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Okyere J, Aboagye RG, Ayebeng C, Dosoo AK, Salu S, Dickson KS. Hormonal contraceptive use among women living with hypertension in sub-Saharan Africa: insights from 12 countries. BMC Res Notes 2024; 17:167. [PMID: 38898484 PMCID: PMC11186193 DOI: 10.1186/s13104-024-06830-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVES Given the well-established link between hormonal contraceptives and hypertension risk, and the paucity of research on hormonal contraceptive use dynamics in this particular demographic, we hypothesize that there is a likelihood of low utilization of high-risk hormonal contraceptives among women living with hypertension in SSA. This study investigates the prevalence and factors associated with hormonal contraceptive use among women living with hypertension in the SSA. RESULTS Only 18.5% of women living with hypertension used hormonal contraceptives. Hormonal contraceptive use was high among women with a higher level of education (aOR = 2.33; 95%CI: 1.73-3.14), those currently working (aOR = 1.38; 95%CI: 1.20-1.59), those who have heard about family planning on the radio (aOR = 1.27, 95%CI: 1.09-1.47), listened to the radio at least once a week (aOR = 1.29, 95%CI: 1.10-1.51), and those residing in rural areas (aOR = 1.32; 95%CI: 1.14-1.54). Conversely, women aged 45-49 exhibited a substantial decrease in the odds of hormonal contraceptive use (aOR = 0.23, 95%CI: 0.14-0.38) compared to younger women (15-19 years). Likewise, the odds of HCU were low among cohabiting (aOR = 0.66; 95%CI: 0.48-0.89) and previously married women (aOR = 0.67; 95%CI: 0.50-0.91) than never married women.
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Affiliation(s)
- Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
- Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Castro Ayebeng
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Abigail Kabukie Dosoo
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Department of Human Resource Management, School of Business, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Salu
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
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Ndayishimye S, Olorunfemi G, Nahayo B. Prevalence and factors associated with female sterilization in Rwanda: evidence from the demographic and health survey data (2019-2020). BMC Public Health 2023; 23:2446. [PMID: 38062388 PMCID: PMC10701991 DOI: 10.1186/s12889-023-17334-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Female sterilization is a safe and effective surgical procedure of achieving contraception. There is disparity in the prevalence of female sterilization globally, with high income countries having higher rates than low- and middle-income countries. However, current evidence of the uptake of female sterilization in Rwanda is not known. We therefore evaluated the prevalence and factors associated with female sterilization among women of reproductive age in Rwanda. METHODOLOGY This was a secondary data analysis of 14,634 women of reproductive age (15-49) in Rwanda. The data utilized was from the Rwanda Demographic Health and Survey (RDHS) 2019/2020. The predictors of female sterilization were determined using multivariable binary logistic regression analysis. RESULTS We found that the prevalence of female sterilization was 1.1% among women of reproductive age in Rwanda. Women older than 35 years had about 8 times higher chance of being sterilized as compared to younger women (aOR: 7.87, 95% CI: 4.77-12.99). Women living with their partners had higher odds of being sterilized as compared to never married women (aOR: 19.23, 95% CI: 4.57-80.82), while women from minority religion are more likely to be sterilized as compared to those of the catholic religion (aOR: 2.12, 95% CI: 1.03-4.37). Women from rich household had a higher chance to be sterilized as compared to their counterparts from poor households (aOR: 3.13, 95% CI: 1.94-5.03). Women from the Western region were more likely to accept sterilization compared to women from Kigali (aOR: 2.025, 95% CI: 1.17-3.49) and women who had more than 5 children had higher odds when compared to women who had 5 or less children (aOR: 1.49, 95% CI: 1.06-2.10). CONCLUSION The overall prevalence of sterilization among Rwandan women of reproductive age was 1.1%, which was very low as compared to India (29%), China (14.1%) and United States of America (13.7%). The age, marital status, religion, household wealth quintile, region and children ever born were associated with the uptake of female sterilization among Rwandan women. Public awareness campaign on the advantages of female sterilization should be done to improve uptake.
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Affiliation(s)
- Samuel Ndayishimye
- Reproductive Health Programme, Pan African University Life and Earth Sciences Institutes, University of Ibadan, Ibadan, Nigeria.
