5 youth

Youth centers lottery method
center

Addis 1,4,6,9 Woreda 9 youth

Ketema S/C Youth centers lottery method center

Bole S/C 1,2,4,5,6 Woreda 6 youth

Youth centers lottery method center

24
4.7 Data Collection instruments
self-administered structured questionnaire was prepared in English then translated in to
Amharic and translated back in to English to check for consistency. The questionnaire
included socio- demographic characteristics, Sexual Behavior and Knowledge about
Reproductive Health Service, available RH service, Utilization of Reproductive Health
Service, Preferences and Attitude to the Existing Youth Center RH Clinic .

For qualitative data collection method an open-ended semi- structured interview guide
applied, this help to study the service providers knowledge, attitude and skills about RH
service, types of RH services provided, factors affecting reproductive health Services
availability and utilization, Provider attitudes in providing RH services. Moreover, checklist
used to inspect the types of health facilities and commodities available at the clinics.

7.2 Data collector personnel

One data collector deployed for each youth center, who had diploma and with some
experience on data collection. Two supervisors who have health background recruited then
short training and orientation given for both the interviewers and supervisors for one day. The
actual data collection done March 15 to July 15, 2013

4.8 Data Quality issues

The quality of data assured through careful design, translation, back translation and pretest of
the questionnaire, proper training of the data collectors and supervisors, close supervision of
the data collecting procedures, proper categorization and coding of the data, carful entry of
the data and cleaning after entrance.

4.9 Measurement variables

Dependent variables:

- Service preferences and utilization

- Availability of reproductive health service

Independent variables:-

Socio demographic characteristics such as sex, age, ethnicity, religion, educational level, job,
family background and marital status
25
4.10 Data Analysis
Data entry, processing and analysis done using Epi Info version 3.5 and SPSS 20 statistical
software programs. Descriptive statistics such as frequencies, percentage, appropriate graphic
presentation and tables besides measures of central tendency and measures of dispersion used
for univariate analysis. Odds ratio and 95% confidence interval was used to check significant
association between dependent & independent variables.

4.12 Operational Definitions

Acceptance of reproductive health service: - the attitude towards and willingness to use RH
service by young people or others.

Early sexual activity: - regardless of marital status practicing of sexual intercourse before
reaching to age 18.

Service utilization: - consumption of reproductive health service that provided in youth

center or other clinics.

Service preferences: - the interest and choose of clients towards the type of RH service and
means of providing the service.

Voluntary counseling and testing (VCT): is process by which an individual undergoes

counseling that enabling him or her to make informed choice.

Young people: - defined as age group 15-29 this is according to EFDR youth policy.

Youth Center: - are a social and recreational center intended primarily for use by young
people ages.

4.11 Ethical Considerations

The proposal ethically cleared by the ethical clearance committee of School of Public Health,
Addis Ababa University and at local level necessary arrangements and approval made. The
data exclusively used for research purpose. Issues of the rights to privacy and confidentiality
were taken in to consideration when data collected. The findings of the study used to improve
reproductive health services that provided in youth centers.

4.13 Dissemination of Result

The result will be presented to Addis Ababa University School of Public Health then

26
documents will be disseminate to the study areas primarily to Federal and Addis Ababa
women, youth and children affair and to the youth centers were the study was conducted. In
addition, the result will be disseminated through presenting the finding at different meetings,
workshops and trying to publish in scientific journals.

27
CHAPTR FIVE

RESULTS

Socio Demographic Characteristic of Respondent

From the 423 youth who projected for the study, full responses obtained while 16 responses
were inconsistent and incomplete as a result they discarded. Thus, the response rate was
96.21% of the targeted sample size. As it was shown in Table-1, out of 407 respondents, 232
(57%) were male with the male to female ratio of 1.32:1. Out of the total respondents, 159
(39.12%) of them belong to the age 15 to 19 years and 126(31%) in age group 20-24 with
mean age of 20.

The Socio Demographic Characteristics indicate that 287(78.5%) respondent live more than
11 years in the interviewed woreda. Among the respondent 333(91.9 %) attended secondary
school and above, 347(85.3%) were unmarried and 46(11.3%) married. 272(67%) of the
study subject were followers of orthodox Christian and 81(20%) Muslim followed by other
religious sects. This study also indicate that, ethnically 183(45%) were Amhara and
96(23.6%) Oromo followed by others. Out of the total interviewee 273(67.1%) of them were
student 127(31.2%) have private or governmental job and 30(7.4%) are unemployed (Table 1)
Table 1:- Socio Demographic Characteristics of Respondent Addis Ababa, Ethiopia,
June 2013.

Variable Category Frequency Percent Cumulative

N=407 percent
Sex Male 232 57.0 57.0
Female 175 43.0 100.0
Age 15-19 159 39.12 39.18
20-24 127 31 70.12
25-29 61 14.98 85.1
No answer 42 10.3 95.4
I don’t know 18 4.42 100.00
Educational level Only read and 1 0.2 0.2
write
1 to 6 grade 9 2.2 2.5
7 to 10 128 31.4 33.9
11 to 12 121 29.7 63.6
diploma 96 23.6 87.2
28
 degree and above 52 12.8 100.00
Marital status Married 47 11.3 11.3
Unmarried 347 85.3 96.6
Divorced 6 1.5 98.0
Widowed 1 0.2 98.3
Separated 6 1.5 100.00
Religion Catholic 7 1.7 1.7
Muslim 82 20.0 21.7
Orthodox 272 67.0 88.7
Protestant 38 9.4 98.0
Other 8 2.0 100.00

Ethnic group Oromo 96 23.6 23.6

Amhara 183 45.0 68.6
Tigiri 38 9.3 77.9
Guraghe 63 15.5 93.4
Others 27 6.6 100.00
Occupation Student 237 58.2 58.2
House Wife 4 1.0 59.2
Unemployed 30 7.4 66.6
Govt employ 63 15.5 82.1
Private 64 15.7 97.8
Others 9 2.2 100.0
currently school attended Yes 273 67.1 67.1
No 134 32.9 100.00
Number of years live in the 2-4years 49 12 12
current woreda 10years 71 17.4 29.5
> 11 years 287 70.5 100.00

Parent Education, Occupation and Income of the Study Population

As indicated in table 2, 262 (64.40%) respondent live with both parents and 45 (11.1%) of
respondent lost both parents. 108 (26.5%) respondent father completed secondary education
121(29.7%) are illiterate, 133 (32.8%) respondent mothers completed elementary education
and136 (33.5%) of mothers have no any educational background. Respondent Parents job
status indicate that 129(31.5%) of parent had job, 135(33.2%) only fathers and 64(15.5%)
only mothers had job. the family average monthly income reveal that 143(35.1%) family’s
have average family income of more than one thousand Ethiopian birr and 17(4.2%) family
had less than 200 ETB income per month.
29
Table 2:- Description of respondent parents by education, occupation, and income,
Addis Ababa, Ethiopia, June 2013

Variable Category Frequency Percent Cumulative

N=407 percent
parents alive Father alive 18 4.4 4.4
mother alive 82 20.1 24.6
both alive 262 64.4 88.9
both not alive 45 11.1 100.0
Educational status of Illiterates 121 29.7% 29.7%
father Elementary 84 20.6% 50.4%
secondary 108 26.5% 76.9%
College and above
78 19.2% 96.1%
Informal education 5 1.2% 97.3%
Read & write 11 2.7% 100.0%
Educational status
of Illiterates 136 33.5% 33.5%
mother Elementary 133 32.8% 66.3%
Secondary 80 19.5% 85.7%
College and above 29 7.1% 92.9%
Read & write 29 7.1% 100.0%
Parents job status Both have works 129 31.7% 31.7%
Father have work 135 33.2% 64.9%
Mother have work 64 15.7% 80.6%
Both not work 65 7.5% 88.1%
Not concerned 14 11.1% 100.0%
Family average monthly <200ETB 13 3.2% 3.2%
income 201-400 ETB 17 4.2% 7.4%
401-600 ETB 30 7.4% 14.7%
601-1000 ETB 75 18.4% 33.2%
>1000 ETB 143 35.1% 68.3%
I don’t know 129 31.7% 100.0%

Respondent Sexual Behavior and Knowledge about Reproductive Health Service

available in youth centers

Concerning respondent sexual behavior 200(49.1%) currently has sexual partner and 212
(51.6%) ever makes sexual intercourse. Respondent report that 101(47.6%) of them always
use condom during sexual intercourse, 57(26.9%) sometimes and 54(25.5%) never use
condom. From the study participant 10(2.4%) responded that they make their first sexual
intercourse below the age of 15, 37(9.1%) in the age of 17 and 66(16.2%) in age of 18 or 19.
30
The majority of respondent 66.3 % ever had sexual partners in their life time that is 27.6%
report they have had one, 22.4% two, 9.4% three, 6.9% more than four sexual partners ever
and 137(33.7%) said still they have had no sexual partners.

About respondent knowledge and awareness on what service are available in youth center RH
clinics, 240(59.3%) respondents have knowledge of at least one service among this
183(40.7%) respond VCT, 146(60.8%) RH Counseling, 144(60%) condom distribution and
111(46.25%) family planning service and 165(40.7%) reported that they does not know any
service available in youth centers (Table 3).

Table 3:- Respondent Sexual behavior and Knowledge of Reproductive Health Service
avilability, Addis Ababa, Ethiopia, June 2013

Variable Category Frequency Percent Cumulative

N=407 percent
Had sexual partners now Yes 200 49.1 49.1

No 207 50.9 100.00

Ever make sex Yes 212 51.4 51.1

No 195 48.6 100.00

Condom usage during sexual Always 101 47.6 47.6

intercourse (N=212) Some times 57 26.9 74.5

Never used 54 25.5 100.00

Age at First sexual intercourse < 13 1 0.2 0.2

13-15 10 2.4 2.7

16-17 58 14.3 17.0

18-19 66 16.2 33.2

20-22 49 12.1 45.2

>22 12 2.9 38.8

never make sex 197 48.4 96.6

no answer 12 2.9 99.5

I don’t know 2 0.5 100.00

Sexual partners ever had in 1 112 27.6 27.6

2 91 22.4 50.0
life time
3 38 9.4 59.4
≥4 28 6.9 66.3

None 138 33.7 100.00

31
 knowledge of RH service Yes 240 59.3 59.3

availability in youth center No 167 40.7 100.00

Mentioned RH Service by VCT 183 76.2

respondent (more than one Family 111 46.25

possible answer) planning

RH Counseling 146 60.8

Condom 144 60
distribution
Other 2 0.8

Staff Patterns of Youth Centers Reproductive Health Clinics

All of the youth centers are governmental owned and funded. They fall under Addis Ababa
women, youth and children Affairs bureau. The youth centers clinics usually had two rooms
one for laboratory and the other for nurse. The numbers of staff are two, a nurse and a
laboratory technician. As shown in Table 4, five youth center have only one-health workers,
totally there have been 10 nurse and 5-laboratory technician nine of them are females and six
are males. The nurses interviewed using semi-structured questioner they are six female and
four male, five of them are in the age group of 23-27 and the remaining in age group of 28-32
(table 4).

Table 4:- Staff patterns of youth centers reproductive health clinics, Addis Ababa,
Ethiopia, June 2013

Name of youth No. Sex Nurse Lab. Technician

center of
staff
M F trained Not partially Trained Not
trained trained trained
Addis Ketema s/ c 1 0 1 1
woreda 09 youth C.

Akaki Kality S/C 2 0 2 1 1

wereda 01 youth C.

Arada S/C wereda 2 1 1 1 1

04 youth center

32
 Bole S/C wereda 06 1 1 0 1
youth center

gulele S/C wereda 2 1 1 1 1

05 youth center

kirkose S/C wereda 1 0 1 1

10 youth center

Kolfe keraniyo S/C 1 1 0 1

wereda 09 youth C.

ledeta S/C wereda 1 0 1 1

03 youth center

nefase selke lafeto 2 1 1 1 1

S/C wereda 08
youth center

Yeka S/C wereda 2 1 1 1 1

08 youth center

Total 15 6 9 2 1 7 3 2

The assessment of whether the RH service providers are trained or not indicate that only two
nurses and two-laboratory technician have taken full training on knowledge and skill that
help to provide youth friendly RH service. Seven nurses attend only one training mainly
about VCT and one nurse and three laboratory technicians never attend any training (Table
5). As indicated in figure 1, the time that health workers participated in training was listed
and most of them attend training before one year ago (Figure 1).

