Submission ID 130608
| Issue/Objective | Adolescents in sub-Saharan Africa (SSA) face persistent barriers to accessing family planning (FP) services despite widespread awareness campaigns. Conventional top-down approaches have struggled to translate knowledge into practice. Citizen science(CS), which positions adolescents as co-producers of knowledge and solutions, offers a promising but under-explored pathway to improve FP outcomes. The study aimed to strengthen adolescent-centered FP services in Northern Uganda by assessing adolescents' knowledge, attitudes, and practices, identifying multi-level barriers and facilitators to FP utilization, and leveraging a CS approach to generate actionable insights for improved service delivery. This aligns with theme one as it tackles the structural and systemic factors (upstream determinants) that shape adolescents' access to and use of FP services. |
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| Methodology/Approach | We conducted a parallel convergent mixed-methods study in May to July 2025 among adolescents aged 10-19 years in Lira District and Lira City, Northern Uganda. Quantitative data were collected through structured surveys and analyzed using modified Poisson regression with robust standard errors. Qualitative data were generated from 24 focus group discussions, 20 key informant interviews, and 10 in-depth interviews. A Citizen Science-Gender Transformative Approach (CS-GTA) engaged adolescents in identifying barriers, interpreting findings, and co-developing solutions. Data were integrated using triangulation. |
| Results | A total of 502 adolescents participated, with the majority being older adolescents(15-19) (70.1%), female (54.6%), and rural residents (71.3%). Awareness of FP was 58.2%, but only 19.3% demonstrated adequate knowledge and 14.5% reported practice. Older adolescents had significantly higher knowledge (aPR 12.44; 95% CI: 3.93-39.33) and practice (aPR 1.59; 95% CI: 1.30-1.94). Adolescents identified barriers at individual, interpersonal, community, and health system levels, including stigma, misinformation, restrictive norms, and limited adolescent -responsive services. CS engagement revealed system-level barriers not captured by conventional surveys and highlighted intersectional inequities shaped by gender, age, schooling, and geography. |
| Discussion/Conclusion | Engaging adolescents as CS generates contextually grounded insights into FP challenges and actionable strategies to improve access and utilization. Integrating participatory, adolescent-driven approaches into health systems can bridge the persistent knowledge-practice gap and enhance equity in FP outcomes. Evidence supports gender-transformative, youth-responsive policies that dismantle stigma and structural inequities. Embedding CS in national FP strategies enables broader, sustainable equity gains across SSA. |
| Presenters and Affiliations | Bernard Omech Lira University Maxson Kenneth Anyolitho Lira University Judith Akello Abal Lira University Samson ¹ Udho Lira University Odette Murara Univeristy of Calgary, |
