A qualitative study in Rwamagana District, Rwanda, on the acceptability and utilisation of sexual and reproductive...

Teenage pregnancies remain a pressing issue in Sub-Saharan Africa, including Rwanda. Adolescent girls and young women (AGYW) continue to face a myriad of challenges in accessing sexual reproductive health (SRH) services. This study examines the accessibility and utilization of SRH services provided to AGYW in youth corners in Rwamagana district, Rwanda. It seeks to explore challenges and opportunities for accessing SRH services in youth corners.

Utilising a descriptive qualitative research design, the study included 8 in-depth focus group discussions and 4 key informant interviews. Stratified sampling methodology was utilised to increase the representativeness of the AGYW and 71 AGYW participated in the study. The feminist standpoint theory aided in focusing on marginalised voices, analysing power structures and contextualising experiences of AGYW in Rwamagana. The socio-ecological model was used to analyse data using thematic analysis.

The findings reveal various SRH services accessed by AGYW in youth corners, including family planning, services regarding sexually transmitted infections (STIs) and menstrual hygiene management. Barriers to service utilisation included limited knowledge about the available services, distance to health facility, unavailability of some services, AGYW being viewed as a prostitute when one is seen with condoms, norms that discourage open discussions about sexual health, and stigma surrounding the use of contraceptives. This was further worsened by the gender norms which create additional hurdles for AGYW, as they navigate societal expectations and restrictions that are not equally imposed on their male counterparts. The inconsistent availability of services coupled with diverse operating schedules also posed a challenge to accessing services. Most AGYW expressed trust in the healthcare providers' ability to maintain confidentiality, given their training and professional obligations. This sense of trust acted as a motivating factor for AGYW to be more open and forthcoming in utilising the available SRH services.

Addressing the identified challenges faced by AGYW in accessing SRH services in youth corners will help to promote their well-being and bodily autonomy.