Table 5:- Types of Training that Reproductive Health Provider Nurses Attended, Addis
Ababa, Ethiopia, June 2013

Types of training Trained Not trained Total

No. % No. % No. %

training on youth friendly RH service 3 30 7 70 10 100

training on STI and VCT service 8 80 2 20 10 100

training on family planning 2 20 8 80 10 100

33
 Figure 2:- Types of Training Service Providers Attended by
time, Addis Ababa, Ethiopia, june 2013
9
8
7
6
5
5 < 6 month
4 6mo. - 1year
3 1yr. -2yr
2 2
2 > 2 year
1 none
0
RH training on youth STI and VCT service family planning
friendly service

Reproductive Health Services Available in Youth Centers

• Family Planning methods (pills and depo provera)

• Voluntary Counseling and Testing (VCT)
• Reproductive Health Counseling
• Peer Education
• Emergency Contraceptive
• Condom promotion and distribution
•Training on Reproductive Health

RH Services and Commodities Available in the Study Conducted Facilities

The RH clinics of youth center had family planning service but only four (40%) are currently
providing family planning service. Contraceptives found in these centers were condoms,
emergency contraceptive, pills and Depo Provera. Four (40%) clinics are providing
emergency contraceptive, three (30%) of them have pregnancy testing service, nine (90%)
clinics have HIV testing service and all have STI counseling service.

None of the clinics had basic clinic equipment like – stethoscope, scales, thermometer, and
sphygmanometer and fetoscope. All have a sink, running water and toilets that shared with
other offices in the building and electricity. All had BCC materials such as posters, pamphlets
and penile modal. None had media’s aids like TV and videos. There were no enough seats
and waiting place for clients in all clinics.

All clinics had shelf except one and medicine kept in a manner that ensures good
preservation. All facilities received materials and drug from the Health Centers, with the
34
exception one clinics that receive directly from zewditu hospital and condom distributed for
all from sub city HAPCO.

Document Review on Service Availability and Utilization

The reproductive health clinics of youth centers provide different kinds of service for youth
the major ones are Voluntary Counseling and Testing (VCT), Family Planning, Reproductive
Health Counseling and condom distribution, further more they facilitate peer education,
prepare training on reproductive health matters and first aid service. Documents from the
above-mentioned 10 youth center clinics reviewed. However, not all of them had available
records of the service provided; which made completion of this task not easy, but the
available document records from all clinics for other service pointed out. Maximum number
of young people visit the center RH clinics in summer time were December to February
account highest.

VCT service accounts the highest share of service provided second to condom distribution.
All clinics provide male condoms and have no Female condoms, but two facilities have for
display purposes. Nine clinics provide VCT service and one doesn’t have, summery of the
nine clinics result indicate that 563(65.3%) of male and 298(34.5%) female utilized VCT
service within last one year (June2012-June2013) one clinics doesn’t give the service due to
absence of trained providers.

Regarding family planning, four clinics provide short-term family planning service such as
pills, depo provera and emergency contraceptive. Five clinics stop providing the service
because of the absence of trained providers and one clinics have no family planning service
since RH service providing begin this is due to lack of resource and trained providers. The
summery from the four youth center indicate that 146 youth come for service within last one
year, 91(62.3%) for emergency contraceptive, 24(16.4%) for pills and 31(21.2%) for depo
povera.

Counseling services that provided not yet recorded, it is unclear to understand from available
records how much youth counseled, and on what topics dose the counseling covered. The
unique thing regarding counseling is that yeka sub city woreda 8 youth center RH clinic offer
free phone counseling service, this clinic also get technical and material support from zewditu
hospital which is not the case for others that they get material and drug support from nearby
health center and condom from sub city HAPCO health office.

35
Although, it is not regular and well-organized five clinics report that they facilitate peer
education programs and two youth center provide training on sexual and reproductive health,
the other thing is that six youth center clinics provide first aid service.

Reproductive Health Service Utilization in youth center

Regarding youth center Reproductive Health Service utilization 172(42.6%) respondent ever
visited the clinics at least for one time. The reason for visits were the highest 118(45.7%) for
VCT and the lowest 27(10.4%) for family planning. In the past one year 143(34.5%) youth
visited the RH clinics and the reason was 78(45.6%) for VCT with highest and 14(8.2%) for
family planning lowest reason. as shown in figure 2, respondents said the reason for today
visit of the youth center is library the highest 130(31.94%) and family planning the lowest
4(1.7%).

Figure 3:- reason for todays visit of the youth center,Addis

Ababa, Ethiopia, June 2013
140

120

100

80

60

40

20

Regarding to reproductive health clinic ever visit 118(45.7%) respondent come for VCT
service, 69(26.7%) for RH Counseling, 27(10.4%) for family planning service and 44(17%)
to take condom (Table 6).

36
Table 6:- Utilization of Reproductive Health Service in youth center, Addis Ababa,
Ethiopia, June 2013

Variable Category Frequency Percent Cumulative

N=407 percent
ever visited youth center RH Yes 172 42.6 42.6
clinics No 235 57.4 100.00

reason for ever visit (more VCT 118 45.7 45.7

than one possible answer) Family planning 27 10.4 56.1
N=172 RH Counseling 69 26.7 82.8
To take Condom 44 17.2 100

other 0 0 100
Those visited youth center Yes 143 34.5 34.5
RH clinics in last one year No 257 63.7 98.2
I don’t remember 7 1.8 100.00
reason for last one year visit VCT 78 45.6 45.6
(more than one possible Family planning 14 8.2 53.8
answer) N=143 RH Counseling 43 25.1 78.9
To take Condom 36 21.1 100

other 0 0 100
Who ever came for VCT yes 118 28.99 28.99
service No 289 71.01 100.00

Thos who get VCT service yes 111 94.06 94.4

No 7 5.94 100.00
the reason for not get the no VCT service 2 28.57 28.57
VCT service (N=7) The Clinic was 2 28.57 57.14
closed
no providers 1 14.28 71.42
Return back fear 2 28.57 100.00
of result
Other 0 0 0
Who ever came for Family Yes 28 6.87 6.87
planning service No 379 93.13 100.00
Thos who get Family yes 28 100 100.00
planning service No 0 0 0
Who ever came for RH yes 80 19.65 19.65
Counseling service No 327 80.35 100.00

37
Thos who get RH Counseling Yes 80 80 100
service No 0 0 100

From the logistic regression, analyses of possible explanatory socio demographic and other
variables over reproductive health utilization indicate that some socio demographic and other
variables were significantly associated with utilizing of reproductive health service provided
in youth center. Being male sex (OR=1.48; 95% CI=1.09-2.02), and age group 20-24
(OR=1.23; CI=1.87-2.32) increased the likelihood of utilization. Grade 11/12 student
(OR=1.76; 95% CI=1.22-2.52) and having diploma (OR=1.45; 95% CI=1.07-2.08) are
significantly reported utilization of RH service in youth center. Unmarried respondent
(OR=2.3; 95% CI=1.25-4.43) have positive association with RH service utilization. Those
respondent live more than ten years in the study conducted woreda (OR=1.4; 95% CI=1.18-
1.77) significantly associated with utilization.

Those respondent whose both parent alive (OR= 1.27; 95% CI= 1.27-2.1) show most likely to
be visiting RH clinics of youth center. Family average monthly income more than 1000 ETB
(OR =1.46; CI= 1.05-2.04) and who did not know their family income (OR= 1.84; CI= 1.28-
2.65) have positive association with utilization of youth center reproductive health service
(Table 7).

Table 7:- Logistic regression analyses of socio demographic and other variables over
youth center reproductive health utilization, Addis Ababa, June 2013

Variables Frequency Ever Utilized Crude odd ratio Adjusted odd

N=407 YC RH service (95% CI) ratio (95% CI)
Sex
Male 232 102 1.48(1.09-2.02) 0.85(0.54-1.32)
Female 175 70 1.00 1.00
Age
15-19 159 52 1.00 1.00
20-24 126 57 1.23(1.87-2.32) 1.9(1.2-2.3)
25-29 62 28 2.1(0.69-2.6) 2.8(0.7-.18)
No answer 42 26 1.7(0.59-2.9) 2.1(0.98-3.6)
I don’t know 18 10 2.6(0.78-3.2) 3.1(0.48-2.9)
Educational level
Only read and 1 1 1.00 1.00
write
1 to 6 grade 9 5 1.00 0.67(0.05-8.21)
7 to 10 128 46 0.6(0.14-2.52) 1.39(0.18-10.5)
11 to 12 121 49 1.76(1.22-2.52) 1.02(0.14-7.53)
diploma 96 51 1.45(1.07-2.08) 0.98(0.12-7.57
degree and 52 20 0.88(0.59-1.31) 1.39(0.17-10.9)

38
above
Marital status
Married 46 28 1.00 1.00
Unmarried 347 137 2.3(1.25-4.43) 1.75(0.85-3.60)
Divorced 6 4 0.38(0.04-3.76) 0.37(0.034-4.14)
Widowed 1 1 1.00 1.00
Separated 6 2 3.11(0.51-3.12) 3.3(0.49-20.7)
No answer 1 0 1.00 1.00
Religion
Catholic 7 4 1.00 1.00
Muslim 82 29 1.75(1.11-2.77) 1.01(0.20-4.94)
Orthodox 272 119 1.27(1.05-1.6) 0.71(0.15-3.3)
Protestant 38 14 1.64(0.84-3.2) 0.77(0.14-4.11)
Other 8 6 0.33(0.67-1.65) 0.15(0.02-1.56)
Ethnic group
Oromo 96 36 1.00 1.00
Amhara 183 86 1.12(0.84-1.5) 0.65(0.37-1.14)
Tigiri 38 15 1.4(0.76-2.82) 0.87(0.37-2.01)
Guraghe 63 27 1.29(0.78-2.1) 0.63(0.31-1.27)
Others 27 8 2.3(1.04-5.4) 1.35(0.47-3.8)
Occupation
Student 237 84 1.00 1.00
House Wife 4 3 0.33(0.035-3.2) 0.50(0.037-6.9)
Unemployed 30 13 1.3(0.63-2.6) 0.85(0.37-1.95)
Govt employ 63 33 0.90(0.55-1.5) 0.62(0.30-1.27)
Private 64 34 0.88(0.54-1.44) 0.64(0.34-1.2)
Others 9 5 0.8(0.21-2.97) 0.49(0.12-2.0)
Number of years
live in the recent
woreda
2-4years 49 17 1.00 1.00
4-10years 71 29 1.44(0.9-2.32) 1.78(0.46-6.8)
> 10years 287 119 1.4(1.1-1.77) 1.68(0.46-6.0)

sexual partners
ever had
One 112 56 1.00 1.00
Two 92 45 1.00(0.66-1.51) 1.04(0.58-1.84)
Three 38 17 1.23(0.65-2.34) 1.13(0.53-2.41)
≥4 28 21 0.33(0.14-.78) 0.35(0.13-0.91)
None 137 32 3.2(2.16-4.78) 3.06(1.75-5.37)

parents alive
Father alive 18 6 1.00 1.00
mother alive 82 45 0.82(0.53-1.27) 0.01(0.02-0.05)
both alive 262 98 1.27(1.27-2.1) 0.02(0.04-0.09)
both not alive 45 23 0.95(0.53-1.71) 0.028(.05-0.16)

39
 Family average
monthly income
< 200 ETB 13 7 1.00 1.00
201-400 17 9 0.89(0.34-2.30) 1.18(0.33-4.22)
401-600 30 18 0.61(0.28-1.29) 0.96(0.30-3.01)
601-1000 75 35 1.14 (0.72-1.78) 1.56(0.63-3.01)
>1000 143 58 1.46(1.05-2.04) 1.89(0.81-4.39)
I don’t know 129 45 1.84(1.28-2.65) 2.04(0.84-4.95)

Factors Affecting Utilization of RH Service

The respondent also assessed that whether they consider young people are properly using the
RH service available in the youth center or not and the result indicate that 57(14.1%) respond
yes, 234(56.1%) no and 116(28.8%) replayed I do not know what is exactly. As shown in
figure- 3, below the possible factor that affect/prevent youth from vesting youth center clinics
were 145(35.62%) mentioned that the service provided/available at youth center clinic
doesn’t known by youth, 106(26.04%) lack of confidence, 57(14%) fear of being seen by
friends or other who may know them (Figure 4 and Table 8).

