1. Demographic characteristics of Study respondents
The study involved 372 respondents, with the majority aged 13-18 (n = 291, 78.23%). The gender distribution was 66.13% female (n = 246) and 33.87% male (n = 126). In terms of education, 65.05% (n = 242) had secondary education, 22.58% (n = 84) had primary education, and 12.37% (n = 46) had no formal education. Marital status included 79.57% (n = 296) categorized as "not applicable," 12.63% (n = 47) married, 6.18% (n = 23) single, and 1.61% (n = 6) widow/widower. Most participants (79.57%, n = 296) were students, while other occupations accounted for 20.43% (See the below table for the rest).
Table 1: Characteristics of the respondents
Age group (Years) Frequency Percent (%) Cumulative percent (%)
13-18 291 78.23 78.23
19-25 31 8.33 86.56
26-35 29 7.80 94.35
36-45 10 2.69 97.04
46-56 11 2.96 100.00
Total 372 100
Gender
Male 126 33.87 33.87
Female 246 66.13 100.00
Total 372 100.00
Education level
Primary 84 22.58 22.58
Secondary 242 65.05 87.63
None educated 46 12.37 100.00
Total 372 100.00
Marital status
Married 47 12.63 12.63
Single 23 6.18 18.82
Widow/widower 6 1.61 20.43
Not applicable 296 79.57 100.00
Total 372 100.00
Occupation
Businessman 3 0.81 0.81
Farmer 3 0.81 1.61
Student 296 79.57 81.18
Others 70 18.82 100.00
Total 372 100.00
Source: Field data, (2023)
1.2. Respondents with access to information on Sexual Reproductive Health Services
The researcher aimed at finding on respondents’ with access to information on sexual reproductive health services. Findings on the accessibility of Sexual and Reproductive Health Services (SRHS) show among 372 participants, of the total, 290 participants (77.96%, n = 290) reported having access to SRHS ("Yes"), while 82 participants (22.04%, n = 82) indicated a lack of access ("No"). The cumulative percentages reflect that 77.96% of respondents have access to SRHS, and 100% provided responses.
Table 2: Respondents with access to information on SRHS
Info_srhs Freq. Percent Cum
Yes 290 77.96 77.96
No 82 22.04 100.00
Total 372 100.00
1.3 Respondents utilization on SRHS
This category was based on responses from 372 participants, it summarizes their utilization of Sexual and Reproductive Health Services (SRHS). A significant majority (77.96%, n = 290) reported having utilized SRHS, while a small minority (22.04%, n = 82) indicated not having used such services, see table 3 below
Table 3. Respondents' utilization SRHS
Utilization_srhs Freq. Percent (%) Cum.
Yes 290 77.96 77.96
No 82 22.04 100.00
Total 372 100.00
Source, field (2023)
1.4 Respondents satisfaction level with sexual reproductive health services
The study also evaluated respondents’ satisfaction with Sexual and Reproductive Health (SRH) services using a Likert scale from 1 to 5, collecting subjective feedback. The findings revealed that 47.85% (n = 178) of participants reported being satisfied with SRH services. About 7.5% (n = 28) expressed dissatisfaction. Most respondents (44.09%, n = 164) fell in the neutral category. Only a small percentage were very dissatisfied (0.27%, n = 1), while another 0.27% (n = 1) were very satisfied. Overall, the majority were either satisfied or neutral, indicating a reasonable level of satisfaction with the services received as shown in the table below;
Table 4. Respondents satisfaction level with sexual reproductive health services
Srhs_satfc Freq. Percent (%) Cum.
Very dissatisfied 1 0.27 0.27
Dissatisfied 28 7.53 7.80
Neutral 164 44.09 51.88
Satisfied 178 47.85 99.73
Very satisfied 1 0.27 100.00
Total 372 100.00
Source, field (2023)
1.4.1 Respondents visits to primary health facility for utilization of SRHS
The study explores the frequency of respondents' visits to primary health facilities specifically for Sexual Reproductive Health Services (SRHS). Approximately 33.06% (n = 123) reported monthly visits for SRHS, while 44.89% (n = 167) did so quarterly. Notably, 22.04% (n = 82) stated that they never visited primary health facilities for SRHS.
