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IntroductionThis paper aims to describe and assess social demographic factors associated with childbearing decision-making, fertility and contraceptive intentions among street adolescents and youth in Kampala, Uganda while considering rural-urban migration as an explanatory factor.Materials and MethodsA cross-sectional survey of 513 adolescents and youth aged 12–24 years self-identifying as street adolescents and youth were interviewed with a structured questionnaire in 2019. Street adolescents and youth who migrated from other rural districts to Kampala were compared with those from the city. Logistic regression was performed to assess associations between the independent factors and personal childbearing decision-making, fertility and contraceptive intentions.ResultsOverall, 80.31% of the street adolescents and youth had a rural-urban migration experience. Fifty six percent (56.32%) of the street adolescents and youth made personal childbearing decisions, 94.15% expressed intentions to have children in the future and 42.88% expressed intentions to use contraceptives in the future. Intentions to use contraceptives were significantly higher among males (58.75%) than females (20.00%), and higher among migrants (65.91%) compared to non-migrants (34.09%). Contraceptive intentions were positively associated with self-perceived permanent residential status (aOR = 10.26, 2.70–39.08), intra-urban mobility (aOR = 4.99, 95%CI 1.50–6.59) and intentions to migrate to other towns within the country (aOR = 5.33, 95%CI 1.59–17.80). Being married (aOR = 0.13, 95%CI 0.02–0.85), a large shelter population size (aOR = 0.13, 95%CI 0.03–0.63) and having repeat migrations between the city and home district (aOR = 0.23, 95%CI 0.05–0.94), including migration-associated challenges reduced the odds of street youth's personal childbearing decision-making, while belonging to a social support group increased the odds of childbearing decision-making. We found no significant association between social demographic characteristics and fertility intentions.DiscussionFactors that influenced personal childbearing decision-making and contraceptive intentions among street adolescents and youth in Kampala operate mainly at the interpersonal and community levels, with marital status, shelter population size, rural-urban migration and its associated challenges associated with childbearing decision-making. Interventions to promote childbearing decision-making and contraceptive use among street adolescents and youth should take into consideration their migration and intra-urban mobility patterns.

Background While the nexus of migration and health outcomes is well acknowledged, the effect of rural–urban migration on the use of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural–urban migration on the use of SRH services, while controlling for confounding, and whether there is a difference in the use of SRH services among migrant and non-migrant street children and young adults. Methods Data were collected from 513 street children and young adults aged 12–24 years, using venue-based time-space sampling (VBTS). We performed multivariate logistic regression analysis using Stata 16.0 to identify factors associated with SRH services use, with rural–urban migration status as the main predictor. Participants were further classified as new migrants (≤ 2 years of stay in city), established migrants (> 2 years of stay in city) or non-migrants (lifelong native street children) with no rural–urban migration history. Results Overall, 18.13% of the street children and young adults had used contraception/family planning, 58.67% had tested for human immunodeficiency virus (HIV) and knew their status and 34.70% had been screened for sexually transmitted infections (STIs). Non-migrants were 2.70 times more likely to use SRH services (HIV testing, STI screening and family planning) compared to the migrants (aOR = 2.70, 95% CI 1.23–5.97). Other factors associated with SRH services use among street children and young adults include age (aOR = 4.70, 95% CI 2.87–7.68), schooling status (aOR = 0.33, 95% CI 0.15–0.76), knowledge of place of care (aOR = 2.71, 95% CI 1.64–4.46) and access to SRH information (aOR = 3.23, 95% CI 2.00–5.24). Conclusions SRH services utilisation among migrant street children and young adults is low compared to their non-migrant counterparts and is independently associated with migration status, age, schooling status, knowledge of place of care and access to SRH information. Our findings call for the need to design and implement multi-dimensional interventions to increase the use of SRH services among street children and young adults, while taking into consideration their migration patterns.

Background: While the nexus of migration and health outcomes is well acknowledged, the effect of rural-urban migration on use of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural-rural migration on the use of SRH services while controlling for confounding and whether there is a difference in the use of SRH services among migrant and non-migrant street children and young adults.Methods: Data were collected among 513 street children and young adults aged 12 - 24 years using face‐to‐face interviews using venue-based time-space sampling (VBTS). Using STATA 16.00, multivariate logistic regression analysis was performed to identify factors associated with SRH services use, with rural-urban migration status as the main predictor. Participants were further classified as new migrants (≤ 2 years of stay in city), established migrants (> 2 years of stay in city), or non-migrants (lifelong native street children) with no rural-urban migration history.Results: Overall, 18.13% of the street children and young adults had ever used contraception/family planning, 58.67% had ever tested for HIV and knew their status while 34.70% had ever been screened for sexually transmitted infections (STIs). Non-migrant street children and young adults were 2.7 times more likely to use SRH services (HIV testing, STI screening and family planning) compared to the migrants (aOR = 2.7, 95%CI 1.23-5.97). Other factors associated with SRH services use among street children and young adults include age (aOR=4.70; 95%CI 2.87 - 7.68), schooling status (aOR = 0.33, 95%CI 0.15-0.76), knowledge of place of care (aOR = 2.71, 95%CI 1.64 - 4.46) and access to SRH information (aOR = 3.23, 95%CI 2.0 - 5.24). Conclusions: Access to and use of SRH services among migrant street children and young adults is low compared to the non-migrant street children and young adults and is independently associated with migration status, age, schooling status, knowledge of place of SRH care and access to SRH information. Our findings call for the need to design and implement multi-dimensional interventions to increase use of SRH services among street children and young adults while taking into consideration their migration patterns.

