Sociocultural factors influencing utilization of reproductive health services in selected South Sudan public health facilities

Background: Africa faces significant maternal health challenges, with nearly half of maternal deaths occurring in the region. Insufficient reproductive health services account for 18% of the global disease burden, disproportionately affecting women of reproductive age at 32%. Despite the benefits of family planning, only 13% of married women in Sub-Saharan Africa use contraceptives. This study aimed to identify sociocultural factors influencing the utilization of RHS in South Sudan's public health facilities. Methods: Using a mixed-methods approach, the research combined a longitudinal ecological study and an analytical cross-sectional study. Data from the South Sudan Ministry of Health (2015-2020) were reviewed, and community members and health professionals were surveyed across four levels of the health system in Western and Central Equatoria states. The study focused on women aged 15-49, with 384 respondents selected from various counties. Results: The study indicated that 72.5% of respondents utilized RHS, with family planning and STI prevention/management being the most common services (25.1% each). Maternal/newborn care and HIV counseling/testing followed at 18.1% and 15.3%, respectively. While RHS uptake increased overall, specific declines were noted in the third quarter of each year. Utilization was significantly higher among respondents aged 30 and older, urban residents, and those with higher educational levels. Conclusions: The study highlights a positive trend in RHS uptake but underscores the need to address declines in specific services. Age, residence, and education significantly influence RHS utilization. Policy interventions should consider South Sudan's unique sociocultural contexts and demographics. Enhancing education and awareness, especially in rural areas, is crucial to improving RHS access and reducing maternal mortality rates.