THE UTILIZATION OF YOUTH FRIENDLY CLINICS AMONG SECONDARY SCHOOL STUDENTS IN IBADAN NORTH LOCAL GOVERNMENT AREA, OYO STATE, NIGERIA

Abstract

Surveys in developing countries show that reproductive health problems are more prevalent in adolescents. The need for improved adolescent reproductive health services is being increasingly recognized throughout the world. However it had been reported that young people tend not to use existing reproductive health services. The objective of this study was to determine the factors influencing the utilization of existing youth friendly clinics (YFC) within lbadan North Local Government Area (LGA) in Oyo State, Nigeria. A cross-sectional descriptive study was conducted using a combination of stratified and systematic sampling technique to select respondents from four secondary schools within close proximity to a functional YFC in the LGA. The instruments for data collection were Focus Group Discussion (FGD), in-depth interview and a pre-tested semi-structured questionnaire focusing on knowledge of services rendered at the clinics, interaction between adolescents and clinic service providers, attitude and barriers to utilization of services. Eight FGDs were conducted and 299 students were interviewed. The FGD data were transcribed and categorized using key themes while quantitative data were analyzed using SPSS-package, to generate frequencies and cross tabulations of variables. There were slightly more females (52.3%) than males (47.3%); the mean age was 14.0 years (SD±2.14). Sixty three (21%) of the respondents were aware of YFC. Of this number, 41.3% had ever utilized the services of the clinic while 58.7% had never done so. There was no significant difference between awareness of the YFC and use of services (p>0.05). Majority of the users 42.3% were from senior secondary classes, 88.5% were Yoruba. 65.4% were Christians and 34.6% were Moslems. Only 3.8% of user went for reproductive health services 57.6% for treatment of common illness, 34.6% for counseling services, 7.7% for laboratory services and 7.7% for prevention and management of sexual violence. All the respondents who had ever used the YFC' reported that they were welcomed and made comfortable by health service providers. Specifically, 62.2% respondents reported that YFC service providers encouraged them to discuss reproductive health issues and this is statistically significant with attitude to utilization of services (p<0.05). By contrast, 46.2% of the users were not comfortable being counseled and examined by health care providers of the opposite sex. Among the 58.7% non users, 54.1% were females while 45.9% were males. Majority, 62.2% were from junior secondary classes, 89.2% were Yoruba. 1.6% was Hausa, 62.2% were Christians and 35.1% were Moslems. The major factors attributable to low utilization of YFC included lack of awareness of its existence (78.0%), lack of knowledge of types of services rendered (8.7%) and lack of funds to obtain services (6.7%). Respondents expressed the desire for awareness talk on YFC and information on the types of services rendered there. These results indicate low awareness of YFC among non users who are predominantly from junior secondary classes but positive health provider client relationship existed among the few users. There is a strong need for increased awareness of the existence of YFC and available services to secondary school students.