KNOWLEDGE, ACCESS AND UTILIZATION OF YOUTHS TOWARDS YOUTH

FRIENDLY SERVICES AMONG YOUTHS AT MPODWE-LHUBIRIHA TOWN

COUNCIL

BY

BIIRA MARGARET

2021/U/MMU/BNSE/021

A RESEARCH PRPOSAL SUBMITTED IN PARTIAL FULFILLMENT OF THE

REQUIREMENT OF AWARD OF BACHELORS IN NURSING AT MOUNTAINS OF
THE MOON UNIVERISTY

JUNE, 2024
 DECLARATION

I Biira Margret hereby declare that this Research proposal is my own original work and has
never been presented by any person to any institution for any Academic award.

The literature that was used was however got from other cases indicated in the references.

Sign………… Date…………………….

i
 APPROVAL

This Research proposal was under my supervision as the institutions Research supervisor

Supervisor’s name………………………………….. Sign………………….

Date……………………………..

ii
 TABLE OF CONTENTS

DECLARATION..............................................................................................................................i

APPROVAL....................................................................................................................................ii

TABLE OF CONTENTS...............................................................................................................iii

ABBREVIATIONS.........................................................................................................................v

OPERATIONAL TERMS..............................................................................................................vi

CHAPTER ONE; INTRODUCTION..............................................................................................1

1.0 Introduction...........................................................................................................................1

1.1 Background of the study........................................................................................................1

1.2 Problem statement..................................................................................................................3

1.3 Purpose of the study...............................................................................................................3

1.4 Specific objectives.................................................................................................................3

1.5 Research questions.................................................................................................................4

1.6 Justification of the study.........................................................................................................4

1.7 Significance of the study........................................................................................................4

CHAPTER TWO; LITERATURE REVIEW..................................................................................7

2.1 knowledge about youth friendly services among youths.......................................................7

2.2 Utilization of youth friendly services among youths.............................................................8

2.3 The accessibility of youths to friendly services among youths.............................................9

Chapter three..................................................................................................................................11

3.0 Introduction..........................................................................................................................11

3.1 Study Design........................................................................................................................11

3.2 Study setting.........................................................................................................................11

3.4 Sample size determination...................................................................................................12

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 N = (0.02 (1-0.02) X1.962)/0.12..................................................................................................12

3.5 Sampling technique/procedure.............................................................................................12

3.6. sampling procedure.............................................................................................................12

3.7 Data collection method........................................................................................................12

3.8 Data collection tools.............................................................................................................13

3.9 data collection procedure.....................................................................................................13

3.10 Study variables...................................................................................................................13

3.11.3 Inclusion criteria..........................................................................................................14

3.11.4 Exclusion criteria.........................................................................................................14

3.12 data analysis and presentation............................................................................................14

3.13 Ethical consideration..........................................................................................................14

3.4. study limitations..................................................................................................................14

3.15 dissemination of results......................................................................................................14

Appendix I: Consent Form............................................................................................................16

Appendix II: Research Questionnaire............................................................................................17

Appendix III: Study Work Plan.....................................................................................................22

Appendix four; Study Budget........................................................................................................23

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 ABBREVIATIONS

FP Family Planning

HIV Human Immunodeficiency Virus

LMICs Low- and Middle-Income Countries

MMU Mountain of the Moon University.

MOH Ministry Of Health

SRH Sexual and Reproductive Health

SSA Sub-Saharan Africa

STIs Sexually Transmitted Infections

WHO World Health Organization

YFHS Youth Friendly Health Services

YFS Youth Friendly Services

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 OPERATIONAL TERMS

Knowledge: This term refers to the level of understanding, awareness, and information possessed
by the youth attending Mpondwe-Lhubiriha Town Councilabout the youth-friendly services
available at the health center.

Access: In this study, "access" relates to the ease with which youth attending Mpondwe-
Lhubiriha Town Councilcan physically reach the health center and gain entry to avail themselves
of youth-friendly services.

