Journal Article

Differential use of adolescent reproductive health programs in Addis Ababa, Ethiopia

Purpose
Adolescent reproductive health programs in Africa have largely remained as small-scale pilot programs, however, there is increasing interest in bringing programs to scale. Evaluations have focused on individual programs and few have gathered population-based information on the reach of program models and the profile of adolescents who utilize services, versus those who do not. This study examines the coverage and utilization of existing adolescent programs in Addis Ababa, Ethiopia.

Methods
Population-based surveys were undertaken among over 1,000 adolescents aged 10-19 years in slum areas of Addis Ababa, Ethiopia. An inventory of youth programs including youth centers and peer education programs was compiled in the study area.

Results
Eight peer education programs and six youth centers were operating in the study area. Twenty percent of boys and only 7 percent of girls had visited a youth center in the last year; 27 percent of boys and 15 percent of girls had had contact with a peer educator. Older adolescents, especially boys, were more likely to utilize programs. Girls who work long hours and who are isolated are less likely to access and benefit from programs.

Conclusions
Greater segmentation of the adolescent population is needed in the design and content of adolescent reproductive health programs. In addition, programmers should pay attention to the specific circumstances of young people in local settings, particularly vulnerable, hard-to-reach sub-groups of adolescents, including girls.