http://www.inosr.

net/inosr-arts-and-humanities/
Mulegi et al
INOSR ARTS AND HUMANITIES 9(1): 35-47, 2023
©INOSR PUBLICATIONS
International Network Organization for Scientific Research ISSN: 2705-1676

Assessment of the level of knowledge and awareness of women on

sexual and reproductive health services (SRH) under decentralization in
Kampala Uganda
1
Tom Mulegi, 2Ndagire Laila, 2Mwaniki Roseanne and 2Eleanor Kirahora
Barongo
1
Department of Political & Administrative Studies, College of Humanities and Social
Sciences, Kampala International University, Uganda.
2
Department of Development, Peace & Conflict Studies, College of Humanities & Social
Sciences, Kampala International University, Uganda.
ABSTRACT
This is an assessment of the level of knowledge and awareness of women on sexual and
reproductive health services under decentralization in Kampala Uganda. It examined
knowledge and perceptions about SRH. Kyanja parish in Nakawa division which is located
in Kampala district was purposively selected as the study area. A purposive and simple
random sampling techniques were used in selecting 77 respondents from the 5 zones in
the parish. The study was cross-sectional and it employed both qualitative and quantitative
methods of data collection. The results of the study reveal that respondents understood
SRH in different ways. Majority of the respondents believe that SRH is a general
reproductive health care among women. However, some men think that women who seek
for SRH are immoral something that limit most women from seeking for such services on
time. There is need to address the existing gender and social cultural factors that limit
women’s liberation.
Keywords: Assessment, knowledge, awareness, women and sexual reproductive health
(SRH).
INTRODUCTION
Sexual and Reproductive Health (SRH) is a having access to sexual and reproductive
state of complete physical, mental and information and services, free from
social well-being and not merely the violence and discrimination. Knowledge
absence of diseases, in all matters about Sexual and Reproductive Health
relating to the reproductive system and to amongst women and girls is an important
its functions and processes [1]. Thus SRH step towards getting access to and
implies that people are able to have a utilization of related information and
satisfying and safe sex life and that they services in a timely and effective manner
have the capability to reproduce and the [4]. However knowledge and level of
freedom to decide if, when and how often awareness among women and girls across
to do so. Sexual and Reproductive Health the globe on specific areas of SRH
entails various services which includes; information and its related services have
family planning, counseling, sexual varying levels based on a number of
health education, HIV testing, diagnosis factors. According to [5]. These include;
and treatment of sexually transmitted geographical area and surrounding
illnesses as well as antenatal, delivery and environment, age, economic status among
postnatal care services [2]. According to others. A study carried out on
[3], the right to SRH also means that determinants of adolescents reproductive
everyone should be entitled to control health service utilization in Ethiopia by
their own health and body, including [2] asserts that, unlike married women