Utilization: "Utilization" refers to the actual use of youth-friendly services by the youth attending
Mpodwe-Lhubiriha Town Council This term involves assessing the extent to which these
services are employed by the target population.

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 CHAPTER ONE; INTRODUCTION

1.0 Introduction

This chapter describes the background of the study, statement of the problem, broad objective
and specific objectives

1.1 Background of the study

The World Health Organization (WHO) defined youth age as 15–24 years. It is the phase when
physical, cognitive, and psychosocial development takes place between childhood and
adulthood. (WHO, 2018). Even though they are assumed to be healthy, they are more prone to
unwanted pregnancies, unsafe abortions, sexually transmitted infections (STIs), human
immunodeficiency virus (HIV), and acquired immunodeficiency syndrome (AIDS), as well as
violence, accidents, and psychiatric problems. It is a risky period for smoking and substance
abuse, risky sexual practices, and violence (UN-DESA, 2015). Around 17% (1.2 billion) of the
global population was youth of which 19% of them (226 million) lived in Africa, Youth are
suffering from different health problems throughout the world. However, this study will focus on
youth health services (Motuma et al., 2016).

Globally, about 33% of new HIV infections occur among youth. In Sub-Saharan Africa (SSA),
women aged 15–24 years account for almost half of women acquiring HIV. YFS comprises a
major component of the global burden of sexual ill-health. Nearly a quarter of girls aged 15–
19 years are married with an estimated 16 million adolescents giving birth each year globally,
95% of whom are from low- and middle-income countries (LMICs) (Negash et al., 2016),
Trends in delayed marriages do not indicate a decrease in the age of onset of sexual activity
among the young people but rather highlights the need to improve access to YFHS information,
skills and improve services to learn more about sexuality and prevent unwanted pregnancies and
Globally, Numerous surveys in LMICs indicated that only 33% of young men and 20% of young
women have comprehensive knowledge of HIV but still less than half of young men and women
surveyed reported using condoms at their last time of sexual activity.(MOH, 2016)

In many African countries, sexual and reproductive health (SRH) needs of young people / youth
are often underserved and underestimated despite their demonstrated need and the urgency of

1
these services (WHO, 2017). Continental population remain high at approximately 1.2 billion
with the highest number being youth aged 15–24 years, 226 million—19% of the global youth p
In sub-Saharan Africa, adolescents face many significant SRH challenges such as limited access
to youth-friendly services (YFS) including information on growth, unsafe abortion, gender-based
violence, sexuality, and family planning (FP). This has led youth into risky sexual behavior
resulting in high STI and HIV prevalence among young people, early pregnancy, and
vulnerability to delivery complications resulting in high rates of death and disability (Nambile et
al., 2022). opulation of whom live in sub-Saharan Africa (Binu et al., 2016).

In Uganda, youth-friendly services remain scarce, with only 10% of the health facilities in the
country offering such services (Bukenya et al., 2019). In Uganda, the 2020 Uganda Demographic
and Health Survey (Amongin et al., 2020) reported that 24.8% of girls aged 15–19 had begun
bearing children. Over 30.4% of 15–19-year-old girls who require contraceptives are unable to
access such services, while 17.2% of adolescent girls die because of childbirth-related
complications (Amongin et al, 2020). In addition, only 41.1% of pregnant adolescent girls
attended the eight antenatal visits that are recommended by the WHO (Nabisere et al., 2019) To
my knowledge, no earlier study has been done to explore the availability, access, and utilization
of youths about youth friendly services among youths in Kasese district. This therefore tempts
the researcher to seek the previously mentioned aspects of YFS but specifically youth friendly
health services at Mpondwe-Lhubiriha Town Council.

2
1.2 Problem statement
In Uganda, a substantial proportion of youths lack comprehensive knowledge about YFS
(Okonjo et al.,2019). This knowledge gap translates into risky sexual behaviors, unintended
pregnancies, and increased vulnerability to HIV/AIDS (Fajardo et al., 2021). Moreover,
socioeconomic factors, stigma, and limited service availability further restrict access to YFS,
particularly for young people in marginalized communities (Mathieson et al., 2017).

