Accessibility and quality of adolescents’ sexual and reproductive health services in Dar es Salaam

Adolescence is a period of transition from childhood to adulthood, and is a period during which youths experience many changes such as biological, behavioral and psychological changes. Today than ever before, adolescents are becoming sexually active at very tender ages. As a result, they face many sexual and reproductive health problems that affect their health and development, for instance, sexually transmitted infections including HIV/AIDS and early pregnancies, which lead to many health and social dilemma. The main objective of the research was to assess the accessibility and quality of sexual and reproductive health services available to adolescents. This research was done in Dar es Salaam region. A total of 384 adolescents aged between 10 and 19 were sampled from four schools and three wards in the region. Also the study involved collecting information from five sexual and reproductive health services providers. Both primary and secondary data were collected using interview schedules and documentary review respectively. The raw data were processed and analyzed using the Statistical Package for Social Scientists (SPSS). This study found that about 61 percent of the respondents were sexually active. About 77 percent of the respondents were aware of the adolescents’ sexual and reproductive health (ASRH) service centers, but only 32.5 percent had ever visited the centers to obtain any services. The services available for adolescents were mainly information on SRH, testing for HIV and counseling. Most of the respondents who had ever visited the centers mentioned the contraceptives as unavailable. The majority of those who ever visited the centers affirmed that the services were affordable, confidential and the reception was welcoming. All the staff at the centers admitted that they had received special training to serve youths. The majority of respondents, about 64 percent, had never visited the centers. Several factors were found to hinder the adolescents from visiting the centers. These factors include the distance of centers from adolescents’ areas of residence and schools; parents or guardians not allowing them to use the services; and most adolescents thought they could get the information and other services from magazines, shops, televisions and radios. It was further found that most adolescents preferred to obtain preventive services like condoms and contraceptives from pharmacies rather than specialized centers like the youth centers, and they would like to obtain services through outreach programs. From the findings it is recommended that drug dealers in pharmacies should be trained to offer youth-friendly services and proper counseling to adolescents; service providers expand their outreach programs to serve more adolescents; providers should use attractions such as recreation activities like sports and games to draw more adolescents to the centers.