Figure 4:- Factors that affect RH utilization in youth center clinics, Addis Ababa,
Ethiopia, June 2013

Other
5
Lake of interest
7
service avilabel doesn’t known
145
some service not available
29
Long waiting time
1
service fee is expensive.
0
service delivery time.
33
Youth get embarrassed
12
Lack of confidence
106
providers are Judgmental
25
Fear of being seen
57
located at far distance
18

40
Table 8:- Factors that affect youth center RHS Utilization, Addis Ababa, Ethiopia, June
2013

Variable Category Frequency percent Cumulative

N=407 frequency
is young people are yes 57 14.1 14.1
properly utilizing RH No 234 56.1 71.2
service provided in youth I don’t know 116 28.8 100.00
center
Factors that prevent youth Youth center 18 4.1 4.1
from visiting reproductive are located at
health clinic of youth far distance.
centers. (remark: more Fear of being 57 13.16 17.26
than one possible answer) seen by others
providers are 25 5.7 22.96
Judgmental
towards youth
RH needs
Lack of 106 24.48 47.44
confidence
Youth get 12 2.7 50.14
embarrassed at
needing
reproductive
health service.
Inconveniency 33 7.6 57.74
of service
delivery time
service fees are 0 0 57.74
expensive
Long waiting 1 0.002 57.742
time for service.
The service 29 6.7 64.442
needed by
youth doesn’t
available

41
 The service 145 33.5 97.442
give doesn’t
known by youth

Lake of 7 1.7 99.14

interest

Other 5 0.88 100

Providers Reception and Communication to Young Clients

Regarding waiting time 116(75.3%) respondent said that waiting time to get the service was
reasonable, 136(87.2%) said the provider greet me in friendly fashion and took my concern
seriously and 36(22.6%) of respondent said that there have been thing which interrupt
discussion with the provider. Most of the respondent 127(81.4%) agreed that the provider
explain information Cleary and spend enough time with them to discuss what they want
(Table 9).

From those ever visited the clinics 53(34%) respond that there are areas that the clinic need
improvement, make more comfort and increase privacy, 18(11.5%) said that we asked to pay
for the service although the service provided freely. Regarding the quality of the service they
received 39(25%) said very good, 52(33.3%) good, 31% medium, 10(6.4%) poor and
7(4.5%) very poor (Figure 4). 74(47.4%) respondent ensured that we heard from family or
friends positive thing about the service quality given in these clinics, 13(8.3%) negative and
69(44.2%) nothing.

Figure 5:- the quality of RH service provded in youth center

clinics according to respondent, Addis Ababa, Ethiopia,June
2013
Very poor
poor 5%
6%
Very good
25%

medium
31%

good
33%

42
 Table 9:- RH Service Providers Reception and Communication to Young Clients, Addis
Ababa, Ethiopia, June 2013

Variable Category Frequency percent Cumulative

N=172 frequency
Is your waiting time to get the service Yes 125 75.3 75.3
was reasonable
No 47 24.7 100.00

Did the provider greet you in a Yes 144 87.2 87.2

friendly fashion and took your
concerns seriously No 28 12.8 100.00

Did anything occur to interrupt your Yes 33 22.6 22.6

discussion with the provider
No 117 77.4 100.00
I don’t No 22 18.6 100.00
Have you spend enough time with Yes 133 80.1 80.1
the provider No 39 19.9 100.00
Is there areas of the clinic that you think Yes 61 34 34
need improvement, more comfortable
No 110 66 100.00
and private

Asked to pay for services received Yes 26 11.5 11.5

No 146 88.5 100.00
What can you say about the service Very good 45 25 25
quality being given good 57 33.3 58.3
medium 53 30.8 89.1
poor 15 6.4 95.5
very poor 12 4.5 100.00
What have you heard from your family positive 80 47.4 47.4
or community about the quality of
negative 18 8.3 55.8
services
Nothing 74 44.2 100.00

Visual aid and Providers Approach to Young Clients

Concerning visual aid providers used in the discussion session with the youth 46(39.3%)
respondent said that the provider used sexual and reproductive health related drawing
(posters) to explain more. Regarding the type of question, that provider asks clients to
explain about them 88(61.1%) of respondent said, explained about HIV/AIDS and

43
134(85.9%) of respondent believe that the providers have knowledge and ability to give RH
service. Most respondent 112(71.8%) asked by the providers if they have had any question or
un-clarity and checked whether they understood the information properly or not. Some
respondent 38(24.4%) said that the provider said things that make me feel uncomfortable.
49(31.4%) of respondent have next appointment and overall 89(57.1%) of respondent stated
that they satisfied with the service and 57(36.5%) respond it is medium (Table 10).

Table 10:- Visual aid and Providers Approach to Young Clients, Addis Ababa, Ethiopia,
June 2013

Variable Category Frequency percent Cumulative

N=172 frequency
provider used visual aids Posters/broacher 56 35.89 35.89
during the session
Drawings 60 39.3 75.19

Video 0 0 0

Model 41 23.07 98.26

Nothing 14 1.7 100.00

Did the provider ask you Yes 123 70.5 70.5

questions about yourself
No 59 29.5 100.00

kinds of questions the Contraceptive 32 15.27 15.27

provider asked clients to methods
explain about them
HIV/AIDS 98 61.1 76.37

Other STIs 41 21.42 97.79

U pregnancy 11 2.08 100.00

Do you think that the service Yes 142 85.9 85.9

providers have the knowledge
and capacity to provide No 30 14.1 100.00

Was the information given by Yes 144 87.2 87.2

the provider clear and simple
No 28 12.8 100.00

44
 Did the provider cheek to Yes 123 70.5 70.5
make sure you understood the
information properly No 59 29.5 100.00

Who satisfied with the service Yes 95 57.1 57.1

No 15 6.4 63.5

Medium 63 36.5 100.00

Perception and Preference to the Existing RH service

Respondent asked for the institution that youth prefer for reproductive health service and they
respond that youth center is first our preference 251(62%), government hospitals or health
center 107 (26.4%) and 18(4.4%) private clinic and other. The convenient time youth prefer
to get RH service also assessed and 156(38.7%) prefer in the usual working hours,
119(29.5%) in weekend and 83(20.6%) out of the usual working hours. Concerning the
service fees for youth RH service 279(68.7%) said it should be free of charge, 108(26.6%)
with discount for youth. Regarding the preference of service provider sex and age
166(40.9%) prefer provider to be young and the same sex, 150(36.9%) young and opposite
sex and 46(11.3%) to be any provider (Figure 5).

Figure 6:- respondent preferns to sex and age of reproductive

health provider,Addis Ababa, Ethiopia, June 2013
Other
0%

Young provider of
opposite sex
37%
Young provider of
the same sex
41%

Adult provider of
opposite sex
2%
Any provider could Adult provider of
be the same sex
11% 9%

45
As indicated in table 11, The respondent assessed if there is any change in the community
regarding RH seeking behavior after the youth center start providing RH service 138(34%)
said yes, 76(18.7%) no change and 47.7% I don’t know . Finally, the respondent asked
whether they recommend service provided in the youth center RH clinics for others or not
325, (80.4%) said yes I recommend for friends and others.

Table 11- Youth Preference of Reproductive Health Service, Addis Ababa, Ethiopia,
June 2013

Variable Category Frequency percent Cumulative

N=407 frequency
youth prefers of health government hospital or 109 26.4 26.4
institution for health center
reproductive health Private clinics 18 4.4 30.9
service youth centers 251 62.0 92.8
other 29 7.2 100.00
Convenient time for In the usual working hours 159 38.7 38.7
RH health service
out of the usual working 83 20.6 59.3
hour
At weekend 119 29.5 88.8
other 45 11.2 100.00
prefers on service fees Free of charge 280 68.7 68.7
for youth RH service With discount for youth 108 26.6 95.3
like other health institution 13 3.2 98.5
fees
Other 6 1.5 100.00
Prefers of youth Young provider of the 167 40.9 40.9
reproductive health same sex
Adult provider of the same 34 8.4 49.3
provider
sex
Any provider could be 46 11.3 60.6
Adult provider of opposite 9 2.2 62.8
sex
Young provider of 150 36.9 99.8
opposite sex
Other 1 0.2 100.00
Is there any behavioral Yes 140 34 34

46
 change in the No 46 11.1 45.1
community after the No change 77 18.7 63.8
youth center started the
I don’t know 149 36.2 100.00
reproductive
Would health Yes
you recommend 325 80.4 80.4
service
this provider for friends No 38 8.7 89.1
Other 44 10.9 100.00

Qualitative result
For the open-ended question if there are any areas of the clinic that need improvement or to
be more confidential the respondent mention that.
“Waiting place is uncomfortable there is high noise disturbance from indoor game users”
“Poor hygiene of the room,the surrounding and materials” , “most of the time the clinic is
closed,” , “The youth center and the woreda administrative office share the same compounde
this increase feer of youth seen by family or same one they know”, “Providers have no good
approach and care and communication skills,” .

For the question that, what should done to improve the service quality and utilization
respondent answered that it is better to separate the RH clinics from the youth center
building, the youth center should also be in separate compound from the woreda
administrative office and not to be in front of youth center library that will increase the fear
of binge seen by others and gat embarrassed or feeling shame due to their utilization. Service
delivery time should include time out of the usual working hour, mobilization and promotion
about RH to increase awareness and decrease fear, community toke show about RH should be
prepared.

Concerning the question if there is any additional service that should be included in the
system the following point was mentioned STI diagnoses and treatment, BP measurement,
full family planning service including emergency contraceptive, entertaining and educational
program, Pregnancy test, different brand of condoms, improving the room size of the clinics
and waiting place.

For the possible factors that prevent youth from visiting of reproductive health service at
youth centers in addition to what have mentioned the following reason also cited “Lack of
close relationship between youth center and youth” In addition, “The youth center has no
good name in the community so youth doesn’t want to be seen here” also listed.

47
Regarding convenient time for youth RH service to arranged, they respond from Monday to
Monday, 24 hour, until 8PM night and weekend. Assessment also done for these that
interrupt the discussion with providers they said there have been repeated in and out of
people (“ten times in and out”), the provider have no respect and have been joking on us also
stated.

48
CHAPTER SIX

DISCUSSION

The response rate for this study was 96%, which is significant to avoid risk of serious bias
and sufficient for most purposes therefore regarded as ideal for analysis and ensure data
reliability. Most of the respondents and reproductive service utilizes are male which is not the
case in other counters (36,37) this may be duo to factor that youth center consider by the
community as a place were jobless gathered and youth especially females doesn’t wont to
attend here. Concerning sexual behavior of respondent, 66.4% of respondent have sexual
partners and 51.4% are sexual active this result agree with other studies conducted in the
country (41, 42).

The research exposed that 88% engaged in premarital sex that is higher than the report from
above mentioned studs (32). The result on age at first sex indicate that 33.4% of respondent
had mead their first sex at 17 ± 2 this age is much lower than studies conducted in the country
and other African country(39, 41). These indicate that young populations are being
increasingly involving in early and premarital sex although the action is culturally and
socially unacceptable. The other thing is that 25% of respondent never use condom in their
sexual intercourse and 27% utilize condom sometimes, it is much lower with respect to
condom utilization than previous conducted studies at Harare and Southern Ethiopia (32, 39).
This may be due to the reason that youth consider condom decrease sexual satisfaction.

