Disparities in Sexual and Reproductive Health Service Utilization and Associated Factors among Agrarian and Pastoralist Adolescents in South Omo Zone, Ethiopia: A Community-Based Comparative Cross-Sectional Study

Introduction: Around1.2 billion of the world’s population is adolescents aged between 10 and 19 years. In Ethiopia, pastoralists are about 12% of total population. Studies on sexual and reproductive health service uptake in Ethiopia have been conducted, but they hadn’t shown the disparity in service utilization between agrarian and pastoralist settings. Method : A community-based, comparative, cross-sectional study was conducted from May to June 2023. A multi-stage sampling technique was used, and 502 adolescents were randomly selected to participate in the study. The data were entered into Epi data 4.6 version and the analysis was performed using SPSS version 25. Bivariate and multivariate logistic regression analyses were performed. Significance was considered at P-value <0.05, in the multivariate analysis. Results: In total, 98.2% adolescents took part in the study. The overall utilization of SRH services was 27.4% (95%CI: 26.9, 27.8). There was a significant difference in SRH service utilization between agrarians 36% (95%CI: 35.5, 36.5) and pastoralists 18.7% (95%CI: 18.3, 19.1). Level of Education :- Uneducated Adjusted Odds Ratio (AOR=0.187, 95%CI 0.065, 0.536), father/mother encouragement (AOR=2.817, 95% CI 1.120, 7.089), parent discussion (AOR=3.729, 95% CI 1.315, 10.574), and distance to SRH service (AOR=3.645, 95% CI 1.423, 9.337) were determinants of adolescent SRH service utilization. Conclusion : Overall, ASRH service utilization in the study area was very low. Promoting father/mother encouragement and establishing SRH service centers at health institutions and school levels should be emphasized. The health sector and other stakeholders need to strengthen their efforts to establish SRH services near adolescents in places where they do not yet exist, in both agrarian and pastoralist areas.