Identifying the sexual and reproductive health needs of adolescent: A participatory study

There is a large variation in receiving reproductive health (RH) services across places. Due to wide scope of services and its variation across places, it is expected that the RH services should be suitable to the needs of the people of particular area. Therefore, instead of the researchers and program managers, it is more appropriate for the community to identify their service needs. In this study the adolescents identified their own RH problems, and suggested possible solutions. Participatory rural appraisal (PRA) techniques were employed for the study which included transects walk, key informant interview, free listing and PRA sessions. A total of 24 PRA sessions were conducted with adolescents. Findings suggests that dysmenorrheal, vaginal discharge, frequent prolonged menstruation, and social exclusion during menses were the major concerns of female adolescent. Unmarried male adolescent expressed concerns related to wet dreams, masturbation, burning urination, erectile dysfunction, and stone in penis. Traditional healers are mostly consulted for RH problems. Qualified medical practitioner was consulted if the problem became serious. For some problems such as menstrual problems, erectile dysfunction, discharge problems, and wet dreams adolescents sought treatment from religious leader or canvasser. Lack of awareness and several misperceptions were identified as barriers to utilize RH services. Gatekeepers, especially parents, did not allow adolescents to visit health facilities. Inadequate number of providers and medicine supply, inappropriate waiting arrangements and behavior change communication materials were identified as barriers of health facilities. This study allows the researcher and program managers greater understanding of local RH needs to design appropriate and sustainable service delivery model.