- University of Ibadan, Ibadan, Oyo State, Nigeria.
| | - Gbenga Olorunfemi
- Division of Epidemiology and Biostatistics, University of Witwatersrand, Johannesburg, South Africa
| | - Bonfils Nahayo
- Reproductive Health Programme, Pan African University Life and Earth Sciences Institutes, University of Ibadan, Ibadan, Nigeria
- University of Ibadan, Ibadan, Oyo State, Nigeria
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Nabhan A, Kabra R, Ashraf A, Elghamry F, Kiarie J. Implementation strategies, facilitators, and barriers to scaling up and sustaining demand generation in family planning, a mixed-methods systematic review. BMC Womens Health 2023; 23:574. [PMID: 37932747 PMCID: PMC10629088 DOI: 10.1186/s12905-023-02735-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Demand generation aims to increase clients' desire to use family planning. The aim of this work was to systematically summarize strategies, facilitators, and barriers to scaling up and sustaining demand generation in family planning. METHODS We searched electronic bibliographic databases from inception to October 2022. We included quantitative, qualitative, and mixed methods reports on demand generation strategies in family planning, regardless of country, language, publication status, or methodological limitations. We assessed abstracts, titles and full-text papers according to the inclusion criteria, extracted data, and assessed methodological quality of included reports. We used the convergent integrated approach and a deductive thematic synthesis to summarize demand generation themes and subthemes. We used the health system building blocks to synthesize the factors affecting implementation (barriers and facilitators). We used GRADE-CERQual to assess our confidence in the findings. RESULTS Forty-six studies (published 1990-2022) were included: forty-one quantitative, one qualitative, and four mixed methods). Three were from one high-income country, and forty three from LMIC settings. Half of reports were judged to be of unclear risk of bias. There were unique yet interrelated strategies of scaling-up demand generation for family planning. Interpersonal communication strategies increase adoption and coverage of modern contraceptive methods, but the effect on sustainability is uncertain. Mass media exposure increases knowledge and positive attitudes and may increase the intention to use modern contraceptive methods. Demand-side financing approaches probably increase awareness of contraceptives and the use of modern contraceptive methods among poor clients. Multifaceted Demand generation approaches probably improve adoption, coverage and sustainability of modern methods use. Factors that influence the success of implementing these strategies include users knowledge about family planning methods, the availability of modern methods, and the accessibility to services. CONCLUSIONS Demand generation strategies may function independently or supplement each other. The myriad of techniques of the different demand generation strategies, the complexities of family planning services, and human interactions defy simplistic conclusions on how a specific strategy or a bundle of strategies may succeed in increasing and sustaining family planning utilization. TRIAL REGISTRATION Systematic review registration: Center for Open Science, osf.io/286j5.
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Affiliation(s)
- Ashraf Nabhan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Ramses Street, Cairo, Egypt.
| | - Rita Kabra
- Department of Sexual and Reproductive Health including UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - Alyaa Ashraf
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - James Kiarie
- Department of Sexual and Reproductive Health including UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
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NeJhaddadgar N, Ziapour A, Jafarzadeh M, Ezzati F, Rezaei F, Darabi F. Explaining barriers to childbearing using the risk communication and community engagement (RCCE) strategy: Based on action research. Health Sci Rep 2023; 6:e1606. [PMID: 37808930 PMCID: PMC10551272 DOI: 10.1002/hsr2.1606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/09/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
Background and Aims Reluctance to childbearing and then the reduction of the total fertility rate are common experiences of developed countries and many developing countries, including Iran, therefore, the purpose of this study was explaining barriers to childbearing using the risk communication and community engagement (RCCE) strategy. Methods The study was conducted by action research and according to RCCE during 9 months in Ardabil city. The statistical population consisted of 41 married women aged 15-54 who were eligible for childbearing, these women were purposefully selected from among the people covered by Ardabil health centers and interviewed. Data were collected using open and in-depth interviews by the researcher and analyzed by content analysis. Results The results of data analysis led to the extraction of three main categories, personal, familial, and social barriers. The "personal barriers" category was classified into three subcategories, namely mental, belief, and awareness barriers, the "familial barriers" category was classified into two subcategories, namely social and financial barriers, and the "social barriers" category was classified into two subcategories, political and managerial barriers. Conclusions According to the results, a set of personal, familial, and social factors could affect childbearing among married women. Identification of these factors can play an effective role in designing educational and managerial programs.