The service available in youth centers includes family planning methods (Emergency
contraception (30%), pills and depo provera(40%)), Pregnancy test (30%), VCT (90%), RH
Counseling (100%) and condom (100%). None of the youth center has STI diagnoses/
treatment, abortion care and other service available in other African countries youth centers
(36, 37). There are no enough seats and waiting place for clients in all of the clinics. None of
them has clinic equipment such as – stethoscope, scales, thermometer, sphygmanometer,
couch and feta scope. In addition, no media aids like TV, video or audio. This make the youth
centers of Addis Ababa very Poor as compared to youth centers of Botswana, Nigeria and
South African (36, 37).

Although, there is high termination of workers in the youth center clinics, the concerned body
are not active in early deploying of workers, this create immense gap in service providing
capacity of the center and enforce youth to return back, only five youth center clinics(50%)
have two service providers. In some youth centers, the nurses accomplish the laboratory
49
technician duty at the same time. The problem is not only in deploying service providers
there is also problem in training and equipping with necessary knowledge and skill. Only two
(20%) of nurses and two (40%) of the Laboratory technician trained on the topics essential
and that is directly related to their careers, these have impact on service quality of the clinics.

The respondent knowledge about the service available in youth centers assessed.
Accordingly, 59.3% of participant has knowledge on one or more service available but only
42.6% ever utilized RH service in youth center, the result agree with previous report from
school in Addis Ababa (31) and much higher than what indicated on studies conducted in
Ghana and Botswana (36). 56.1% Study participant reflect that they consider young people
are not properly utilizing RH service provided in youth center despite the high need for RH
service in this age group (32).

The reason for visiting the RH clinics was VCT 68.6%, RH counseling 40.1% and family
planning 15.6%. The reason for visiting is different from other studies done in Jimma town,
the report from Jimma indicate that most of the clients come for family planning service
followed by VCT (39) and this discrepancy may be duo to that family planning service were
available only in few youth center.

This study assessed the ever utilization of RH services that is 42.6% and the last one year
utilization of RH service 34.5%. Both result agreed with a report from other study done in
Addis Ababa (39) and lower than report from Tanzania (37) and the developed world (38,
39). This may be due to respondent lower knowledge and lack of information about the RH
service available on youth center.

The document review from the clinics record indicate that only small portion of youth have
utilized the clinics, more than 300 youth visit the youth centers per week but only 10-20 (3-
5%) of them approach to the centers RH clinic. These magnify the gap and absence of
promotion and mobilization that will initiate the youth towards RH service. According to
what documented, Youth visit the centers clinics mainly for condom and VCT service. The
documentation lack complete information, it is difficult to get full information regarding
users’ characters like sex and age the problem is higher in provided service type family
planning, counseling and condom distribution. This indicates the carelessness of providers to
documentation.

50
The analysis of IEC materials and visual aids that providers used in discussion and
counseling session with youth, point out that 39.3% respondent stated provider used picture,
drawings and broacher. None of the center has media aides such as TV/video or audio it is
better if considered in the future. Although, pictures and broacher help to increase
understanding nothing substitute the importance of media aids. This makes our country youth
centers poor in equipment than other Africa countries (37, 38)

Those utilized the service responded to the question that how they evaluate service quality
33.3% said it is good, 30.8% medium and the remaining respond that it is poor. Almost two
third of the respondent satisfied with the quality of service they acquired, the reason for these
may be related with the providers greeting and friendly fashion welcome of users and the
providers took their concern seriously. Most of the respondent said that they acquired
knowledge regarding RH and the providers explained information clearly, until they
understand it.

The report show that the approach of service providers is good, 81.4% from those utilized the
service mentioned that the time they spend with the providers was sufficient; they appreciated
by the service providers to rise if they have any question/ unclear and discussed properly.
This is much higher than from other studies done before (35, 36). 57% of the participant
stated that they satisfied with the service, it is much higher than previous studies (36) and
6.4%, respondent are not satisfied and judged the service quality as poor, the reason for this
include providers disrespect them and are judgmental, long waiting time to get the service
and absence of service they want. However, this is very low as compared to other studies
(36).

The study finding and confirm from other study(36) indicate that factors such as
inconveniency of service delivery time (8.1%), youth center located at far distance (4.4%),
lack of interest to RH service (1.7%) and judgment of health workers towards youth RH
needs (6.1%) record as miner factor that affect service utilization. The major factors that
prevent youth from visiting the youth center clinics were lack of knowledge on service
availability (35.6%), lake of confidence (26%) and fear of seen by family or who may know
them (14%). This is somewhat different from other studies (39, 40, 44, 45). This may be due
to our countries sociocultural factors that dominated by 76 absences of opens and close
relation between parent and children. Some other mentioned that they would visit if the time
adjusted out of working hour and if they know more about the service available.

51
A number of authors suggested the possible explanation for young people’s poor utilization
of available RH service. They state that confidentiality, fear of disapproval and lack of access
have significant effect on utilization. Most adolescent want privacy in needing RH service,
this is confirmed in the same report which indicate that young people do not want their Parent
or other who may know them to see in RH clinics and think that they are sexually active (40,
44,45). Unless having no other choice none of them prefers to utilize youth center
reproductive health clinics because they lack privacy and most of them share the same
compounded with woreda administration offices were people come for different service.

The assessment on preference of where youth reproductive health service should provided
indicates that, 62% preferred it to be in youth center and 26.4% on government health center
or hospital. The other thing 68.7% of them preferred service should be free of charge this
agree with other studies (37, 44), and the time to be rearranged as 38.9% in usual working
hours, 29.5% weekend and 20.6% out of the usual working hour. This result show that
service delivery time had significant impact on utilization, 49.5% of them choose the time out
of working hour and weekend this may be due to most of youth center users are students
similar with reported in other studies (39, 43, 44, 45).

Regarding respondent preference of service provider 40.9% preferred young provider of the
same sex, higher than what is indicated in other studies (31, 33, 39) this might be due to the
reason that young and the same sex may create comfort to youth to tell their problems freely
and consider they share common problem. Similarly, if the service is free of charge, it could
create comfort to those youth who cannot afford the price; those who can afford may prefer to
be seen in private health institution. Pregnancy test and different kind of family planning
method were preferred by youth to incorporate in youth center.

There is poor management in youth centers that gives poor attention for the RH clinics; the
youth center managers have no idea about the clinics functionality and already have no
interest to know it, most service are not being provided or stopped due to small problem that
could solved with simple intervention. The clinics are not equipped with materials and
instruments, this can understood from the fact that there is no basic clinical equipment, which
does not need huge expanse or investment.

The youth centers are not structurally fall under health sector they are under Addis Ababa
women, youth and children affairs which have no health professionals who can give support
and follow up for the youth center RH service providers. The providers have no trust on the
52
office and need the entire structure of the clinics to be merged to the health sector. The idea
more strengthen by the providers answer to the question, what should be done to improve the
service availability of the clinics and boost utilization, and they respond the following
important points.

- Attention should be give to improve the management competence, skill of service providers
and equipping of the clinics.
- Solving problems related to absence of budget, Poor supervision and technical support.
All interviewed providers mentioned the major problem and the root cause for poor service
delivery is that structural problem of the clinics they said it is better to shift the clinics
accountability and belongings to health sector than what is now.

Generally, the studies indicate that the existing reproductive health service clinics in youth
center are not fully understood, aware and utilized by youth. Although, more than 300 youth
per week youth visit youth center for different service they did not imagine, give attention
and approach to RH service. The other thing is that the clinics have limited service as
compared to other country youth center and they are poor equipped.

53
7. STRENGTH AND LIMITATION OF THE STUDY

7.1 Strength of the study

• Ethical clearance from AAU, necessary arrangement from concerned body and verbal
consent from study subjects obtained.
• All governmental youth center that provides reproductive health service was included in the
sampling in order to make a representative study.
• The study complemented by qualitative method to explore factors that was not addressed by
the quantitative data.
• Information gathered from both youth center users and service providers that helped to
understand same problems from both sides.

7.2 Limitation of the study

• Only youth who visited youth center were included in the study
• Self reported information is subjected to errors and missed information
• Temporal relationship cannot be determined

54
CHAPTER SEVEN

Conclusion and Recommendation

Conclusion

- The RH service available in youth center includes VCT, family planning, condom and RH
counseling. It is very limited as compared with other African countries youth center that they
have STI diagnoses/ treatment, abortion care, life skill training and others.

- From the report one can conclude that there is poor utilization of RH services although
respondent are sexual active, only 5-10% of those visit the youth center come to the RH
service clinics.

- The research indicate that the main reason that push youth from visiting the RH clinics are
Lack of knowledge on available service, lack of confidence and fear of being seen by parents
or who may they know.

-Youth prefer the working hour of youth center clinics to include weekend, service fee to be
free, service like family planning including emergency pills and pregnancy testing to be
always available.

55
Recommendation

1. to Addis Ababa women, youth and children office

- Crate system that includes health professionals that can provide support and follow up the
youth centers RH clinics
- Early deploying provider and scale up there skill by preparing training.
- Equipping the facilities with clinical materials
- Financial support and budget allocation for promotion, training, peer education and other
activities
- to add new service like STI diagnoses/ treatment, abortion care and others.
2. to youth center management
- Create good working environment.
- Facilitating working hour to include weekend
- Facilitating peer education with provider
- Preparing regular Promotion and mobilization programs
- Preparing adequate room for the clinics and waiting place for users
- Outreach activity to increase awareness and knowledge on available RHS
3. To service providers
- Good approach and youth friendly service
- Regularly Promotion and mobilization activity
- Early reporting of drug and material shortage
4. to health centers
- Early providing of material and drug requests of the RH clinics
5. to sub city and woreda women, youth and children office
- Training of the providers
- Preparing regular supportive supervision
- Solving problems related to material and equipment shortage
6. For other researchers
Further study needs to conducted on areas like, determine why females are not utilizing the
services unlike other counters report and how to increase RH services utilization culture of

56
young peoples. In addition, identify whether the best structure of the RH clinics of youth
center to be in health bureau or to continue as it is now in women, youth and children affairs

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59
Annex 1:- Questionnaire

Tool I- Interview questioner for youth center users

Instruction: Circle the code number given parallel to the answer that chosen and for
Questions that the respondent gives direct answer, write the answer in the space
provided. Part I. Socio demographic and academic characteristics of the respondents

S.No. Characteristics Responses Skip

to

101. Sex of respondents a. Male b. Female

102. How old were you at your last a. Don’t know b. No

birthday? Age in completed response
years_______

103. Have you ever attended school? If no

a. Yes b. No
skip to Q5.
104. What is the highest level of a. Only read and write b.
education you completed?
1 to 6 grade c. 7
to 10 grade
d. 11 to 12 grade
e. diploma
f. degree and above
105 What is your current marital status? a.Inrelationship b.single
c.Married
d.Divorced
e.Widowed
f. No answer
106 What is your religion? A. Catholic b. Muslim
c.Orthodox d.Protestant

60
 e. Other--------------

107 To which ethnic group do you a.Oromo b.Amhara

belong? c.Tigirie d.Gurage
e. Other -----------------------

108 What is your occupation? a.Student b.Housewife

c.Unemployed
d.Merchant
e.Government employee
f.private g. Other
specify---------------------
109 How many yours did you live in a.<1year b.1-3years
these woreda c.4-10years d. > 10
years
110 is your parents alive? A.Father alive
b.mother alive c. both
alive d. both not alive
111 If yes, what is the Educational status a.Illiterates
of your father? b.Elementary school
c. secondary school
d.college and above
112 If yes, what is educational status of a.Illiterates
your mother? b.Elementary school
c. secondary school
d.college and above
113 What is your parents’ job status? a. Both have work
b. Only my father works
c. Only my mother works
d. Both do not have work

114 What is your family monthly average a. <200ETB b. 201-

income? 400 ETB c. 401-600 ETB
d. 601-1000 ETB
e.>1000 ETB f. I don’t
know

61
PART II KNOWLEDGE, PREFERANCE AND UTILIZATION OF REPODUCTIVE
HEALTH SERVICE

201 Do you have sexual partners know? a. yes b. no

if yes have you make sex a. yes b. no

202 if yes, did you use condom a. yes b. no

203 At what age did you have the first

sexual intercourse? Age in
completed years_______
204 How many sexual partners have you
A a. One b. two c.
ever had in your life time? three d. more than
three
205 Have you ever make sexual a. yes b. no
intercourse without condom
206 If yes, have you visited RH clinics a. yes b. no
regarding the situation
207 do you know what service is being a. yes b. no
given at youth center clinic

208 can you mention it (circle the a. VCT b. RH service c.

response) family planning d. condom
distribution e. other----------
209 Have you ever visited youth center a. yes b. no
clinics for reproductive health
service?
210 Do you remember the reason?