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who are often specifically interested in promote sexual and reproductive health
seeking for SRH information and services service uptake among women and girls,
like family planning, antenatal, delivery its utilization remains very low. For
and postnatal care services, adolescent instance, according to 2016 Uganda
girls below 18 years on the other hand are Demographic Health Survey, there is a
often interested in SRH services such as dramatic knowledge gap among the youth
counseling, sexual health education and on contraceptives, pregnancy related
information of contraceptive. In line with information and HIV/AIDS. Therefore, due
the above, [6] adds on that knowledge on to limited knowledge of contraceptive use
SRH also differs based on geographical coupled with poor access to sexual and
location, where they contest that SRH reproductive health care services, young
knowledge seeking behavious between people engage in unprotected sex to
most developed countries differs satisfy their sexual desires and curiosity
dramatically from those women and girls and at the end, they become victims of
in developing countries. Where the level HIV and unwanted pregnancy. For
of awareness and knowledge on SRH is instance, [15] statistics showed that one
often high in developed countries and low in 4 (25%) girls aged 15-19 have begun
in developing countries especially those childbearing and also a high number of
in Africa. This could be the reason why them have been affected by HIV/AIDs due
90% which is approximately 10.8 million to low knowledge on contraceptive and its
out of 12 million of unplanned pregnancy use. Furthermore, by the fact that Uganda
do happen among women and girls is a culturally rich nation with vast
developing countries with highest kingdoms, norms are still highly
prevalence being in sub-Saharan Africa, respected and the majority of women are
where out of these unintended confined in private sphere to perform
pregnancies about 5.6 million are aborted domestic and agricultural based work,
with about 3.9 million using unsafe hence leaving them with little or no time
means due to lack of adequate knowledge to seek for SRH something that limit their
on SRH [1]. Scholars such as [7]; [8]; [9]; knowledge on available services and SRH
[10]; [11] have given an account into the information [16]. For instance, according
causes of low level of knowledge on SRH to [17], women and girls do the large
among women and girls, where a number majority of unpaid care work, typically 5
of factors ranging from individual times more than men. The population
behavior, socio-cultural to religious as especially in poor rural areas households
well as due to low socio-economic status spend least 5-6 hours per day on basic
and infrastructural development have care needs of the household which limits
been cited to be the leading causes of low their participation in productive or
levels of knowledge on SRH. However, development work including seeking for
government policies such as lack of SRH information and services that could
formal and comprehensive sex education enhance their health [17]. Due to such
in schools in some countries where patriarchal practices most women have
Uganda is inclusive has also been stated been denied their rights specially, the
by [12]; [13] to be the contributors. On the right to work, the right to have the
other hand lack of parental involvement number of children they desire to have
in the sexuality education of their and rights to seek for health including
children also plays a key role in limiting SRH in desired places. As such in most
knowledge acquisition as they grow up cases women have been forced to produce
[14]. With this parents are failing to be children to fulfil the man’s desire making
prominent socializing agents of sexuality Uganda one of the country with highest
for their children. This in turn adversely fertility rate in the world with about 4.895
affects adolescents as they transits into births per woman in 2019 though this had
adulthood [14]. In Uganda, despite policy a 2.3% decline from 2018 which was 5.010
actions and strategic efforts made to births per woman and a 2.98% decline

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INOSR ARTS AND HUMANITIES 9(1): 35-47, 2023
from 2017 [1]. According to [18], this has why maternal mortality rate (MMR) in
persistently declined from 7.1 children Uganda has remained high at 343 per
per woman in 2006 however, despite the 100,000 live births [19]. Approximately,
above, the number of women attending 16 women die every day in Uganda as a
antenatal clinics has been very low result of pregnancy related complications
partially due to gender and social cultural due to inadequate knowledge, access and
factors. This could be one of the reasons utilization of SRH [15].
Aim of the study
To assess the level of knowledge and decentralization in Kampala district,
awareness of women on sexual and Uganda.
reproductive health services under
Research Question
What is the level of knowledge and reproductive health services under
awareness of women on sexual and decentralization?
METHODOLOGY
Research design
Given the nature of the study, a cross- which was developed in reference to the
sectional design was adopted. This design stated objectives. According to [21]
is normally used in situations where the mexed methods are compatible and can
population of study is large and is be used at the same time. Qualitative
examined at a single point in time [20]. It methods was used because some SRH
also involves collection of data on more challenges especially those that related
than one case at a single point in time in with culture may not be not be quantified
order to gather a body of quantifiable while quantitative methods was used for
data in connection with two or more quantifiable information. Although the
variables, which are then examined to study focuses mainly on women in child
detect their pattern of association [20]. bearing age, some male key informants
Hence it is suitable for the proposed particularly the doctors and local leaders
study. The study also employed a mixed will also be consulted for purposes of
approach of both qualitative and analyzing gender asymmetries without
quantitative methods of data collection bias. This helped in bringing out a clear
and analysis. The methods include, use of picture on gender factors.
questionnaires and in-depth interviews
Area of study
The study was carried out in Kyanja 5 km from the nearest health facility,
parish which is located in Nakawa whether public or private. Because of this
division in Kampala district. Kyanja one reason, a good number of residents gets a
of the 23 parishes that make up Nakawa challenge in seeking for health care, more
division, one of the five administrative so sexual and reproductive health care
divisions that make up Kampala district. services. Apart from this, there are other
It is located approximately 8 km by road, factors such as cultural, social and
North West of Kampala city center economic factors that hinder access and
(Kampala Capital City Authority [22]. utilization of SRH care services, though
According to Uganda Bureau of Statistics, little has been done to investigate on this,
despite Kyanja parish being in a formal hence the need to carry out a study for
developed settlements, majority (about furtherinvestigation.
15%) of households are located more than

