Interventions to improve adolescents' contraceptive behaviors in low- and middle-income countries: a review of the evidence base

Gottschalk, Lindsey B.; Ortaylı, Nuriye

doi:10.1016/j.contraception.2014.04.017

Cited by 62 publications

(55 citation statements)

References 24 publications

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“…In Ghana, Opoku (2010) and Hindin, McGough, and Adanu (2014) have reported similar barriers to condom use, including shyness in buying contraceptives, the cost of contraceptives, and non-youth friendly health services being barriers to access. Two recent reviews show the critical importance of changing selfefficacy and behavioural control beliefs in increasing young people's condom use (Gottschalk and Ortayli 2014;Napierala Mavedzenge, Doyle, and Ross 2011). Our results suggest that changing efficacy beliefs towards buying and negotiating condom use among young women could be a useful focus of future interventions aiming at preventing teenage pregnancies in Ghana.…”

Section: Discussionmentioning

confidence: 83%

Beyond love: a qualitative analysis of factors associated with teenage pregnancy among young women with pregnancy experience in Bolgatanga, Ghana

Krugu

Mevissen

Münkel

et al. 2016

Culture, Health & Sexuality

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Globally, an estimated 16 million young women aged 15 to 19 years give birth every year. Most teenage pregnancies are unintended and being pregnant or delivering a baby as a teenager can have serious adverse consequences. Knowledge of the environmental factors and social cognitive determinants influencing young women's failure to protect against unintended pregnancy is necessary to address the high rate of teenage pregnancies. We conducted semi-structured in-depth interviews with 21 young women, who had experience of pregnancy, in Bolgatanga, Ghana. The interview protocol included themes (relationships, sex, pregnancy, family planning) and determinants (knowledge, attitudes, self-efficacy, norms, risk perceptions) derived from empirical studies and theories related to sexuality behaviour. Findings show that young women's motivations for sexual relationships are mostly 'beyond love' and seem to focus on economic factors. The main means of sexual protection seems to be condom use. Other forms of contraception were believed to be linked to infertility. Sexuality remains a largely taboo topic for open discussion and sex education in schools seems limited to abstinence-only messages. The need for more open communication on matters of sexuality with young people and the provision of a more comprehensive sexuality education in school to address teenage pregnancies in Ghana, is discussed.

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Section: Discussionmentioning

confidence: 83%

Beyond love: a qualitative analysis of factors associated with teenage pregnancy among young women with pregnancy experience in Bolgatanga, Ghana

Krugu

Mevissen

Münkel

et al. 2016

Culture, Health & Sexuality

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“…[30] A literature review on the topic reported that most interventions to improve adolescent access to care focused on making services more adolescent-friendly, including provider awareness of adolescents’ needs and barriers to care, counseling skills and providing privacy and confidentiality. [32] An analysis of nationally representative survey data about family planning quality-of-care from the healthcare user’s perspective in Mexico found that adolescent and younger women (15–24 years) were less likely to receive high quality care than adult women (25–29 years). [33]…”

Section: Discussionmentioning

confidence: 99%

Quality of reproductive healthcare for adolescents: A nationally representative survey of providers in Mexico

Villalobos¹,

Allen‐Leigh²,

Salazar-Alberto³

et al. 2017

PLoS ONE

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ObjectiveAdolescents need sexual and reproductive health services but little is known about quality-of-care in lower- and middle-income countries where most of the world’s adolescents reside. Quality-of-care has important implications as lower quality may be linked to higher unplanned pregnancy and sexually transmitted infection rates. This study sought to generate evidence about quality-of-care in public sexual and reproductive health services for adolescents.MethodsThis cross-sectional study had a complex, probabilistic, stratified sampling design, representative at the national, regional and rural/urban level in Mexico, collecting provider questionnaires at 505 primary care units in 2012. A sexual and reproductive quality-of-healthcare index was defined and multinomial logistic regression was utilized in 2015.ResultsAt the national level 13.9% (95%CI: 6.9–26.0) of healthcare units provide low quality, 68.6% (95%CI: 58.4–77.3) medium quality and 17.5% (95%CI: 11.9–25.0) high quality reproductive healthcare services to adolescents. Urban or metropolitan primary care units were at least 10 times more likely to provide high quality care than those in rural areas. Units with a space specifically for counseling adolescents were at least 8 times more likely to provide high quality care. Ministry of Health clinics provided the lowest quality of service, while those from Social Security for the Underserved provided the best.ConclusionsThe study indicates higher quality sexual and reproductive healthcare services are needed. In Mexico and other middle- to low-income countries where quality-of-care has been shown to be a problem, incorporating adolescent-friendly, gender-equity and rights-based perspectives could contribute to improvement. Setting and disseminating standards for care in guidelines and providing tools such as algorithms could help healthcare personnel provide higher quality care.

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“…Evidence from reviews and studies that fed into the WHO Guidelines “Preventing Early Pregnancy and Poor Reproductive Outcomes Among Adolescents” as well as subsequent systematic reviews point to the factors that contribute to improved contraceptive access to adolescents [14–16]. For planning purposes, it is useful to conceptualize these factors into those that are supply and demand, as some frameworks have done [17, 18].…”

Section: Introductionmentioning

confidence: 99%

A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it

et al. 2017

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BackgroundIncreasingly, the health and rights of adolescents are being recognized and prioritized on the global agenda. This presents us with a “never-before” opportunity to address adolescent contraception. This is timely, as there are enormous numbers of adolescents who are currently unable to obtain and use contraceptives. From research evidence and programmatic experience, it is clear that we need to do things differently to meet their needs/fulfil their rights.Main bodyIn this commentary, we call for action in several key areas to address adolescents’ persistent inability to obtain and use contraceptives. We must move away from one-size-fits-all approaches, from a ‘condoms-only’ mind set, from separate services for adolescents, from ignoring the appeal of pharmacies and shops, and from one-off-training to make health workers adolescent friendly. Our efforts to expand access to quality contraceptive services to adolescents must be combined with efforts to build their desire and ability to use them, and to do so consistently. In order for these changes to be made, action must be taken on several levels. This includes the formulation of sound national policies and strategies, robust programme implementation with monitoring, regular programmatic reviews, and implementation research. Further, high-quality collection, analysis, and dissemination of data must underlie all of our efforts. As we move ahead, we must also recognize and draw lessons from positive examples of large scale and sustained programmes in countries that have led the way in increasing contraceptive use by adolescents.ConclusionThis unprecedented moment in history gives us a real opportunity to bring about transformational change, particularly when there is so much at stake.

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Interventions to improve adolescents' contraceptive behaviors in low- and middle-income countries: a review of the evidence base

Abstract: Though the evidence base is weak, there are promising foundations for adolescent contraceptive interventions in nearly every region of the world. We offer recommendations for programmers and identify gaps in the evidence base to guide future research.

Cited by 62 publications

References 24 publications

Beyond love: a qualitative analysis of factors associated with teenage pregnancy among young women with pregnancy experience in Bolgatanga, Ghana

Beyond love: a qualitative analysis of factors associated with teenage pregnancy among young women with pregnancy experience in Bolgatanga, Ghana

Quality of reproductive healthcare for adolescents: A nationally representative survey of providers in Mexico

A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it

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