Prevalence and factors associated with modern contraceptive use among adolescent girls and young women (Aged 15-24 Years) in Buyende District, Uganda

Abstract

Introduction: Adolescent girls and young women (AGYW) in Uganda have one of the highest rates of unwanted pregnancy at 43.9% and lowest modern contraceptive uptake among the sexually active population. Prevalence and factors associated with modern contraceptive use among adolescents and young women had not been quantified in Buyende district. This study therefore sought to determine the prevalence and factors associated with the use of modern contraceptives as well as explore barriers and enablers of modern contraceptive use among adolescent girls and young women in Buyende district, Uganda. Methodology: A descriptive cross-sectional study, utilizing mixed methods was conducted. A total of 351 randomly selected adolescent girls and young women in Buyende district were interviewed using an interviewer administered semi-structured questionnaire. 23 in-depth interviews among selected adolescent girls and young women, 8 key informant interviews with the DHO and selected health care providers as the qualitative methods were employed. Quantitative data was imported into STATA 15.0 for data analysis. Bivariate and multivariable modified Poisson regression were used in reporting prevalence ratios and their 95% CI and p-values. Qualitative transcripts were analyzed thematically using Atlas ti 7.0 Software. Results: The prevalence of modern contraceptive use among adolescent girls and young women in Buyende district was 44%. The most commonly used methods were implants (50.7%), followed by oral contraceptives (pills) (20.2%). 170 (63.9%) of the respondents heard about contraceptives from their peers. AGYW who got to know about contraceptives from health workers were 23% more likely to use contraceptives compared to those who came to know about them from a friend or male partner [APR (95% CI) =1.23(1.06, 1.44); p-value= 0.007]. Residing in a distance of 4-5km away from the health facility was associated with 15% times less likelihood of using contraceptives compared to living a distance of 2-3km other factors held constant [APR (95% CI) =0.85(0.75, 0.96); p-value= 0.011]. Conclusion: This study reported a low prevalence of modern contraceptive use among adolescent girls and young women. The location of AGYW, the occupation of AGYW, being knowledgeable about contraceptives, and distance to the health facilities were significantly associated with modern contraceptive use. Similarly, encouragement by mothers/ female peers, perceived risk of teenage pregnancy and availability of community based SRHR Education were the major facilitators of contraceptive use. On the other hand, poor follow up for side effect management, high costs associated with removal of contraceptives / FP methods, discouragement from sexual partner, regular stock out of contraceptives, myths and misconceptions about using modern contraceptives and stigma associated with modern contraceptive use were significant barriers to modern contraceptive use among AGYW. Efforts to improve access to contraceptives and increased sexuality education are crucial to improve uptake of modern contraceptives among for AGYW.