Evidence map›Paper›PMID 40554534›Full record

ArticlePloS one2025

Access and utilization of youth friendly sexual and reproductive health services among illiterate adolescents in Rwanda: A mixed-methods participatory study.

Madeleine Mukeshimana, Aimable Nkurunziza, Gerard Nyiringango, Eliphaz Karamage, Domina Asingizwe, Claudine Nshutiyukuri, Sandra Musabwasoni, Vedaste Bagweneza, Michael Habtu, Josephine Uzayisenga and 2 more

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Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Madeleine MukeshimanaUniversity of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
Aimable NkurunzizaUniversity of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.ORCID 0000-0001-5052-6172
Gerard NyiringangoUniversity of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
Eliphaz KaramageMinistry of Health, Rwanda Biomedical Center/Maternal, Child and Community Health Division, Kigali, Rwanda.
Domina AsingizweUniversity of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
Claudine NshutiyukuriUniversity of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
Sandra MusabwasoniUniversity of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
Vedaste BagwenezaUniversity of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
Michael HabtuUniversity of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
Josephine UzayisengaUniversity of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.
Oluyinka AdejumoUniversity of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda.ORCID 0000-0002-0243-1627
Endale TamratThe Center of International Reproductive Health Training, University of Michigan (CIRHT-M), Michigan, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundYouth Friendly Health Services Centers (YFHS) in Rwanda have been established to address the lack of information and services related to reproductive health. However, there is a paucity of studies investigating the hurdles faced by illiterate adolescents when seeking sexual and reproductive health services. This study assessed adolescents' sexual and reproductive health (ASRH) accessibility and utilization in YFHS among illiterate adolescents in Rwanda.

methodsThis study used a mixed-method participatory study design. One hundred fifty illiterate adolescents were recruited using a convenience sampling. A checklist was used to observe the 16 YFHS. In the quantitative phase, data were organized using Statistical Package for the Social Sciences (SPSS) version 26, and analyzed through descriptive and inferential statistics. Two focus group discussions moderated by trained illiterate adolescents were conducted. Data were organized using Dedoose software and analyzed thematically.

resultsThe proportion of YFHS utilization was 25.3%. In the multivariate regression analysis, five outcomes remained significant to utilize YFHS: ever heard about YFHS (Adjusted Odds Ratio [AOR] = 6.32; 95% Confidence Interval [CI] = 2.07-19.27, having ASRH information (AOR = 8.99; 95 CI = 1.43-56.77), having information about any family planning (AOR = 19.00; 95 CI = 1.52-236.84), use of any type of contraceptives (AOR = 4.45; 95%CI = 1.34-14.85), and having information on prevention and management (AOR = 24.99; 95 CI = 2.76-226.53). Observers rated the quality of SRHs in YFHS at 24.36%. Facilitators to access YFHS include having information about ASRH, free-of-charge services, and peer educators. The reported barriers included providers' negative attitudes, internalized stigma, and lack of materials tailored to illiterate adolescents. The study participants suggested ways to improve the YFHS, such as community awareness, staff training, entertainment, and increasing the number of YFHS.

conclusionsThe utilization of YFHS among illiterate adolescents remains low, highlighting the need for targeted interventions to improve access and quality. Key facilitators, such as access to information, peer education, and free services, should be strengthened, while addressing barriers like provider attitudes, stigma, and resource limitations. These findings underscore the necessity of enhancing both the accessibility and quality of YFHS to ensure comprehensive reproductive health care for illiterate adolescents.

Indexed as

Health Services AccessibilityReproductive Health ServicesAdolescentEducational StatusFemaleFocus GroupsHealth Knowledge, Attitudes, PracticeHumansMaleReproductive HealthRwandaSexual BehaviorSexual HealthYoung Adult

Identifiers

PMID40554534
PMCPMC12186876

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.