Adolescence and young adulthood (10-24 years old) are crucial stages for physical, mental, and
social development (World Health Organization, 2020). During this time, young people require
access to essential Youth Friendly Services (YFS) to navigate sexual and reproductive health
(SRH) challenges, prevent HIV infection, and make informed decisions (Guttmacher Institute,
2023).

The Ugandan government, in collaboration with NGOs and international organizations, has
implemented various strategies to improve YFS access. These include establishing youth corners
in health facilities, training healthcare providers in youth-friendly approaches, and utilizing peer
education programs (Uganda Ministry of Health, 2020).

Despite these efforts, challenges remain. Studies by Kagoora et al. (2020) highlight the need for
context-specific interventions that address the unique needs and barriers faced by AYP in
different geographical settings. This study aims to investigate the knowledge, access, and
utilization of YFS among youths in Mpondwe-Lhubiriha Town Council, Kasese District,
Uganda. Mpondwe-Lhubiriha, a border town with a potentially high youth population, presents a
unique context for exploring YFS access and utilization patterns.

1.3 Purpose of the study

To assess the knowledge, access, and utilization of youth friendly services among youth at
Mpondwe-Lhubiriha Town Council, Kasese district

1.4 Specific objectives

To determine the knowledge of the youths about youth-friendly services at Mpondwe-Lhubiriha
Town Council, Kasese district.

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To ascertain the access of youths to friendly services among youths at Mpondwe-Lhubiriha
Town Council, Kasese district

To find out the utilization of youth-friendly services among youths at Mpondwe-Lhubiriha Town
Council, Kasese district.

1.5 Research questions

What is the knowledge of the youths on youth friendly services at Mpondwe-Lhubiriha Town
Council, Kasese district?

What is the accessibility of youths to friendly services among youths at Mpondwe-Lhubiriha

Town Council, Kasese district?

What is the level of utilization of youth friendly services among youths at Mpondwe-Lhubiriha
Town Council, Kasese district?

1.6 Justification of the study

The extent to which the youths attending services at Mpondwe-Lhubiriha Town Council are
aware of the available youth friendly services, their ability to access these services, and their
willingness to utilize them isn’t yet known and is what is to be assessed in this study

1.7 Significance of the study

The significance of the academic research study on extends to various stakeholders and bodies
involved in adolescent and youth healthcare, policy development, and community well-being as
described below.

Local Health Authorities and Mpondwe-Lhubiriha Town Council

The study provides critical insights into the gaps and challenges in providing youth-friendly
health services at a local health facility.

It can help identify areas for improvement in service delivery, resource allocation, and training of
healthcare personnel to better cater to the needs of adolescent and young adult populations.

Ugandan Ministry of Health:

4
The research findings can inform policy development and revisions related to adolescent
healthcare services in Uganda, contributing to the alignment of healthcare policies with the
specific needs of young people.

Non-Governmental Organizations (NGOs) and Donor Agencies:

NGOs and donor agencies working in the field of youth health can use the study's results to tailor
their programs and allocate resources more effectively to address the identified challenges.

Youth Advocacy Groups:

Youth advocacy groups can leverage the study's findings to advocate for improved access to
youth-friendly services in Mpondwe-Lhubiriha Town Council District and other underserved
areas, promoting the rights and well-being of young people.

Researchers and Academics:

The research contributes to the body of knowledge on youth-friendly healthcare services in

resource-constrained settings, serving as a reference point for future research and academic
studies in the field of adolescent health.

International Health Organizations:

International organizations like the World Health Organization can use the study's findings to
support their global initiatives for adolescent health and provide recommendations for improving
youth-friendly healthcare services in similar contexts worldwide.

Community Members and Parents:

The study's results can raise awareness among community members and parents about the
importance of accessible and youth-friendly healthcare services for their adolescent children,
leading to increased support and demand for such services.

