Determinants of adolescents reproductive health service utilization in Ethiopia: a systematic review of quantitative evidence

Purpose: Adolescents in Ethiopia face many health problems which emanate from low knowledge and awareness of their reproductive health (RH), though there are additional factors contributing to the problem. Provision of adequate, friendly, and quality RH services to this group of young people is vital to have healthy and productive generation. This systematic review aimed to assemble the top obtainable evidence for the determinants of adolescent RH services utilization in Ethiopia. Methods: Systematic review of literature searches in major databases, MEDLINE, CINAHL, EMBASE, and Popline was conducted. English language articles published from 2010 onwards were sought. Socio-demographic and behavioral related outcomes were our interest. Fixed effect model with mantel Haenszel method was used to conduct meta-analysis using Revman5 software. Records were assessed for eligibility by two independent reviewers, with a third reviewer resolving disagreements. Result: Four community-based cross-sectional studies were included in the review. Results of the meta-analysis showed that adolescents whose educational level was primary were 57% less likely to use RH services than adolescents whose educational level was secondary and above. In-school adolescents were 2.39 more likely to utilize Family Planning services than adolescents who were out-of-school. Moreover, adolescents who ever discussed on RH issues with relatives/family/health workers were 3.63 more likely to utilize the services than adolescents who did not discuss with anyone else. Conclusion: We found adolescents' educational level; schooling status and ever discussion on RH issues were associated with RH service utilization in Ethiopia. Health information/education should be given in a regular manner to adolescents in schools and out of school on the availability and need for RH services. Developing the culture of discussion on RH issues within the community may help adolescents to be aware and utilize the available services.