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Affiliation(s)
- Nazila NeJhaddadgar
- Social Determinants of Health Research CenterArdabil University of Medical SciencesArdabilIran
| | - Arash Ziapour
- Cardiovascular Research Center, Health Institute, Imam‐Ali HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Mohammad Jafarzadeh
- Department of Infectious DiseasesSchool of Medicine, Ardabil University of Medical SciencesArdabilIran
| | - Farahnaz Ezzati
- Health Care Center ProvinceArdabil University of Medical SciencesArdabilIran
| | - Farshid Rezaei
- Health Education and Promotion Department, Health DeputyMinistry of HealthTehranIran
| | - Fatemeh Darabi
- Department of Public HealthAsadabad School of Medical SciencesAsadabadIran
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Osuafor GN, Akokuwebe ME, Idemudia ES. Male Involvement in Family Planning Decisions in Malawi and Tanzania: What Are the Determinants? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5053. [PMID: 36981959 PMCID: PMC10048949 DOI: 10.3390/ijerph20065053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/26/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
The participation of males in joint spousal decisions is urgently needed in achieving the fundamental indicators of reproductive health. The low involvement of males in family planning (FP) decision-making is a major determining factor in low FP usage in Malawi and Tanzania. Despite this, there are inconsistent findings regarding the extent of male involvement and the determinants that aid male participation in FP decisions in these two countries. The objective of this study was to assess the prevalence of male involvement in FP decisions and its associated determinants within the household context in Malawi and Tanzania. We used data from the 2015-2016 Malawi and Tanzania Demographic and Health Surveys (DHSs) to examine the prevalence and the determinants inhibiting male involvement in FP decisions. The total sample size of 7478 from Malawi and 3514 males from Tanzania aged 15-54 years was employed in the analysis by STATA version 17. Descriptive (graphs, tables and means), bi-variate (chi-square) and logistic regression analyses (unadjusted (U) and adjusted odds ratio (AOR)) were performed to identify the determinants associated with male involvement in FP decisions. The mean age of respondents in Malawi was 32 years (±8 SD) and in Tanzania, 36 years (±6 SD), with the prevalence of male involvement in FP decisions being 53.0% in Malawi and 26.6% in Tanzania. Being aged 35-44 years [AOR = 1.81; 95% CI: 1.59-2.05] and 45-54 years [AOR = 1.43; 95% CI: 1.22-1.67], educated (secondary/higher) [AOR = 1.62; 95% CI: 1.31-1.99], having access to media information [AOR = 1.35; 95% CI: 1.21-1.51] and having a female head of household [AOR = 1.79; 95% CI: 1.70-1.90] were determinant factors of male involvement in FP decisions in Malawi. Primary education [AOR = 1.94; 95% CI: 1.39-2.72], having a middle wealth index ranking [AOR = 1.46; 95% CI: 1.17-1.81], being married [AOR = 1.62; 95% CI: 1.38-1.90] and working [AOR = 2.86; 95% CI: 2.10-3.88] were higher predictors of male involvement in FP decisions in Tanzania. Increasing the role of males in FP decisions and involvement in FP utilization may improve uptake and continuity of FP usage. Therefore, the findings from this cross-sectional study will support redesigning the ineffective strategic FP programs that accommodate socio-demographic determinants that may increase the likelihood of male involvement in FP decisions, especially in the grassroots settings in Malawi and Tanzania.
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Affiliation(s)
- Godswill Nwabuisi Osuafor
- Department of Population Studies and Demography, North-West University, Mafikeng 2735, South Africa;
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Hellwig F, Barros AJD. What are the sources of contraceptives for married and unmarried adolescents: Health services or friends? Analysis of 59 low- and middle-income countries. Front Public Health 2023; 11:1100129. [PMID: 36815169 PMCID: PMC9939762 DOI: 10.3389/fpubh.2023.1100129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/16/2023] [Indexed: 02/08/2023] Open
Abstract
Background Despite the efforts to promote universal coverage for family planning, inequalities are still high in several countries. Our aim was to identify which sources of contraceptives women mostly rely on in low- and middle-income countries (LMICs). We also explored the different sources according to age and marital status. Methods We used data from national health surveys carried out in 59 LMICs since 2010. Among all sexually active women at reproductive age, we explored inequalities in demand for family planning satisfied by modern methods (mDFPS) and in the source of modern contraceptives according to women's age, classified as: 15-19, 20-34, or 35-49 years of age. Among adolescents, mDFPS and source of method were explored by marital status, classified as married or in union and not married nor in a union. Results mDFPS was lower among adolescents than among adult women in 28 of the 59 countries. The lowest levels of mDFPS among adolescents were identified in Albania (6.1%) and Chad (8.2%). According to adolescents' marital status, the pattern of inequalities in mDFPS varied widely between regions, with married and unmarried adolescents showing similar levels of coverage in Latin America and the Caribbean, higher coverage among unmarried adolescents in Africa, and lower coverage among unmarried adolescents in Asia. Public and private health services were the main sources, with a lower share of the public sector among adolescents in almost all countries. The proportion of adolescents who obtained their contraceptives in the public sector was lower among unmarried girls than married ones in 31 of the 38 countries with data. Friends or relatives were a more significant source of contraceptives among unmarried compared to married adolescents in all regions. Conclusions Our findings indicate lower levels of mDFPS and lower use of the public sector by adolescents, especially unmarried girls. More attention is needed to provide high-quality and affordable family planning services for adolescents, especially for those who are not married.
