Baraka M Morris, Suleiman Chombo, Connie M Ulrich, Deodatus Cv Kakoko
Background Tanzania has made efforts to improve access to sexual and reproductive health services (SRHS) for teenagers, yet few teens actually use them. One possible reason is that what teens expect from care may not match what their communities find acceptable. There is also limited information on whether concerns about informed consent, privacy, confidentiality, and community attitudes toward premarital sex affect whether teens seek SRHS. This study examined these concerns and their relationship to SRHS use among unmarried teens in Morogoro, Tanzania. Methods We selected 614 unmarried teens from various areas of Morogoro. Of these, 604 agreed to participate, and 382 (63.2%) returned completed questionnaires. After excluding 70 largely incomplete ones, 312 teens were included in the final analysis. We collected information using a modified WHO questionnaire with 38 additional questions about ethical issues related to sexual and reproductive health services. We grouped similar questions to identify key ethical aspects and examined whether these aspects were linked to teens' use of the services. Results Three main ethical aspects were identified: informed consent, moral views about premarital sex, and privacy and confidentiality. Moral views about premarital sex and privacy and confidentiality were linked to greater use of SRHS. Conclusion Teens often feel they need their community's approval before seeking sexual and reproductive health services, while also needing their privacy to be protected. Respecting community values while providing private, comfortable, and teen-friendly care may help improve the use of these services.