211 Have you visited youth center clinics a. yes b. no

in the last one year for reproductive
health service
212 Do you remember the reason? a. VCT b. RH service c.
family planning d. condom
distribution e. other----------

62
213 What type of services did you come a.VCT b. Family planning
for today? c. RH Counseling d. to take
condom e. other specify--
------

214 Did you get the services you came a. Yes b. No If

for it no: Why not? What happened?

215 did u came ever to take VCT service a. yes b. no

216 if yes have u got the service a. yes b. no

217 if no what have been the resonce A. no VCT service

b. office closed c. no
officer d. fear result e.
other-----------------------

218 did u came ever to take Family a. yes b. no

planning service
219 if yes have u got the service a. yes b. no

220 if no what have been the resonse A. no VCT Family planning

service b.
office closed c. no
officer d. fear result
e. other-----------------------

221 did u came ever to take RH a. yes b. no

Counseling service
222 if yes have u got the service a. yes b. no
223 if no what have been the response A. no VCT RH Counseling
service b.
office closed c. no
officer d. fear result
e. other----------------------

RECEPTION and COMMUNICATON

63
224 Do you think that your waiting time A. Yes b. no
was reasonable

225 Did the provider greet you in a.

a Yes b. no
friendly fashion and took your
concerns seriously?

226 do you think the provider asked you a. yes b. no

properly the reason you come today
227 Did anything occur to interrupt your a. Yes b. No
discussion with the provider?
If yes, what? ------------------------------

228 Do you feel that the provider/staffa. Yes b. No

explained information clearly?
228 Have you able to spend enough time a.Yes b. No
with the nurse/educator discussed
your needs?
229 Are there any areas of the clinic that a. Yes b. No
you think need improvement, to
make them cleaner, more
comfortable, or more private?

If yes: Please tell me which ones. ----------------------------------

230 did there service that should be

------------------------------------------
added? If yes explain --------------------

231 Were you asked to pay for services a.Yes b. No

you received today?
232 what can you say about the service a.verygood b.good
quality being given c.medium d.poor
e. very poor

64
233 What have you heard from your a.positive b.negative
family or friends or others in your c. nothing
community about the quality of
services at this clinic?

PROVISION OF SERVICES

234 Did the provider use any one of the A.Posters B.Drawings
following visual aids during the C.Booklets D. Video
session?
235 Did the provider ask you 1. Yes 2. No
questions about yourself?
If yes, what kinds of questions did A. Contraceptive methods
the provider ask? B. HIV/AIDS C. Other
STIs D. Unwanted
pregnancies
236 Do you think that the service a. Yes b. No
providers have the knowledge and
capacity to provide?
237 Did the provider ask you if you had a. Yes b. No
any questions or un-clarity?

238 . Did you feel comfortable asking the a. Yes b. No

provider questions?

239 Was the information given by the a. Yes b. No

provider clear and simple?

240 Did the provider check to make sure a.Yes b. No

you understood the information
properly?
241 Do you feel like enough time was a.Yes b.
spent with the provider? No

242 Did the provider do or say anything A.Yes b .No

that made you feel uncomfortable?
243 Did you set a date for your next a. Yes b. No
appointment?

65
244 Overall, were you satisfied with the A.Yes b.No
service? c. Not bad
245 do you think the young people are a.yes b. no
using RH service in this youth
center?
246 Please answer Yes (write 1) or No a. youth center are located at
(write 2) to the following possible far distance. b. Fear of being
factors that may prevent youth from seen by friends or others who
visiting of reproductive health know them. c.
service at youth centers. Health professionals are
Judgmental towards youth RH
needs d.Lack of
confidentiality e.Youth get
embarrassed at needing
reproductive health service.
f. Inconveniency of service
delivery time. g. health
service fee is expensive
i. Long waiting time for
service. j. In
consistence of service delivery
242 In which of the following health a. government hospital or
institution do you think youth health center b.
reproductive health service is given Private clinics c.
better? youth centers d.
other Specify

66
 243 In which of the following way do a. Within the existing
you prefer youth reproductive health health institution as it is
service to be rearranged? having its own youth
reproductive health service
room’s
c. In health institute that give
only Youth reproductive
health d. By expanding
Youth reproductive health in
youth center e. Other
specify._______

244 Which time do you think it is a. In the usual health institute

convenient for youth health service? working hours b. out of the
usual working hour
c. at weekend
245 What do you prefer on service fees a. At usual rate b.
for youth RH service? With discount for youth c.
Free of charge d.
Other specify
246 Whom do you prefer to be youth a. Young provider of the same
reproductive health provider? sex b. Young provider of
any sex c. Adult provider
of the same sex d. Adult
provider of e. Any
provider could be f. Other
specify
247 Is there any change in the a. Yes b. No
community after the youth center c. I don’t know
started the reproductive health
service?
248 Would you recommend this provider to
A. Yes b. No
a friend?

Tool III: Interview guide line of service providers

67
 Part I. socio demographic and academic characteristics of the respondents

Name of youth center: _________________________________________ Date

of interview: _____________________________________________

101 Position of person interviewed a. Professional nurse b.

Peer Educator c. other
specify-------------------------

102 Sex of respondents a. Male b. Female

103 How old were you at your last a. Don’t know b. No

response
birthday? Age in completed
years_______
104 What is the highest level of a. Only read and write b. 1
education you completed? to 6 grade c. 7 to 10 grade
d. 11 to 12 grade e. diploma
f. degree and above

105 What is your current marital a. Unmarried b. Married

status? c. Divorced d. Widowed e.
No answer

Part II: Service provider work experience, knowledge, attitude and skills in Sexual and
reproductive health service

201 How long have you been

a. < 6 month
working in this youth center? b. b. 6 months- 1 year
c. c. 1-3 year
d. > 3 year

68
 202 How many service providers ----------------
have been deployed here?
203 How many of them are Know -----------------------
at work?
204 At what location dose the youth a. At the center of the woreda
center is located? b. at one side or edge of the
woreda c. I
don’t know
d. other specify-------------
205 On average how many youth a. < 100 b. 100-200 c.
came in this youth center for 200-300 d. > 300 e. I
service per week don’t know

206 On average how many youth a. < 15 b. 15-30 c. 30-45

came in this clinic for service d. > 45 e. I don’t know
per week?
207 Have you attended any RH a.Yes, after I recruited here
training for youth-friendly b. yes, before I recruited here
service? c. not at all

208 If yes when it the last time a. < 6 month b. 6 months- 1

year c. 1-3 year d. > 3 year

209 Have you attended any specific a. Yes, after I recruited here
training on STI/HIV training b. yes, before I recruited here
workshops? c. not at all

210 If yes when it the last time a. < 6 month b. 6 months- 1

year c. 1-3 year d. > 3 year
211 Have you attended any specific a. Yes, after I recruited here
training on family planning? b. yes, before I recruited here
c. not at all
212 If yes when it the last time a. < 6 month b. 6 months- 1
year c. 1-3 year d. > 3 year

Provider attitudes in providing ASRH services to a young person

69
 213 Do you feel that Sexual and a. Yes b. no
reproductive health services
should have been become part of
mainstream youth center?
214 How do you feel providing a. i don’t fill comfort b. i fill
Sexual and reproductive health comfort c. I don’t realize it d.
services for young people? I don’t know e.
other specify------------
215 Do you support of contraceptive a. Yes b. no
use by young people to prevent
unplanned pregnancy?
216 Do you support of condom use a. Yes b. no
by young people for sexual
activity?
217 Have you ever tasted for A.< 1 year b. 1-2 year c. >
HIV/AIDS? If yes, when? 2year d. I don’t remember

Part III: factors affecting reproductive health Services availability and utilization in the
youth center:

301 What services do you provide to ----------------------------------------

clients on this youth center? ------------------------------------
302 Do your service that you give for a. Yes b. no
clients vary by age?
303 Do you feel that young people a. Yes b. no
have needs for reproductive health
Services and yet they are not
coming to clinic?
304 if yes, What do you think the a. They don’t know the service
reason that youths are not using availability b. they prefer
this clinic as needed? other health institution for the
service c. There is no service
they went at this clinic
d. I don’t know
e.other specify----------------

70
305 what can you say about the a. very good b. good
quality of service provided in this c. medium d. bad
clinic e. very bad
306 Do you feel confident and a, Yes b. no
competent in providing
reproductive health Services and
counseling for young people?
307 Is there shortage of any material a. Yes b. no
or drug needed in the past 6
month?
308 if yes, can you specify some of
them?
309 What is the major reason for stoke a. The supply is not enough
out of drugs or material b. not provided on time c.
client flow increased
d. other specify-------------------

310 Do you feel this clinic is a. Yes b. no

adequately set up and equipped to
offer RH services?
311 If no, what needs to be put in place
to strengthen RH services?
312 What is the most common service a.FP b. condom c. VCT
that youth came for it? d. counseling d. other specify-
313 Is there a service that was ever not
given but is available in clinic
here?
314 Do you think that clients are a. yes b. no
satisfied and go on the service
given here
315 Is there any mechanism that the a. yes b. no
youth center do to advocate the
service given in the clinic
if yes list it---------------------------

71
314 Have you been referring young a. health center b. hospital
clients to other health institution? c. private clinics d. not referred
If so, where are they being referred d. other specify--
to?
315 Are you satisfied by your work? a. Yes b. no
316 If no, what do you think about the a. Salary b. management
reason? c. working environment d. the
work is not successful
f. other specify---------------------
317 Did you receive supervision from a. Yes b. no
concerned body?
319 Do you think that you are gating a. Yes b. no
enough support and follow up
from the concerned body?

Tool I. TYPES OF HEALTH FACILITIES & COMMODITIES AVAILABLE

AT THIS CLINIC

Commodity/facility Yes No Remark

Contraceptives type (list which ones are available)

Pregnancy Testing kits

Emergence contraceptive
HIV testing kits
STI testing
Condoms
RH Clinic Equipment in good order (list which ones
are available):

Does clinic have enough dust bin, containers and

cleansing agents?

Is there a Sterilizer

72
Are medications and other supplies kept in a manner
that ensures good preservation
Are medications and contraceptives in stock within
the expiry date?

Clinic furniture: Is this adequate in all areas of the

clinic including client waiting areas, procedure
rooms and treatment rooms

properly dispose material of sharps and other

medical waste

Are gloves, needles/syringes and antiseptic solutions

available in necessary quantities?

Toilet

Water and
Electricity

Light and
Ventilation

IEC/BCC materials: Are relevant client-education

materials available and displayed for each type of
adolescent health service provided

- posters,

- Brochures

- and models

Clinic furniture: Is this adequate in all areas of the

clinic including client waiting areas, procedure
rooms and treatment rooms?

