Factors Influencing the Uptake of Sexual and Reproductive Health Services Among Adolescent Girls in Humanitarian Crises: A Case Study of Bor County, South Sudan.

Abstract

Sexual and reproductive health services are critical to the well-being of adolescent girls, yet those in humanitarian crises face several obstacles in accessing these essential services. Despite recognition of these vulnerabilities, significant gaps remain in understanding the specific SRH challenges faced by adolescent girls in South Sudan. The study adopted a mixed method research design and targets adolescent girls aged 15-19 years. By adopting purposive sampling, the study involved key informant interviews, focus group discussions, and adolescent girls to gather comprehensive data. Descriptive statistics was used to analyze the primary data of quantitative nature. SPSS Version 25 was used to analyze data from the questionnaire. On the other hand, thematic analysis with NVivo software was done for qualitative data. Ethical considerations included informed consent, data protection, and culturally appropriate engagement with participants was used appropriately. The study revealed that accessibility was the most influential factor (Beta = 0.311, p = 0.021), with long distances to clinics, poor transportation, and lack of youth friendly services as major barriers. Awareness and knowledge (Beta = 0.219, p = 0.032) were hindered by inadequate school-based SRH education and reliance on peers, often leading to misinformation. Psychosocial factors (Beta = 0.201, p = 0.001), including stigma, fear of judgment, and trauma, significantly discouraged service utilization. Socio cultural and economic factors (Beta = 0.156, p = 0.002), such as cultural taboos and poverty, had the least but still significant impact. The regression model indicated that these four factors accounted for 52.4% of the variance in SRH service uptake. To improve SRH service uptake, the study recommends establishing youth-friendly satellite clinics and mobile health units in rural areas, to enhance geographic accessibility. Comprehensive sexuality education should be integrated into school curricula, supplemented by peer education and media campaigns to boost awareness. Community sensitization programs involving leaders and parents are needed to destigmatize SRH topics. Healthcare providers should be trained in adolescent-friendly and trauma-informed care, with strict privacy protocols. Psychosocial counseling and peer support groups should be integrated into SRH services to address emotional barriers. Finally, strengthening supply chains for SRH commodities is critical to ensure consistent service availability.