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Table 1 characteristics of included studies exploring barriers to access and facilitators of the utilisation of youth-friendly sexual and reproductive health services among the youth

From: Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review

Authors name and year Country Study settings Study design Aim and objective Approach Age and sex Findings CASP quality assessment
Mulaudzi et al. 2018 (50) South Africa Hospital Cross sectional To explore barriers to providing adolescent friendly sexual and reproductive health services Focus group discussion and semi structured interviews Both female and male Barriers; health care providers attitude, Counsellors reported inadequate training to address adolescent psychosocial issues, including adolescents-specific ages as counsellors High quality
Godia et al. 2014 (47) Kenya Health care facilities and youth centers Cross sectional Understanding of the SRH problems young people face and document perceptions of available SRH services as reported by young people themselves. explored experiences and perceptions of young people Focus group discussion and indepth interviews 15–24 boys and girls Barriers; in their responses were broad and reflect the cultural, social and economic environment in which they live
Facilitators; Recreational activities attract the boys. Increasing awareness through outreaches
Helamo et al. 2017 (42) Ethiopia Institutions Cross sectional Assesses factors affecting adolescents and youths friendly reproductive health service utilisation among high school students in Hadiya zone, Ethiopia Quantitative 15–24 years female and male Barriers; Youths with a good knowledge of the type of A/YFSRHS were more likely to utilize the service than their counterparts, utilisation levels were low and youth were unaware of the services being provided Medium
Ajike et al. 2016 (44) Nigeria Rural and urban Cross sectional The knowledge of youths on available adolescent/youth friendly services (A/YFRHS) in Ikeja, Lagos State, Nigeria Quantitative 15–24 years
boys and girls
Barriers; The participants knew what adolescent/youth friendly services were but did not know where to get these services from because they were not aware of the available A/YFRHS facilities High quality
Self et al. 2018 (48) Malawi Community Qualitative To explore the perspectives of youth and adults about the drivers and barriers to youth accessing family planning and their ideas to improve services Focus group discussion 15–24 years female and male Barriers; to youth accessing family planning included contraception misconceptions, the costs of family planning services, and negative attitudes. Parents had mixed views on FP, High quality
Atuyambe et al. 2015 (51) Uganda Urban and peri urban Qualitative To assess the sexual reproductive health needs of the adolescents and explored their attitudes towards current services available Focus group discussions 10–24 years male and female Recommendations; establishing adolescent-friendly clinics with standard recommended characteristics (sexuality information, friendly health providers, a range of good clinical services such as post abortion care High quality
Chandra-Mouli et al. 2013 (39) Tanzania Urban and rural Survey To extend the reach of Adolescent Friendly Health Services (AFHS) in the country Qualitative 15–24 years female and male Barriers; poor knowledge, it had received reports that the quality of the AFHS being provided by some organizations was poor High quality
        Recommendations/policy; standardized definition of AFS  
Zewdie et al. 2018 (49) Ethiopia In schools Cross sectional Young people’s perceptions and barriers towards the use of sexual and reproductive health services in Southwest
Focus group discussion 15–24 years female and male Barriers; poor perceptions about SRH, feeling of shame, fear of being seen by others, restrictive cultural norms, lack of privacy, in available services High quality
Rukundo et al. 2015 (52) Uganda Community Cross sectional Views concerning factors affecting availability, accessibility and utilization of teenager friendly antenatal services in Mbarara Municipality, southwestern Uganda Key informant interviews 15–19 years female and male Barriers; health workers described their experience with teenagers as challenging due to their limited skills when it comes to addressing adolescent-specific needs Medium
Eremutha et al. 2019 (40) Nigeria Rural and urban areas Stratified and purposive To generate increased understanding of the barriers that limit youth access to sexual and reproductive health services(SRH) offered by
Primary Health Care (PHC) facilities in Nigeria
Mixed method 10–24 female and male Facilitators; community mobilization for awareness creation and support on SRH issues will support youth to better access
Barriers; lack of awareness, negative attitude of health workers, cost of service and parents perception or fear
High quality
Betebebu Mulugeta et al. 2019 (53) Ethiopia Facility based Cross sectional To assess youth-friendly service quality and associated factors at public health facilities in
Arba Minch town,
Southern Ethiopia
Quantitative 15–19 female and male Facilitators; comfort and providers sex, waiting time, place of YFS, are factors which are significantly associated with client satisfaction in a health facility High quality
Ayehu et al. 2016 (43) Ethiopia Community Cross sectional To assess young people’s sexual and reproductive health service utilization and its associated factors in Awabel district, Northwest Ethiopia Quantitative 15–24 years male and females Facilitators; Young people from families of higher family expenditure, lived with mothers, participated in peer education and lived near to a Health Center were more likely to utilize SRHS at youth centers High quality
Binu et al. 2018 (6) Ethiopia School based Cross sectional To assess utilisation of Sexual and Reproductive Health (SRH) services and its associated factors among secondary school students in Nekemte town, Ethiopia Quantitative 10–24 years female and male Barriers; Inconvenient times, lack of privacy, religion, culture, and parent prohibition were barriers to SRH service uptake cited by the school youths Low
James et al. 2018 (35) South Africa Health facilities Cross sectional To detail the evaluation of AYFS against defined standards to inform initiatives for strengthening these services Qualitative 15–24 years male and female Barriers; Facilities had the essential components for general service delivery in place, but adolescent specific service provision was lacking especially the sexual and reproductive health services Medium
Geary et al. 2014 (41) South Africa Rural health facilities Survey Investigate the proportion of facilities that provided the Youth Friendly Services programme and examine healthcare workers’ perceived barriers to and facilitators of the provision of youth friendly health services Qualitative 12–24 years female and male Barriers; lack of youth-friendly training among staff and lack of a dedicated space for young people, health workers attitude, did not appear to uphold the right to access healthcare independently. breaches in young people’s confidentiality High quality
Motuma et al. 2016 (45) Ethiopia Community Cross sectional to assess the extent of youth friendly service utilization and the associated factors among the youth Mixed methods 15–24 years female and male Barriers; source of information and having knowledge about services were associated with utilisation, negative perception about counselling affected the outcomes High quality
Renju et al. 2010 (13) Tanzania Health facilities Survey A process evaluation of the tenfold scale up of an evaluated youth friendly services intervention in Mwanza Region, Tanzania, in order to identify key facilitating and inhibitory factors from both user and provider perspectives Mixed methods 15–24 years female and males Barriers; scale up faced challenges in the selection and retention of trained health workers and was limited by various contextual factors and structural constraints High quality
Obonyo Perez Akinyi 2009 (24) Kenya Community Cross sectional Examined how those factors determined or affected the utilization patterns of YFRHS by the youth. mitigating and addressing challenges to scale up Mixed methods 10–24 years female and male Facilitators; level of education, type of school and youth’s awareness about existence of reproductive health facility and services offered were significantly associated with utilization Medium
Uzoma 2017 (46)
Nigeria Health facility Cross sectional To assess the utilization of youth friendly health services by young people in Port Harcourt and factors that affect utilisation Mixed methods 15–24 years female and males Barriers; low knowledge levels
Facilitators; Friends/family/contemporary and notice board were major sources of information
High quality
Berhe et al. 2016 (54) Ethiopia Community Cross sectional Assess utilization of youth-friendly services and associated factors in Mekelle city Mixed methods 15–29 years females and males Barriers; negative attitude towards youth friendly service utilization
Facilitator; awareness and prior knowledge were predictors of utilisation
  1. Numbers in brackets in this table are corresponding number of articles retrieved from the inclusion criteria