Adolescents’ Perspectives regarding their Communication with Reproductive Health Service Providers in Rwanda, An Explorative Study.

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Abstract Background: Adolescents in low-middle-income countries often face limited access to health information and services for several different factors like poverty, gender inequality, social-economic status, social norms, and tradition. Proper communication of sexual issues between adolescents and health care providers has been proven to be one of the strategies that could “encourage adolescents to avoid unprotected sexual intercourse thus reducing associated health risks while the ineffective communication between health care providers and adolescents silently exposes many of them to health risks. This study aims to assess adolescents’ perspectives regarding their communication with reproductive health service providers in Rwanda. Methods: A phenomenological exploratory qualitative study was used. Eleven focus group discussions were conducted among adolescents aged 10 to 19 years between December 2020 and January 2021. All participants were identified through their respective health care providers in youth-friendly centers available in the Kigali district representing the urban area and Kamonyi district representing the rural area. All interviews were transcribed and translated into English and analysed by using thematic content analysis. Results: The study attempted to explore adolescents' perspectives about their communication with sexual reproductive health service providers in Rwanda and found that those who were attending rural youth centers are well informed about sexual reproductive health, while the participants attending urban youth centers have inaccurate information about sexual reproductive health. They consider peer information to be their primary source of information, while youth-friendly services are ignored by many, who believe that those attending them are sex workers. A lack of communication between healthcare providers and adolescents was attributed to the judgmental attitudes of some healthcare providers, while good communication was cited by many adolescents as an important source of access to services. There have been reports of barriers to accessing health information resulting from cultural, uncomfortable environments and judgmental provider attitudes, while the physical distance between youth centers and homes, as well as poverty among some adolescents, have been mentioned. All adolescents were eager to access reproductive health services and be educated about reproductive health issues whereas they indicated that the way reproductive health services are delivered does not involve continuous health education about issues such as unintended pregnancy, HIV, and other sexually transmitted infections (STIs), and unsafe abortion. Conclusion: Reproductive health mass education should be delivered by health care providers regularly because adolescents have a lot of concerns related to the evolution of their bodies. Effective communication is essential when it comes to providing reproductive health services, as this establishes a strong relationship between a service provider and an adolescent who wants to talk about their concerns, while poor communication prevents adolescents from asking questions about unknown topics.

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