title: Understanding sexual and reproductive health needs of adolescents: evidence from a formative evaluation in Wakiso district, Uganda.
abstract: BACKGROUND
  Adolescents are frequently reluctant to seek sexual and reproductive health services (SRH). In Uganda, adolescent health and development is constrained by translation of the relevant policies to practice. Recent studies done in central Uganda have shown that there is need for a critical assessment of adolescent friendly services (AFS) to gain insights on current practice and inform future interventions. This study aimed to assess the sexual reproductive health needs of the adolescents and explored their attitudes towards current services available.
  
  
  METHODS
  A qualitative study was conducted in Wakiso district, central Uganda in September 2013.Twenty focus group discussions (FGDs) stratified by gender (10 out-of-school, and 10 in-school), were purposefully sampled. We used trained research assistants (moderator and note taker) who used a pretested FGD guide translated into the local language to collect data. All discussions were audio taped, and were transcribed verbatim before analysis. Thematic areas on; adolescent health problems, adolescent SRH needs, health seeking behaviour and attitudes towards services, and preferred services were explored. Data was analysed using atlas ti version 7 software.
  
  
  RESULTS
  Our results clearly show that adolescents have real SRH issues that need to be addressed. In and out-of-school adolescents had sexuality problems such as unwanted pregnancies, sexually transmitted infections (STIs), defilement, rape, substance abuse. Unique to the females was the issue of sexual advances by older men and adolescents. We further highlight RH needs which would be solved by establishing adolescent friendly clinics with standard recommended characteristics (sexuality information, friendly health providers, a range of good clinical services such as post abortion care etc.). With regard to health seeking behaviour, most adolescents do not take any action at first until disease severity increase.
  
  
  CONCLUSIONS
  Adolescents in Uganda have multiple sexual and reproductive health needs that require special focus through adolescent friendly services. This calls for resource support in terms of health provider training, information education and communication materials as well as involvement of key stakeholders that include parents, teachers and legislators.
authors.affiliation: Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda. atuyambe@musph.ac.ug.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Atuyambe
authors.affiliation: Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda. pskibira@musph.ac.ug.
authors.forename: Simon P S
authors.initials: SP
authors.lastname: Kibira
authors.affiliation: Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda. jbukenya@musph.ac.ug.
authors.forename: Justine
authors.initials: J
authors.lastname: Bukenya
authors.affiliation: Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda. cmuhumuza@musph.ac.ug.
authors.forename: Christine
authors.initials: C
authors.lastname: Muhumuza
authors.affiliation: Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda. apobecca@gmail.com.
authors.forename: Rebecca R
authors.initials: RR
authors.lastname: Apolot
authors.affiliation: Department of Community Health, Mbarara University of Science and Technology, Kampala, Uganda. emulogo2000@gmail.com.
authors.forename: Edgar
authors.initials: E
authors.lastname: Mulogo
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D000328:Adult; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D020380:Needs Assessment; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D036301:Qualitative Research; D060728:Reproductive Health; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D014454:Uganda; D055815:Young Adult