An Analysis of Adolescents’ Utilization of Reproductive Health Counseling Services in the Adolescent-Friendly Health Services (PKPR) Program

Abstract

Adolescent-Friendly Health Services (Pelayanan Kesehatan Peduli Remaja, PKPR) provide counseling to address adolescents’ reproductive health needs. However, program implementation does not necessarily translate into optimal service utilization. This study aimed to examine adolescents’ understanding of reproductive health and their utilization of reproductive health counseling within the PKPR program in the service area of Tanjung Marulak Community Health Center, Tebing Tinggi City, Indonesia. A mixed methods approach involved 92 adolescent respondents and 10 informants. Data were collected through questionnaires, in-depth interviews, observations, and document review. The findings showed that only eight respondents (8.7%) reported having participated in PKPR, while 84 (91.3%) had never participated. Fifty respondents had limited understanding of reproductive health, and 70 had limited understanding of ways to improve reproductive health. Qualitative findings indicated that the program was supported by health personnel who had received PKPR orientation and by collaboration across sectors and health programs. However, the counseling room was shared with nutrition services, educational resources and funding were limited, peer counselors’ roles were underdeveloped, and PKPR-specific standard operating procedures were unavailable. Barriers to service utilization included conflicts between service hours and school activities, confidentiality concerns, and fear of stigma. PKPR participation remained low, alongside limited reproductive health understanding and shortcomings in counseling delivery. The health center should ensure privacy, adapt service hours to adolescents’ needs, strengthen peer counseling and education, and establish program-specific procedures and adequate funding.