Background: Adolescents in developing countries face a range of sexual and reproductive health problems. Lack
of health care service for reproductive health or difficulty in accessing them are among them. In this study we
aimed to examine health care workers' attitudes toward sexual and reproductive health services to unmarried
adolescents in Ethiopia.

Methods: We conducted a descriptive cross-sectional survey among 423 health care service providers working in
eastern Ethiopia in 2010. A pre-tested structured questionnaire was used to collect data. Descriptive statistics,
chi-square tests and logistic regression were performed to drive proportions and associations.

Results: The majority of health workers had positive attitudes. However, nearly one third (30%) of health care
workers had negative attitudes toward providing RH services to unmarried adolescents. Close to half (46.5%) of the
respondents had unfavorable responses toward providing family planning to unmarried adolescents. About 13% of
health workers agreed to setting up penal rules and regulations against adolescents that practice pre-marital sexual
intercourse. The multivariate analysis indicated that being married (OR 2.15; 95% CI 1.44 - 3.06), lower education
level (OR 1.45; 95% CI 1.04 - 1.99), being a health extension worker (OR 2.49; 95% CI 1.43 - 4.35), lack of training on
reproductive health services (OR 5.27; 95% CI 1.51 - 5.89) to be significantly associated with negative attitudes
toward provision of sexual and reproductive services to adolescents.

Conclusions: The majority of the health workers had generally positive attitudes toward sexual and reproductive
health to adolescents. However, a minority has displayed negatives attitudes. Such negative attitudes will be
barriers to service utilization by adolescents and hampers the efforts to reduce sexually transmitted infections and
unwanted pregnancies among unmarried adolescents. We therefore call for a targeted effort toward alleviating
negative attitudes toward adolescent-friendly reproductive health service and re-enforcing the positive ones.