REPRODUCTIVE HEALTH LITERACY AMONG ADOLESCENTS IN THE PHILIPPINES: A CONVERGENT MIXED-METHODS STUDY OF KNOWLEDGE, ATTITUDES, AND BARRIERS TO INFORMATION ACCESS

Abstract

Adolescent reproductive health remains a significant public health concern, particularly in low-resource settings where limited reproductive health literacy and restricted access to reliable information contribute to poor health outcomes. This study examined the knowledge, attitudes, and awareness of adolescents regarding reproductive health in Tabuk City, Kalinga, Philippines, and explored the individual, familial, and sociocultural factors influencing access to reproductive health information and services. A convergent mixed-methods design was employed involving 386 adolescents aged 13–19 years selected through purposive sampling. Quantitative data were collected using a validated structured questionnaire, while qualitative data were generated through key informant interviews and focus group discussions with healthcare providers, educators, and community stakeholders. Descriptive statistics and thematic analysis were used to analyze and integrate the findings. Most participants were aged 15–19 years, enrolled in formal education, living with both parents, and had no history of sexual intercourse. However, discussions on sexuality and reproductive health within families were generally limited. Fewer than half of the participants demonstrated adequate reproductive health knowledge, with misconceptions particularly related to fertility, pregnancy, contraceptive methods, and HIV/AIDS, despite generally favorable attitudes toward responsible reproductive health behaviors. Qualitative findings further revealed that misinformation, limited awareness of adolescent-friendly health services, inadequate access to reliable reproductive health information, poor internet connectivity, and sociocultural norms continue to hinder adolescents' reproductive health literacy and utilization of available services. These findings highlight a critical gap between adolescents' positive attitudes and their actual reproductive health knowledge, underscoring the need for integrated, culturally responsive interventions that strengthen comprehensive sexuality education, improve parent–adolescent communication, and enhance equitable access to adolescent-friendly reproductive health services. The study provides context-specific evidence to inform reproductive health policies and adolescent health promotion strategies in the Philippines and other comparable resource-constrained settings.