title: Utilization of youth friendly services and associated factors among youth in Harar town, east Ethiopia: a mixed method study.
abstract: Youth friendly services are designed to make health services accommodate the unique needs of youth. Nevertheless, in developing countries like Ethiopia, the level of knowledge about the use of these services is limited. The main aim of this study was to assess the extent of youth friendly service utilization and the associated factors among the youth.
  
  
  
  A community based- cross sectional quantitative study design supplemented with qualitative inquiry was used from January to February 2011. Data were collected from a random sample of 845 youth using a pretested structured questionnaire. Qualitative data were collected through interview guides. Odds ratios, along with 95 % confidence level, were estimated to measure the strength of association between the study variables using multivariable logistic regression. Level of statistical significance was declared at p-value less than 0.05. Thematic analysis was used to analyze the qualitative data.
  
  
  
  Nearly 64 % of the youth had already utilized youth friendly services at least once at the time of the survey. In multivariable logistic regression analysis, using friends [AOR = 3.65, 95 % CI (1.81,7.32)], health care providers [AOR = 3.27, 95 % CI (1.18,9.00)], and schools [AOR = 1.79, 95 % CI (1.00,3.19) as source of information, and having knowledge about the youth friendly services [AOR = 2.77,95 % CI (1.93,3.96)] were significantly associated with the utilization of youth friendly services. In contrast, being daily laborer and private worker by occupation [AOR = 0.12, 95 % CI (0.05, 0.92)], having negative perception about counseling [AOR = 0.50, 95 % CI (0.31-0.80)], about reproductive health services [AOR = 0 .13, 95 % CI (0.04-0.46)], and about youth friendly service providers [AOR-0.02, 95 % CI (0.08-0.50)] negatively influenced the outcome variable.
  
  
  
  The utilization of youth friendly services is moderate in this study. Getting youth related services information from different sources and being knowledgeable about the services have increased the utilization of the services. Efforts should be made by all relevant stakes to create conducive environment for the youth through training of the youth service providers, particularly for those who work in the government institutions, and strengthening of the awareness creation strategies among the youth to increase the utilization of the services.
authors.affiliation: School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box. 235, Harar, Ethiopia.
authors.forename: Aboma
authors.initials: A
authors.lastname: Motuma
authors.affiliation: Department of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box. 235, Harar, Ethiopia.
authors.forename: Thomas
authors.initials: T
authors.lastname: Syre
authors.affiliation: Department of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box. 235, Harar, Ethiopia. gudina_egata@yahoo.com.
authors.forename: Gudina
authors.initials: G
authors.lastname: Egata
authors.affiliation: School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box. 235, Harar, Ethiopia.
authors.forename: Abera
authors.initials: A
authors.lastname: Kenay
mesh_terms: D000293:Adolescent; D003153:Community Health Services / Q000706:statistics & numerical data*; D003376:Counseling; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D017144:Focus Groups; D006282:Health Personnel; D006801:Humans; D008297:Male; D011369:Professional-Patient Relations; D034121:Reproductive Health Services / Q000706:statistics & numerical data; D012574:Schools; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Ethiopia; Reproductive health; Utilization; Youth friendly services