Attitudes toward sexual and reproductive health among adolescents and young people in urban and rural DR Congo

Abstract

BackgroundIn the Democratic Republic of Congo (DRC), onset of sexual intercourse is initiated during adolescence, however only two in ten sexually active unmarried women are using modern contraception. Improving adolescents’ and young peoples’ knowledge and practices related to sexual and reproductive health (SRH) is necessary to improve health outcomes. However, little is known about the SRH attitudes and needs among young people in the DRC. The study aims to contribute to the available evidence by examining adolescents’ and young people’s insights on their cultural norms, practices and attitudes towards SRH services.MethodsFourteen focus group discussions were conducted with a total of 224 adolescents and young people aged 15–24 years in urban and rural areas of the DRC. The topics discussed and age groups of participants differed somewhat in the urban and rural areas. Data were analyzed to identify themes in the participants’ discussion of their attitudes towards SRH.ResultsRegardless of age differences, common themes emerged. Both in rural and urban areas premarital sex was largely sanctioned by peers but not adults; adolescents feared pregnancy and had limited knowledge of contraceptive methods. Many were misinformed that certain common pharmaceutical products (e.g., decaris) prevent pregnancy. Key barriers to accessing contraception from health facilities and pharmacies included shame and stigma; urban participants also cited cost and judgmental attitudes of health providers.ConclusionAddressing the SRH needs of adolescents and young people can have life-long protective benefits. Increasingly decision-makers and gatekeepers in the DRC are accepting the concept of providing SRH services and information to young people. This study shows the pressing need for information and services for young people in both urban and rural areas. The continued expansion SRH programming to all health zones and the developed of the National Strategic Plan for Health and Wellbeing of Adolescents and Youth 2016–2020 are steps toward that goal.

Contraceptive use among adolescent and young women in North and South Kivu, Democratic Republic of the Congo: A cross-sectional population-based survey

“…Adolescents should have access to a broad range of methods offered by qualified providers. Although adolescents often seek contraception outside of health facilities, the majority of our sample received their method in a public health facility, consistent with other findings in DRC in which some adolescents express a preference for going to a health facility over a pharmacy for contraception [24]. The use of a health facility is likely related to the high LARC use in this population (as LARCs are rarely available outside a health facility), similar to findings in a review of DHS data from adolescents in 33 countries [25].…”

“…These findings are consistent with studies showing that adolescents often endorse social norms that reinforce gender inequalities, including a lack of control over their own SRH or lack of empowerment [29,30]. In addition, substantial stigma related to contraceptive use, including that women who use contraception are promiscuous, may contribute to this attitude [24,[31][32][33]. Research suggests that women's empowerment may be associated with modern contraceptive use [34,35].…”

Young people’s experiences in accessing sexual and reproductive health services in sub-Saharan Africa from 1994 to 2019 - A content analysis

“…and STI services as well as dictating the type and nature of services young people should have.The review revealed that young people complained that discouraging and sometimes abusive remarks from health service providers were a great source of worry and a major barrier to them seeking SRH services in sub-Saharan Africa and across the world[37,[54][55][56][57][58].Negative attitude of health service providers was responsible for the embarrassment, fear and shame that the young people experienced which made it diffi cult for them to seek SRH services[36,[59][60][61][61][62][63]. Misconceptions about contraceptive methods such as, the use of hormonal methods like the pill and injectable cause infertility were found in the various studies to be major deterrent to some young women from seeking SRH services.…”

A Bricolage on Perception of Sexuality Education among Medical Students

“…The mean age of the participants studied by Duru et al [5] was 22.3±3.3 years and in a study by Opora et al [1] , the students were aged 10 -20 years, with a median age of 15 [1] . Attitudes about reproductive health among males and females aged 15-19 years were studied [15] . The study found 93% did not find sexuality education embarrassing.…”