Predictors of Sexual and Reproductive Health Service Utilisation Among Adolescents in Uganda: A Multivariate Analysis

Adolescents’ utilisation of sexual and reproductive health (SRH) services remains inadequate in Uganda, despite numerous national initiatives aimed at enhancing access to adolescent-friendly health services. This study investigated the influence of health-seeking attitudes, perceptions, and preferences on utilising SRH services among adolescents in the Busoga region of Eastern Uganda. A cross-sectional survey design targeted 408 adolescents aged 13 to 19 years in the Iganga and Bugweri districts. Data were collected using structured questionnaires based on five-point Likert scales to measure variables related to attitudes, perceptions, and preferences concerning SRH services. Descriptive statistics summarised the data, while Pearson correlation and multiple linear regression analyses assessed the relationships and predictive power of the independent variables on SRH service utilisation. Findings revealed that health-seeking attitudes (β = 0.245, 95% CI [0.165, 0.325], p < .001), perceptions (β = 0.162, 95% CI [0.078, 0.246], p = .001), and preferences (β = 0.124, 95% CI [0.035, 0.213], p = .007) significantly predicted adolescents’ SRH service use. Positive attitudes, perceptions of accessibility, confidentiality, and preferences for youth-friendly services were key determinants. Perceptions of accessibility, confidentiality, and provider friendliness significantly shaped adolescents’ willingness to utilise SRH services. Moreover, preferences for youth-friendly services, such as flexible operating hours, same-sex providers, and non-judgmental communication, complemented the effects of attitudes and perceptions. The study concludes that strengthening adolescent-centred interventions that enhance trust, improve perceptions of service quality, and align service delivery with adolescents’ preferences is critical for enhancing SRH service utilisation. These findings offer essential insights for policymakers, health practitioners, and stakeholders seeking to design responsive and inclusive SRH programs tailored to adolescent needs.