Gupta Madhu, Bhatnagar Nidhi, Bahugana Pankaj
Associate Professor, Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Haryana and Punjab, India.
Indian J Public Health. 2015 Jan-Mar;59(1):9-17. doi: 10.4103/0019-557X.152846.
Adolescents are a heterogeneous, vulnerable, and sexually active group. Geographical and educational health disparities exist among urban, rural, and slum adolescents and among out-of-school and school-going adolescents, respectively. Adolescent reproductive and sexual health (ARSH) services should be implemented in a manner to minimize health inequities among them.
To ascertain the extent of awareness and utilization of ARSH services provided under reproductive and child health(RCH) program among adolescents in Chandigarh.
A cross-sectional study was conducted among 854 adolescents (402 household, 200 out-of-school, and 252 school-going adolescents) in Chandigarh using pretested validated interview schedule on awareness and utilization of adolescent reproductive and sexual health services from February to April 2011 in North Indian Union Territory of Chandigarh. Ordinal regression analysis was done to study the association of socio-demographic variables with awareness and utilization of ARSH. Results: Awareness about contraception and health services was significantly less among rural (12.7% and 1.1%, respectively) adolescents as compared to slum (17.9% and 4.6%, respectively) and urban adolescents (33.5% and 7.8%, respectively) (P < 0.05). Out-of-school adolescents were utilizing the preventive [odds ratio (OR) 0.39, P < 0.001] and curative services significantly lesser (OR = 0.54, P < 0.001) and had higher substance abuse (OR = 4.26, P= 0.006). Awareness was significantly associated with older age of adolescents (OR = 4.4,P < 0.001), poor education of father (OR = 0.5, P = 0.002), rural area (OR = 0.56, P = 0.001), and out-of-school status (OR = 0.35, P < 0.001).
Awareness and utilization of ARSH services was inequitable and was more among urban and school-going adolescents. Educational status was the most important factor affecting it.
青少年是一个多样化、易受伤害且性活跃的群体。城市、农村和贫民窟青少年之间以及失学青少年和在校青少年之间分别存在地理和教育方面的健康差异。青少年生殖与性健康（ARSH）服务的实施方式应尽量减少他们之间的健康不平等。
确定昌迪加尔市青少年对生殖与儿童健康（RCH）项目下提供的ARSH服务的知晓程度和利用情况。
2011年2月至4月，在印度北部联邦属地昌迪加尔市，采用预先测试并经验证的关于青少年生殖与性健康服务知晓程度和利用情况的访谈提纲，对854名青少年（402名居家青少年、200名失学青少年和252名在校青少年）进行了横断面研究。采用有序回归分析研究社会人口学变量与ARSH知晓程度和利用情况之间的关联。结果：农村青少年（分别为12.7%和1.1%）对避孕和健康服务的知晓程度明显低于贫民窟青少年（分别为17.9%和4.6%）和城市青少年（分别为33.5%和7.8%）（P<0.05）。失学青少年使用预防性服务的比例（优势比[OR]为0.39，P<0.001）和治疗性服务的比例（OR=0.54，P<0.001）明显较低，且药物滥用率较高（OR=4.26，P=0.006）。知晓程度与青少年年龄较大（OR=4.4，P<0.001）、父亲教育程度低（OR=0.5，P=0.002）、农村地区（OR=0.56，P=0.001）以及失学状态（OR=0.35，P<0.001）显著相关。
ARSH服务的知晓程度和利用情况存在不平等，城市和在校青少年中的情况更为突出。教育状况是影响这一情况的最重要因素。
