2024
Investigating disease awareness of cutaneous leishmaniasis in rural Sri Lanka to inform public health services: a cross-sectional study
Gunasekara S, Agampodi T, Weerasinghe M, Fernando M, Price H, Wickramasinghe N, Agampodi S. Investigating disease awareness of cutaneous leishmaniasis in rural Sri Lanka to inform public health services: a cross-sectional study. BMJ Open 2024, 14: e088714. PMID: 39581720, PMCID: PMC11590865, DOI: 10.1136/bmjopen-2024-088714.Peer-Reviewed Original ResearchConceptsSecondary outcome measuresAnuradhapura districtOutcome measuresProbability sample of householdsTreatment centresMultistage cluster samplingPublic health interventionsPublic health servicesCross-sectional studyData collection periodExpert consensus approachPrimary disease characteristicsRural Sri LankaPrimary outcome measureSample of householdsHealth interventionsLow disease awarenessHealth servicesPerceived susceptibilityEvidence-basedCommunity awarenessDisease awarenessDivisional Secretariat areaCluster samplingProbability sampleGlobal burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
Collaborators G, Brauer M, Roth G, Aravkin A, Zheng P, Abate K, Abate Y, Abbafati C, Abbasgholizadeh R, Abbasi M, Abbasian M, Abbasifard M, Abbasi-Kangevari M, ElHafeez S, Abd-Elsalam S, Abdi P, Abdollahi M, Abdoun M, Abdulah D, Abdullahi A, Abebe M, Abedi A, Abedi A, Abegaz T, Zuñiga R, Abiodun O, Abiso T, Aboagye R, Abolhassani H, Abouzid M, Aboye G, Abreu L, Abualruz H, Abubakar B, Abu-Gharbieh E, Abukhadijah H, Aburuz S, Abu-Zaid A, Adane M, Addo I, Addolorato G, Adedoyin R, Adekanmbi V, Aden B, Adetunji J, Adeyeoluwa T, Adha R, Adibi A, Adnani Q, Adzigbli L, Afolabi A, Afolabi R, Afshin A, Afyouni S, Afzal M, Afzal S, Agampodi S, Agbozo F, Aghamiri S, Agodi A, Agrawal A, Agyemang-Duah W, Ahinkorah B, Ahmad A, Ahmad D, Ahmad F, Ahmad N, Ahmad S, Ahmad T, Ahmed A, Ahmed A, Ahmed A, Ahmed L, Ahmed M, Ahmed S, Ahmed S, Ajami M, Akalu G, Akara E, Akbarialiabad H, Akhlaghi S, Akinosoglou K, Akinyemiju T, Akkaif M, Akkala S, Akombi-Inyang B, Al Awaidy S, Al Hasan S, Alahdab F, AL-Ahdal T, Alalalmeh S, Alalwan T, Al-Aly Z, Alam K, Alam N, Alanezi F, Alanzi T, Albakri A, AlBataineh M, Aldhaleei W, Aldridge R, Alemayohu M, Alemu Y, Al-Fatly B, Al-Gheethi A, Al-Habbal K, Alhabib K, Alhassan R, Ali A, Ali A, Ali B, Ali I, Ali L, Ali M, Ali R, Ali S, Ali W, Alicandro G, Alif M, Aljunid S, Alla F, Al-Marwani S, Al-Mekhlafi H, Almustanyir S, Alomari M, Alonso J, Alqahtani J, Alqutaibi A, Al-Raddadi R, Alrawashdeh A, Al-Rifai R, Alrousan S, Al-Sabah S, Alshahrani N, Altaany Z, Altaf A, Al-Tawfiq J, Altirkawi K, Aluh D, Alvis-Guzman N, Alvis-Zakzuk N, Alwafi H, Al-Wardat M, Al-Worafi Y, Aly H, Aly S, Alzoubi K, Al-Zyoud W, Amaechi U, Mohammadi M, Amani R, Amiri S, Amirzade-Iranaq M, Ammirati E, Amu H, Amugsi D, Amusa G, Ancuceanu R, Anderlini D, Anderson J, Andrade P, Andrei C, Andrei T, Anenberg S, Angappan D, Angus C, Anil A, Anil S, Anjum A, Anoushiravani A, Antonazzo I, Antony C, Antriyandarti E, Anuoluwa B, Anvari D, Anvari S, Anwar S, Anwar S, Anwer R, Anyabolo E, 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Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet 2024, 403: 2162-2203. PMID: 38762324, PMCID: PMC11120204, DOI: 10.1016/s0140-6736(24)00933-4.Peer-Reviewed Original ResearchConceptsDisability-adjusted life yearsHigh body-mass indexTheoretical minimum risk exposure levelSocio-demographic indexBody-mass indexRisk-outcome pairsParticulate matter air pollutionChild growth failureBurden of diseaseGlobal disease burdenGlobal burdenHealth outcomesRisk factorsDisease burdenMetabolic riskAmbient particulate matter air pollutionSocio-demographic Index locationsGlobal Burden of Disease StudyBurden of Disease StudyGlobal Burden of DiseaseComparative risk assessment frameworkAge-standardised ratesExposure to risk factorsPopulation attributable fractionSpecific health outcomesGlobal burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