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Affiliation(s)
- Franciele Hellwig
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil,Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil,*Correspondence: Franciele Hellwig ✉
| | - Aluísio J. D. Barros
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil,Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Schwandt H, Boulware A, Corey J, Herrera A, Hudler E, Imbabazi C, King I, Linus J, Manzi I, Merritt M, Mezier L, Miller A, Morris H, Musemakweli D, Musekura U, Mutuyimana D, Ntakarutimana C, Patel N, Scanteianu A, Shemeza BE, Sterling-Donaldson G, Umutoni C, Uwera L, Zeiler M, Feinberg S. “She is courageous because she does not care what people think about her…”: attitudes toward adolescent contraception use among Rwandan family planning providers and adult female modern contraceptive users. Reprod Health 2022; 19:204. [PMID: 36333785 PMCID: PMC9636625 DOI: 10.1186/s12978-022-01517-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction In Rwanda, only 20% of sexually active unmarried young women use family planning as compared to 64% of married women. Adolescence is an important time of growth and development that often includes the initiation of sexual activity. Sexually active adolescents need support in accessing contraceptive services to prevent negative health outcomes. In sub-Saharan Africa, the adolescent population represents a large share of the total population and that proportion is predicted to expand over time. Adolescent contraceptive needs have largely been unmet, and with growing numbers, there is increased potential for negative health sequelae. Due to the low use of contraception by adolescents in Rwanda, and the growing population of adolescents, this study aims to explore the perspectives of family planning providers and adult modern contraceptive users on adolescent contraceptive use. Inclusion of adult community members in the study is a unique contribution, as research on adolescent contraceptive use in sub-Saharan Africa relies primarily on perspectives from adolescents and family planning providers. Methods This qualitative study in 2018 utilized 32 in-depth interviews with modern contraceptive users and eight focus group discussions with family planning providers. Respondents were from Musanze and Nyamasheke districts in Rwanda, the districts with the highest and lowest modern contraceptive use among married women, respectively. Coding was conducted in Atlas.ti. Results Stigma regarding premarital sex results in barriers to adolescent access to contraceptive services. Family planning providers do provide services to adolescents; however, they often recommend secondary abstinence, offer a limited method selection, and accentuate risks associated with sexual activity and contraceptive use. Providers support adolescent clients by emphasizing the need for privacy, confidentiality, and expedient services, particularly through youth corners, which are spaces within health facilities designed to meet youth needs specifically. Modern contraceptive-using adult female community members advocate for youth access to contraception, however mothers have mixed comfort discussing sexual health with their own youth. Conclusion To destigmatize premarital sexual activity, government efforts to initiate communication about this topic must occur at national and community levels with the goal of continued conversation within the family. The government should also train family planning providers and all health personnel interacting with youth on adolescent-friendly health services. Dialogue between community members and family planning providers about adolescent access to contraceptive services could also reduce barriers for adolescents due to community members’ generally supportive views on adolescent contraceptive use. Efforts to engage adolescent caregivers in how to talk to youth about sex could also contribute to expanded use. In Rwanda, youth who are having sex use family planning less than married women. This study involved asking family planning providers and adults what they think about youth using family planning. Data for this study was collected in 2018, and included 32 interviews with adult family planning users and eight group discussions with family planning providers in two areas of Rwanda. The findings show that Rwandans believe youth should not have sex before they are married. Family planning providers do provide youth with services; however, they often push stopping sexual activity, offer a smaller selection of family planning methods, and exaggerate risks associated with sex and family planning use. Family planning providers support youth by honoring their need for privacy, keeping their secrets, and providing fast services so fewer people see them at the clinic. Providers like to help adolescents in youth corners, which are special spaces within health facilities just for youth. Importantly, adult women who use family planning want youth in their community to be able to use family planning, too. In order to respond to the issues raised, the Rwandan government can start conversations in villages and more broadly about the need for youth to have access to family planning. The government should also teach family planning providers and anyone who comes into contact with youth to offer helpful and friendly services. Setting up spaces for adults to talk with family planning providers about youth access to family planning could also contribute to fewer barriers to services for adolescents.
