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

Humanitarian crises in South Sudan, characterized by conflict, displacement, and disrupted health systems, severely limit adolescent girls' access to SRH services. The study employed a mixed-methods design. This study aimed to examine factors influencing the uptake of SRH services among adolescent girls aged 15-19 in Bor County, South Sudan. The target population included adolescent girls aged 15-19, with a sample size of 225 participants selected through purposive sampling. Data was collected via semi-structured questionnaires for quantitative insights and Key Informant Interviews (KIIs) for qualitative perspectives. Quantitative data were analyzed using descriptive statistics (means, standard deviations, and regression analysis) with SPSS Version 25.0, and results were presented in tables, pie charts, and graphs. Qualitative data were analyzed thematically using NVivo software to identify key patterns and themes. The study found that accessibility was the most significant barrier (Beta = 0.311, p = 0.021), with long distances to clinics, poor transportation, and lack of youth-friendly services limiting uptake. Awareness and knowledge (Beta = 0.219, p = 0.032) were constrained by inadequate school-based SRH education. Psychosocial factors (Beta = 0.201, p = 0.001), including stigma and trauma, significantly deterred service utilization. Socio-cultural and economic factors (Beta = 0.156, p = 0.002), such as cultural taboos and poverty, had a notable but lesser impact. This study enriches the literature by providing context-specific insights into SRH service uptake in humanitarian settings, emphasizing the unique challenges faced by adolescent girls in Bor County. It recommends youth-friendly mobile clinics, comprehensive sexuality education, and community-based stigma reduction programs to align with South Sudan’s adolescent health policies and global humanitarian SRH standards