title: Barriers to sexual reproductive health services and rights among young people in Mtwara district, Tanzania: a qualitative study.
abstract: BACKGROUND
  In Tanzania over 1/3 of the population is under 24 years. Nationwide 23% of teenagers have started childbearing. However, Mtwara Region has the highest percentage (25.5%) of teenagers who begin childbearing early. Mtwara District has a teenage pregnancy rate of 11% with young people utilizing sexual reproductive health services (SRHS) less frequently than adults.This study aimed at gaining insights on barriers to the utilization of SRHS in Mtwara district.
  
  
  METHODS
  A qualitative study was carried out using focus group discussions, facility assessment interviews and case studies. A total of nine focus group discussions (comprising 8 to 10 persons per group) were conducted among girls (10-18 years), community leaders and adults. Data was transcribed using pattern matching methods then merged into relevant themes for analysis and interpretation.
  
  
  RESULTS
  The study revealed that a good number of health facilities do not have skilled service providers (SPs) on sexual reproductive health rights. Girls start sexual intercourse between 9 and 12 years. Services sought included; education, family planning and voluntary counseling and testing. However, the services were inaccessible due to lack of privacy, confidentiality, equipments and negative attitudes from SPs. Initiation ceremonies, early marriages and gender disparities were mentioned as social-cultural barriers to SRH rights.
  
  
  CONCLUSIONS
  This study has demonstrated that factors such as lack of youth friendly services, gender disparity and unfavorable socio-cultural practices may create barriers to accessing adolescent SRHS and rights. Therefore, there is a need to integrate youth friendly services in health facilities and advocate for behavior change.
authors: AMREF in Tanzania, Dar es Salaam, Tanzania.
authors: Rita Moses
authors: RM
authors: Mbeba
authors: Martin Sem
authors: MS
authors: Mkuye
authors: Grace Elias
authors: GE
authors: Magembe
authors: William Lubazi
authors: WL
authors: Yotham
authors: Alfred Obeidy
authors: AO
authors: Mellah
authors: Serafina Baptist
authors: SB
authors: Mkuwa
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003219:Confidentiality / Q000523:psychology; D003466:Cultural Characteristics; D003625:Data Collection; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D018907:Privacy / Q000523:psychology; D034121:Reproductive Health Services / Q000458:organization & administration*; D046269:Reproductive Rights; D012725:Sexual Behavior / Q000706:statistics & numerical data; D013636:Tanzania
keywords: Youth friendly services; counseling and testing; family planning; health services; reproductive health