Female adolescents’ reproductive health decision-making capacity and contraceptive use in sub-Saharan Africa: What does the future hold?

Abstract

Introduction Given the social, economic, and health consequences of early parenthood, unintended pregnancy, and the risks of HIV infection and subsequent transmission, there is an urgent need to understand how adolescents make sexual and reproductive decisions regarding contraceptive use. This study sought to assess the association between female adolescents' reproductive health decision-making capacity and their contraceptive usage. Materials and methods Data was obtained from pooled current Demographic and Health Surveys (DHS) conducted in 32 countries in sub-Saharan Africa (SSA). The unit of analysis for this study was adolescents in sexual unions [n = 15,858]. Bivariate and multivariable analyses were conducted using Pearson chi-square tests and binary logistic regression respectively. All analyses were performed using STATA version 14.2. Results were presented using Odds Ratios [OR] and adjusted Odds Ratios [AOR]. Statistical significance was set at p<0.05. Results The results showed that 68.66% of adolescents in SSA had the capacity to make reproductive health decisions. The overall prevalence of contraceptive use was 18.87%, ranging from 1.84% in Chad to 45.75% in Zimbabwe. Adolescents who had the capacity to take reproductive health decisions had higher odds of using contraceptives [AOR = 1.47; CI = 1.31-1.65, p < 0.001]. The odds of contraceptive use among female adolescents increased with age, with those aged 19 years having the highest likelihood of using contraceptives

Predictors of modern contraceptive use among adolescent girls and young women in sub-Saharan Africa: a mixed effects multilevel analysis of data from 29 demographic and health surveys

“…Responses to this question were coded as "no method", "folkloric method", "traditional method" and "modern method". Details of the specific contraceptives under each of the methods have been described elsewhere [30]. The existing DHS variable excluded women who were pregnant and those who had never had sex.…”

Rural-urban Correlates of Modern Contraceptives Utilization Among Adolescents in Zambia: a National Cross-sectional Survey

“…Married adolescents and those who have had a child have been shown to be more likely to utilize modern contraceptives. Our study showed that contraceptive utilization in Zambia is lower than that of the sub-Saharan region average, Europe, Latin America and United States of America (USA) [9,10,[21][22][23] and higher than that in Uganda [17], Chad and Benin [9]. The higher prevalence in Europe and United States of America (USA) can be attributed to the easier access of contraceptives, increased funding of policies, and interventions being implemented by these governments compared to Zambia [22,24].…”

“…Promoting use of modern contraceptives in this age group is a priority intervention that will ensure improvement of pregnancy health-related outcomes [7,8]. Due to the heterogeneous nature of the sub-Saharan region, sub-regional variations exist in contraceptive use among young women [9]. Despite the various interventions and policies to promote modern contraceptives utilization among young women in Sub-Saharan Africa, the utilization rate has remained low [2,10,11].…”

What Influences Modern Contraceptive Utilisation Among Single Mothers in Nigeria? Evidence from Pooled Cross-Sectional Surveys

“…This study investigated the factors in uencing modern contraceptive utilisation among single mothers. The study differs from existing studies that focused on other segments of childbearing women such as adolescents [21][22][23], never married women [24][25][26] and women of advanced reproductive age [27][28][29][30] by focusing on single mothers. This group of women has received little attention in family planning programming in Nigeria.…”

“…Existing studies in Nigeria and elsewhere have examined the associated factors of modern contraceptive utilisation among different segments of women such as adolescents and young people [21][22][23], never married women [24][25][26], women of advanced reproductive age [27][28][29][30]. Other studies have focused the general population of childbearing women [31][32][33][34].…”