A comparative human rights analysis of laws and policies for adolescent contraception in Uganda and Kenya

Abstract

Background Improving access to adolescent contraception information and services is essential to reduce unplanned adolescent pregnancies and maternal mortality in Uganda and Kenya, and attain the SDGs on health and gender equality. This research studies to what degree national laws and policies for adolescent contraception in Uganda and Kenya are consistent with WHO standards and human rights law. Methods This is a comparative content analysis of law and policy documents in force between 2010 and 2018 governing adolescent (age 10–19 years) contraception. Between and within country differences were analysed using WHO’s guidelines “Ensuring human rights in the provision of contraceptive information and services”. Results Of the 93 laws and policies screened, 26 documents were included (13 policies in Uganda, 13 policies in Kenya). Ugandan policies include a median of 1 WHO recommendation for adolescent contraception per policy (range 0–4) that most frequently concerns contraception accessibility. Ugandan policies have 6/9 WHO recommendations (14/24 sub-recommendations) and miss entirely WHO’s recommendations for adolescent contraception availability, quality, and accountability. On the other hand, most Kenyan policies consistently address multiple WHO recommendations (median 2 recommendations/policy, range 0–6), most frequently for contraception availability and accessibility for adolescents. Kenyan policies cover 8/9 WHO recommendations (16/24 sub-recommendations) except for accountability. Conclusions The current policy landscapes for adolescent contraception in Uganda and Kenya include important references to human rights and evidence-based practice (in WHO’s recommendations); however, there is still room for improvement. Aligning national laws and policies with WHO’s recommendations on contraceptive information and services for adolescents may support interventions to improve health outcomes, provided these frameworks are effectively implemented.

Determinants of quality contraceptive counselling information among young women in Sierra Leone: insights from the 2019 Sierra Leone demographic health survey

“…In addition, the practice of family planning is anchored on the use of modern contraceptives to prevent unplanned pregnancies that are unwanted many of these end up as unsafe abortions in many low resource settings [ 3 ]. Therefore, use of modern contraceptives contributes to the progress towards achieving the Sustainable Development Goals (SDGs) by lowering maternal and child morbidity and mortality [ 2 , 4 ].…”

Ever Use of Modern Contraceptive among Adolescents in Uganda: A Cross-Sectional Survey of Sociodemographic Factors

“…Contraceptive prevalence rates in Uganda among married couples increased from 14% in 2011 to 35%, according to the 2016 Uganda Demographic Health Survey (UDHS 2016) yet that of sexually active married and unmarried adolescents was 25.1%. Uganda's National policies on contraception use among adolescents allow sexually active adolescents to access contraceptives without the consent of the parent/guardian [11]. To understand what drives contraceptive use in this age group, data on the association between demographic characteristics and the use of modern contraceptives among adolescents is crucial.…”

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“…11,12 Five articles discuss school health policy, prevention and regulation of internet game disorder, public policy evaluation and literature review of video game addiction policy responses, policymaking interventions and policy strategies for substance abuse in adolescents. [13][14][15][16][17] One article on the analysis of the Juvenile Contraception Law, 18 one article on the literature review on the prevention of mental health disorders. 19 One article systematically reviewed health promotion interventions.…”

“…A comparative human rights analysis of laws and policies for adolescent contraception in Uganda and Kenya. Perehudoff et al 18 Relevant laws and policies applicable between 2010 and 2018 can be accessed via national government websites and legal databases.…”