73
Annex 2:- Amharic Version of the Questioner

የግሇስብ የስምምንት ቅፅ

በአዱስ አበበ ዩኒቨርሰቲ ፣ የህክምና ፊካሉቲ ፣የህብረተስብ ጤና ትምህርተ ቤት አዱስ

አበባ ውስጥ በሚገኙ ውጣት መአከሊት ስሇሚስጠው የስን ተወሌድ ጤና አገሌግልት
አቅርቦትና አጠቃቀም ዙሪያ ሇሚካሄዯው ጥናት የተዘጋጅ የግሇስብ ስምምነት ቅፅ

እኔ በዚህ ጥናት ሊይ የምስራው በመርጃ ስብሳቢነት ሲሆን የዚህ ጥናት አሊማ በውጣት
መእከሊት ስሇሚስጠው የስን ተወሌድ ጤና አገሌግልት አቅርቦትና አጠቃቀም ዙሪያ
ዲስሳ ሇማዴርግ ነው፡፡ በሚገኝው መርጃ መስርት በውጣት መአከሊት የሚስጠውን
የስን ተዋሌድ ጤና አገሌግልት ዙሪያ ተጭማሪ እሰትራቲጂዎችን ሇመቀይስ እንዱሁም
በተሻሻሇ መሌኩ የተጥቃሚውን ፌሊጎት መስርተ ያዴርጉ የተሇያዩ አገሌግልቶችን
ሇመስጥት ይርዲለ፡ ይህንን አሊማ ሇማሳካት በቀናና በትክክሇኛ መሌስ መጥይቁን
በመሙሊት የምታዯርጉት ተሳትፍ በጣም ጠቃሚ ነው፡፡ ሇማረጋገጥ የምንፌሌግው ነግር
የእናንተ ስም በዚህ መጠይቅ ሊይ አይሞሊም እንዱሁ<ም ሚሰበሰበው ሀሳብ
ሚስጠ=ርነቱ የተጠበቀ ነው:: በዚህ ጥናት በጠቅሊሊው አሇመሳተፌ፣በከፉሌ መሳትፌ
ወይም በማንኛውም ግዚ የማቋረጥ መብታችሁ የተጠበቀ ነው፡፡ ነገር ግን ከእናንተ
የምናገኝው ጠቃሚ ሀሳብ ጥናቱን ሇማሳካትና የአዱስ አበባ ወጣት መአክሊት በስነ
ተዋሌድ ጤና ዙሪያ የሚሰጡትን አገሌግልት ሇውጥ ሇማምጣትና ሇማሻሻሌ በጣም
ጠቃሚ ነው፡፡

አመስግናሇሁ፡፡

በዚህ ጥናት ሊይ ሇመሳትፌ ፌቃዴኛ ነህ/ነሽ

አዎ---------------- አይዯሇሁም-----------------

የመሊሹ ፉርማ------------------------

የመርጃ ስብሳቢው ስምና --------------------- ፉርማ ------------------- ቀን -------------

74
የሱፕርቫይዘሩ ስም------------------------ ፉርማ ----------------------

የጥናቱ ዋና ተጠሪ

ሰም፡ አንዋር ሁሌጊቾ

አዴራሻ፡ሞባይሌ- 0913089163 ኢሚሌ - anesoft123@yahoo.com/

aneben123@gmail.com

ቅፅ 1፣ የወጣት መአክሊት ተጠቃሚች መጠይቅ

መመሪያ፤ ምርጫ ሊሊቸው ጥያቂዎች መሌስ የሆነውን ፉዴሌ ከፉት ሇፉታችው

ያክብቡ የፅሁፌ መሌስ ሇሚያሰፌሌጋችው ዯግሞ ክፌት ቦታ ሊይ ይፃፈ

ክፌሌ 1፣ ማህብራዊና ስነህዝብ ሁኔታዎቸን በተመሌክት

101 የመሊሹ ፆታ ሀ.ወንዴ ሇ.

ሴት
102 በባሇፌው ሌዯትህ ስንት ሀ.አሊውቀውም
አምትህ/ሸ ነበር----------------- ሇ. መሌስ የሇም
103 እስከ ስንተኛ ክፌሌ ትምህርተ ሀ. ማንበብና መጻፌ
ሇ. ከ1-6ኛ ክፌሌ
ተከታትሇሀሌ/ሻሌ
ሏ. ከ7-10ኛ ክፌሌ
መ. ከ11-12ኛ ክፌሌ
ሠ. ዱፕልማ
ረ. ዱግሪና ከዚያ
በሊይ
104 የጋብቻ ሁኔታ ሀ.ያግባ
ሇ.ያሊግባ
መ.የተፊታ
ሠ.የሞተበት ረ.
የተሇያያ
105 ሀይማኖት ሀ.ካቶሉክ
ሇ.ሙስሉም
ሏ.ኦርቶድክስ

75
 መ.ፕሮቴስታንት
ሠ.ላሊካሌ ይጠቅሰ-
-------
106 ቤሄርስብ ሀ.ኦሮሞ
ሇ.አማራ
ሏ.ትግራይ
መ.ጉራጌ
ሠ.ላሊ ካሇ ይጠቀስ-
--------
107 መተዲዯሪያ ሰራ ሀ.ተማሪ ሇ.
የቤት እመቤት
ሏ. ስራ የላሇው
መ.ነጋዳ
ሠ.የመንግሰት
ስራተኛ
ረ.የግሌ ስራ
ሸ. ላሊ ካሇ-----------
108 በአሁኑ ስአት ትምህርተ ሀ. አዎ ሇ. አይ
በመከታትሌ ሊይ ነህ
109 በዚህ ወርዲ ውሰጥ ሇስንት ሀ. ከ1 አመት በታች
አመት ኖርሀሌ ሇ. ከ1-3 አመት
ሏ. ከ4-10 አመት
መ. ከ10 አመት
በሊይ
110 ወሊጆጅህ/ሽ በህይዎት አለ ሀ.አባቴ አሇ ሇ.እናቴ
አሇች ሏ. ሁሇቱም
በህይዎት አለ
መ. ሁሇቱም
በህይዎት የለም
111 የአባትህ የትምህርት ዴርጃ ሀ.ያሌተማር
ሇ.የመጅመሪያ ዴርጃ
ሏ. ሁሇትኛ ዴርጃ

76
 መ. ኮላጅ ና ከዚያ
በሊይ
112 የእናትህ የትምህርት ዴርጃ ሀ.ያሌተማር
ሇ.የመጅመሪያ ዴርጃ
ሏ. ሁሇትኛ ዴርጃ
መ. ኮላጅ ና ከዚያ
በሊይ
113 የውሊጆችህ የስራ ሁኔታ ሀ. ሁሇቱም ስራተኞች
ናችው ሇ. አባቴ
ብቻ ስራ አሇው
ሏ. እናቴ ብቻ ስራ
አሊት መ. ሁሇቱም
ስራ የሊችውም
114 የቤተስባችሁ አማካይ ገቢ ሀ.ከ200 በታች
ስንት ነው ሇ.ሇ201-400
ሏ.ከ401-600
መ.ከ601-1000
ሠ.ከ1000 በሊይ ረ.
አሊውቅውም

ክፌሌ 2፡ የስን ተዋሌድ ጤና እውቀት፣ፌሊጎትናአጠቃቅምን በተመሌከት

201 የፌቅር ጓዴኛ አሁን ሊይ ሀ.አዎ ሇ. አይ

አሇክ/ሽ
202 አዎ፣ ከተባሇ የግብር ስጋ ሀ.አዎ ሇ. አይ
ግኑኝነት ጀምራቸኀሌ
203 አዎ፣ ከተባሇ ኮንድም ሀ.ሁሌግዜ
ትጠቀማሊችሁ ሇ.አንዲንዳ ሏ.
አንጠቀምም
204 የመጀመሪያ የግብረስጋ -------------------
ግንኙነት ሲያዴርጉ ስንተ
አመቶ ነበር

77
205 እስከ አሁን ዴረሰ ስንት ሀ. 1 ሇ. 2 ሏ.3 መ.
የፌቅር ጓዴኞች ነበሮት ከ4 በሊይ ሠ. ምንም
206 ያሇ ኮንድም የግብረስጋ ሀ. አዎ ሇ. አይ አይ፣ከተባ
ግንኙነት አዴርገው ሇ ወዯ
ያውቃለ 208
የሄደ
207 ከዚያ ቦኃሊ ሇምክረ ወይም ሀ. አዎ ሇ. አይ
ሇላሊ አገሌግልት ወዯ ስን
ተዋሌድ ጤና ክሉኒክ
ሄዴው ነበር
208 በዚህ ውጣት ማእከሌ ሀ. አዎ ሇ. አይ አይ፣ከተባ
ክሉኒክ የሚሰጡ ሇ ወዯ
አገሌግልቶችን ታውቃሇህ 210
የሄደ
209 የምታውቀውን ሀ. ቪሲቲ ሇ.
ሌትጠቅስሌኝ ትችሊሌ. ቤተሰብ እቅዴ ሏ. ሇስነ
ተዋሌድ ምክር አገሌግልት
መ. ኮንድም ስርጭት
ሠ.ላሊ---------
210 ከዚህ በፉት እዚህ የወጣት ሀ. አዎ ሇ. አይ አይ፣ከተባ
መአከሌ ክሉኒክ መጥተው ሇ ወዯ
ነበር 214
የሄደ
211 ምክኒያቱን ታሰታውሳሇህ ( ሀ. ሇ VCT ሇ.
ከ 1በሊይ መሌስ ይቻሊሌ) ሇቤተስብ እቅዴ ሏ.
ሇስነ ተዋሌድ ምክር
መ. ኮንድም ሇመውስዴ
ሠ. ላሊ ካሇ የጠቀስ
212 በዚህ አንዴ አመት ውስጥ ሀ.አወ
እዚህ የወጣት መአከሌ ሇ.አይ
ክሉኒክ መጥትው ነብር ሏ.አሊሰታውስም

78
213 ምክኒያቱን ታሰታውሳሇህ ( ሀ.ሇ VCT ሇ. `
ከ 1በሊይ መሌስ ይቻሊሌ) ሇቤተስብ እቅዴ ሏ.
ሇስነ ተዋሌድ ምክር
መ. ኮንድም ሇመውስዴ
ሠ. ላሊ ካሇ የጠቀስ
214 አሁን ሇምን አገሌግልት ሀ.ሇVCT ሇ.
ነው የመጣህው/ሸው ሇቤተስብ እቅዴ ሏ.
ሇስነ ተዋሌድ ምክር መ.
ኮንድም ሇመውስዴ
ሠ. ሊይብራሪ ረ. ICT
ሰ.ካፉ ሸ. መዘናኛ
ቀ. ላሊ ካሇ የጠቀስ-----------
----------
215 ሇቪሲቲ አገሌግልት ሀ. አዎ ሇ. አይ
መጥተክ/ሸ ታውቃሇህ
216 የመጣህበትን አገሌግልት ሀ. አዎ ሇ. አይ
አግኝተህ/ሸ ነበር
217 አይ ከታባሇ፣ ምክኒያቱ ሀ.አገሌግልቱ አሌነበርም
ምን ነበር ሇ. ክሉኒኩ ዝግ ነበር ሏ.
ባሇሙያዎች አሌነበሩም
መ. ፌረቼ ተመሇኩ ሠ. ላሊ
ካሇ ይጠቀሰ --------------------
-----
218 ሇቤተስብ እቅዴ ሀ. አዎ ሇ. አይ
አገሌግልት መጥተክ
ታውቃሇህ
219 የመጣህበትን አገሌግልት ሀ. አዎ ሇ. አይ
አግኝተህ ነበር
220 አይ ከታባሇ፣ ምክኒያቱ ሀ. አገሌግልቱ አሌነበርም
ምን ነበር ሇ. ክሉኒኩ ዝግ ነበር ሏ.
ባሇሙያዎች አሌነበሩም
መ. ጉዲቱን ፌረቼ ተመሇኩ
79
 ሠ. ላሊ ካሇ ይጠቀሰ ---------
--------------------
221 ሇስነ ተዋሌዯ ምክር ሀ. አዎ ሇ. አይ
አገሌግልት መጥተክ
ታውቃሇህ
222 የመጣህበትን አገሌግልት ሀ. አዎ ሇ. አይ
አግኝተህ ነበር
223 አይ ከታባሇ፣ ምክኒያቱ
ሀ. አገሌግልቱ አሌነበርም ሇ.
ምን ነበር ክሉኒኩ ዝግ ነበር ሏ.
ባሇሙያዎች አሌነበሩም
መ. ፌረቼ ተመሇኩ ሠ. ላሊ
ካሇ ይጠቀሰ ---------------