Figure 1: Frequency of respondents visits to primary health facility for SRHS
Furthermore, the findings provide insights into gender differences in the frequency of self-rated health status assessments and suggest that both genders tend to monitor their health regularly although there is a slightly difference among gender as shown in the figure 2
Figure 2 HCF attendances Male Vs Female
Based on the cross-tabulation test conducted to observe the differences in SRHS frequency between male and female respondents, the data indicates that a greater proportion of females (58.1%, n = 144) visit health facilities for SRH services compared to males (41.9%, n = 104).
1.6 Sufficient healthcare facilities with SRHS
This research was also interested in finding out the if there are sufficient health facilities with SRHS within the district, this was done mainly to establish the relationship of existence of sufficient health facilities and how will contribute the reduction of FGM prevalence in the District, table 5 shows the response from participants towards availability of sufficient health facilities with SRHS within the district.
Table 5: Health facility with sufficient SRH service
suffc_srhs Freq. Percent Cum.
Yes 208 55.91 55.91
No 164 44.09 100.00
Total 372 100.00
Source, field (2023)
It's noteworthy that over half of the 372 participants, accounting for 55.91%, perceive that there are adequate Sexual and Reproductive Health (SRH) facilities in their area, signifying a level of satisfaction. However, the findings also reveal that a significant 44.09% feel there is a need for more SRH facilities.
Moreover, to enhance our understanding of the adequacy of Sexual and Reproductive Health (SRH) facilities in the district, the study goes beyond quantitative data.It delves into qualitative insights from interviews with healthcare professionals responsible for reproductive, adolescent, and child health clinics. These experts provide in-depth perspectives on facility availability. The findings revealed the existence of SRHS in the district as portrayed by respondents form different health facilities. The following are the quotes from different respondents,
“...our district has 54 health facilities that include 1 hospital, 50 dispensaries and 3 health centre, and all these facilities provide sexual reproductive health service which is one of the component in RCH department and there are health care providers who received short course training during ARP project implementation…” (DRCHCO, Handeni dc).
“...Our facility provides sexual and reproductive health services to all customers who are in need of our services, however we mostly observed the incidence of FGM during ANC clinics and labour…” (RCH in charge form Msata health centre).
"...At our facility, we prioritize health education and have a schedule displayed on our notice board. We conduct education sessions on weekdays during working hours. Additionally, we run outreach services to reach remote and nomadic communities...” (RCH in charge Msomera health centre).
1.7 Relationship between FGM practice and SRHS utilization
A univariate analysis was conducted to determine the relationship between FGM practice as the dependent variable and other independent variables which are use or utilization of SRHS and number of health facilities for SRHS. This was mainly established to see the relationship between these variables and how one variable can have an association with another .See table 6.
Table 6: Association between FGM Practice and SRHS Utilization
|
Coef.
|
Std. Err
|
t
|
p>t
|
[95% Conf
|
Intercept
|
Use-srhs
|
-0.1613
|
0.0670
|
-2.41
|
0.017
|
-0.2931
|
-0.02
|
Vst-srhs
|
-0.1902
|
0.0452
|
-4.21
|
0.000
|
-0.1013
|
-0.27
|
-cons
|
1.6529
|
0.0831
|
19.89
|
0.000
|
1.4895
|
1.81
|
Model Summary: - F(2,369) = 10.44, P = 0.0001 - R-square = 0.0655 -Adj R-aquare = 0.0607 Root MSE = 0.34686
|
The regression model's coefficient estimates shed light on factors influencing FGM practice. Notably, the findings show significant association between the "Use of SRHS" and the practice of FGM (χ² = 129.1208, Pr = 0.000). For every one-unit increase in "Use of SRHS," FGM practice tended to decrease by approximately 0.1613 units. Additionally, a one-unit increase in the "number of HCF’s visits for SRHS" corresponded to a reduction of about 0.1902 units in FGM prevalence.