Sexual and reproductive health information and service needs and preferences of adolescents and young adults in Sri Lanka: a systematic review.

BACKGROUND: Sexual and reproductive health is a key component of young people's right to health during their development years. However, in the health policies of many low-to-middle-income countries such as Sri Lanka, sexual and reproductive healthcare is primarily conceptualised and implemented through the lens of family planning, which has resulted in a lack of awareness about the diverse sexual and reproductive health needs of the growing adolescent and young adult demographic. Therefore, this study aims synthesise and analyse the evidence on the sexual and reproductive health information and services needs and preferences of young people in Sri Lanka. METHODS: A systematic review of quantitative, qualitative, and mixed-methods studies on the sexual and reproductive health information and services needs of young people aged 10-24 years was carried out according to the 'Preferred Reporting Items for Systematic Reviews and Meta-Analysis' guidelines. Electronic searches were conducted in Ovid Medline, Ovid Embase, Ovid Global Health, and Ovid PsycInfo, for peer reviewed articles. Two authors conducted the full text screening, data extraction, and quality assessment independently. Data were extracted and analysed thematically. RESULTS: The database search yielded 1198 results, of which 16 papers met the inclusion criteria and were included in the review. Overall, young people face multiple barriers relating to availability, accessibility, and quality when accessing formal youth friendly sexual and reproductive health services. Some of these barriers included embarrassment, fear of stigma, and lack of knowledge about available services. Our findings indicate that young women preferred to receive sexual and reproductive health information from their mothers, while young men preferred to seek information from their peers. In contrast, young people in included studies were less likely to prefer more formal sources of information and care, such as resources at their schools (teachers and the school curriculum), and trained healthcare providers. CONCLUSIONS: Potential strategies to improve sexual and reproductive health information and services in Sri Lanka to better meet the needs of young people include the education of parents and teachers, increased partnerships with young people to develop effective healthcare interventions, and tailored promotion of available youth-friendly resources. More research is needed on how sexual and reproductive health needs vary between young people from different socio-demographic groups.