Abstract
INTRODUCTION: Sexual and reproductive health (SRH) is a fundamental aspect of overall well-being, shaped not only by sociocultural and institutional barriers faced by patients, but also by healthcare providers' information-seeking behaviours, attitudes and clinical practices. Evidence examining these provider-level determinants remains limited in low- and middle-income settings. This study aimed to assess healthcare providers' knowledge, attitudes and practices related to SRH and to identify key obstacles and opportunities for improving service delivery. METHODS: A cross-sectional survey was conducted from June 2023 to March 2024 across tertiary care hospitals in Pakistan. Healthcare providers completed a structured, self-administered questionnaire capturing sociodemographic information, SRH-related knowledge, attitudes, practices and perceived barriers to care. Descriptive statistics and Pearson's χ(2) tests were used to assess associations between categorical variables. Multivariable logistic regression identified factors associated with positive SRH-related knowledge-seeking behaviours, attitudes and practices. RESULTS: Among 319 participants, 59.6% reported counselling patients on SRH, though only 38.2% had attended relevant workshops. Fear of stigmatisation (60.8%), religious beliefs (48.6%) and lack of knowledge (47.3%) were reported as major barriers to SRH access. While participants generally expressed progressive attitudes, such as support for comprehensive sex education (86.5%) and youth access to contraception (75.6%), engagement in related practices remained limited. Positive SRH attitudes were significantly associated with employment in private institutions (OR 3.93, 95% CI 1.18 to 13.14), higher confidence in personal SRH knowledge (OR 1.97, 95% CI 1.08 to 3.58), and ease in discussing SRH with male guardians (OR 2.20, 95% CI 1.22 to 3.97). CONCLUSIONS: Despite encouraging attitudes among healthcare providers, substantial gaps in SRH education and proactive engagement persist. Addressing these deficiencies through structured training programmes, supportive institutional environments and policy-level reforms is essential to advancing SRH equity and quality in Pakistan.