Urban‒rural differences and determinants of utilization of sexual and reproductive health services among males in Anambra State, South-eastern Nigeria.

INTRODUCTION

Males have substantial sexual and reproductive health (SRH) needs, but there is low utilization of these SRH services. We compared the utilization and ascertained factors associated with the utilization of sexual and reproductive health services among males in urban and rural areas of Anambra State, Nigeria.

METHODS

A community-based cross-sectional study was conducted in Anambra State. Using multistage sampling, 1147 respondents were surveyed via interviewer-administered, structured questionnaires. Data was collected on socio-demographic characteristics, utilization of, and factors associated with the utilization of SRH services. We compared differences in the utilization of SRH services among males using Z test. Simple binary logistic regression analysis was performed to obtain odds ratios and 95% confidence intervals of the crude associations between each predisposing, enabling, and need factor and the utilization of male SRH services. Factors that had a p-value of ≤ 0.05 in the bivariable analysis were included in a multivariable logistic regression analysis to ascertain the independent association between each factor and the utilization of SRH services while controlling for the other factors. The level of statistical significance was set at < 0.05.

RESULTS

The mean age of the respondents was 28.00 ± 9.35 years. There was a low level of utilization, with males in rural areas (35.6%) having a higher level of utilization than males in urban areas (27.0%). Rural location, older age, higher educational level, communication with sexual partner, access to SRH information, exposure to SRH information on mass media, access to health insurance, being sexually active, feeling susceptible to SRH diseases, and having a diagnosis of SRH disease in the last 12 months were positively associated with the utilization of male sexual and reproductive health services. Marital and employment status, number of children, number of sexual partners and recent sexual intercourse were negatively associated with the utilization of male sexual and reproductive health services.

CONCLUSION

There is suboptimal utilization of SRH services in Anambra State, Nigeria. Interventions targeting these identified factors could increase the utilization of male sexual and reproductive health services in such settings.