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Source: Modified from:

http://www.mcgill.ca/mchg/projects/edible/kampala/kampalainfo/Figure 1: Map with
administrative boundaries of Kampala districts showing the study area (Nakawa)
Study population
The target population in this study was of research assistants, particularly the
comprised of 64 women who are in their trained midwives from the area of study.
reproductive age of 15-49 years. These Other groups included key informants
included both the singles and those that such as; health officials, medical staff
are married. About 13 key informants will such as gynecologist and midwives,
also be included. These groups of traditional birth attendants, TBA’s and
respondents will be selected by the help local leaders in the area.
Sampling methods
This study employ simple random and leaders. In-depth interviews was used in
purposive sampling techniques to select gathering the required information from
the required number of respondents. these key informants. On the other hand,
Purposive sampling technique was used in random sampling technique was used in
selecting key informants in different selecting women in child bearing age
villages within the parish. These included; where information about the challenges
health officials, medical staff especially, they face with regard to access and
such as nurses and doctors as well as the utilization of SRH services were collected
traditional birth attendants and local usingquestionnaires.
Sample Size
[23], defines a sample as a subset of [24]. Therefore out of this number, 11.4%
predetermined size from a population of error margin was considered to select a
interest. According to the 2014 Uganda sample size of 61 respondents. This was
housing and population census, Nakawa arrived at using Yamane (1967) formula
division has a total population of 317,023 shown below,

Where;
n= sample; N= Population = 317,023;
e= Error margin of 11.4%
n = 317,023/ 1+ 317,023 (0.11392)

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n = 317,023/ 4,117.163
n = 77.00035
n=77 respondents
These participants were distributed as illustrated in the following proposed
accordingly based on [24] sampling tables sample structure table;
Table 1: Sampling structure
Structure Category Method used Target Actual
Number selection
Survey 55 48
Women (questionnaires)
Child bearing age 1 FGD of 8 married 8 8
women
1 FGD of 8 women 8 8
who were not in
marriage
Key Women (2 doctors, 2 TBAs and 2 In-depth 8 8
informants nurses/midwives, 1 interview
representatives from NGOs, 1
local leader)
Men (2 doctors, 2 opinion In-depth interview 5 5
leaders, 1 local leader)
Total 84 77

Research Instruments
The current study employed two research various aspects influencing access to and
instruments. These include; key utilization of SRH care services were
informant interview guides for key gathered. The key informant guide was
informants and questionnaire for women used during the consultations with the
in childbearing age. The questionnaires providers of health services for example,
were administered on a randomly selected doctors such as gynecologists, medical
sample of women in child bearing age assistants, nurses, midwives, TBA,
who are the main target groups in this opinion leaders and local leaders.
study. Using these tools, responses on
Validity and reliability of instruments
According to [25], validity is the best extent to which instruments produces
available approximation to the truth or consistent scores when the same group of
falsity of a given inference, proposition or individuals is repeatedly measured under
conclusion. While reliability measures the the same conditions.
Validity testing
According to [25], validity is the best the supervisor. For instance, a small
available approximation to the truth or group of experts were specifically
falsity of a given inference, proposition or requested to answer some questions from
conclusion. Validity in the current study the draft questionnaire by indicate
was measured through Content Validity whether the items used in the study
Indices test (CVI). With this, instruments adequately addresses the study objectives
were revised based on the feedback from or not. The CVI was arrived at using the
experts in the field of SRH as well as from followingformula.

R
CVI =
N
Where CVI = Content Validity Index R = Number of respondents rating all
items in the instruments as relevant