5
Young People Themselves:

Adolescents and young adults can benefit directly from the study by gaining better access to
healthcare services that are tailored to their unique needs, promoting their physical and mental
well-being.

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 CHAPTER TWO; LITERATURE REVIEW

2.0 Introduction
This chapter presents the existing literature that is available in the world by different writers,
journal articles, and newspapers. It is divided into knowledge about YFS, the accessibility of
YFS and the utilisation of YFS. The sources of literature include published research reports,
journals, dissertations, and textbooks.

2.1 knowledge about youth-friendly services among youths

Youth-friendly services encompass a range of healthcare and social services designed to cater to
the specific needs of adolescents and young adults. The level of knowledge among youths about
the existence and availability of these services significantly influences their utilization. In their
study, Anker and Khonje (2019) found that awareness of youth-friendly services among
adolescents in Malawi was relatively low, with only 45% of the surveyed youths reporting
knowledge of such services. This suggests a need for increased efforts in disseminating
information about youth-friendly services to potential beneficiaries.

Several studies have identified barriers that hinder young people from obtaining information
about youth-friendly services. In a study conducted by Jones et al. (2020) in the United States,
stigma surrounding sensitive topics such as sexual health was identified as a significant deterrent
to knowledge acquisition. Similarly, a lack of comprehensive sexuality education in schools was
noted as a limiting factor in youths' awareness of available services (Smith & Brown, 2018).

The level of knowledge about youth-friendly services directly correlates with their utilization.
Young people who are well-informed about the availability of these services are more likely to
access them. In a study by Garcia and Rodriguez (2017) in Spain, it was observed that
adolescents with higher levels of knowledge about youth-friendly services were more likely to
seek sexual health advice and use contraceptive methods. This underscores the importance of
knowledge as a catalyst for service utilization.

Healthcare providers play a crucial role in disseminating information about youth-friendly

services. Lemoine et al. (2019) conducted a study in Canada that revealed the positive impact of
healthcare provider counseling on youths' knowledge and utilization of such services. This

7
highlights the potential for healthcare professionals to act as catalysts for knowledge
dissemination.

The level of knowledge about youth-friendly services among youths attending services has
significant implications for policy and practice. It underscores the need for comprehensive
sexuality education in schools, as well as the importance of healthcare providers actively
promoting these services to their adolescent patients. Furthermore, reducing the stigma
surrounding sensitive topics is essential for improving youths' knowledge and access to youth-
friendly services.

This literature review has highlighted the importance of assessing the level of knowledge about
youth-friendly services among youths attending services. Research indicates that knowledge is a
key determinant of service utilization, and efforts should be made to improve awareness among
young people. Comprehensive sexuality education, reduced stigma, and the active involvement
of healthcare providers are essential components of increasing knowledge and improving the
utilization of youth-friendly services.

2.2 The accessibility of youths to friendly services among youths

Geographical factors play a significant role in determining the accessibility of youth-friendly
services. Research by Goodman and Srofenyoh (2019) highlighted that rural areas often face
challenges in providing these services due to limited infrastructure and healthcare facilities. On
the other hand, urban areas may have better access, but issues of transportation and distance can
still pose barriers to youths seeking services (Smith et al., 2017).

Research also highlights strategies to enhance the accessibility of youth-friendly services.

School-based health programs, outreach initiatives, and online resources have been effective in
reaching young people who may otherwise face barriers to access (Sznitman et al., 2019).
Moreover, the integration of comprehensive sexual education within school curricula has shown
promise in improving awareness and promoting service utilization (UNESCO, 2018). conomic
factors, such as affordability and insurance coverage, can greatly impact the accessibility of
youth-friendly services. Studies by Anderson et al. (2018) found that financial constraints can
deter youths from seeking services, especially when these services are not covered by insurance
or require out-of-pocket expenses.

