Assessment of sexual and reproductive health literacy among adolescents in Moldova

Abstract

Introduction. Despite significant progress in sexual and reproductive health (SRH) in Moldova, adolescents, particularly vulnerable populations such as refugees and the Roma minority, still face barriers to accessing accurate information and services. INTERSOS Moldova, Youth Friendly Center “Neovita”, “Nicolae Testemițanu” SUMPh, and two non-governmental organizations providing healthcare are collaborating to develop a digital resource to improve health literacy and access to healthcare among refugee and disadvantaged youth in Moldova. Aim of study. To learn about adolescents’ and young refugees SRH needs in terms of knowledge and healthcare; to co-design an App content and to promote social cohesion and collaboration among local and refugee youth in addressing SRH challenges. Methods and materials. Focus group discussions (FDG) were organized and conducted in 3 geographically distinct regions of Moldova, carried out by 2 experienced researchers in Romanian, Russian, or both and audio recorded with the participants permission. Each FDG groups lasted between 90 to 120 min. In total, 50 young participants from the Republic of Moldova, Ukrainian refugees, and Roma individuals aged between 15 and 24 years old get involved in. Interview guide had 12 opened questions related to: knowledge use of Apps and websites; what young people would like to know about SRH; where young people currently go for SRH information; where young people currently go for SRH care and digital health issues. The ethics committee’s approval was obtained. Results. Participants demonstrated a strong reliance on social media, particularly platforms like Instagram, TikTok, and YouTube, for SRH information. Important gaps in awareness and a demand for improved education on contraception, sexually transmitted infections, male and female puberty, and menstruation were identified. Health professionals were considered credible sources, but shame and fear of dismissal hindered direct engagement. Anonymity, confidentiality, and the use of digital platforms, such as Apps, were identified as potential enablers for accessing SRH information. Conclusion. The findings underscore the potential for a digital youth-focused SRH resource that adolescents can use independently. Clarity through easily understandable formats, including audio and video content were considered important features. Collaboration with health professionals and official health organizations is essential for credibility, and a resource incorporating opportunities for anonymous access to experts was proposed. To enhance SRH education, involving peer educators and facilitating direct interactions with younger health professionals in schools are recommended. Acknowledgement. The work reported in this publication was funded by the European Union. The authors gratefully acknowledge all members of INTERSOS Moldova and "Nicolae Testemițanu" SUMPh for their work on the project overall and for the contributions of project documentation used in this manuscript.