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Impact of Sexual Health Clinics on Sexual Health Service Utilization among Female Undergraduates in Nigeria

Abstract

Sexual health is an important component of the overall health and wellbeing of young women, particularly female undergraduates who may experience sexual and reproductive health concerns during their university years. Access to appropriate sexual health services can support the prevention, early detection, and management of sexually transmitted infections (STIs), unintended pregnancies, and other sexual and reproductive health conditions. However, sexual health service utilization among female undergraduates in Nigeria may be affected by inadequate awareness, stigma, concerns about confidentiality, cultural beliefs, fear of judgment, financial constraints, limited availability of youth-friendly services, and geographical or institutional barriers. Sexual health clinics may provide accessible and confidential services, including sexual health education, STI screening and treatment, contraceptive counselling, HIV testing, and referral services. Against this background, this study investigates the impact of sexual health clinics on sexual health service utilization among female undergraduates in Nigeria. The study will be anchored on Andersen's Behavioral Model of Health Services Use, the Health Belief Model, and the Social Ecological Model. Andersen's Behavioral Model explains how predisposing characteristics, enabling resources, and healthcare needs influence students' utilization of sexual health services. The Health Belief Model explains how perceived susceptibility to sexual health problems, perceived severity, perceived benefits of using sexual health services, perceived barriers, and cues to action may influence service utilization. The Social Ecological Model emphasizes the interaction between individual, interpersonal, institutional, community, and broader societal factors in determining access to and utilization of sexual health services. Collectively, these theoretical perspectives provide a suitable framework for explaining how sexual health clinics may influence sexual health service utilization among female undergraduates in Nigeria. The study will adopt a quantitative analytical cross-sectional or quasi-experimental research design. The study population will comprise female undergraduate students enrolled in selected universities across Nigeria. A multistage sampling technique will be used to select states, universities, faculties, departments, and eligible female students. Sexual health clinic availability and accessibility will be assessed using indicators such as availability of dedicated sexual health services, operating hours, accessibility, affordability, confidentiality, privacy, availability of trained healthcare personnel, STI screening and treatment, HIV testing, contraceptive counselling, sexual health education, pregnancy-related services, referral arrangements, and follow-up services. Sexual health service utilization will be assessed using indicators such as attendance at sexual health clinics, STI screening, HIV testing, contraceptive counselling and services, sexual health consultations, treatment of identified conditions, referral compliance, and follow-up attendance. Data will be collected using structured questionnaires, clinic attendance registers, service utilization records where appropriate, and relevant university health programme documents. Descriptive statistics will be used to summarize participants' characteristics, accessibility of sexual health clinics, and patterns of service utilization. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of sexual health clinics on service utilization. Where a quasi-experimental design is adopted, sexual health service utilization before and after the introduction or expansion of clinic services may be compared, while relevant demographic, socioeconomic, academic, cultural, and healthcare-access factors are appropriately controlled. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that accessible and youth-friendly sexual health clinics have a significant positive impact on sexual health service utilization among female undergraduates in Nigeria. Students with access to confidential and affordable sexual health clinics are expected to be more likely to utilize STI screening and treatment, HIV testing, contraceptive counselling, sexual health education, and appropriate referral services than students with limited access to such services. Sexual health clinics may improve utilization by providing privacy, non-judgmental care, convenient access, and services tailored to the needs of young women. Increased utilization may support early identification and management of sexual health problems and encourage preventive practices. However, stigma, fear of judgment, concerns about confidentiality, cultural beliefs, financial barriers, limited clinic availability, inconvenient operating hours, and inadequate awareness of available services may reduce utilization. The study therefore expects accessible, confidential, affordable, youth-friendly, and culturally sensitive sexual health clinics to contribute significantly to improved utilization of sexual health services among female undergraduates in Nigeria. The study is expected to contribute to the literature on sexual health clinics, sexual health service utilization, female undergraduates, sexual and reproductive health, STI prevention, HIV prevention, contraceptive services, youth-friendly healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency, universities, university health centres, sexual and reproductive health clinics, healthcare providers, development partners, student welfare departments, and policymakers regarding strategies for improving sexual health service utilization among female undergraduates. The study will also provide evidence-based recommendations for strengthening university-based sexual health clinics, improving confidentiality and privacy, expanding youth-friendly services, reducing financial and accessibility barriers, increasing awareness of available sexual health services, strengthening referral and follow-up systems, and integrating comprehensive sexual and reproductive health services into university health programmes across Nigeria.

Keywords: Sexual health clinics, sexual health service utilization, female undergraduates, sexual and reproductive health, youth-friendly healthcare, STI services, HIV testing, contraceptive services, university health services, Nigeria, public health.