8
Improved accessibility to youth-friendly services has been linked to positive health outcomes
among young people. For instance, access to sexual and reproductive health services is
associated with reduced rates of unintended pregnancies and sexually transmitted infections
(Bearinger et al., 2007). Mental health services accessibility, on the other hand, has been
correlated with reduced rates of depression and substance abuse (Patton et al., 2016). ngaging
youths in the planning and development of services can enhance accessibility. McMillan et al.
(2016) discussed the importance of involving young people in the design and evaluation of
youth-friendly services to ensure their unique needs and preferences are met.

Understanding the perspectives of youths attending these services is crucial. Studies have
shown that involving young people in the design and evaluation of youth-friendly services can
enhance their accessibility and acceptability (Agampodi et al., 2018). Listening to the voices of
young 1service users can provide valuable insights into improving service provision. Policy and
legal frameworks also influence the accessibility of youth-friendly services. Studies by
Anderson and Johnson (2021) emphasized the importance of having supportive policies and
laws that facilitate the provision of these services and protect the rights of young individuals.

2.3 Utilization of youth friendly services among youths

Youth-friendly services encompass a range of healthcare services designed to meet the specific
needs of adolescents. These services are characterized by accessibility, acceptability,
affordability, and appropriateness, ensuring that young people can access them without barriers
and receive care that respects their unique developmental stage. Several studies have assessed the
utilization of youth-friendly services among youths and highlighted various factors influencing
their usage.

Accessibility is a key determinant of utilization. According to Ajuwon (2016), the location of

health facilities plays a crucial role in whether young people seek services. Youth-friendly clinics
located in proximity to schools and community centers are more likely to be utilized.
Additionally, transportation barriers and service hours have been identified as factors affecting
accessibility (UNFPA, 2018).

Youth awareness of the existence and benefits of youth-friendly services is essential. Studies by
Viner et al. (2015) suggest that young people often lack awareness of such services, leading to

9
underutilization. Comprehensive sex education and targeted health promotion campaigns have
been recommended to improve knowledge.

The fear of stigmatization and breaches of confidentiality can deter youths from seeking services.
Dixon-Mueller and Germain (2014) highlight that healthcare providers' attitudes and behaviors
significantly influence the willingness of adolescents to access services. Ensuring non-
judgmental, confidential, and respectful care is paramount in promoting utilization.

Peer and parental support or opposition can sway youths' decisions to access services. Lammers
et al. (2015) found that positive parental involvement and peer encouragement were associated
with increased utilization. Conversely, negative reactions from parents or peers could discourage
service uptake.

Cultural and societal norms also play a role in utilization. In some societies, discussions related
to sexual health may be considered taboo, hindering youths' access to information and services
(UNICEF, 2020). Efforts to challenge and change these norms are essential in promoting
utilization.

Gender disparities in utilization have been documented. Ganchimeg et al. (2016) suggest that
females are more likely to access youth-friendly services than males. Understanding these
gender-based differences can inform targeted interventions.

The utilization of youth-friendly services among youths is influenced by various factors,

including accessibility, knowledge, stigmatization, parental and peer influence, cultural norms,
and gender disparities. Recognizing these factors is essential for designing effective interventions
that encourage young people to access the healthcare services they need. Further research is
needed to assess the impact of specific interventions and strategies to improve utilization rates
among adolescents.

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 Chapter three

Research Methodology

3.0 Introduction
This chapter presents the methods and processes of the study which include the study design,
study setting, study population, inclusion and exclusion criteria, sample size determination,
sampling technique, data management, ethical considerations, study limitations, and
dissemination of results.

3.1 Study Design

A quantitative cross-sectional study approach will be conducted in order to determine
Knowledge, access and utilization of youth friendly services among youth attending services at
Mpondwe-Lhubiriha Town Council, Kasese district. This design will be opted because cross-
sectional studies are conducted at once in a time and they do not require follow-up of
respondents.

3.2 Study setting

The study will be conducted at Mpondwe-Lhubiriha Town Council, Kasese district. Mpondwe is
approximately 55.5 kilometres (34 mi), by road, south-west of Kasese, where the district
headquarters are located. This is about 131 kilometres (81 mi) southwest of Fort Portal, the
nearest large city. Bwera is located approximately 424 kilometres (263 mi), by road, west
of Kampala, Uganda's capital and largest city. The geographical coordinates of the town are 0°
02' 24.00"N, 29° 43' 30.00"E (Latitude:0.0400; Longitude:29.7250). The town sits at an average
elevation of 1,220 meters (4,000 ft) above mean sea level.

