Factors associated with knowledge about family planning and access to sexual and reproductive health services by sexually active immigrant youths in Hillbrow, South Africa: a cross-sectional study

Abstract

In South Africa, universal access to health care services, including those relating to sexual and reproductive health (SRH) care, is contained in Section 27 of the Constitution and commits the country to supporting the United Nations 2030 Agenda for the Sustainable Development Goals (SDGs). The objective of this study was to examine the factors associated with knowledge about family planning and access to SRH services among sexually active immigrant youths in Hillbrow, South Africa. This cross-sectional study was based on data from a household survey conducted in Hillbrow during December 2019. Interviewer-administered questionnaires were used to collect information from immigrant youths (18–34 years old). Data on 437 sexually active respondents was analysed in STATA 14 using univariate, bivariate, logistic, and multinomial regression models. A p-value of < 0.05 was chosen as the level of significance. About half of the respondents had poor knowledge about family planning; about one-third (35%) of the immigrant youths had no access to SRH services, 42% had some access, and 23% had access. The adjusted logistic regression model showed that being a female (AOR = 3.85, CI: 2.34–6.35, belonging to age group 30–34 years (AOR = 3.88, CI: 2.00–7.53); belonging to the rich wealth index (AOR = 2.55 (1.32–4.93); not having received information about family planning (AOR = 0.17, CI = 0.10–0.29) and not using a contraceptive at the time of the survey (AOR = 0.37, CI: 0.19–0.70) were factors associated with having knowledge about family planning. The adjusted multinomial regression shows that the factors associated with not having access to SRH services were secondary or higher level of education (ARRR = 1.89, 95% CI = 1.06–3.36), belonging to the rich wealth quintile (ARRR = 2.25, 95% CI = 1.00–5.07), being undocumented (ARRR = 0.49, 95% CI = 0.27–0.88), having experienced discrimination in Hillbrow (ARRR = 2.06, 95% CI = 1.15–3.67) and having received information about family planning 6 months prior to the survey (ARRR = 0.49, 95% CI = 0.26–0.90, p-value < 0.05). To move towards realization of the Constitution of South Africa, achieve the SDGs, and curb associated negative SRH outcomes, there is a need to advocate for the implementation of universal access to SRH services that is inclusive of immigrant youths.