MGHD 2024

Background: Adolescent sexual and reproductive health (SRH) is a global challenge, particularly in low- and middle-income countries (LMICs) where 90% of the 1.2 billion adolescents reside (WHO, 2024). In Sub-Saharan Africa, adolescent birth rates are high, with many unintended pregnancies ending in unsafe abortions (UNICEF, 2024; Sully et al., 2020). Despite Rwanda's efforts to improve adolescent SRH through national strategic plans and youth- friendly health facilities, utilization remains an issue, particularly in the Gatsibo district (MOH [Rwanda], 2018, Gender Monitoring Office, 2020). This study explores adolescents' experiences with SRH services utilization to inform targeted interventions and policies in Rwanda. Methods: A qualitative phenomenological study was conducted in the Kabarore sector, Gatsibo district. In-depth interviews (IDI) were conducted with seventeen adolescents consisting of 10 female and 7 males aged 10-19 years old. Thematic analysis was used to identify key themes and subthemes related to barriers and facilitators to SRH service utilization. Results: Five major themes emerged from the analysis: 1) Cultural norms and religious beliefs along with a lack of open communication with parents deter adolescents from seeking SRH services; 2) Adolescents’ insufficient knowledge and negative perceptions significantly limit their SRH service utilization; 3) Unfriendly SRH services provided by judgmental HCP heavily discourages adolescents from seeking SRH services; 4) SRH commodities were often unavailable, inaccessible, and inadequate infrastructures and 5) Effective SRH interventions/programs and strong peer support positively influences adolescents' utilization of SRH services. These findings draw attention to the lived experiences of adolescents and emphasize the importance of addressing these barriers to enhance SRH service accessibility and quality. Conclusion: This study highlights the complex interplay of factors affecting adolescents' utilization of SRH services in Gatsibo District. The findings underscore the need for multifaceted interventions addressing knowledge gaps, negative perceptions, and systemic barriers while leveraging positive peer influence and effective SRH programs. These insights can inform policy and practice to improve SRH service utilization among adolescents in similar settings.