The town is made up of nine major parishes including 9 major parishes and 35 villages. The
parishes include Bwera ward, Kabuyiri ward, Kambukamabwe, Kyambogho,Mpondwe,
Nyabugando, Nyamambuka,Rusese, Nyakahya.

In 2015, UBOS estimated the population of Mpondwe Lhubiriha Town Council at 52,000. In
2020, the population agency estimated the mid-year population of the town at 58,600 people. Of
these, 30,400 (51.9 percent) were females and 28,200 (48.1 percent) were males. UBOS

11
calculated the annual population growth rate of Mpondwe to average 2.34 percent per year,
between 2015 and 2020.

Mpondwe-Lhubiriha sits at an approximate elevation of 1,220 meters (4,000 feet), offering a

refreshing escape from the scorching lowlands. The town boasts a youthful population, brimming
with energy and shaping the future of the region. While specific figures are elusive, Uganda's
national youth population is estimated to be around 78%, and Mpondwe-Lhubiriha likely reflects
a similar demographic.

3.3 Study population

The study will include all the youths in the 9 parishes of MLTC. These will include those in the
age range of 15 years to 25 years.

3.4 Sample size determination

Sample size was calculated based on the Kish Leslie formula for sample size determination of
cross-sectional studies.

e sample size was based on Kish Leslie’s formula for cross-sectional studies

Where N = Number of respondents needed, p = Estimated proportion of the population could

have utilized the youth-friendly services. In this study, 2% (0.02) which is the worst scenario was
used since there is no study done to my knowledge, Z is 1.96 (the Z score corresponding to 95%
confidence interval), d = Maximum error the researcher is willing to allow = 0.1.

N = (0.02 (1-0.02) X1.962)/0.12

N = 236 respondents.

Therefore 236 respondents Will be recruited for the study.

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3.5 Sampling technique/procedure
A stratified sampling random sampling method. The researcher will opt for this method because
probability sampling methods give Participants equal opportunities to be recruited for the study
hence minimising selection bias.

3.6. sampling procedure

Each parish of the town council will be considered strata hence making 9 strata. For each
stratum, the villages will be listed on a piece of paper, folded and placed in a cylindrical
container, and shaken. The researcher will then collect a random paper and the name of the
village on the paper will be considered for sampling. 26 youths from each village will be
randomly sampled to meet the sample size. This will be done in a period of 18 working days
using 2 days to sample each strata.

3.7 Data collection method

Primary data will be collected quantitatively using a self-administered questionnaire with closed-
ended questions assessing the Knowledge, access, and utilization of youth-friendly services
among youth attending services at Mpodwe-Lhubiriha Town Council

3.8 Data collection tools

Data will primarily be collected using an interviewer-administered questionnaire with four
sections.

3.9 data collection procedure

The researcher will meet the targeted respondents physically/. Each participant will be required
to give informed consent before enrolling in the study. The researcher will then administer the
questionnaires to the respondents and assist them with the filling procedure. The properly filled
questionnaires will then be collected and taken for analysis. A pen and paper will be used to
record the necessary information.

3.10 Study variables

Independent Variables:

Knowledge about youth-friendly services: This refers to the exhibition of information about
the different YFS the youth could access, the why, when, and where to access these services.

13
Accessibility of youth-friendly services: This captures the ease with which young people can
reach and utilize the services. Factors like clinic hours, location within the hospital, wait times,
transportation costs, and stigma associated with seeking youth-friendly care can all influence
accessibility.

Dependent Variable:

Utilization of youth friendly services This refers to the actual use of the services offered at
Mpondwe-Lhubiriha Town Council by the young people attending health services there.