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Waqas M, Ward P, Wassie E, Watson S, Watson S, Weerakoon K, Wei M, Weintraub R, Weiss D, Westerman R, Whisnant J, Wiangkham T, Wickramasinghe D, Wickramasinghe N, Wilandika A, Wilkerson C, Willeit P, Wilson S, Wojewodzic M, Woldegebreal D, Wolf A, Wolfe C, Wondimagegene Y, Wong Y, Wongsin U, Wu A, Wu C, Wu F, Wu X, Wu Z, Xia J, Xiao H, Xie Y, Xu S, Xu W, Xu X, Xu Y, Yadollahpour A, Yamagishi K, Yang D, Yang L, Yano Y, Yao Y, Yaribeygi H, Ye P, Yehualashet S, Yesiltepe M, Yesuf S, Yezli S, Yi S, Yigezu A, Yiğit A, Yiğit V, Yip P, Yismaw M, Yismaw Y, Yon D, Yonemoto N, Yoon S, You Y, Younis M, Yousefi Z, Yu C, Yu Y, Yuh F, Zadey S, Zadnik V, Zafari N, Zakham F, Zaki N, Bin Zaman S, Zamora N, Zand R, Zangiabadian M, Zar H, Zare I, Zarrintan A, Zeariya M, Zeinali Z, Zhang H, Zhang J, Zhang J, Zhang L, Zhang Y, Zhang Z, Zhao H, Zhong C, Zhou J, Zhu B, Zhu L, Ziafati M, Zielińska M, Zitoun O, Zoladl M, Zou Z, Zuhlke L, Zumla A, Zweck E, Zyoud S, Wool E, Murray C. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet 2024, 403: 2100-2132. PMID: 38582094, PMCID: PMC11126520, DOI: 10.1016/s0140-6736(24)00367-2.Peer-Reviewed Original ResearchConceptsAge-standardised death ratesChronic obstructive pulmonary diseaseGlobal burdenLife expectancyObstructive pulmonary diseaseGlobal life expectancyHighest age-standardised death ratesLower respiratory infectionsDeath rateCause-specific death ratesGlobal Burden of Disease StudyCause-of-death dataDecompose life expectancyLatin AmericaBurden of Disease StudyGlobal Burden of DiseaseHigh-income super-regionAge-standardised deathAge-standardised ratesSubnational locationsStudy periodOut-of-sample predictive validityCause-of-death estimatesCause-specific estimatesGBD super-regions
2023
Challenges of Continuation of Exclusive Breast Feeding up to 6 Months in a Setting with High Exclusive Breast Feeding Rates Reported. Experience from Eastern Province of Sri Lanka
Ranasinghe J, Madushika D, Abeysundara S, Agampodi S. Challenges of Continuation of Exclusive Breast Feeding up to 6 Months in a Setting with High Exclusive Breast Feeding Rates Reported. Experience from Eastern Province of Sri Lanka. Maternal And Child Health Journal 2023, 27: 1996-2001. PMID: 37270754, DOI: 10.1007/s10995-023-03724-2.Peer-Reviewed Original ResearchConceptsExclusive breastfeedingNon-exclusive breastfeedingExclusive breast feeding ratesPublic Health Midwife areasDescriptive cross-sectional studyEarly cessationResultsThe mean ageBreast feeding ratesCross-sectional studyWorld Breastfeeding Trends InitiativeExclusive breastSingle centerMean ageMaternal ageChildren 1Risk factorsOdds ratioBreastfeedingMonthsMedical officersUnemployed mothersHealth areaSignificant predictorsBirth orderMothers
2021
The hidden burden of adolescent pregnancies in rural Sri Lanka; findings of the Rajarata Pregnancy Cohort
