Perceptions of adolescents’ sexual and reproductive health and rights: a cross-sectional study in Lahore District, Pakistan

BACKGROUND Sexual and reproductive health (SRH) is a significant aspect of adolescents' growth, safeguarded by SRH rights (SRHR). Despite various global efforts to promote adolescents SRHR (ASRHR), the majority of adolescents still lack awareness and autonomy to access SRH related information and services. This research aimed to explore the knowledge and perceptions of adolescents' sexual and reproductive health rights and highlights key constraints hindering adolescents from accessing and exercising SRHR in the district of Lahore, Pakistan. METHODS The research uses a mixed methods approach including both quantitative and qualitative methods. For quantitative component, household survey was conducted with 600 respondents including adolescents (15-19 years) and their parents/caregivers. A multistage cluster random sampling technique was performed, based on the population proportion of administrative towns in Lahore district, Pakistan. A structured interview schedule was used to collect data. Quantitative data were collected by a standardized quantitative questionnaire; analysis was performed using SPSS version 21. For qualitative data collection, 12 in-depth interviews with teachers and doctors and four focus group discussions with adolescents were conducted, and analysed using thematic areas. RESULTS The research revealed a low level of perception of ASRHR amongst the respondents and identified socio-cultural and structural constraints as the major underlying issues. Although more than half of the respondents were found to be aware of ASRHR, agreed to their importance and were in favour for adolescents to have access to requisite information, nonetheless they believed that adolescents had limited ability to exercise these rights. CONCLUSIONS The research found a low level of perception amongst adolescents and their parents/caregivers about ASRHR in Lahore district emphasising the rights-based approach. There is an urgent need to design specific policies and educational programmes to promote healthy practices. Research is recommended to inform and advocate Punjab Government and communities, including partners, teachers, doctors, religious scholars and media groups, to empower adolescents through health education. This can be achieved through the inclusion of SRH topics in educational curricula, establishing a virtual knowledge centre, encouraging debate competitions, and organising orientation sessions for professionals/experts and community etc.