{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:52:49Z","timestamp":1788871969201,"version":"build-2803163510"},"reference-count":33,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,2,14]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"\n Objectives<\/jats:title>\n The study aimed to assess the prevalence of reproductive health problems among youths and the utilisation of services and associated factors in urban Ethiopia.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n This paper presents findings related to sexual and reproductive health (SRH) based on a formative assessment of the Integrated Youth Activity which is conducted by cross-sectional study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Youths from community and higher education institutions were included from 13 major urban towns of Ethiopia in the study.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n A total of 1954 youths from community settings were included from randomly selected eligible households and 1261 students were included from higher education institutions.<\/jats:p>\n <\/jats:sec>\n \n Primary outcomes<\/jats:title>\n The youths\u2019 experience of unwanted pregnancy; exposure to high-risk sexual behaviour (HRSB); SRH service utilisation; and current use of family planning (FP) services.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among youths, 35% have engaged in HRSB, more than 14% have experienced at least one unwanted pregnancy and 26.7% have used SRH services. Additionally, only 26.4% of female youths use FP. The uptake of SRH services is lower among unmarried youths, those aged 18\u201319, individuals with no access to mass media and those who do not encounter SRH messages. Unintended pregnancy among women is common among those in higher education, lacking comprehensive HIV knowledge and engaging in HRSB. HRSB is prevalent among youths with no education, aged 18\u201319, who have not used SRH or FP services, and those with multiple social media accounts.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n A relatively high proportion of youths exhibit low uptake of SRH and FP services, with a higher proportion exposed to HRSB and unintended pregnancy. Barriers to the utilisation of SRH services as well as increased risk of HRSB, including unwanted pregnancies, are often linked to poor access to accurate and relevant SRH information. To address this gap, delivering targeted SRH-related messages through social media and mass media broadcasts can play a transformative role. This approach not only broadens youth access to reliable SRH information but also enhances their health literacy by increasing the credibility and relevance of the information provided.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-087224","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T12:50:15Z","timestamp":1740574215000},"page":"e087224","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["The state of youth sexual and reproductive health problems and service utilisation in major towns of Ethiopia: a cross-sectional study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1361-9649","authenticated-orcid":false,"given":"Tegene Legese","family":"Dadi","sequence":"first","affiliation":[{"name":"MERQ Consultancy PLC, Addis Ababa, Ethiopia"},{"name":"School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Sidama Region, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girmay","family":"Medhin","sequence":"additional","affiliation":[{"name":"MERQ Consultancy PLC, Addis Ababa, Ethiopia"},{"name":"Aklilu Lemma Institute of Pathology, Addis Ababa University, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fasil Walelign","family":"Fentaye","sequence":"additional","affiliation":[{"name":"MERQ Consultancy PLC, Addis Ababa, Ethiopia"},{"name":"Wollo University, Dessie, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Tadesse","sequence":"additional","affiliation":[{"name":"MERQ Consultancy PLC, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Setegn Tigabu","family":"Tassew","sequence":"additional","affiliation":[{"name":"MERQ Consultancy PLC, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tigist Urgessa","family":"Wakene","sequence":"additional","affiliation":[{"name":"Integrated Youth Activity (Kefeta) Project, Amref Health Africa, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dereje","family":"Haddis","sequence":"additional","affiliation":[{"name":"Integrated Youth Activity (Kefeta) Project, Amref Health Africa, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israel","family":"Lemma","sequence":"additional","affiliation":[{"name":"Integrated Youth Activity (Kefeta) Project, Amref Health Africa, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasihun","family":"Andualem","sequence":"additional","affiliation":[{"name":"Integrated Youth Activity (Kefeta) Project, Amref Health Africa, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chalachew Alemu","family":"Tiruneh","sequence":"additional","affiliation":[{"name":"Integrated Youth Activity (Kefeta) Project, Amref Health Africa, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibeltal Kiflie","family":"Alemayehu","sequence":"additional","affiliation":[{"name":"MERQ Consultancy PLC, Addis Ababa, Ethiopia"},{"name":"Health Policy and Management, Jimma University, Jimma, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"2025121422125202000_15.2.e087224.1","unstructured":"United Nations, Department of Economic and Social Affairs Population Division . World Population Monitoring Adolescents and Youth. 