Non-use of contraception: determinants among Ugandan university students

Abstract

BackgroundIn Uganda, adolescent pregnancy often results in adverse maternal and neonatal health outcomes. In this context, low use of contraception and high rates of maternal mortality rate make preventing unwanted pregnancies critical.ObjectiveThe objective was to determine the relationship between non-use of contraception and socio-demographic factors, alcohol consumption, and types of partner(s) among Ugandan university students.DesignIn 2010, 1,954 students at Mbarara University of Science and Technology in southwestern Uganda participated in a cross-sectional study whereby a self-administered questionnaire was used to assess socio-demographic factors, alcohol consumption, and sexual behaviour including the use of contraceptives. Multivariable logistic regression was used for the analysis and data were stratified by sex.Results1,179 students (60.3% of the study population) reported that they were sexually active. Of these, 199 (18.6%) did not use contraception in their last sexual encounter. Students currently not in a relationship had higher odds of non-use of contraception (odds ratio 1.8, 95% confidence interval 1.2–2.7). The association remained statistically significant for both males and females after controlling for age, sexual debut, area of growing up, and educational level of the household head. Socio-demographic determinants of age (22 or younger), early sexual debut (at age 16 years or earlier), and a rural background were significant for males but not for females. A synergistic effect between not currently being in a relationship and early sexual debut were also observed to have an effect on the non-use of contraception.ConclusionNon-use of contraception among Ugandan university students differs for males and females, possibly due to gendered power relations. Sexual and reproductive health policies and programmes should be designed to take these differences into account.

Contraceptive non-use and associated factors among university students in 22 countries.

“…These country variations seem similar to those in population survey-based observations among never married 15-19 year old women and 15-24 year old men, where modern contraceptive non-use in Nigeria was among women 69% and men 58%, in India (women 82% and men 82%), in the Philippines 96% among women, and in Colombia 41% among women. 2 The study found, in agreement with other studies 10,14,15,17,18 , that younger age, a higher degree of religiosity or intrinsic religiosity and religious affiliation (Hindu and Muslim) were associated with contraception non-use. According to WHO 13 , reasons for a global unmet need for contraception particularly include young people and cultural or religious opposition.…”

“…1 Data from population-based surveys 2 shows low rates of current contraceptive use, among sexually active, never-married women (15)(16)(17)(18)(19) 2 Among sexually active university students, the following proportions of lack or contraception non-use were found: in Botswana: Sometimes/never used contraception among male (20%) and female (26%) 3 ; in China 48.7%-84% had not taken contraceptive measures during the episode of first sexual intercourse 4,5 , in Lebanon: 76% of females had generally not used contraceptives (75.6%) 25% have ever used any contraceptive method 7 and 66% were currently not using contraceptives 8 , in South Africa 19% had not used contraceptives at last sexual encounter 9 , in Uganda 19% did not use contraception in their last sexual encounter 10 ; in Ukraine, 32% and 19% did not use contraceptives at their first and most recent sexual intercourse, respectively 11 and among women in the US, 23% reported not using contraception. 12 Globally, "Reasons for a global unmet need for contraception include: limited choice of methods; limited access to contraception, particularly among young people, poorer segments of populations, or unmarried people; fear or experience of side-effects; cultural or religious opposition; poor quality of available services; gender-based barriers.…”

“…13 Among university students factors associated with contraceptive non-use for women, men or both can be summarized as follows: 1) socio-demographic factors (younger age, lower educational level 10,14,15 , being male 16 , higher degree of religiosity 17,18 , high price of contraceptives 14 ); 2) Sexual behaviour (early sexual debut 10,16,19 , not previously pregnant 20 , more than one sexual partner in the past 12 months 20 , internet use (sex) 21,22 ; Psychosocial factors or internal assets (low locus of control, low personal initiative and assertiveness 14 , lack of life satisfaction 23 , and psychological distress 24,25 ), and 3) other factors (fear of side effects of modern contraceptives 7 , lack of exposure to healthcare worker talking about contraception 12 ).…”

“…10 This study, therefore, seeks to address this gap by correlating the association between socio-demographic factors, sexual behaviour and risk, internal assets, and mental health variables with nonuse of contraception among university students in 22 countries across Africa, Asia and America.…”

Prevention of unintended pregnancies in Nigeria; the effect of socio-demographic characteristic on the knowledge and use of emergency contraceptives among female university students

“…7 The predictors of emergency contraception use as determined by this study are similar to the findings in Uganda. 26 A study in the United States of America also identified moral acceptability and ease of obtaining emergency contraceptives as potent predictors of use. 27 This study has provided important baseline information regarding emergency contraceptives among female university students.…”