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Table 2 Themes, sub-themes and sample illustrative phrases or sentences of quotes showing barriers to using AFSRHs, Hossana Town, Sothern Ethiopia, March 2020

From: What do service providers in Southern Ethiopia say about barriers to using youth-friendly sexual and reproductive health services for adolescents?: Qualitative study

Themes Subthemes Sample codes Sample illustrative phrases /sentences of quotes
Provider level barriers Poor provider competency Providers lack knowledge […] I was very much confused. I tried to... […]
[…]... worry about of HIV /AIDS but, for pregnancy."
[…]If I had understood his feeling, I would have helped him. […]
Providers had negative attitude […] I face problem when educating female servants. […]
Providers lack communication […]“Are you expecting me to say just I am going to eat it? [..]
[…]... providers often do not use a direct language. […]
Confidentiality breach, disrespect and discrimination of adolescents Provider breach confidentiality […]... problem of keeping confidentiality of adolescents’ sexual... […]
[…] I will tell his secrete to his family. […]
Providers disrespect adolescents […]... perform abortions without proper counseling and without looking at other options. […]
Provider discriminate by sex […]... facilities to seeking help for STI problem. Unfortunately,... […]
Providers' lack of follow-up Providers lack follow-up [..]... the service. I referred to but I don’t know their fate […]
Adolescent level barriers Fear to violation of confidentiality and cultural taboos Adolescents fear confidentiality breach […]…are afraid of losing their privacy and confidentiality. […]
Adolescents fear providers […] They felt fear and shame. […]
Lack of information and attitude towards SRHs Adolescents lack knowledge […]They don’t worry about the side effects of post pills. […]
Adolescents lack attitude [..]Many adolescents developed low perceived risk of severity… […]
Preference to seeking care and peer influence Adolescents resist advices […] But, they [adolescents] don’t want to do this [ sexual abstinence].”
Adolescents’ decision is influenced by peers […] I see that adolescents are influenced by peers. […]
Financial constraints Adolescents lack money […]... dependent on family income. They lack transportation cost…[…]
Health facility level barriers Lack of supply and unsupportive environment Shortage of supplies […]… many resources and supplies required to provide services. […]
No entertainment […] …can’t say that youth friendly sexual and reproductive […]
Adolescents lack privacy […]… service itself is not youth friendly at all. […]
Inadequate staff and training Shortage of trained providers […] We intentionally placed the clinic… […]
Lack training for providers […]Health extension workers like me should be trained on SRHs. […]
Long waiting and inconvenient working time Long waiting time [..] I guess waiting time is very high. […]
Community level barriers Community ‘s bad attitude and lack information Poor community awareness […]Why do employers prevent such adolescents from going to youth health centers?[…]
Community negative attitude […]…are considered rude, but those who enter the church are considered polite…[…]
Lack of parental and social support Parents lack discussion […]Parents and teachers don’t talk about sexual and …[…]
Church lack discussion […] …settings especially in “Adar program”. […]
Inadequate support to schools and youth centers Teachers lack help […]Reproductive health clubs in the school are not functional. […]
Youth centers were closed […]…youth centers which were promoting utilization of SRHs were closed
[…]
Inadequate literacy of sexual health Lack of curriculum "I suggest that curriculum should be designed and educated… […]
Presence of unauthorized providers Unauthorized providers provide contraception service […] They don’t want to go to healthcare facilities for… […]
Health system level barriers Poor implementation Government lack commitment [..] Ehh ! I noticed that unemployment is a challenge for not… […]
[…]But, when such programs phased out; activities of peer… […]
Strategy doesn't address adolescents' need [..] I think that this strategy has to be revised…[…]
Poor multi-sectoral engagement Lack of multi-sectoral collaboration […]…were providing various sexual and reproductive health services through collaboration.[…]