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N = Total number of respondents The tools were acceptable as valid if CVI
participating in the pilot study (Those from the calculations that was 0.70 or
who rate all items as relevant (R) plus higher as recommended [26].
those that rate some as Irrelevant (IR).
Reliability testing
Reliability refers to consistency or repeatedly measured under the same
reproducibility of measurements. conditions. The pilot was tested on few
Reliability of instruments in the current respondents and the results were not
study was determined using a test- retest included in the final study. A Cronbach
method which was done within a time alpha reliability test was carried out and
lapse of one week. According to [27], test- only the alpha coefficient of less than 0.5
retest reliability can be used to measure (<0.5) would be accepted as a measure of
the extent to which instruments are reliability of tools as recommended by
expected to produce consistent scores [26].
when the same group of individuals is
Data Sources
Both primary and secondary sources were from respondents in the field. While for
used. For primary sources, data was secondary data, articles and literature
collected through in-depth interviews reviews from different scholars were
with key informants and questionnaires reviewed to supplement primary sources.
Data Management and analysis
Qualitative data from interviews were stored on a backup device like a flash
immediately organized in line with the disk or an external hard drive for
study objectives on what we would have emergency cases if any. Simple
discussed during the meetings to limit descriptive tabulations of the coded data
errors or misinterpretations. In case there was carried out, where frequency,
is any recorded data, transcriptions were percentages and means were generated.
undertaken to transform the collected Further cross tabulations were performed
information into a well-organized to establish the relationship between
interpretations. Data from open-ended demographic information and various
questions were captured into Microsoft challenges associated with access to and
spread sheet, whereby they were utilization of SRH services. This data were
categorized and coded to check for errors presented in form of frequency
and inconsistence. These data were later distribution tables for the cases of
exported into Statistical Package for Social quantitative data while qualitative data
Sciences (SPSS), where they were stored were presented thematically.
before analysis. A copy of data was
Ethical Considerations
Ethical consideration in this study were of participants, a verbal consent was
great concern and therefore specific ways obtained from each participant.
were articulated during the research  Research subjects were respected and
processes to ensure integrity, ethics and informed fully about the purpose,
quality of research. For instance;- methods and intended possible use of
 Approval to conduct the research was the research findings.
obtained from the University before  The confidentiality of information
proceeding to the field. The researcher unveiled by research subjects and the
also informed local leaders in the area anonymity of respondents were also be
of study about the intention of the respected.
study. At this level a permission was  The participation of study subjects in
also obtained from them in form of this study was done on a voluntary
written consent before conducting the basis and free from any coercion and
study in the area. On the other hand, harm.
before the participation of different

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Limitations of the Study

Basing on the sensitivity of this study, However, a thorough explanation on
much more time was required to finish up intended use of the findings was done
data collected as many respondents were hence the anonymity of each set of data
not comfortable in disclosing their collected and treated with utmost
personal sexual health information confidentiality.
despite the challenges experienced.
RESULTS AND DISCUSSION OF FINDINGS
Socio-demographic characteristics of respondents
These include respondent’s level, marital status, of the
age, sex, religion educational respondents.
Table 1: Socio-demographic characteristics of respondents
Characteristics How often have you been experiencing limitations in accessing and
utilizing SRH services in the last 12 months?
Very often Not very often Total
n=35 % n=13 % N=48 %
Age
20- 24 years 7 20 0 0.0 7 14.6
25-29 years 7 20 3 23.1 10 20.8
30-34 years 8 22.9 4 30.8 12 25.0
35-39 years 10 28.6 5 38.5 15 31.2
40-44 years 2 5.7 0 0.0 2 4.2
45-49 years 1 2.9 1 7.7 2 4.2
Education attainment
Never attended 2 5.7 1 7.7
3 6.2
school
Primary school 16 45.7 2 15.4 18 37.5
Secondary schools 17 48.6 8 61.5 25 52.1
Post-secondary 0 0.0 2 15.4 2 4.2

Marital status
Married/ Cohabiting 24 68.6 7 53.8 31 64.6
Single 11 31.4 6 46.2 17 35.4
Separated/divorced 0 0.0 0 0.0 0 0.0
Occupation
House wife 20 57.1 4 30.8 24 50.0
Farming 12 34.3 5 38.5 17 35.4
Business (informal sector) 3 8.3 2 15.4 5 10.4
Civil servant 0 0.0 2 15.4 2 4.2
Total 35 100 13 100 48 100
Source: Field work data, 2020
Distribution of the respondents by age
The section presents the findings on age the study. The distribution of the
of the respondents who participated in population by age is one of the most

