Date of Award

11-2023

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr. Fareeha Shaikh

Second Advisor

Dr. Sarah Saleem

Third Advisor

Mr. Iqbal Azam

Department

Community Health Sciences

Abstract

Background: Sexual and reproductive health literacy (SRHL) incorporates Sexual and Reproductive Health (SRH) into the four domains of literacy, namely, accessibility, understanding, judgement and decision making. Youth is the most vulnerable group to SRH issues, such as; unwanted pregnancies, lack of SRH knowledge, and unavailability of health services but these challenges can be addressed if they are provided with the skills to make healthier choices through SRHL. Moreover, parent’s importance in imparting SRH related information to their children has been emphasized in literature. However, the role of parents’ education in the context of youth SRHL has not been evaluated in our setting. Therefore, in this study we aimed to evaluate the mean sexual and reproductive health literacy of university students living in Karachi in the context of pregnancy, abortion and contraception with respect to parental education and other covariates.
Methods: We conducted an analytical cross-sectional survey to the relationship between SRHL, parental education and other independent variables. Participants were enrolled in the study if they met the eligibility criteria and gave informed consent. Data was collected both in-person at two university’s which gave permission and through a web-based approach from 458 participants through purposive sampling technique. A validated SRHL tool was used after pre-testing and content validation to measure the literacy score of participants within a range of 0 to 50 from lowest to highest. Descriptive analysis was applied to compute mean (SD) for quantitative variables and frequencies with percentages were reported for qualitative variables, factor analysis was used to create socio-economic status and one-way ANOVA was employed to study the relation between SRHL and parental education. Simple and multiple linear regression was used to study the association between SRHL and covariates.
Results: The mean age of participants in this study was 21.4 (1.7) years, with 51.1% males and 49.9% female students. The average SRHL score was 21.2 (7.6) and it was limited in all four domains of SRHL. In univariate analysis, parental education level was not significantly associated with SRHL (p=0.631), although sex and socio-economic status were. Moreover, we found a significant interaction between parental education and age of the student. Among students with both parents who had graduated the estimated mean SRHL score increased by 0.761 (95% CI: -1.646, 1.686) with every year increase in age as compared to students whose vii both parents are not graduates students with no change in age keeping sex and socio economic status constant in the model. A greater proportion of the students considered SRH a stigma (99.1%), had no prior health care experience of it (76.6%), and were not aware of any youth-based SRH clinics in Karachi (85.5%). Friends and siblings were the most preferred sources of SRH information (29%).
Conclusion: The university student population of Karachi has limited SRHL which can result in poor reproductive health outcomes in the youth. Therefore, there is a dire need to improve SRHL of students through parent-child communication, active participation of educational institutions, community stakeholders and policy makers in promoting reproductive health literacy.

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1

Last Page

71

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