3.11 Validity and Reliability

To ensure the validity and reliability of the data collection questionnaire and the authenticity of
the data to be collected, a structured questionnaire will be pre-tested by the researcher in a
different target population, and the necessary amendments made. 13 youths in Kinyaaseke Town
Council which is approximately 5% of the number of participants, will be selected to participate
in the pretest survey. The same questionnaire Will be administered to the study population after
one week to assess the reliability of the questionnaire. The results obtained from the first stage
will be compared to the responses obtained in the second phase. Results obtained from the pre-
test will be used to inform amendments necessary to collect reliable and accurate data. These
questionnaires used in the pretest will not be used as part of the study population questionnaire.
The research assistant will be trained to avoid errors as he helps the researcher collect accurate
data and save time

3.11.3 Inclusion criteria

All youths seeking health care at Mpondwe-Lhubiriha Town Council will be recruited for the
study.

3.11.4 Exclusion criteria

The study will exclude all youths seeking emergency care at the facility,

3.12 data analysis and presentation

All questionnaires will be checked for completeness before respondents leave. For safety,
questionnaires were kept under password protection and kept in a lock and key cupboard with a

14
key accessible to the researcher alone. The data collected will be compiled using Microsoft Excel
version 2019 and then imported into SPSS V.26 for analysis.

Demographic characteristics were analyzed descriptively, the association between dependent and
independent variables will be determined using inferential statistics, and bivariate analysis will
be done to determine if there is a statistical relationship between variables and factors will be
cross-tabulated with the dependent variable where statistical significance will be determined at
p<0.05.

Pearson Chi squares will be used to establish relationships between the independent and
dependent variables. The analyzed data will be presented in charts and tables which will form the
basis for discussion and conclusion among others.

3.13 Ethical consideration.

The researcher will seek approval from the research committee at MMU who will approve and
grant her permission before carrying out the study.

Participants will be given written consent regarding the research to seek consent. Each
participant’s choice to participate or not, will be respected and data collected from participants
will be kept confidential.

3.4. study limitations

Because the study is cross-sectional in nature, causality cannot be established.

The study will rely on self-reported data, which is susceptible to recall bias and social
desirability bias.

3.15 dissemination of results

The results will be presented to a panel of supervisors and experienced researchers at Mountains
of the Moon University.

A printed copy will be presented to the hospital administration at Mpondwe-Lhubiriha Town

Council

A soft copy of the results will be submitted to online journals for review as the results can be
significant to future researchers of the same causality.

15
The research report will be published in peer reviewed journals.

16
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 Appendix I: Consent Form

I am Biira Margret a student of Mountains of the Moon University, Fort Portal. I am researching
the topic of knowledge, access, and utilization of youth towards youth-friendly services
among youths attending services at Mpondwe-Lhubiriha Town Council.

You are requested to participate in this study by responding to the questionnaire and providing
the required. The results of the study will ensure anonymity and confidentiality of the results.
Your participation will not be rewarded financially the information provided will be beneficial
both academically and to the community.

You may choose not to participate or withdraw from the study when you feel you cannot
participate anymore.

I have been told about the study and I have understood the main aim of the study and also that
it's voluntary and confidentiality will be observed.

Therefore, I willingly accept to participate in this study.

Respondent's signature; ………………………………. Date; ………………………..

Researcher's signature; ………………………………. Date; ………………………….

21
 Appendix II: Research Questionnaire

This study is being carried out by Biira Margrett a student pursuing a bachelor’s degree in
nursing and community health at Mountains of the Moon University. The study is entitled
“Knowledge, access and Utilization of youths towards youth friendly services among youths
attending services at Mpondwe-Lhubiriha Town Council The information obtained will be
used for academic purposes and will be kept Thank you very much for your cooperation.

1. Age category

Less than 15 years 16-20 years

20-25 years

2. Gender:

Male Female

3. Educational Level:

Primary Secondary

Tertiary/Higher Education No formal education

4. Marital Status:

Single Married

Divorced/Separated

5. occupation

peasant civil worker

employed student

Knowledge about Youth-Friendly Services:

6. Have you heard about Youth-Friendly Services at Mpondwe-Lhubiriha Town Council

before this study?