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important characteristics in reported to have often experienced
understanding their views about limitations in their quest to seeking SRH
particular problems [28]. Age indicates services while none of the responded to
the level of maturity of individuals. have experienced limitations among those
Therefore, age was so important to aged 40-44 years. According to [29], age
examine the responses. The results on age contributes to the formation of
of the respondents from the participants psychological development in maturity
who took part in the study as illustrated and adulthood development for self-
in table 4.1 shows that age group of management. Therefore it can be
participates was more dominated by concluded that since most of the
those within the age group 35 and 39 respondents were above 20 years, then
years and the lower number was among the respondents were mature enough and
those respondents who were aged able to self-manage answering questions
between 40-49 years. Furthermore, about without due influence from other
28.6% of those in age group 35-39 years persons.
Distribution of the respondents by education background
Education is one of the most important who had at least attained primary
characteristics that might affect the education reported to have often
person’s attitudes and the way of looking experienced limitations in seeking for SRH
and understanding any particular social while none of those with post-secondary
phenomena. In a way, an individual education reported any limitations. The
responds, is likely to be determined by implications of such distribution can be
his or her educational status and concluded that education plays an
therefore it becomes essential to know important role in preventing the
the educational background of the occurrence of patriarchy that limit
respondents. The results suggest that a women’s decision making concerning
higher percentage (45.7%) of respondents their health needs.
Distribution of the respondents by marital status
Marriage is one of the most important to the questions asked. The details of the
social institutions. The perceptions and marital status of the respondents from
attitudes of a person can also differ by the respondents indicate that 68.6% of
the marital status of the persons because respondents who were married reported
the marriage might make the persons to be experiencing limitations in seeking
little more responsible and mature in for SRH as compared to 31.6% who were
understanding and giving the responses single.
Distribution of the respondents by the occupation
The findings on occupation status in civil service, none of them reported to
revealed that higher number (57.1%) of have ever often experienced challenges in
women were housewives often seeking for SRH services. This could be an
experienced limitations compared to only indication that self-reliance in terms of
8.3% of those that were self-employed, income creates freedom in seeking for
most of whom were in informal health among women.
businesses. Among respondents who were
Knowledge and awareness of women on sexual and reproductive health services
The study explored respondent’s women on sexual and reproductive
level of knowledge and awareness of health services.
Knowledge on SRH
This section presents the findings of the respondents defined and understood
level of knowledge and awareness about sexual and reproductive health services.
SRH. The table below shows how the

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Table 2: Knowledge on SRH
How often have you been experiencing
Respondents knowledge about SRH services limitations in accessing and utilizing SRH
services in the last 12 months?
Very often Not very often
n=35 % n=13 %
These are general services that enhance
9 25.7 1 7.7
women and men’s reproductive health
SRH services are services that helps families
in making decisions i.e. on having a
7 20.0 1 7.7
manageable number of children for instance
family planning
SRH services helps to protect women from
getting any problem including getting 5 14.3 4 30.8
diseases during pregnancy
SRH services refers to teachings about
marriage and family formations i.e. how
5 14.3 5 38.5
women and men should behave towards each
other
SRH services involves information about
1 2.9 0 0.0
modern family planning methods
SRH refers to empowerment of women and
men on how to make decisions about their 3 8.6 2 15.4
sexual lives
SRH involves services that can help men and
women to know about their health status 3 8.6 0 0.0
ranging from STDs to general health
Others (i.e. counselling and guidance) 2 5.7 0 0.0
Total
Source: Field work data (2020)
The results of the study revealed that stated that SRH services involve services
about 25.7% of respondents that had been helps to protect women from getting any
experiencing limitation in accessing SRH problem including getting diseases during
and 7.7% of those that had not been pregnancy, teachings about marriage and
experiencing limitations believed that SRH family formations i.e. how women and
services were general services that men should behave towards each other as
enhance women and men’s reproductive well as empowerment programmes for
health. While 20% and 7.7% of women and men on how to make
respondents who had been experiencing decisions about their sexual lives. Focus
limitation and those that did not believed group discussions also revealed
that SRH services are services that helps similarities in definitions and
families in making decisions i.e. on understanding of SRH as illustrated in the
having a manageable number of children above table. For instance a 24 years old
for instance family planning. Others respondent stated,
“I think SRH services are services that are offered to pregnant women from the time
of conceiving up to the time of giving birth. In other words these; could include;
antenatal and post natal care but this can also include advice to unmarried women
and girls on how to keep safe as females” Rebecca, in an FGD, Katumba Zone
Another respondents stated that;

