Terefe, Hirut (PhD)Lulu, Shewaye2018-07-062023-11-182018-07-062023-11-182010-06http://etd.aau.edu.et/handle/12345678/7082With expansion of access to education, more young people spend a reasonable time of their youth in schools. As a result, preparatory school students are among the fast growing segments of adolescents in Ethiopia. Although this development has a positive impact on Sexual and Reproductive Health (SRH) and the future of in-school adolescents, there are also factors that increase the SRH risks of this group. Lack of comprehensive knowledge of the risks, preventive and protective methods and limited access to SRH services are said to be contributories to the vulnerability of this group to SRH problems. The general objective of this study was to assess the status of, and factors to SRH service availability and utilization of preparatory students in rural/urban settings – at Dangilla (Amhara Regional State) and Menelik II (Addis Ababa) Preparatory Schools. A cross sectional comparative study was undertaken among students enrolled in the two schools during the academic year 2009/2010. Quantitative and qualitative methods were deployed which applied questionnaires, interviews, Focus Group Discussion (FGDs), document reviews, and observations. A total of 1068 randomly selected students (442 females and 626 males) participated in completion of the survey questionnaire. Twenty nine (29) purposively selected informants were interviewed; eight (8) FGDs were separately conducted with female and male students, teachers and parents; and relevant documents were reviewed. The findings indicate that in-school adolescents in general and females in particular are considered to be the most vulnerable groups to SRH problems. While most students have good knowledge of key SRH issues such as about most commonly used contraceptive methods and HIV transmission methods, however, rural-urban and male-female disparity in some of the issues is observed. Although female groups in most cases are at the same level, specifically in identifying basic transmission and prevention methods of HIV, misconceptions seem to be more prevalent among female respondents from Dangilla. Discussion on SRH issues among family circles still remains a taboo. In some cases SRH information and services are felt as unnecessarily available. Available RH services widely differ between the two study areas. In Addis, there are various types of SRH services provided by many agencies whereas in Dangilla these are limited both in type and providers. However, in-school SRH services, both curricular and co-curricular were more of the same and focus mainly on HIV/AIDS. Utilization of out of school healthcare services by adolescents is very limited. Some of the main factors that limit use of services were attributed to: lack of comprehensive knowledge and limited awareness on available services; concern over providers and non-youth friendliness of services (privacy/confidentiality, preference for same-sex provider, and miscommunication); societal expectations and fear of stigma (cultural and religious norms and taboos), and economic. The role of these factors varies between sites and among groups. Key words: Addis Ababa, Dangilla, knowledge, schools, reproductive health, students, utilizationenAddis AbabaDangillaknowledgeSchoolsReproductive HealthStudents UtilizationThesis