Abiso Temesgen Lera, Kerbo Amene Abebe, Woticha Eskinder Wolka
School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Wolaita, Ethiopia.
Front Reprod Health. 2025 Aug 18;7:1562495. doi: 10.3389/frph.2025.1562495. eCollection 2025.
Sexual and reproductive health (SRH) services are essential for promoting the wellbeing of individuals and communities. Achieving universal health coverage is unattainable without ensuring equitable access to SRH services and upholding sexual and reproductive rights. Podoconiosis, a neglected tropical disease and non-filarial form of elephantiasis, is caused by prolonged barefoot exposure to irritant volcanic soils. Although SRH services have been increasingly integrated into primary healthcare systems in Ethiopia, people affected by podoconiosis continue to face substantial barriers in accessing these services due to stigma, mobility limitations, and socioeconomic constraints. In this context, the present study aims to assess the utilization of SRH services and the factors associated with their utilization among patients with podoconiosis in Wolaita Zone, South Ethiopia.
A community-based cross-sectional study was conducted among 836 patients with podoconiosis in Wolaita Zone from 12 November to 20 December 2024. Multistage sampling was used to select participants, and data were collected through face-to-face interviews. A multilevel logistic regression analysis was performed to identify the factors associated with SRH service utilization. Statistical significance was set at < 0.05, and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported.
The study found that 154 respondents (18.4%; 95% CI: 16%, 21%) utilized SRH services within the past 12 months. The factors significantly associated with SRH service utilization included the following: age groups 18-29 years (AOR = 3.57; 95% CI: 1.55-8.25), 30-34 years (AOR = 2.89; 95% CI: 1.30-6.40), and 35-39 years (AOR = 5.06; 95% CI: 2.45-10.45); prior experience with health services (AOR = 2.39; 95% CI: 1.56-4.93); family awareness of podoconiosis etiology (AOR = 3.60; 95% CI: 2.13-6.21); positive attitude toward SRH services (AOR = 5.80; 95% CI: 3.16-10.70); family support (AOR = 2.47; 95% CI: 1.47-4.14); and autonomy in using household financial resources for healthcare (AOR = 2.05; 95% CI: 1.18-3.57).
The utilization of SRH services among patients with podoconiosis was found to be low. The significant factors associated with SRH service utilization included the age of respondents, prior experience with health services, family awareness of podoconiosis etiology, family support, autonomy in using household financial resources for healthcare, and positive attitudes toward SRH services.
性与生殖健康（SRH）服务对于促进个人和社区的福祉至关重要。如果不能确保公平获得SRH服务并维护性与生殖权利，就无法实现全民健康覆盖。足分支菌病是一种被忽视的热带疾病，属于非丝虫性象皮病，由长期赤脚接触刺激性火山土壤引起。尽管SRH服务已越来越多地纳入埃塞俄比亚的初级医疗保健系统，但由于耻辱感、行动不便以及社会经济限制，受足分支菌病影响的人们在获得这些服务方面仍然面临重大障碍。在此背景下，本研究旨在评估埃塞俄比亚南部沃莱塔地区足分支菌病患者对SRH服务的利用情况及其相关因素。
2024年11月12日至12月20日，在沃莱塔地区对836名足分支菌病患者进行了一项基于社区的横断面研究。采用多阶段抽样方法选择参与者，并通过面对面访谈收集数据。进行多水平逻辑回归分析以确定与SRH服务利用相关的因素。统计学显著性设定为<0.05，并报告调整后的优势比（AOR）及95%置信区间（CI）。
研究发现，154名受访者（18.4%；95%CI：16%，21%）在过去12个月内利用了SRH服务。与SRH服务利用显著相关的因素包括：18 - 29岁年龄组（AOR = 3.57；95%CI：1.55 - 8.25）、30 - 34岁年龄组（AOR = 2.89；95%CI：1.30 - 6.40）和35 - 39岁年龄组（AOR = 5.06；95%CI：2.45 - 10.45）；既往医疗服务经历（AOR = 2.39；95%CI：1.56 - 4.93）；家庭对足分支菌病病因的认知（AOR = 3.60；95%CI：2.13 - 6.21）；对SRH服务的积极态度（AOR = 5.80；95%CI：3.16 - 10.70）；家庭支持（AOR = 2.47；95%CI：1.47 - 4.14）；以及在使用家庭财务资源用于医疗保健方面的自主权（AOR = 2.05；95%CI：1.18 - 3.57）。
研究发现足分支菌病患者对SRH服务的利用率较低。与SRH服务利用相关的显著因素包括受访者的年龄、既往医疗服务经历、家庭对足分支菌病病因的认知、家庭支持、在使用家庭财务资源用于医疗保健方面的自主权以及对SRH服务的积极态度。
