Stakeholder Perspectives on Adolescent Sexual and Reproductive Health Service Utilisation in Uganda's Busoga Region: A Qualitative Exploratory Study

Objective To explore adolescents' attitudes, perceptions, and preferences regarding sexual and reproductive health (SRH) services in Busoga, Uganda, and to examine community leaders' and health providers' perspectives to inform youth-friendly interventions. Design Exploratory qualitative study under a constructivist paradigm, using key informant interviews (KIIs) and focus group discussions (FGDs). Analysis was inductive, following Braun and Clarke's six-step thematic approach, and guided by the Health Belief Model and Andersen's Behavioural Model. Setting Rural and urban sites in Iganga and Bugweri districts, Uganda. Participants Six KIIs with community leaders and six with health providers; four FGDs with adolescents (n=39). Results Five themes emerged: (1) positive attitudes toward SRH but persistent misconceptions; (2) structural and interpersonal barriers including distance, cost, and judgemental providers; (3) preference for free, peer-led, school/community-based services with gender-matched staff; (4) sociocultural constraints such as early marriage and religious prohibitions; and (5) system gaps including commodity shortages and limited staff training. Conclusion Adolescents are motivated to protect their SRH but face multilevel barriers. Culturally sensitive, adolescent-friendly strategies, peer engagement, and reliable supply chains are urgently needed.