Mapping Evidence Regarding Decision-Making on Contraceptive Use among Adolescents in Sub-Saharan Africa: A Scoping Review

Abstract

This scoping review mapped and synthesised existing evidence on the influence of individual, parental, peer, and societal-related factors on adolescents’ decisions to use contraception in sub-Saharan Africa (SSA). Peer-reviewed and review articles published before May 2022, targeting adolescents aged 10–19 years were searched in PubMed, MEDLINE with Full Text via EBSCOhost, PsychINFO via EBSCOhost, CINAHL with Full Text via EBSCOhost, Google Scholar, Science Direct, and Scopus databases. Seven studies were included and analysed using thematic analysis based on the social-ecological model (SEM) and reported using the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Individual (fear of side effects, fear of infertility), parental (parental disappointment and disapproval), peer (social stigma), partner (association with promiscuity and multiple sexual partners), societal and community (contraceptive use disapproval and stigma), and institutional and environmental factors (lack of privacy and confidentiality) influence contraceptive decisions among adolescents. These also include a lack of accurate information, social exclusion, negative health provider attitudes, and a lack of infrastructure that provides privacy and safe spaces. Identifying and addressing core issues within the context of local cultural practices that restrict contraceptive use is important. Holistic, inclusive approaches that promote the well-being of adolescents must be utilised to provide a conducive environment that ensures privacy, confidentiality, safety, and easy access to contraceptive services.

Does Quality of Counseling and Exposure to Family Planning Messages Influence the Use of Modern Contraceptives Among Women in Northern Nigeria?

“…Although a few studies (24,30) have also reported a non-significant effect of media exposure. There is evidence in literature on how effective mass media can promote accurate information about contraceptives, stimulating attitudinal and behavioural changes, increasing community awareness and mobilization and combating the spread of misinformation and socio cultural and religion myths regarding the use of contraceptives (38)(39)(40)(41)(42).…”

“Everyone has their own problems and realities so the religious community cannot judge someone.” Contraception motivations and perceived consequences among young contraceptive users who practice a religion in Burkina Faso

“…Numerous factors at the individual, interpersonal, and societal levels have been identified to be related to contraceptive use, non-use (or ineffective use) among adolescents and youth [ 6 ]. Among the societal factors, the influence of religious norms is important to highlight since these norms often support high fertility (and non-use of contraception) while at the same time they condemn sexual relations outside of marriage [ 7 – 10 ].…”