2012."},{"key":"2025121422125202000_15.2.e087224.2","unstructured":"Central Statistical Agency (CSA) [Ethiopia] . Population Projections for Ethiopia 2007-2037. Population Census Commission: Addis Ababa. 2013."},{"key":"2025121422125202000_15.2.e087224.3","unstructured":"Central Statistics Agency (CSA) [Ethiopia] . Population Projections for Ethiopia 2007-2037. Addis Ababa. 2013."},{"key":"2025121422125202000_15.2.e087224.4","unstructured":"WHO . Adolescent and young adult health, 2023. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/adolescents-health-risks-and-solutions"},{"key":"2025121422125202000_15.2.e087224.5","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1503\/jpn.150268","article-title":"Adolescence as a unique developmental period","volume":"40","author":"Jaworska","year":"2015","journal-title":"J Psychiatry Neurosci"},{"key":"2025121422125202000_15.2.e087224.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2010.08.033"},{"key":"2025121422125202000_15.2.e087224.7","unstructured":"United Nations Children\u2019s Fund (UNICEF), t.W.H.O.W., the World Bank Group and the United Nations Department of Economic and Social Affairs, Population Division . Levels & Trends in Child Mortality. 2023."},{"key":"2025121422125202000_15.2.e087224.8","unstructured":"PRB . Adolescent And Youth Demographics: A Brief Overview. 2010."},{"key":"2025121422125202000_15.2.e087224.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60371-7"},{"key":"2025121422125202000_15.2.e087224.10","unstructured":"World Economic Forum . Adolescent health has been overlooked for too long 2018, Available: https:\/\/www.weforum.org\/agenda\/2018\/10\/adolescent-health-overlooked-too-long"},{"key":"2025121422125202000_15.2.e087224.11","unstructured":"A Collaborative Project of the Association of Maternal and Child Health Programs and the National Network of State Adolescent Health Coordinators . A Conceptual Framework for Adolescent Health. 2005."},{"key":"2025121422125202000_15.2.e087224.12","unstructured":"Federal Democratic Republic of Ethiopia Ministry of Health . Adolscent and Youth engagment guidline. 2020."},{"key":"2025121422125202000_15.2.e087224.13","unstructured":"Ministry of Health - Ethiopia . National Adolescent and Youth Health Strategy. 2016."},{"key":"2025121422125202000_15.2.e087224.14","unstructured":"Commission, F.D.R.o.E.P.a.D . Ten years development plan: a pathway to prosperity. Addis Ababa: Planning and Development Commission, 2020."},{"key":"2025121422125202000_15.2.e087224.15","unstructured":"Fasil Walelign Fentaye YKA , Teklu AM , Tesfaye Y , et al . The state of youth and youth-serving organizations in major cities of Ethiopia: formative assessment of kefeta integrated youth activity master report. Addis Ababa, Ethiopia: MERQ Consultancy PLC, USAID, Amref Health Africa, 2022."},{"key":"2025121422125202000_15.2.e087224.16","unstructured":"Central Statistical Agency (CSA) [Ethiopia] and ICF . Ethiopia demographic and health survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF, 2016."},{"key":"2025121422125202000_15.2.e087224.17","unstructured":"Hinson L , Kapungu C , Jessee C , et al . Measuring positive youth development toolkit: a guide for implementers of youth programs. Washington, DC: Youth Power Learning, Making Cents International, 2016."},{"key":"2025121422125202000_15.2.e087224.18","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-018-0501-z","article-title":"Sexual and reproductive health services utilization and associated factors among secondary school students in Nekemte town, Ethiopia","volume":"15","author":"Binu","year":"2018","journal-title":"Reprod Health"},{"key":"2025121422125202000_15.2.e087224.19","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0242850","article-title":"Correction: Youth friendly sexual and reproductive health service utilization among high and preparatory school students in Debre Tabor town, Northwest Ethiopia: A cross sectional study","volume":"15","author":"Simegn","year":"2020","journal-title":"PLoS One"},{"key":"2025121422125202000_15.2.e087224.20","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-018-0659-4","article-title":"Reproductive health services utilization and its associated factors among adolescents in Debre Berhan town, Central Ethiopia: a community-based cross-sectional