Utilization and associated factors of sexual and reproductive health services among adolescents of Kathmandu district, Nepal

Sushma Pokhrel, Susmita Nepal, Prajita Mali, Swechhya Baskota, Richa Aryal, Alisha Thapa, Vidya Chaudhary, Nabina Malla


Background: There seems to be huge differences in availability and utilization of Sexual and Reproductive Health information and services despite of taking decisive step by Government of Nepal. The main aim of the study is to access the utilization and factors associated with SRH services among adolescents.  

Methods: This cross-sectional descriptive study was carried out among 406 adolescent students of grade 11 and 12 which were taken as census in selected higher secondary schools of Kathmandu District through simple random sampling technique. The utilization of SRH services was assessed by semi-structured validated and pretested questionnaire which includes socio-demographic, utilization of sexual health and reproductive health (SRH) services and sexual behaviours. Data were entered and analyzed in SPSS version 20 where Chi-square tests is done to identify the associated factors with utilization SRH services utilization.

Results: Overall utilization in last 12 months was 17.2% and was found to be strongly associated with availability of services within 30 minutes of walking distance (p value=0.001), interaction with parents (p-value: 0.02) and with sexually being active within 12 months (p value=0.001). Utilization of SRH services was slightly higher among females (19.8%) compared to males (15.3%). Most utilized services were services related to menstrual problems and family planning including ECP. This study concludes that fear of family and society hinders the utilization of SRH services.

Conclusions: As adolescent fear to talk and seek for the services, due to the social cultural norms and stigma attached to SRH services, utilization among adolescent of selected colleges in Kathmandu is low.


Adolescence, Sexual and reproductive health, Utilization, Health service

Full Text:



Lejibo TT, Assegid S, Beshir M, Handiso TB. Reproductive health service utilization and associated factors among female adolescents in Kachabirra District, South Ethiopia: a community based cross sectional study. Am J Biomed Life Sci. 2017;5(5):103-12.

Khanal P. Adolescents knowledge and perception of sexual and reproductive health and services-a study from Nepal. Institute of Public Health and Clinical Nutrition Faculty of Health Sciences University of Eastern Finland, Kuopio February. 2016;1:78.

Bam K, Haseen F, BC RK NM, Chaudhary A, Thapa R, Bhuyia I. Perceived sexual and reproductive health needs and service utilization among higher secondary school students in urban Nepal. Am J Public Health Res. 2015;3(2):36-45.

Kuruvilla S, Bustreo F, Kuo T, Mishra C, Taylor K, Fogstad H, et al. The Global strategy for women’s, children’s and adolescents’ health (2016–2030): a roadmap based on evidence and country experience. Bulletin of the World Health Organization. 2016;94(5):398.

Unies N. Report of the international conference on population and development: Cairo, 5-13, Sept 1994:UN;1995.

Unfpa C, Unicef Ministry of Health and Population Department of Health Services Family Health Division. The Qualitative Study on Assessing Supply Side Constraints Affecting the Quality of Adolescent Friendly Health Services and the Barriers for Service Utilization in Nepal. 2015.

Regmi P, Simkhada P, Van Teijlingen E. Sexual and reproductive health status among young peoples in Nepal: opportunities and barriers for sexual health education and services utilization. Kathma Univ Medic J. 2008;6(2):1-5.

Regmi PR, Van Teijlingen E, Simkhada P, Acharya DR. Barriers to sexual health services for young people in Nepal. J Heal Populat Nutrit. 2010;28(6):619.

Ministry of Health and Population. Annual Report of Department of Health Services. Ramshah Path, Kathmandu, Nepal: Department of Health Services MoHP. 2074/75 (2017/18).

Denno DM, Hoopes AJ, Chandra-Mouli V. Effective strategies to provide adolescent sexual and reproductive health services and to increase demand and community support. J Adolesce Heal. 2015;56(1):S22-41.

Kesterton AJ, de Mello MC. Generating demand and community support for sexual and reproductive health services for young people: A review of the Literature and Programs. Reproduct Heal. 2010;7(1):25.

Khatri R, Schildbach E, Schmitz K, Silwal P, Van Teijlingen E. National Adolescent Sexual and Reproductive Health Programme: Mid Ter Evaluat Repo. 2013.

Puri MC, Busza J. In forests and factories: sexual behaviour among young migrant workers in Nepal. Cult, Heal, Sexual. 2004;6(2):145-58.

Johnson V, Leach B, Beardon H, Covey M, Miskelly C. Love, sexual rights and young people: learning from our peer educators how to be a youth centred organisation. 2013.

Abajobir AA, Seme A. Reproductive health knowledge and services utilization among rural adolescents in east Gojjam zone, Ethiopia: a community-based cross- sectional study. Brit Med Cent Heal Serv Res. 2014;14(1):138.

Masatu MC, Klepp K-I, Kvåle G. Use of health services and reported satisfaction among primary school adolescents in Arusha, Tanzania. J Adolesc Heal. 2001;28(4):278-87.

Kennedy EC, Bulu S, Harris J, Humphreys D, Malverus J, Gray NJ. “Be kind to young people so they feel at home”: a qualitative study of adolescents’ and service providers’ perceptions of youth-friendly sexual and reproductive health services in Vanuatu. Brit Med Centr Heal Serv Res. 2013;13(1):455.

Organization WH. Strategic directions for improving adolescent health in South-East Asia Region. WHO Regional Office for South-East Asia, 2011.

Baral S, Khatri R, Schildbach E, Schmitz K, Silwal P, Van Teijlingen E. National Adolescent Sexual and Reproductive Health Programme Mid-Term Evaluation Report. GIZ, Department of Health Services. 2013.

Niranjan S, Damaru PP, Kalpana J. Sexual health behaviors of adolescents in Pokhara, Nepal. Ind J Comm Heal. 2012;24(2):73-9.