Access to and use of sexual and reproductive health services among street children in Uganda: Does migration matter?

Abstract

Abstract; Background: While the nexus of migration and health outcomes is well acknowledged, the effect of rural-urban migration on use of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural-rural migration on the use of SRH services while controlling for confounding and whether there is a difference in the use of SRH services among migrant and non-migrant street children and young adults.Methods: Data were collected among 513 street children and young adults aged 12 - 24 years using face‐to‐face interviews using venue-based time-space sampling (VBTS). Using STATA 16.00, multivariate logistic regression analysis was performed to identify factors associated with SRH services use, with rural-urban migration status as the main predictor. We defined migrants as street children and young adults aged 12 - 24 years who migrated from rural districts and settled in Kampala city for a period of not more than 24 months preceding the survey.Results: Overall, 18.13% of the street children and young adults had ever used contraception/family planning, 45.89% had ever tested for HIV and knew their status while 34.70% had ever been screened for sexually transmitted infections (STIs). Migrant street children and young adults had reduced odds of using SRH services (HIV testing, use of FP and screening for STIs compared to non-migrant street children and young adults (aOR=0.59, 95%CI 0.36 - 0.97). Other factors associated with use of SRH services among street children and young adults include age (aOR=4.51; 95%CI 2.78 - 7.33), schooling status (aOR=0.34; 95%CI - 1.830 0.15-0.76), knowledge of place of care (aOR=3.37,95%CI 2.04 - 5.34) and access to SRH information (aOR=2.7, 95%CI 1.67 - 4.53). Conclusion: Access to and use of SRH services is low among migrant street children and adults compared to the non-migrant street children and young adults and is independently associated with rural-urban migration status, age, schooling status, knowledge of place of SRH care and access to SRH information. Our findings call for the need to design and implement multi-dimensional interventions to increase use of SRH services among street children and young adults while taking into consideration their migration patterns.