study","volume":"15","author":"Tlaye","year":"2018","journal-title":"Reprod Health"},{"key":"2025121422125202000_15.2.e087224.21","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2023.1062325","article-title":"Reproductive health service use and associated factors among youths in Becho district, southwest Ethiopia","volume":"11","author":"Waga","year":"2023","journal-title":"Front Public Health"},{"key":"2025121422125202000_15.2.e087224.22","article-title":"Reproductive health service utilization and associated factors: the case of north Shewa zone youth, Amhara region, Ethiopia","volume":"25","author":"Negash","year":"2016","journal-title":"Pan Afr Med J"},{"key":"2025121422125202000_15.2.e087224.23","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6963-14-138","article-title":"Reproductive health knowledge and services utilization among rural adolescents in east Gojjam zone, Ethiopia: a community-based cross-sectional study","volume":"14","author":"Abajobir","year":"2014","journal-title":"BMC Health Serv Res"},{"key":"2025121422125202000_15.2.e087224.24","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-023-09616-z","article-title":"Sexual and reproductive health services use among adolescents in pastoralist settings, northeastern Ethiopia","volume":"23","author":"Zepro","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"2025121422125202000_15.2.e087224.25","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1177\/0272684X20976519","article-title":"Youth Risky Sexual Behavior: Prevalence and Socio-Demographic Factors in North-West Ethiopia: A Community-Based Cross-Sectional Study","volume":"42","author":"Geremew","year":"2022","journal-title":"Community Health Equity Res Policy"},{"key":"2025121422125202000_15.2.e087224.26","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0259262","article-title":"Unintended pregnancy and the factors among currently pregnant married youths in Western Oromia, Ethiopia: A mixed method","volume":"16","author":"Merga","year":"2021","journal-title":"PLoS One"},{"key":"2025121422125202000_15.2.e087224.27","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1186\/s12905-022-02048-7","article-title":"Prevalence and factors associated with unintended pregnancy among adolescent girls and young women in sub-Saharan Africa, a multilevel analysis","volume":"22","author":"Ayalew","year":"2022","journal-title":"BMC Womens Health"},{"key":"2025121422125202000_15.2.e087224.28","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-022-09014-x","article-title":"Factors associated with pregnancy and induced abortion among street-involved female adolescents in two Nigerian urban cities: a mixed-method study","volume":"23","author":"Obiyan","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"2025121422125202000_15.2.e087224.29","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-016-0195-z","article-title":"Unintended pregnancy and its correlates among currently pregnant women in the Kwango District, Democratic Republic of the Congo","volume":"13","author":"Dhakal","year":"2016","journal-title":"Reprod Health"},{"key":"2025121422125202000_15.2.e087224.30","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0240695","article-title":"Risky sexual behavior and associated factors among sexually-active unmarried young female internal migrants working in Burayu Town, Ethiopia","volume":"15","author":"Baru","year":"2020","journal-title":"PLoS One"},{"key":"2025121422125202000_15.2.e087224.31","doi-asserted-by":"crossref","DOI":"10.1080\/26410397.2023.2267893","article-title":"Associations of social media and health content use with sexual risk behaviours among adolescents in South Africa","volume":"31","author":"Banougnin","year":"2023","journal-title":"Sex Reprod Health Matters"},{"key":"2025121422125202000_15.2.e087224.32","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.jpag.2014.03.001","article-title":"The impact of social media on the sexual and social wellness of adolescents","volume":"28","author":"Cookingham","year":"2015","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2025121422125202000_15.2.e087224.33","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0198657","article-title":"The prevalence of risky sexual behaviors among youth center reproductive health clinics users and non-users in Addis Ababa, Ethiopia: A comparative cross-sectional study","volume":"13","author":"Fetene","year":"2018","journal-title":"PLoS One"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-087224","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T06:13:06Z","timestamp":1765779186000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-087224"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,26]]},"published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1136\/bmjopen-2024-087224"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-087224","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]}}}