Out of the students of Mizan-Tepi University Tepi Campus enrolled in the study, 220(51.4%) reported having no acces to any YFRHS in their locality and this was comparable with previous studies conducted in Jimma, 47.1% [18]. But it was much higher than a study conducted in Bahir Dar, 13.6% [19] Adiss Ababa 40% [20], and community based study in Jimma 41% [18] and Harar 36% [21].
For 131(30.6%) and 151(35.3%) of the respondents, their friends and school teachers were the major sources of information about YFRHS, respectively, and this is quite similar with findings from Mekelle Town and Bahir Dar, that reported the media outlets as a source of information is for 35.5% of the students [19]. Whereas, finding of this study is in contrast to studies done in Nigeria [22], Tanazania [23] and Ghana [1], that indicates parents, close friends and peers of youths are the most common sources of information.
The major sources of information about YFRHS were different medias, in our study about 21% of participants got information from different medias and this was in agreement with a study done in Harar that showed media as source of information for 22.8% participants [24]. However, this finding is less than a study in Bahir Dar and Mekelle (35.5%) [19, 15]. Majority (55.4%) of respondents lack basic information and knowledge of YFHRS and this was similar with a study in Meda Wolabu University students [16]. However, it was found much less than a research from Hadiya Ethiopia (78.5%) [25]. On the other hand, 27.6% of the respondents believed that females are the only one to use youth friendly health service and this agrees with researches done in Moldova [9].
Of a total of 428 participants, only 49% had utilized YFRHS, which is higher than a study report from Bahir Dar (32%) [19]. Treatment of STIs services (63.6%) and VCT (42.1%) were the most utilized services by the study cases. However, family planning and contraception (40.7%) was a less utilized service at YFRHS centre. This was in contrast to the finding in Hadiya Zone, Ethiopia [25], that reported VCT 343(68.9%), and contraception 321(64.5%), as the most utilized YFRHS. One of the most reported reasons by the students for not utilizing the services was the unavailabilty of the service in their locality (51.1%), and less availability of services even in some of the areas where the service provider is available, and this was also reported in West Gojjam Zone of Ethiopia [13]. Other study from Bahir Dar indicated inconvenience hours and fear of being seen by parents, colleagues, neighbors or other people as roadblocks in utilizing reproductive health services [19]. Among the respondents, condom [195(45.6%)]and emergency pills [169(39.5%)] are the most commonly used contraceptive methods. Ths finding was supported with other studies conducted in different parts of the Ethiopia[7, 13, 14] and beyond like South Africa and Tanzania [23, 26, 27]. And, this requires a great attention of both governmental and non-governmemtal organizations working in provision of YFRHS across parts of Ethiopia. On chi-square test analysis, the factors that were found to be significantly associated with knowledge of students toward YFRHS were sex, age, mother’s education and father’s educational status, availability of any YFRH service in the respondents’ area and source of information. This was in agreement with studies conducted in Bale[28] and Wollisso [29].
Male students had more knowledge and practicing experience than female student and this is in line with studies done in South Gondar [30], Gujarat India[31] and China [32]. This might be lack of awareness given for female students on YFRHS or lack of service giving facility in their surroundings nearby. However, it is opposing to the study done in East Gojjam zone, Ethiopia [33]. Students in the age group 21–22 were 2.732 times and in age group 23–24 were 4.345 times more likely to have knowledge compared to student in the age group of 18–20 years, respectively, Moreover, students in the age group of 21–22 years were 2.275 times more likely experienced YFHS compared to students in the age group of 18–20 years. This study is in agreement with studies conducted in Bahir Dari [34], Jimma city [18], India[35] and East Gojjam [33]. Following the growth of students’ in age, there is a subsequent increase in having knowledge about YFHS, this might be due to information gap about the service on time. However, it contradicts with study done using multi-country data analysis in China [32].
Students whose permament residence was Tigiray and Oromia regions had less knowledge about YFHS compared to Addis Ababa city administration. This could be due to student from urban had more YFHS offering facility access than students from rural parts of the country. As Addis Ababa is the capital city of Ethiopia and also there are many governmental and non-governmental health facilities. Mother and father education status had statistical significant effect on the knowledge, attitude and practice of students toward YFHS. As shown in this finding, when the mother and father education level increased the knowledge, attitude and practice of students toward YFRHS also increased. This study is in line with study conducted in Awabel district northwest Ethiopia [36] and it is contradicting with the study done in south Gondar [30].
Students who had YFRHS access in their surroundings were 3.23 times more likely to have knowledge and 2.475 times more likely practicing experience about YFRHS compared to students who had no any service in their surroundings respectively this study is consistent with a studies done in Hadiya Zone of Ethiopia [25] and Kenya [37]. Having this information, it can be expected as youths becoming more familiar with the service settings as well as type of services offered, and they will freely adopt to what type of the service they have to use. Students who get information about YFRHS from their parents are more likely to have knowledge compared to students who get from different media. This finding agreed with study conducted in Awabel district northwest Ethiopia [36]. Students who get information from newspaper were 7.776 times more likely to have positive attitude compared to students who get information from their parents. This study is consistent with study conducted in Jimma city [18]. Participants who get information from media were 5.177 times more likely to have positive attitudes compared to students who get information from parents. According to practicing experience of YFRHS, this study revealed that there is opposite outcomes for practice and attitudes based on the source of information. This might be due to students had information about the YFRHS, but no any services given for them.
, margin of error 5% (d=0.05), and assuming the prevalence of having knowledge of YFHS 50% (p = 0.5). Then the sample size (n) was determined as follows: