A reduction in maternal mortality remains critical, particularly in sub-Saharan Africa, were significant disparities in access to healthcare affect outcomes. In Angola, almost half of women give birth outside the health system, highlighting the need to increase access to maternity services and information related to women’s sexual and reproductive health and rights (SRHR). The study comprehensively examines young Angolan women’s health literacy in SRHR and its role for institutional delivery. The data were derived from a cross-sectional survey involving 1139 women aged 18–24 years who had given birth, recruited from the provinces of Luanda, Huambo and Lunda Sul. The results included a univariate description of the participants’ socio-demographics and SRHR characteristics, and the barriers and facilitators to institutional delivery they identified. In addition, logistic regression models assessed associations between the participants health literacy levels and the odds for institutional delivery. Findings revealed that more than half of the women delivered in healthcare institutions. These women were comparably economically advantaged, often literate and resided in urban areas. Major barriers identified included lack of transportation and financial resources; facilitators also included companionship and trust in respectful treatment. Regardless of the delivery setting, many women lacked information on fundamental SRHR topics. There were significant associations between health literacy and the site of delivery in all areas considered, except in Lunda Sul. Women who had acquired SRHR information from healthcare professionals, had access to several sources of SRHR information and were acquainted with multiple SRHR topics exhibited higher odds of having had an institutional delivery. The study underscores the need to bolster young women’s access to essential SRHR information and knowledge. However, addressing socio-economic barriers and healthcare limitations concurrently is essential. Multisectoral approaches are vital to ensure widespread access to quality maternity services, thereby ensuring women can safely give birth in quality healthcare settings.

The authors have declared no competing interest.

GP and AM received grant no. 2020-03102 from the Swedish Research Council (https://www.vr.se/). FVDR was funded through a Calouste Gulbenkian Foundation PALOP and East Timor (https://gulbenkian.pt/en) PhD scholarship (Process number: 1445517). The funding agencies did not influence the design, conduct or analysis of the study.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was obtained from the Ethics Committee Institutional Review Board of the Angolan Ministry of Health (24/C.E.). U/2021, 2021-07-07), the Ethics Committee at the Universidade Católica de Angola (Aprovação 153, CEIH 230, 2021-06-30) and the Swedish Ethics Review Authority (Dnr 2022-06393-01, 2023-01-25).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data are fully available without restriction.