title: Inequity in awareness and utilization of adolescent reproductive and sexual health services in union territory, Chandigarh, North India.
abstract: BACKGROUND
  Adolescents are a heterogeneous, vulnerable, and sexually active group. Geographical and educational health disparities exist among urban, rural, and slum adolescents and among out-of-school and school-going adolescents, respectively. Adolescent reproductive and sexual health (ARSH) services should be implemented in a manner to minimize health inequities among them.
  
  
  OBJECTIVE
  To ascertain the extent of awareness and utilization of ARSH services provided under reproductive and child health(RCH) program among adolescents in Chandigarh.
  
  
  METHODS
  A cross-sectional study was conducted among 854 adolescents (402 household, 200 out-of-school, and 252 school-going adolescents) in Chandigarh using pretested validated interview schedule on awareness and utilization of adolescent reproductive and sexual health services from February to April 2011 in North Indian Union Territory of Chandigarh. Ordinal regression analysis was done to study the association of socio-demographic variables with awareness and utilization of ARSH. Results: Awareness about contraception and health services was significantly less among rural (12.7% and 1.1%, respectively) adolescents as compared to slum (17.9% and 4.6%, respectively) and urban adolescents (33.5% and 7.8%, respectively) (P < 0.05). Out-of-school adolescents were utilizing the preventive [odds ratio (OR) 0.39, P < 0.001] and curative services significantly lesser (OR = 0.54, P < 0.001) and had higher substance abuse (OR = 4.26, P= 0.006). Awareness was significantly associated with older age of adolescents (OR = 4.4,P < 0.001), poor education of father (OR = 0.5, P = 0.002), rural area (OR = 0.56, P = 0.001), and out-of-school status (OR = 0.35, P < 0.001).
  
  
  CONCLUSIONS
  Awareness and utilization of ARSH services was inequitable and was more among urban and school-going adolescents. Educational status was the most important factor affecting it.
authors.affiliation: Associate Professor, Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Haryana and Punjab, India.
authors.forename: Madhu
authors.initials: M
authors.lastname: Gupta
authors.forename: Nidhi
authors.initials: N
authors.lastname: Bhatnagar
authors.forename: Pankaj
authors.initials: P
authors.lastname: Bahugana
mesh_terms: D000293:Adolescent; D001364:Awareness; D003267:Contraception / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007194:India; D008297:Male; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012424:Rural Population; D019966:Substance-Related Disorders / Q000453:epidemiology; D014506:Urban Renewal; D055815:Young Adult