Agampodi TC, Wickramasinghe ND, Jayakodi HG, Amarasinghe GS, Warnasekara JN, Hettiarachchi AU, Jayasinghe IU, Koralegedara IS, Gunarathne SP, Somasiri DK, Agampodi SB. The hidden burden of adolescent pregnancies in rural Sri Lanka; findings of the Rajarata Pregnancy Cohort. BMC Pregnancy And Childbirth 2021, 21: 494. PMID: 34233652, PMCID: PMC8265066, DOI: 10.1186/s12884-021-03977-1.Peer-Reviewed Original ResearchConceptsEdinburgh Postpartum Depression ScaleAdolescent pregnancyPregnancy cohortPregnant womenRural Sri LankaLower body mass indexUtilization of SexualLower hemoglobin levelsBody mass indexPostpartum Depression ScaleReproductive health servicesMental health statusPeriod of gestationHealth care servicesLow education levelMental health effectsResultsBaseline dataBlood investigationsPrimigravida mothersHemoglobin levelsMass indexFirst pregnancyClinical examinationMaternal healthSRH services
2019
Suicidal ideation and intentional self-harm in pregnancy as a neglected agenda in maternal health; an experience from rural Sri Lanka
Arachchi NSM, Ganegama R, Husna AWF, Chandima DL, Hettigama N, Premadasa J, Herath J, Ranaweera H, Agampodi TC, Agampodi SB. Suicidal ideation and intentional self-harm in pregnancy as a neglected agenda in maternal health; an experience from rural Sri Lanka. Reproductive Health 2019, 16: 166. PMID: 31729997, PMCID: PMC6858764, DOI: 10.1186/s12978-019-0823-5.Peer-Reviewed Original ResearchConceptsEdinburgh Postpartum Depression ScalePregnant womenSuicidal ideationRural Sri LankaMaternal mental health issuesAdditional pregnant womenTertiary care centerPrevalence of depressionHigher EPDS scoresCross-sectional studyData extraction sheetPostpartum Depression ScaleSelf-administered questionnaireMental health issuesCurrent pregnancyProbable anxietyThird trimesterEPDS scoresMaternal healthPregnancy recordsPregnant mothersSectional studyCare centerPregnancy periodClinical dataBody image perception and body dissatisfaction among rural Sri Lankan adolescents; do they have a better understanding about their weight?
Goonapienuwala BL, Agampodi SB, Kalupahana NS, Siribaddana S. Body image perception and body dissatisfaction among rural Sri Lankan adolescents; do they have a better understanding about their weight? Ceylon Medical Journal 2019, 64: 82-90. PMID: 32115403, DOI: 10.4038/cmj.v64i3.8950.Peer-Reviewed Original ResearchConceptsBody dissatisfactionBody image perceptionImage perceptionBody image distortionPubertal Development ScaleFigure Rating ScaleIdeal body sizeHalf of boysSri Lankan adolescentsDiscrepancy scoresCurrent body sizeRural adolescentsDevelopment ScaleAdolescentsDissatisfactionMore boysBoysGirlsPerceptionRating ScalePubertal developmentStudentsOverweight studentsImage distortionPhysical problemsStudy protocol: characterising the clinical, epidemiological and aetiological aspects of leptospirosis in Sri Lanka: a hospital based clinico-epidemiological study
Agampodi S, Warnasekara J, Jayasundara D, Senawirathna I, Gamage C, Kularatne S, Siribaddana S, Maththias M, Vinetz J. Study protocol: characterising the clinical, epidemiological and aetiological aspects of leptospirosis in Sri Lanka: a hospital based clinico-epidemiological study. BMJ Open 2019, 9: e027850. PMID: 31511281, PMCID: PMC6738675, DOI: 10.1136/bmjopen-2018-027850.Peer-Reviewed Original ResearchConceptsEthics Review CommitteeMultilocus sequence typingOutpatient departmentClinico-epidemiological studyMulticentre prospective studyDay of admissionMicroscopic agglutination testPresence of diseaseHospital stayFebrile patientsMedical wardsProspective studySri Lankan isolatesRisk factorsVenous bloodDisease progressionEthical clearanceHigh incidenceAetiological aspectsPatientsAgglutination testMolecular epidemiologyPatient contextBedside inoculationLeptospirosisAn outbreak of leptospirosis with predominant cardiac involvement: a case series
