Evaluating Sexual and Reproductive Health of Reproductive Age women in Dhaka City

Background Sexual and reproductive health (SRH) is fundamental to women's well-being and a key component of human rights. In urban Dhaka, despite health infrastructure improvements, reproductive-age women face multiple barriers such as poverty, low health literacy, and sociocultural constraints in accessing SRH services. Prior studies have focused largely on rural contexts, leaving a gap in urban-specific data necessary for effective policy and program design. Objective This study aims to evaluate the sexual and reproductive health practices, perceptions, and service utilization among reproductive-age women in Dhaka. Method A cross-sectional study was conducted among reproductive-age women (15–49 years) in Dhaka. Data on demographic variables, reproductive history, SRH knowledge, and service utilization were collected and analyzed using descriptive statistics, chi-square tests, and binary logistic regression to determine associations between sociodemographic factors and SRH service use. Result Among 384 of participants, the mean age was 27.71 years. SRH service utilization was high (73.4%), with pharmacies and private hospitals being the main sources. However, 59.1% never discussed SRH topics, and only 45.3% were aware of specialized services like HIV testing and cervical cancer screening. Higher education levels correlated with better SRH knowledge and utilization. Logistic regression revealed that women aged 25–34 (COR = 14.49, p  < 0.001) and ≥ 35 (COR = 5.89, p  = 0.004), widowed status (COR = 1.88, p  = 0.027), and employment were significantly associated with higher service use. Women living with partners or never discussing SRH topics were significantly less likely to utilize services. Conclusion Despite relatively high SRH service utilization in urban Dhaka, substantial gaps remain in SRH knowledge, early sexual initiation, and communication. Key sociodemographic factors including age, marital and employment status, and interpersonal communication strongly influence SRH service use. Targeted, culturally sensitive interventions promoting SRH education and dialogue, especially among young, married, and unemployed women, are essential to improving reproductive health outcomes in urban Bangladesh.