Service Marketing and Intentions to Access Sexual and Reproductive Health Among Young Adults in Nakivale Refugee Settlement: A Qualitative Perspective

Abstract

Background: Access to sexual and reproductive health (SRH) products is vital for enhancing individual well-being and socio-economic outcomes. However, marginalized populations, particularly refugees in Uganda, face significant barriers that limit their ability to seek and utilize these essential health services. Understanding these barriers is crucial for addressing the needs of these vulnerable groups. Methodology: This qualitative study explores factors influencing young adults’ intentions to access SRH products within the Nakivale Refugee Settlement. Data were collected through in-depth interviews, and thematic analysis was used to identify how various components of the service marketing mix—such as price, place, promotion, products, process, physical evidence, and personnel—interact with cultural beliefs, economic realities, and social norms, influencing attitudes and behaviours toward SRH services. Results: The findings reveal significant barriers, including a lack of essential SRH products, high costs necessitating informal payment methods, and infrastructural challenges that impede service access. Cultural stigmas and privacy concerns further complicate service uptake, often overshadowing promotional efforts. While some participants reported positive healthcare interactions, many expressed dissatisfactions due to substandard care and unwelcoming environments. Conclusion: This study underscores that social pressures and traditional values significantly influence SRH health-seeking behaviours, diminishing the effectiveness of basic marketing strategies. There is an urgent need for culturally sensitive and trust-building approaches to address these issues. By integrating marketing principles with community engagement, stakeholders can develop more effective interventions, ultimately improving sexual and reproductive health outcomes in refugee settlements.