Jayathilaka PGNS, Mendis ASV, Perera MHMTS, Damsiri HMT, Gunaratne AVC, Agampodi SB. An outbreak of leptospirosis with predominant cardiac involvement: a case series. BMC Infectious Diseases 2019, 19: 265. PMID: 30885170, PMCID: PMC6423826, DOI: 10.1186/s12879-019-3905-7.Peer-Reviewed Original ResearchConceptsColombo North Teaching HospitalCardiac involvementMulti-organ dysfunctionCase seriesSevere leptospirosisTeaching hospitalDynamic T-wave changesInotropic/vasopressor supportNon-specific clinical findingsEvidence of myocarditisPredominant cardiac involvementRapid atrial fibrillationSingle medical wardAcute kidney injuryMean arterial pressureStudy of patientsCourse of illnessT-wave changesCase presentationWe reportOutbreak of leptospirosisPossible leptospirosisResidual complicationsVasopressor supportKidney injuryCommon complication
2016
Clinical Features and Transmission Pattern of Hepatitis A: An Experience from a Hepatitis A Outbreak Caused by Two Cocirculating Genotypes in Sri Lanka.
Dahanayaka NJ, Kiyohara T, Agampodi SB, Samaraweera PK, Kulasooriya GK, Ranasinghe JC, Semage SN, Yoshizaki S, Wakita T, Ishii K. Clinical Features and Transmission Pattern of Hepatitis A: An Experience from a Hepatitis A Outbreak Caused by Two Cocirculating Genotypes in Sri Lanka. American Journal Of Tropical Medicine And Hygiene 2016, 95: 908-914. PMID: 27382079, PMCID: PMC5062799, DOI: 10.4269/ajtmh.16-0221.Peer-Reviewed Original ResearchConceptsHepatitis A virusMost patientsHepatitis AHAV immunoglobulin MIntermediate endemic areaAcute viral hepatitisUpper abdominal discomfortHepatitis A outbreaksHigh-risk groupStrains of HAVMilitary personnelAcute hepatitisHAV vaccinationPale stoolsAbdominal discomfortViral hepatitisClinical featuresHepatitis outbreakSubgenotype IAClinical informationInfected personsPatientsA virusHepatitisSerial outbreaks
2015
The 2013 measles outbreak in Sri Lanka: experience from a rural district and implications for measles elimination goals
Dahanayaka NJ, Pahalagamage S, Ganegama RM, Weerawansa P, Agampodi SB. The 2013 measles outbreak in Sri Lanka: experience from a rural district and implications for measles elimination goals. Infectious Diseases Of Poverty 2015, 4: 51. PMID: 26627462, PMCID: PMC4667465, DOI: 10.1186/s40249-015-0084-7.Peer-Reviewed Original ResearchConceptsMeasles elimination goalElimination goalsMeasles immunization schedulePosterior cervical lymphadenopathyCommon clinical featuresIntensive care unitUniversity Medical UnitMonths of ageBasic demographic detailsCervical lymphadenopathyKoplik's spotsMaculopapular rashImmunization statusPrior immunizationVaccine scheduleCare unitClinical featuresImmunization scheduleMeasles vaccineSevere pneumoniaMeasles immunizationProspective studyRespiratory difficultyRubella vaccineEpidemiological profileDermatoglyphics in hypertension: a review
Wijerathne B, Meier RJ, Agampodi TC, Agampodi SB. Dermatoglyphics in hypertension: a review. Journal Of Physiological Anthropology 2015, 34: 29. PMID: 26265377, PMCID: PMC4534102, DOI: 10.1186/s40101-015-0065-3.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedBiomarkersDermatoglyphicsFemaleHumansHypertensionMaleMiddle AgedYoung AdultConceptsDermatoglyphic markersMeta-Analyses (PRISMA) statementPreferred Reporting ItemsSystematic literature searchMean total ridge countTotal ridge countGlobal burdenHypertensionHigh riskElevated riskReporting ItemsClinical standpointFetal developmentSystematic reviewHypertensive samplesLiterature searchWhorl patternGoogle ScholarConsistent findingMedical advancementsAvailable studiesGrey literatureRelevant publicationsNumber of studiesRiskRisk factors associated with purchasing pesticide from shops for self-poisoning: a protocol for a population-based case–control study