22
Yes No

7. How did you first learn about Youth-Friendly Services? (Select all that apply)

Healthcare provider Friends or peers

Family School

Social media

8. On a scale of 1 to 5, how well do you understand the services offered under Youth-
Friendly Services at Mpondwe-Lhubiriha Town Council?

1 2 3

4 5

2 How often have you come across information about sexual and reproductive health in the
past year?

Rarely Weekly

Monthly daily

Never

3 Are you aware of the specific location of the Youth-Friendly Services within Mpondwe-
Lhubiriha Town Council?

Yes Not sure

4 Please select the sources where you have obtained information about sexual and reproductive
health:

Television Radio

Internet/websites School/educational institutions

Healthcare providers Friends or peers

Family Social media

Others

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Access to Youth-Friendly Services:

5 Have you ever visited Mpondwe-Lhubiriha Town Council for Youth-Friendly Services?

Yes No

6 If you have visited, how would you rate the ease of accessing these services? (1 = Very
Difficult, 5 = Very Easy)

1 2 3

i. 5

7 What barriers, if any, have you encountered when trying to access Youth-Friendly Services?
(Select all that apply)

Lack of transportation

Stigma or judgment

Lack of information

Long waiting times

Financial constraints

8 Have you ever attended a sexual and reproductive health awareness program or workshop
organized by Mpondwe-Lhubiriha Town Council?

Yes No

9 On a scale of 1 to 5, how accessible do you find sexual and reproductive health information
in your community? (1 = Not accessible, 5 = Highly accessible)

1 2 3

i. 5
10 Are you comfortable discussing sexual and reproductive health issues with healthcare
providers or counselors at Mpondwe-Lhubiriha Town Council?

24
 Yes No

Utilization of Youth-Friendly Services:

11 Please indicate which of the following Youth-Friendly Services you have utilized at
Mpondwe-Lhubiriha Town Council:

Sexual health education

Contraceptive services

STI testing and treatment

Counseling and support

HIV testing and counseling

Maternal health services

None

12 How satisfied are you with the quality of services provided at Mpondwe-Lhubiriha Town
Council's Youth-Friendly Services? (1 = Very Dissatisfied, 5 = Very Satisfied)

1 2 3

i. 5
13 Would you recommend Youth-Friendly Services at Mpondwe-Lhubiriha Town Council to
your friends or peers?

Yes No Not sure

14 How many times have you utilized the Youth-Friendly Services at Mpondwe-Lhubiriha
Town Council in the past year?

0 times

1-2 times

3-5 times

More than 5 times

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15 What factors influenced your decision to utilize Youth-Friendly Services? (Select all that
apply)

Privacy and confidentiality

Availability of services

Trust in healthcare providers

Recommendations from peers or family

Convenience of location

None of the above

16 Please rate your overall satisfaction with the cleanliness and ambiance of the Youth-Friendly
Services facility at Mpodwe-Lhubiriha Town Council (1 = Very Dissatisfied, 5 = Very
Satisfied)

1 2 3

4 5

19, How satisfied are you with the waiting times at Mpondwe-Lhubiriha Town Council when
accessing Youth-Friendly Services? (1 = Very Dissatisfied, 5 = Very Satisfied)

1 2 3

4 5

Thank you

26
 Appendix III: Study Work Plan

Months / May June July August Septembe October November

activities 2024 2024 2024 2024 r 2024 2024 2024
Proposal
writing
Data
collection
Data
analysis
Statistical
analysis
Report
writing
Binding
and
submission
of the
report

27
 Appendix Four; Study Budget

Activities Particulars Quantity Price (Ugx) Total Amount

(Ugx)
Printery Typing, printing, 100,000 100,000
and binding
Data collection Facilitation of 4 50,000 200,000
data clerks
Data analysis Interpretation of 1 100,000 100,000
data
Miscellaneous 150,000
Total 550,000

28