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SRH services are general guidance on safe motherhood. Personally, I engaged in early
sexual activities when I was in primary school, by then I did not know the calculation
of mistral cycle. A onetime incident resulted to have unwanted pregnancy at a very
young age. After that incident, each and every person including midwife where I used
to go for checkups, blamed me for conceiving my first born at the age of 15 without
knowing that I was not aware of SRH but if I was taught about such services early, I
think I would be a professor at this time. But it was maybe Gods plan that my
education ends in primary school after pregnancy” Akello, in an FGD, Kondogoro
Zone A
Among the key informants, the level of instance, one of the gynecologist stated
knowledge and awareness about SRH was that, “SRH is a general reproductive health
well understood since most of the key that is administered to both men and
informants were medical specialists. For women from the onset of puberty”.
Community perception on SRH services
The findings indicated that despite high instance, in the questionnaires,
level of knowledge about SRH among respondents were also asked to give their
women and girls in the area of study, views on how community members
some few community members especially perceive reacts towards someone who
men had their own perception when a intends or goes to seek for SRH services,
person was seen seeking for any and the table below illustrates some of
information about SRH services. For the responses.
Table 3: Community perception on SRH services
How often have you been
experiencing limitations in
accessing and utilizing SRH
services in the last 12 months?
What are often the perception of people in your
community when they see you seeking for SRH services
Very often Not often
like family planning, information on contraceptives like
condoms, HIV testing etc.?
n=35 % n=13 %
Many people especially men believe that it is immoral to
get associated with seeking for SRH services like family 18 51.4 6 46.2
planning
They become supportive 8 22.9 5 38.5
They say that it is a normal for women to seek for SRH
1 2.9 1 7.7
services such as antenatal
They just ignore 7 20.0 1 7.7
Others 1 2.9 0 0.0
Source: Field work data, 2020
As illustrated in the table above, about to those that seen seeking for SRH
51.4% of respondents who stated that services and others often tend to ignore if
they have been experiencing hardships in such a thing happens. Based on the above
accessing and utilizing SRH in the last 12 responses, it is evident that women who
months, confirmed that many people are in need of SRH services are likely to
especially men believe that it is immoral get little support from community
to get associated with seeking for SRH members especially men of which the
services like family planning. However, findings quoted them as being less
there are some who are often supportive supportive to SRH.

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DISCUSSION OF THE FINDINGS

Knowledge and level of awareness about SRH
Using focus group discussions, in-depth information on contraceptives, then it
interviews and questionnaires, implied that such a person was
investigations were undertaken on the considered as being immoral, something
level of knowledge and awareness as well that sometimes makes women and girls to
as local perception about SRH and its shun in seeking for such services.
influence on general reproductive health According to the study by [30], which was
outcome among women in Kyanja parish. carried out on the risk factors for severe
The findings indicated that, a big number SRH complications like pre-eclampsia and
of respondents knew what SRH services eclampsia in Mulago Hospital, found out
were all about especially. However, the that, the level of understanding about the
level of understanding about it varied causes of severe pre-eclampsia among
according to respondents’ gender. For some respondents in Kampala included,
instance, the results indicated that, SRH the belief that pre-eclampsia is a
involved general health services that culturally inherited disease which is
enhance women and men’s reproductive associated with the family history among
health where examples given included; the women’s family, therefore whenever a
maternal health care, guidance and woman would get it, they would accuse
counselling, family planning and her based on her family background
decisions making on having a manageable without helping her to seek for SRH
number of children among others. guidance. Hence the above findings gives
However, seeking for SRH was also a similar picture on why many women in
perceived differently among the Kyanja are sometimes faced with
community members in the area of study. challenges in accessing and utilizing SRH
For instance, some men believed that due to fear of being mistaken.
however seeks for SRH such as
CONCLUSION AND RECOMMENDATIONS
Knowledge and level of awareness about SRH services among women and girls
The findings indicated that there was high medical health workers are the same as
levels of understanding about SRH and those services offered by traditional
related services and they influence health herbalists and counsellors commonly
among women and girls in Kyanja central. known as (Ssengas and Kojjas). These
However, seeking for SRH services and herbalists sometimes do mislead women
information like family planning, and girls by recommending use of
information of contraceptives such as unapproved medicines and information
condoms, pills among others are locally that in most cases lead to various sexual
perceived by majority of residents as and reproductive complications or death
sources of immorality among those in especially during pregnancy.
need of them. Despite vast knowledge Furthermore, sometimes these herbalists
among women and girls who participated engage in illegal activities such as
in the study, many of them also believed abortion which are against the law.
that SRH services offered by trained
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