Weerasinghe M, Konradsen F, Eddleston M, Pearson M, Gunnell D, Hawton K, Jayamanne S, Pabasara C, Jayathilaka T, Dissanayaka K, Rajapaksha S, Thilakarathna P, Agampodi S. Risk factors associated with purchasing pesticide from shops for self-poisoning: a protocol for a population-based case–control study. BMJ Open 2015, 5: e007822. PMID: 25995242, PMCID: PMC4442210, DOI: 10.1136/bmjopen-2015-007822.Peer-Reviewed Original ResearchConceptsAlcohol Use Disorders Identification TestSuicidal Intent ScaleRisk factorsPopulation-based case-control studyCase-control studyBeck's Suicidal Intent ScaleDisorders Identification TestLogistic regression modelsEthical review committeeFaculty of MedicineEthical approvalMethod of suicideSemistructured questionnaireIntent ScaleReview CommitteeScientific peer-reviewed articlesCharacteristics of individualsIntervention strategiesIdentification TestPeer-reviewed articlesRajarata UniversityAllied Sciences
2013
Emergence of cutaneous leishmaniasis in Polonnaruwa, Sri Lanka 2008–2011
Sandanayaka R, Kahawita I, Gamage A, Siribaddana S, Agampodi S. Emergence of cutaneous leishmaniasis in Polonnaruwa, Sri Lanka 2008–2011. Tropical Medicine And International Health 2013, 19: 140-145. PMID: 24438012, DOI: 10.1111/tmi.12232.Peer-Reviewed Original ResearchConceptsCutaneous leishmaniasisAnnual incidenceMajority of patientsMean annual incidencePolonnaruwa districtDermatology unitClinical detailsGeneral HospitalStudy populationEpidemiology UnitUpper limbLeishmaniasis surveillanceCase incidenceLeishmaniasisPatientsStudy periodIncidenceCommon typeCase distributionLesionsMore malesHospitalPopulationPolonnaruwaSri LankaFactor structure and normative data of the Sinhalese version of self reported Strength and Difficulties Questionnaire (SDQ) for adolescents
Perera S, Thalagala E, Chandrarathna S, Agampodi T, Nugegoda D, Agampodi S. Factor structure and normative data of the Sinhalese version of self reported Strength and Difficulties Questionnaire (SDQ) for adolescents. Ceylon Medical Journal 2013, 58: 66-71. PMID: 23817936, DOI: 10.4038/cmj.v58i2.5682.Peer-Reviewed Original ResearchMinor Ailments in Pregnancy Are Not a Minor Concern for Pregnant Women: A Morbidity Assessment Survey in Rural Sri Lanka
Agampodi SB, Wickramasinghe ND, Horton J, Agampodi TC. Minor Ailments in Pregnancy Are Not a Minor Concern for Pregnant Women: A Morbidity Assessment Survey in Rural Sri Lanka. PLOS ONE 2013, 8: e64214. PMID: 23675528, PMCID: PMC3651131, DOI: 10.1371/journal.pone.0064214.Peer-Reviewed Original ResearchConceptsPregnant womenQuality maternal health careAcute maternal illnessHeartburn/regurgitationCause of hospitalizationFrequency of hospitalizationMain outcome measuresMaternal health careHealth promotion strategiesCross-sectional studyGlobal public health agendaIll-health conditionsPublic health agendaTwo-stage clusterAnuradhapura districtMaternal illnessMaternal morbidityAcute illnessSecondary outcomesGestational ageCommon symptomsTotal admissionsMaternal mortalitySectional studyPregnancy period
2012
Anaemia in pregnancy in the district of Anuradhapura, Sri Lanka – need for updating prevalence data and screening strategies