While research on the nexus of migration and wellbeing of individuals has gained recognition in recent years, far less attention has been devoted to intra-urban mobility especially among the urban poor young populations. We assess the drivers of intra-urban mobility using a random sample of 412 migrant street children and youth in Kampala city, Uganda. This paper draws from a larger cross-sectional survey of circular migration and sexual and reproductive health choices among street children in Kampala, Uganda. We define ‘migrants’ as street children and youth with a rural-urban migration experience and ‘intra-urban mobility’ as the number of places stayed in or moved since migrating to the city, measured on a continuous scale. More than half (54.37%) of the migrant street children and youth had lived in two or more places since migrating to the city. Multivariate negative binomial regression analysis reveals migrant street children and youth’s intra-urban mobility to be associated with gender (aIRR = 0.71, 95%CI 0.53–0.96), sex work (aIRR = 1.38, 95%CI 1.01–1.88), a daily income of one USD or more (aIRR = 1.57, 95%CI 1.16–2.13) and duration of stay in the city (aIRR = 1.54, 95%CI 1.17–2.01). Other drivers of intra-urban mobility included availability of causal work, personal safety and affordability of rental costs. Our findings suggest the need for urban housing and health policies to take into account street children and youth’s intra-urban mobility and its drivers. Future research on all drivers of street children and youth’s intra-urban mobility and its linkage with their health outcomes is recommended.

Background: While the nexus of migration and health outcomes is well acknowledged, the effect of rural-urban migration on use of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural-rural migration on the use of SRH services while controlling for confounding and whether there is a difference in the use of SRH services among migrant and non-migrant street children and young adults.Methods: Data were collected among 513 street children and young adults aged 12 - 24 years using face‐to‐face interviews using venue-based time-space sampling (VBTS). Using STATA 16.00, multivariate logistic regression analysis was performed to identify factors associated with SRH services use, with rural-urban migration status as the main predictor. We defined migrants as street children and young adults aged 12 - 24 years who migrated from rural districts and settled in Kampala city for a period of not more than 24 months preceding the survey.Results: Overall, 18.13% of the street children and young adults had ever used contraception/family planning, 45.89% had ever tested for HIV and knew their status while 34.70% had ever been screened for sexually transmitted infections (STIs). Migrant street children and young adults had reduced odds of using SRH services (HIV testing, use of FP and screening for STIs compared to non-migrant street children and young adults (aOR=0.59, 95%CI 0.36 - 0.97). Other factors associated with use of SRH services among street children and young adults include age (aOR=4.51; 95%CI 2.78 - 7.33), schooling status (aOR=0.34; 95%CI - 1.830 0.15-0.76), knowledge of place of care (aOR=3.37,95%CI 2.04 - 5.34) and access to SRH information (aOR=2.7, 95%CI 1.67 - 4.53). Conclusion: Access to and use of SRH services is low among migrant street children and adults compared to the non-migrant street children and young adults and is independently associated with rural-urban migration status, age, schooling status, knowledge of place of SRH care and access to SRH information. Our findings call for the need to design and implement multi-dimensional interventions to increase use of SRH services among street children and young adults while taking into consideration their migration patterns.

Background While the nexus of migration and health outcomes is well acknowledged, the effect of rural-urban migration on uptake of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural-rural urban migration on uptake of SRH services and whether there is a difference in uptake of SRH services among migrant and non-migrant street children. Methods Data were collected among 513 street children aged 12-24 years using face‐to‐face interviews. Participants were recruited by venue-based time-space sampling (VBTS). Using STATA 16.00, we performed multivariate binary logistic regression to identify correlates of SRH service uptake with migration status as the main predictor while controlling for confounding. In this study, migrants are defined as children who had moved to settle in the city for at least 24 months preceding the survey. Results Overall, two-thirds (66.82%) of children had moved to the city in the last 2 years, 20% in the last 3-5 years and 13.18% in 6 years or longer. Only 18.13% of the street children had ever used contraception/family planning, 45.89% had ever tested for HIV and knew their status while 34.70% had ever been screened for sexually transmitted infections. Multivariate analysis shows that migrant street children had reduced odds of using sexual and reproductive health services (HIV testing, use of contraception and screening for STIs) compared to the lifelong native street children (aOR=0.59, 95%CI 0.36- 0.97). Other factors associated with use of SRH services among street children include age (aOR=4.51; 95%CI 2.78-7.33), schooling status (aOR=0.34; 95%CI -1.830 0.15-0.76), knowledge of place of care (OR=3.37,95%CI 2.04-5.34) and access to SRH education information (aOR=2.7, 95%CI 1.67- 4.53). Conclusion Rural-urban migration is associated with low SRH service uptake. Access to and use of SRH services among migrant street children is low compared to non-migrant street children. Our findings point to the need for urban health systems to design effective interventions to improve equitable access to and use of quality SRH services among street children while taking into consideration their migration patterns.