Negotiating Access to Sexual and Reproductive Health Services: The experiences of Young Ugandan Women

Objectives: The healthcare needs of young people, particularly young women in African countries, are as important as ever. As the concept of Sexual and Reproductive Health (SRH) becomes increasingly acknowledged as vital for global development, it is of immense importance to understand how young women recognise and meet their SRH needs. Uganda provides a representative context to explore these issues with a view to eliciting the multiple strategies young women adopt to overcome obstacles they may face. With a greater understanding of their needs and ways of negotiating access to care we can begin to develop pragmatic solutions to these complex issues. Methods: We conducted semi-structured interviews and focus group discussions with 15-24 year old women in- and out-ofschool in Wakiso District, Uganda to investigate their strategies for accessing SRH services. Results: SRH needs were frequent and although lay-persons were often consulted for advice, most young women preferred to access biomedical advice and treatment. However, financial limitations often blocked access and diverted informants to traditional medicine, especially for abortions. Even without a financial barrier young women may be denied services due to their age and perceived immaturity. Conclusions: Young women use diverse strategies to negotiate multiple barriers along their pathways to care and some can lead them to greater risk or cost. Only with enhanced education of individuals, healthcare professionals and society alongside increased healthcare spending and implementation of key policies will young women be able to address these essential needs.