Chathurani U, Dharshika I, Galgamuwa D, Wickramasinghe N, Agampodi T, Agampodi S. Anaemia in pregnancy in the district of Anuradhapura, Sri Lanka – need for updating prevalence data and screening strategies. Ceylon Medical Journal 2012, 57: 101-6. PMID: 23086024, DOI: 10.4038/cmj.v57i3.4148.Peer-Reviewed Original ResearchConceptsPrevalence of anemiaMean corpuscular hemoglobin concentrationMean corpuscular volumePregnant womenMean corpuscular hemoglobinDistrict of AnuradhapuraHemoglobin concentrationAnemic pregnant womenMedian hemoglobin concentrationCorpuscular hemoglobin concentrationAnuradhapura districtHaemoglobin Colour ScaleAntenatal clinicSerum hemoglobinGestational ageThird trimesterAnemia prevalenceMethemoglobin methodClinical examinationStudy populationAnemiaCorpuscular volumePregnancyPrevalence dataCorpuscular hemoglobinInadequacy of the risk factor based approach to detect gestational diabetes mellitus
Dahanayaka N, Agampodi S, Ranasinghe O, Jayaweera P, Wickramasinghe W, Adhikari A, Chathurani H, Dissanayaka U. Inadequacy of the risk factor based approach to detect gestational diabetes mellitus. Ceylon Medical Journal 2012, 57: 5-9. PMID: 22453704, DOI: 10.4038/cmj.v57i1.4193.Peer-Reviewed Original ResearchConceptsGestational diabetes mellitusRisk factorsIADPSG criteriaPregnant womenDiabetes mellitusPrevalence of GDMOral glucose tolerance testCross-sectional descriptive studyEligible pregnant womenPregnancy Study GroupsGlucose tolerance testSectional descriptive studyPresent risk factorsGDM patientsGDM casesGestational ageWHO criteriaPlasma glucoseTolerance testStudy groupStudy populationDescriptive studyMedical officersHealth areaMellitus
2010
Prevalence of Mental Health Problems in Adolescent Schoolchildren in Galle District, Sri Lanka
Agampodi TC, Agampodi SB, Fonseka P. Prevalence of Mental Health Problems in Adolescent Schoolchildren in Galle District, Sri Lanka. Asia Pacific Journal Of Public Health 2010, 23: 588-600. PMID: 20460278, DOI: 10.1177/1010539509349866.Peer-Reviewed Original ResearchConceptsMental health problemsPrevalence of MHPsAdolescent schoolchildrenHealth problemsDescriptive cross-sectional studyCross-sectional studySelf-administered questionnaireStudy populationSinhalese versionPrevalenceDifficulties QuestionnaireStudy instrumentGalle districtMonthsSchoolchildrenPresent studyQuestionnaireSri Lanka
2008
Adolescents perception of reproductive health care services in Sri Lanka
Agampodi SB, Agampodi TC, UKD P. Adolescents perception of reproductive health care services in Sri Lanka. BMC Health Services Research 2008, 8: 98. PMID: 18454869, PMCID: PMC2386785, DOI: 10.1186/1472-6963-8-98.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdolescent Health ServicesAdultAttitude to HealthConfidentialityFemaleFocus GroupsHealth Services Needs and DemandHumansMaleMasturbationMenstrual CyclePsychology, AdolescentQualitative ResearchReproductive Health ServicesSri LankaStress, PsychologicalSurveys and QuestionnairesUrban PopulationConceptsHealth care servicesCare servicesHealth problemsHealth servicesRoutine health care servicesReproductive health care servicesYouth-friendly service provisionReproductive health service deliveryCommonest health problemReproductive health problemsYouth-friendly servicesHealth seeking behaviourReproductive health knowledgeYouth health serviceHealth care providersYears of ageHealth service deliveryPublic health systemMethodsThis qualitative studyHealth care programsReproductive health mattersSemi-urban settingFocus group guideLack of confidentialityMenstrual cycle