ክፌሌ 3፣ የባሇሙያዎች አቀባበሌና ኮሚዩኒኬሽን

301 የስን ተዋሌድ ሀ.አዎ ሇ. አይ

አግሌግልቱን ሇማግኘት
የጠበክበት ስአተ
ምክኒያታዊ ነው በሇህ
ታስባሇህ
302 ባሇሙያዎቹ ጥሩ ሰሊምታ ሀ. አዎ ሇ. አይ
ና አቀባበሌ
አዴረገውሌኛሌ ብሇህ
ታስባሇህ
303 ባሇሙያዎቹ ዛሪ ሀ. አዎ ሇ. አይ
የመጣህበትን ምክኒያት
በተገቢው መሌኩ
ጠየቀውኛሌ ብሇህ
ታስባሇህ
304 ከባሇሙያዎቹ ጋር ሀ.አዎ ሇ.አይ
በነበረህ ቆይታ
ውይይታችሁን የሚርብሸ

80
 ነገር ነበር

አዎ ከሆነ ምን ነበር -------------

305 ባሇሙያዎቹ ሀ.አዎ ሇ. አይ

የምፇሌገውን መርጃ
በተገቢው መሌኩ
አብራርተውሌኛሌ ብሇህ
ታስባሇህ.
306 ከባሇሞያዎች ጋር በቂ ሀ. አዎ ሇ. አይ
ግዜ አገኘቼ የምፇሌገውን
ነገረ ተነጋግሪያሇሁ ብሇህ
ታስባሇህ
307 መሻሻሌ አሇብት ሀ. አዎ ሇ. አይ
ብሌህ የምታስበው
የክሉኒኩ አክባቢ
አሇ፣ወይም ዯግሞ ነፁህ
፣ምቹናነፃነት ያሇበት
ቢሆን የምትሇው
-
አዎ ከሆን፣ ሌትነግረኝ --------------------------------
ትችሊሇህ
308 መጨመር አሇባቸው -----------------------------------------------
የምትሊቸው አገሌግልቶቸ --------------
አለ
309 ሇአገሌግልት ሀ.አዎ ሇ. አይ
የተጠይከው ክፌያ ነበር
310 ሰሇ አገሇግልት ሀ. በጣም ጥሩ ነው ሇ.ጥሩ ነው
አስጣጥ ጥራታቸው ምን ሏ.መሀከሇኛ መ. ጥሩ አይዯሇም
ትሊሇህ ሠ. በጣም ጥሩ አይዯሇም
311 ከቤተስብክ ወይም ሀ.ጥሩ ነገር ሇ. ጥሩ ያሌሆነ
ከጓዯኞች ወይም ነገር ሏ.ምንም ነገር አሌሰማሁም
ከህብረተስቡ እዚህ ሰሇ መ. ላሊ

81
 ሚስጡ አገሌግልቶች
ጥራት ሲባሌ የስማህው
ምንዴው

ክፌሌ 4፣ የአገሌግልት አስጣጥ

401 ከባሇሙያዎች ጋር በነበረክ ሀ. ፖስተር ሇ. ሰእሌ

ውይይት ከሚከተለት ውሰጥ ሏ.ቪዱዮ መ. ሞዳሌ
የተጠቀሙት የእይታ መርጃ
መሳሪያዎች አለ
402 ስሇ ራስህ እንዴትገሌፅሊቸው ሀ. አዎ ሇ. አይ
ጠይቀውህ ነበር
አዎ፣ ከተባሇ በምን ዙሪያ ነበር ሀ. ስሇ እርግዝና መከሊከያ
የጠይቁህ ሇ.ሰሇ ኤች.አይ.ቪ/ኤዴስ
ሏ. ሰሇ አባሊዘር በሽታዎች
መ. ላሊ-------------------
403 ባሇሙያዎቹ በቂ እውቀት ሀ. አዎ ሇ.
ወይም ችልታ አሊችው ብሇህ አይ
ታስባሇህ
404 መጨርሻ ሊይ ባሇሙያው ሀ. አዎ
ጥያቂ ወይም ግሌፅ ያሌሆነ ጉዲይ ሇ.አይ
ካሇክ በል ጥይቆክ ነበር
405 ባሇሙያዎቹን ጥያቂ ሀ.አዎ ሇ.
ሇመጥይቅ የሚያሰችሌ ምቾት አይ
ተስምቶህ ነበር
406 በባሇሙያዎቹ የተሰጠህ መርጃ ሀ. አዎ ሇ.
ግሌፅና ቀሊሌ ነበር አይ
407 ባሇሙያዎቹ የሰጡህን መርጃ ሀ.አዎ ሇ.
ወይም ትምህርተ በትክክሌ አይ
መርዲትህን አርጋግጥው ነበር
408 ባሇሙያዎቹ ጋር የሚብቃኝን ሀ.አዎ ሇ.
ያህሌ ግዜ አሳሌፉያሇሁ ብሇህ አይ

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 ታስባሇህ

409 ባሇሙያዎቹ ሲያናግሩሀ ምቾት ሀ.አዎ ሇ.

ያሌሰጠህ ወይም ቅር ያሰኝህ ነገር አይ
ተከስቶ ነበር
410 የሚቀጠሌ ቀጠሮ ካሇህ ቀን ሀ.አዎ ሇ.
ወስናቹ ነው የወጣችሁት አይ
411 በአጠቃሊይ በተስጥህ የምክር ሀ.አዎ ሇ. አይ ሏ.
አገሌግልት እርክቻሇሁ ብሇህ ምንም አይሌም
ታስባሇህ
412 በዚህ ወጣት መአከሌ ሀ. አዎ ሇ. አይ
የሚስጠውን የስነ ተዋሌድ ጤን ሏ. አሊውቅም
አገሌግልት የአከባቢው ነዋሪዎች/
ወጣቶች በአግባቡ እየተጠቀሙበት
ነው ብሇህ ታስባሇህ
413 በዚህ ውጣት መአክሌ ሀ. ውጣት መአክለ እሩቅ
የሚሰጥውን የስነተዋሇድ ጤና ሰሇሆነ ሇ.
አገሌግልት የአክባቢው ወጣቶች ጓዴኞቻቸው ወይም
እንዲይጠቅሙ ያዴርጋችው ብሇህ የሚያውቋቸው ስዎች
የምታስበው ምክኒያት ከሚከተለት እንዲያዩቸው ሰሇሚፇሌጉ
ውሰጥ የተኞቹ ሏ. ሉጠቀሙ ሇሚመጡ ስዎች
ናቸው(የተዝርዘሩትነ ክፌ ባሇ ባሇሙያዎቹ ጥሩ አመሇካክት
ዴምፅ አንብብሊቸው) ሰሇላሊችው መ. መጥተው
ሇመጠቀም ወጣቶች በራስ
መተማምን ሰሇሚጎሊችው
ረ. እዚህ ሲገባ የታይ ስው
ሰሇሚሰዴብ ወይም
ሰሇሚያበሽቁት
ሠ. የአገሌግልት መሰጫ
ስአቶቹ ምቹ ሰሊሌሆነ
ሸ. ክፌያቸው ውዴ ሰሇሆን
ቀ. አገሌገልቱን ሇማግኝት በዙ

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 ሰዓት ሰሇሚያሰጠብቅ
በ. በውጣቱ የሚፌሇጉ
አገሌግልቶች ሰሇማይገኙ
ተ. እዚህ የሚሰጡ
አገሌግልቶችን ወጣቶች
ስሇማያውቁ
ቸ. ላሊ ካሇ ይጠቀስ ------------
-------
414 የወጣቶች የስን ተዋሌድ ጤና ሀ. ጤና ጣቢያ ወይም
አገሌግልት ከሚከተለት ተቋማት ሆሰፒታሌ ሇ. የግሌ ክሉኒክ
ወስጥ በየትኛው ቢሰጥ ጥሩ ነው ቸ. በውጣት መአክሊት መ.
ብሊቹ ታስባሊቸሁ ላሊ ካሇ የጠቀስ------------------
415 የወጣቶች የስን ተዋሌድ ጤና ሀ. ባለት የጤና ተቋማት
አገሌግልት ከሚከተለት በየተኛው ውስጥ ሆኖ የራሱ ክፌሌ
መሌኩ ቢስተካከሌ ጥሩ ነው ብሇህ ቢኖርው
ታስባሇህ ሇ. የወጣቶች የስን ተዋሌድ
ጤና አገሌግልት ብቻ የሚስጡ
ክሉኒኮች ቢኖሩ ሏ.
በውጣት መኣክሊት ቢስጥ
መ. ላሊ ካሇ የጠቅስ-------------
-------
416 የወጣቶች የስን ተዋሌድ ጤና ሀ.በተሇምዴው የስራ ስዏት
አገሌግልት በይተኛው ስአት ሇ. ከስራ ስዓት ወጪ
ቢስጥ ጥሩ ነው ብሇህ ታስባሇህ ሏ.ቅዲሚና እሁዴ
መ. ላሊ ካሇይጠቅስ -------------
-------
417 የወጣቶች የስን ተዋሌድ ጤና ሀ. በነፃ መሆን አሇበት
አገሌግልት ሊይ ሰሇሚጠየቁ ሇ. በቅናሽ መሆን አሇበት
ክፌያዎች ምን ተሊሇህ ሏ. እንዯ ላሊው የጤና
አገሌግልቶች ቢያሰከፌለ
መ. ላሊ ካሇ ቢጠቅስ -----------
--------

84
418 አግሌግልት ሰጪ ባሇሙያዎች ሀ. ወጣት ሆኖ ተመሳሳይ ፆታ
እነማን ቢሆኑ ትመርጣሇህ ያሇው ሇ. ወጣት ሆኖ
ተቃራኒ ፆታ ያሇው ሏ.
ትሊቅ ስው ሆኖ ተመሳሳይ ፆታ
ያሇው መ. ትሊቅ ስው ሆኖ
ተቃራኒ ፆታ ያሇው ካሇ
ቢጠቅስ ---------------------------
419 ይህ ወጣት መአክሌ ስራ ሀ. አዎ ሇ. አይ
ከጅመር ቦኃሊ ከስነ ተዋሇድ ጤና ሏ. ከበፉቱ የተሇየ ነግረ የሇም
አገሌግልት አስጣጥ ጋር በተያያዘ መ. አሊውቅም
ሇውጥ አሇው ብሇህ ታስባሇህ
420 ላልች ስዎች አዚህ መአክሌ
ሀ. እዚህ መአከሌ ይጠቅሙ ሇ.
መጥተው ቢጠቀሙ የሻሊሌ ወይሰ ላሊ ተቋም የሄደ ሏ. ላሊ
ላሊ ተቋም የሄደ ትሊሇህ ካሇ ይጠቅሰ------------------------
---------

ቅፅ ሶስት፣ ሇአግሌግልት ሰጪ ባሇሙያዎቸ የተዘጋጅ መጠይቅ

ክፌሌ 1፣ ማህብራዊና የስነ ህዝብ ሁኔታዎቸን በተመሌክት

መመሪያ፤ በምርጫ ሇቀርቡ ጥያቂዎች መሌስ የሚሆኑ ከፉት ሇፉታችው ያለ

ፉዯልችን ያክብቡ የፅሁፌ መሌስ ሇሚያሰፌሌጋችው ዯግሞ ክፌተ ቦት ሊይ ይፃፈ

101 የወጣት መአከለ ስም

102 ቃሇ-መጠይቁ የተካሄዯበት ቀን
103 ቃሇ-መጠይቅ የሚዯረግሇት ሰው ሀ.ፕሮፋሽናሌ ነርስ
ሙያ ሇ. የስነ ሌቦና ባሇሙያ
ሏ. የሊብራቶሪ ባሇሙያ
መ.ላሊ ካሇ -
104 የመሊሹ ፆታ ሀ ሀ. ወንዴ ሇ. ሴት
105 በባሇፇው ሌዯትህ ስንት አመት ሀ. አሊውቀውም ሇ. መሌስ
ሆነህ -------- የሇም