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Affiliation(s)
- Hilary Schwandt
- grid.281386.60000 0001 2165 7413Western Washington University, Bellingham, WA USA
| | - Angel Boulware
- grid.263934.90000 0001 2215 2150Spelman College, Atlanta, USA
| | - Julia Corey
- grid.422659.e0000 0000 9111 4134Wheaton College, Norton, USA
| | - Ana Herrera
- Northwest Vista Community College, San Antonio, USA
| | - Ethan Hudler
- grid.422656.10000 0000 9839 7069Whatcom Community College, Bellingham, USA
| | | | - Ilia King
- grid.268355.f0000 0000 9679 3586Xavier University, New Orleans, USA
| | - Jessica Linus
- grid.266673.00000 0001 2177 1144University of Maryland Baltimore County, Baltimore, USA
| | | | - Madelyn Merritt
- grid.281386.60000 0001 2165 7413Western Washington University, Bellingham, WA USA
| | - Lyn Mezier
- grid.264273.60000 0000 8999 307XSUNY Oswego, Oswego, USA
| | - Abigail Miller
- grid.281386.60000 0001 2165 7413Western Washington University, Bellingham, WA USA
| | - Haley Morris
- grid.268194.00000 0000 8547 0132Western Oregon University, Monmouth, USA
| | | | - Uwase Musekura
- grid.255407.10000 0001 0579 3386Eastern Oregon University, La Grande, USA
| | | | | | - Nirali Patel
- grid.252353.00000 0001 0583 8943Arcadia University, Glenside, USA
| | | | | | | | | | - Lyse Uwera
- grid.442742.30000 0004 0435 552XINES, Ruhengeri, Rwanda
| | - Madeleine Zeiler
- grid.281386.60000 0001 2165 7413Western Washington University, Bellingham, WA USA
| | - Seth Feinberg
- grid.281386.60000 0001 2165 7413Western Washington University, Bellingham, WA USA
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Kawuki J, Gatasi G, Sserwanja Q, Mukunya D, Musaba MW. Utilisation of modern contraceptives by sexually active adolescent girls in Rwanda: a nationwide cross-sectional study. BMC Womens Health 2022; 22:369. [PMID: 36068524 PMCID: PMC9447358 DOI: 10.1186/s12905-022-01956-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/31/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Modern contraceptive use has been shown to influence population growth, protect women’s health and rights, as well as prevent sexually transmitted infections (STIs) for barrier contraceptive methods such as condoms. The present study aimed at assessing the level of utilization and factors associated with modern contraceptive use among sexually active adolescent girls in Rwanda.
Methods
We used secondary data from the Rwanda Demographic and Health Survey (RDHS) 2020 data of 539 sexually active adolescent girls (aged 15 to 19 years). Multistage stratified sampling was used to select study participants. We conducted multivariable logistic regression to assess the association between various socio-demographics and modern contraceptive use using SPSS version 25. Modern contraception included the use of products or medical procedures that interfere with reproduction from acts of sexual intercourse.
Results
Of the 539 sexually active girls, only 94 (17.4%, 95% CI: 13.8–20.1) were using modern contraceptives. Implants (69.1%) and male condoms (12.8%) were the most used options. Modern contraceptive use was positively associated with older age (AOR = 10.28, 95% CI: 1.34–78.70), higher educational level (AOR = 6.98, 95% CI: 1.08–45.07), history of having a sexually transmitted infection (AOR = 8.27, 95% CI: 2.54–26.99), working status (AOR = 1.72, 95% CI: 1.03–2.88) and being from a female-headed household (AOR = 1.96, 95% CI: 1.12–3.43). However, not being in a union (AOR = 0.18, 95% CI: 0.10–0.35) and region (AOR = 0.28, 95% CI: 0.10–0.80) had negative associations.
Conclusions
To promote utilisation of modern contraceptives, family planning campaigns need to place more emphasis on the younger, unmarried adolescents, as well as those with lower educational levels. Consideration of household and regional dynamics is also highlighted.
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