Original article
Differential use of adolescent reproductive health programs in Addis Ababa, Ethiopia

https://doi.org/10.1016/j.jadohealth.2005.03.026Get rights and content

Abstract

Purpose

Adolescent reproductive health programs in Africa have largely remained as small-scale pilot programs, however, there is increasing interest in bringing programs to scale. Evaluations have focused on individual programs and few have gathered population-based information on the reach of program models and the profile of adolescents who utilize services, versus those who do not. This study examines the coverage and utilization of existing adolescent programs in Addis Ababa, Ethiopia.

Methods

Population-based surveys were undertaken among over 1000 adolescents aged 10 to 19 years in slum areas of Addis Ababa, Ethiopia. An inventory of youth programs including youth centers and peer education programs was compiled in the study area.

Results

Eight peer education programs and six youth centers were operating in the study area. Twenty percent of boys and only 7% of girls had visited a youth center in the last year; 27% of boys and 15% of girls had had contact with a peer educator. Older adolescents, especially boys, were more likely to utilize programs. Girls who work long hours and who are isolated are less likely to access and benefit from programs.

Conclusions

Greater segmentation of the adolescent population is needed in the design and content of adolescent reproductive health programs. In addition, programmers should pay attention to the specific circumstances of young people in local settings, particularly vulnerable, hard-to-reach sub-groups of adolescents, including girls.

Section snippets

Methods

Data for this study are from a population-based survey of adolescents aged 10 to 19 years conducted in Addis Ababa, Ethiopia in early 2004. The survey took place in two slum areas of Addis Ababa, Mercato area (Kebele 13) and Kazanchis (Kebele 10; kebeles are the lowest administrative units in Ethiopia), which are among the city’s poorest areas. These are very densely populated areas with an average of 5.4 members per household.

The survey took place in two stages: an initial household listing

Sample characteristics

In all, 1044 young people aged 10 to 19 years were interviewed (Table 1). The response rate for both boys and girls was 87%, which is consistent with other surveys of adolescents using similar methods of data collection [19]. More girls than boys were interviewed, which may be a reflection of the greater number of female immigrants into the area. (The greater number of girls in the sample is a reflection of the number of girls listed. In all, 1350 girls were listed, compared with 866 boys. The

Discussion

This study examines the utilization, nonuse, and coverage of two popular youth program models—youth centers and peer education—among urban youth. Other studies of program utilization rely on service statistic data that allow managers to understand only who is using the services, but does not allow them to understand who is not being reached. This study uses population-based data, allowing us to profile who is not taking advantage of youth programs offered in their communities. Data were not

Acknowledgments

This study was made possible by financial support from UNICEF Ethiopia and DfID. We are grateful to Ayo Ajayi and Judith Bruce for very helpful comments on this article, to Assefa Hailemariam for assistance in data collection, and to Lucy N’gan’ga for assistance with data processing.

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    Copyright © 2006 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.