85
 106 የትምህርት ዯረጃህ/ሽ ምንዴን ሀ. ማንበብ እና መፃፌ ብቻ
ነው? የሚችሌ
ሇ.1ኛ-6ኛክፌሌ
ሏ.7ኛ-10ኛከፌሌ
መ.11ኛ-12ኛከፌሌ
ሠ.ዱፕልማ ረ .
ዱግሪ እና ከዚያ በሊይ
107 የጋብቻ ሁኔታ ሀ.ያሊገባ ሇ.ያገባ
ሏ.የፇታ መ.ባሎ የሞተባት
ሠ. የተሇያየ

ክፌሌ 2፣ የአግሌግልት ሰጪ ባሇሙያዎች የስራ ሌምዴ፣እወቀት፣አመሇካክትናበስን

ተዋሌድ ጤና ዙሪያ ያሊችው ክህልት

201 በወጣት ማዕከለ መሥራት ሀ ሀ. < 6 ወር

ከጀመርክ ምን ያህሌ ጊዜ ሆኖሀሌ ሇ. ከ 6 ወር - 1 ዓመት
ሏ. ከ1 - 3 ዓመት
መ. > 3 ዓመት
202 ምን ያህሌ አገሌግልት የሚሰጡ ---------
ባሇሞያዎች አለ?
203 ምን ያህለ ስሇ ስራቸው -------------
የሚስጠውን ስሌጠና ወስዯዋሌ
204 ወጣት ማዕከለ ከወርዲው ሀ. አማካይ ቦታ ሊይ
አቀማመጥ አንፃር የት ነው ሇ. አማካይ ያሌሆነ ቦታ ሊይ
የሚገኘው ሏ. አሊውቀውም መ. ላሊ
ካሇ
205 በአማካኝ በሳምንት ውስጥ ምን ሀ.<100
ያህሌ ወጣቶች ውዴ ማእከለ ሇ.ከ100-200
ሇተሇያዩ አገሌግልቶች ሏ.ከ200-300
ይመጣለ መ.> 300 ረ. አሊውቀም
206 በአማካኝ በሳምንት ውስጥ ምን ሀ.< 10 ሇ. ከ10 - 20
ያህሌ ወጣቶች ውዴ ክሉኒካችሁ ሏ.ከ20-30 መ. > 30

86
 አገሌግልት ፇሌገው ይመጣለ ረ. አሊውቀም

207 የስነ-ተዋሌድ ጤና ሰሌጠና ሀ. አዎ,እዚህ ከተቀጠርኩ

ወስዯህ ታወቃሇህ/ሺ በኃሊ ሇ.
አዎ, ከዚህ ከመቀጠሪ በፉት
ሏ.ምንም ወስጂ አሊውቅም
መ. ላሊ ካሇ የጠቀሰ --------------
----
208 መሌስ አዎ ከሆነ መቼ ነው ሀ. < 6 ወር
የወሰዴከውህ/ሺ ሇ.ከ6ወር-1ዓመት ሏ.ከ1-
3ዓመት መ. > 3
ዓመት
209 በአባሊዘር በሽታዎች ወይም ሀ. አዎ, እዚህ
በኤች.አይ.ቪ/ኤዴስ ዙሪያ ስሌጠና ከተቀጠርኩ በኃሊ
ወሰዯህ/ሺ ታውቃሇህ/ሺ ሇ. አዎ, እዚህ ከመቀጠሪ በፉት
ሏ.ምንም ወስጂ አሊውቅም
210 መሌስ አዎ ከሆነ መቼ ነው ሀ. < 6 ወር
የወሰዴህ/ሺ ሇ. ከ 6 ወር - 1 ዓመት
ሏ. ከ1 - 3 ዓመት
መ. > 3 ዓመት
211 በቤተስብ እቅዴ ዙሪያ ሀ. አዎ, ከዚህ
ስሌጠና ወሰዯህ/ሺ ታውቃሇህ/ሺ ከተቀጠርኩ በኃሊ ሇ. አዎ,
ከዚህ ከመቀጠሪ በፉት ሏ.
ምንም ወስጂ አሊውቅም
212 መሌስ አዎ ከሆነ መቼ ሀ. < 6 ወር ሇ.
ነው የወሰዴህ/ሺ ከ 6 ወር - 1
መት ሏ. ከ1 - 3 ዓመት
መ. > 3 ዓመት

ክፌሌ 3፣ ሇውጣቶች በሚሰጡ የሰነ ተዋሌድ ጤና ዙሪያ አገሌግልት ሰጪዎች

ያሊቸው አመሇካከት

87
301 የስነ-ተዋሌድ ጤና ክሉኒክ ሀ, አዎ ሇ. አይ
የወጣት ማዕከለ አንደ የስራ ሏ. አሊወቅም
ክፌሌ መሆን አሌነበርበትም
ብሇህ/ሺ ታስባሇህ/ሺ
302 የወጣቶች ስነ-ተዋሌድ ጤና ሀ. ምቾት አይሰጠኝም
አገሌግልት ሰጪ በመሆንህ ምን ሇ.ይመቸኛሌ ሏ.
ይሰማሀሌ? ተረዴቼው አሊውቅም
መ.አሊውቅም ሠ. ላሇ
ካሇ
303 ያሌተፇሇገ እርግዝና ሀ. አዎ ሇ.
እንዲይከሰት ወጣቶች የወሉዴ አሊውቅም
መቆጣጠሪያ መጠቀማቸውን
ተዯግፇዋሇህ?
304 በግብረ ስጋ ግንኙነት ግዜ ሀ. አዎ ሇ. አይ
ወጣቶች ኮንድም መጠቀማቸውን ሏ. አሊውቅም
ተዴግፇዋሌህ
305 የኤች.አይ. ቪ/ኤዴስ መርምራ ሀ.<1ዓመት
አዴርገህ/ሽ ታውቃሇህ/ሽ፣አዎ ሇ.ከ1-2ዓመት
ከሆነ መቼ ሏ.>2ዓመት መ.
አሌታወቀም

ክፌሌ 4፣ በውጣት መአከሊት የሚሰጡ አገሌግልቶች አቅርቦትና አጠቃቅምን የሚጎደ

ነግሮችን በተመሇከተ

401 በወጣት ማዕከለ ምን ምን -----------------------------

አገሌግልቶች ይሰጣለ --------------------------------
---
402 የሚሰጡ አገሌግልቶችሀ ሀ. አዎ ሇ.አይ
አሰጣጣቸው በእዴሜ ይሇያያለ አዎ ከሆን በአጭሩ
ቢዘርዘሩ -------------------
-----------------------
403 ወጣቶች የሚያስፌሌጋቸውን ሀ. አዎ ሇ. ሇአይ፣
ያክሌ የስነ ተዋሌድ ጤና ወዯ

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 አገሌግልት እይተጠቀሙ ነው አይዯሇም 405
ብሇህ ታስባሇህ? ይሄደ

404 አዎ፣ ከሆነ ምክንያቱ ምንዴን ሀ. አገሌግልት መኖሩን

ነው ብሌህ/ሺ ታሰባሇህ/ሺ ስሇማያወቁ
ሇ. ሇአገሌግልቱ ላሊ ጤና
ተቋማትን ይመረጣለ
ሏ. ጤና ጣቢያው ውስጥ
አገሌግልት ስሇሚሰጥ
መ.ዴፌርት ማጣት
ሠ.አሊውቅም ረ.
ላሊ ካሇ ---------------------
------------
405 በዚህ ክሉኒክ የሚስጠውን የስነ- ሀ. ጥሩ ሇ. በጣም
ተዋሌድ ጤና እና የምክር ጥሩ ሏ. መካከሇኛ
አገሌግልት የት ውሰጥ ይመዴባሌ መ.ዝቅተኛ
ሠ. በጣም ዝቅተኛ
406 ባሇፇው 6 ወር ውሰጥ የግብአት ሀ. አዎ ሇአይ፣
እጥርት ነበር? ሇ. የሇም ወ ዯ
409
ይሄደ
407 አዎ ከሆነ ሌትገሌፅሌኝ/ጭሌኝ ------------------------------
ትችሊሇህ/ሺ
408 ሇግበአቶቹ እጥረት ምክንያት ሀ. በቂ ግባአት
ምን ነበር ስሊሌነበርን ሇ.
ጊዜውን ጠብቁ
ሰሇማይሰን ሏ.የዯንበኞች
ቁጥርመጨመር
መ. ኤክስፓየርዴ
ስሊዴርገ ሠ.
ላሊ ካሇ --------
409 ይሄ ክሉኒክ የስነ ተዋሌድ ጤናሀ ሀ. አዎ

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 አገሌግልት ሇመስጠት አቅም ሇ.አይ
አሇው ብሇህ ታስባሇህ
410 አይ ከተባሇ የስነ-ተዋሌድ ጤና --------------------------------
አገሌግልቱን ሇማጠናከር ምን ----------
ያስፇሌጋሌ ብሇህ/ሺ ታስባሇህ/ሺ
411 ወጣቶች በአብዛኛው ሇምን ሀ.ሇቤተሰብእቅዴ
አይነት አገሌግልት ነው ሇ.ሇኮንድም
የሚመጡት? ሏ.ሇምክር አገሌግልት
መ.በፌቃዯኝነት ሊይ
ሇተመሰረተ
ኤች.አይ.ቪ/ኤዴስ ምክር
አገሌግልት
ሠ. ላሊ ካሇ----------------
412 በወጣት ማዕከሌ ክሉኒክ ውስጥ --------------------------------
አገሌግልት እያሇ ተስጥቶ -----------------
የማያውቅ አገሌግልት አሇ?
413 እዚህ በሚሰጡ አገሌግልቶች ሀ. እንዲንዳ ሇ.
ዯንበኞች እረክተው ይመሇሳለ ሁሌግዜ ሏ.
ብሇህ ታስባሇህ ምንም
414 በወጣት መአከለ ክሉኒክ ሀ.አዎ፣አንዲንዳ
የሚሰጡ አገሌግቶችን አሰመሌክቶ ሇ.አዎ፣ሁሌግዜ
የማሰተዋውቅና ቅሰቀሳ የማዴርግ ሏ. ምንም አይዯርግም
ስራዎች በእቅዴ ይከናውናሌ.
415 ዯንበኞችን ሇበሇጠ አገሌግልትሀ ሀ.ጤናጣቢያ
ወዯ ላሊ ጤና ተቋም ሪፇር ሇ. ሆስፒታሌ ሏ. የግሌ
ታዴርጋሊችሁ ጤና ተቋም መ. አይ
፣ከሆነ ወዱት ነው የሚሇኩት ሠ. ላሊ ካሇ----------
416 በስራዩ ዴሰተኛ ነኝ ብሇህሀ. አዎ ሇ.
ታስባሇህ አይ
417 አይ፣ ከሆነ ምክንያቱ ምንዴነው ሀ.ዯሞዝ
ብሇህ ታስባሇህ? ሇ.የማኔጀመንት
(አስተዲዯራዊ ጉዲይ)
90
 ሏ. ከስራ ባሇዯርቦች ጋር
ያሇ መስማማት
መ. ስራው ሴኪታማ
አሇመሆን
ሠ. ላሊ ካሇ-----------------
---
418 በሚመሇከተው አካሌ ሀ. አዎ ሇ.
ሱፐርቪዥን ተዯረጉሊቸሁ አይዯረገም
ያውቃሌ?
419 በሚመሇከተው አካሌ በቂ የሆነ ሀ. አዎ ሇ.
ዴጋፌና ክትትሌ ይዯረጋሌ አይዯረገም
ብሊችሁ ታስባሇችሁ?

91