Use of contraceptives and associated factors among male adolescents in rural secondary schools, Coast Region, Tanzania: a school-based cross-sectional study

Abstract

Background Teenage pregnancy is still one of the reproductive health concerns facing adolescents in Tanzania. The problem has been associated with physiological, psychological, and social changes and increases the risk of unsafe abortion and adverse maternal, fetal, and neonatal outcomes among adolescents. Low utilization of contraceptive methods among adolescents is one of the key causes. The strategy of involving male adolescents in sexual and reproductive health programs can increase the rate of contraceptive use among adolescents, thereby preventing teenage pregnancy. Objective To examine factors associated with the uptake of contraceptives among male secondary school adolescent students. Methods This was a cross-sectional study conducted in rural secondary schools in Kisarawe District, Coast Region, Tanzania. Multi-stage sampling methods were used to recruit participants. Descriptive and multiple regression analyses were conducted to assess the prevalence and factors associated with contraceptive use. 95% confidence interval and p-value < 0.05 were considered statistical significance. Univariate and multivariate logistic regression were tested for the Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) respectively. Results The study involved 422 male students with the majority of them 58.1% aged 17–19 years, 50.2% were Muslim, 76.3% were studying in government schools, 62.3% were from households size of 4–6 members, 87.4% were not in a relationship, and 64.2% were living with both parents. Less than half (38.9%) of male students reported ever having sex in their lifetime, and among them, very few (29.8%) used any method of contraceptive. The reported lowest age for the first sex was 10 years. The male condom was the most method used (69.4%) and Pharmacy/Chemist Shops were the common source of contraceptive services (55.1%). Students who had adequate knowledge of contraceptives were more likely to report the use of contraceptive methods compared to those who had inadequate knowledge (AOR = 2.704, 95% CI: 1.220–5.995, p = 0.014). Participants in Private schools were 4.3 times more likely to report the use of contraceptives than those in government schools (AOR = 4.347, 95% CI: 1.758–10.762, p = 0.01). Students in a relationship were 3.5 times more likely than those not in a relationship to report the use of a contraceptive method (AOR = 3.51, 95% CI: 1.421–8.670, p = 0.006). Conclusion The study found the low use of contraceptives among male adolescents who ever had sex in their lifetime. Thus, it’s suggested that age-tailored comprehensive sexual and reproductive health education should start to be taught from a very young age as adolescents initiate sex at an early age. Also, Teenage pregnancy prevention programs should involve males as the key players during the development and implementation of the program as most of the decisions among partners are from men.

Prevalence and Determinants of Contraceptive Use Among Men in Tanzania: Analysis of Tanzania Demographic and Health Survey 2022

“…This suggest that in order to improve the use of family planning among Tanzanian men increasing education is key. This nding is similar to the ndings reported elsewhere (Lyimo et al, 2024;Wondim et al, 2020) However, the study ndings contradicted with the ndings reported 60% contraceptive use among men in Kibaha, Tanzania (Msovela, 2016). Though the time of the study may have led to this remarkable difference in the prevalence as time differences among the two studies time is six years.…”

“…Majority of population found in rural area (66%), and this showed the need to focus interventions on addressing the contraceptive use challenges encountered by this group on both married (51%) and unmarried (49%) population. The substantial proportion (82%) of the population possessed knowledge of contraception methods indicated a promising likelihood of informed decisionmaking and adoption of family planning methods, potentially leading to a reduction in population growth as reported in other studies (Lyimo et al, 2024;Msovela et al, 2020). This emphasized the importance of education and awareness in promoting contraceptive use and responsible reproductive informed choices (Ochako et al, 2017).…”

“…Furthermore, it has been demonstrated that both age and educational progress play a role in the utilization of contraceptives, indicating that maturity and educational attainment serve as factors promoting family planning among Tanzanian men, as it was also reported in other studies (Wondim et al, 2020). This emphasized the importance of education as a key element in improving the adoption of contraceptives and highlights the necessity for reproductive health education among adolescents to prevent unintended pregnancies (Lyimo et al, 2024). Moreover, with advancing age, it becomes increasingly probable that a man has initiated a family and has achieved the desired number of children compared to younger individuals.…”

Trends in Utilization of Emergency Contraceptives in Tanzania: A Retrospective Longitudinal Study From 2018 to 2023

“…Most studies examining the acceptability of ECs by potential users and health providers have demonstrated acceptance of this method. ECs are generally perceived as particularly useful for adolescents who initiate sexual activity without contraceptive protection and in cases of rape or accidents during the use of other contraceptives [11,16]. According to different studies, IUDs are preferred by women who have given birth [17].…”

“…Research conducted in various countries has revealed a lack of knowledge regarding ECs. Unfortunately, this issue has not been adequately documented in Tanzania[10][11][12]. The primary aim of this study was to analyze the consumption trends of ECs over six consecutive years and provide insights into consumption trends, including exploring the reasons behind the observed fluctuations in consumption.…”