Contraceptive use among adolescent girls in Zambia: a study on adolescents’ needs, preferences and perspectives on contraception methods.
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Date
2023
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Abstract
The fertility rate in Africa is among the highest in the world, and this trend is projected to
continue unless drastic interventions are put in place to avert the situation. Contraceptive use
among adolescents in sub-Saharan Africa remains very low despite various interventions to
improve the uptake. The study aimed to examine the key determinants of contraceptive use
among adolescent girls in Zambia; specifically, i) examining patterns, trends and factors that
drive poor usage of contraceptives; ii) exploring the motivators and influencers of decisionmaking
regarding contraceptive use among adolescent girls; and finally, iii) understanding their
perspectives on existing contraceptive methods.
The study examined patterns, trends and factors associated with contraceptive use among
adolescents in Zambia, using data from 1996, 2001/2, 2007 and 2013/14 Zambia Demographic
and Health Surveys. Qualitative data was collected through focus group discussions and
analysed using thematic analysis. Permission to conduct the study was obtained from the
Ministry of Health and the National Health Research Authority. Ethical approvals were
provided by the Biomedical Research Ethics Committees (BRECs) of the University of Zambia
and the University of KwaZulu-Natal in South Africa.
Results revealed that contraceptive use among adolescent girls in Zambia remained low over
the 18 years and increased by only 3%, particularly among younger, uneducated, and unmarried
sexually active adolescent girls. Marriage or living with a partner contributed the most to the
change in contraceptive use (44%), while living in a rural area accounted for approximately
20%. Adolescent girls' experience with contraceptives was affected by various factors such as
knowledge of contraceptives, including sources of information and contraceptives, experience
with using contraceptives, challenges with access to contraceptives, and misconceptions about
contraceptives. The interaction of factors related to their personal experience, their community
and the environment in which they access contraceptive services all contribute to the overall
patient experience and influence the adolescent girls’ contraceptive decision. Most of the
motivators for the use and/or non-use of contraceptives are intrapersonal and interpersonal.
Contraceptive use among adolescent girls remains low and is determined by various factors.
Key influencers and motivators for contraceptive use involve people in their lives, such as
partners, family and community members. Interventions targeting increasing demand, access and use of contraceptives among adolescents must be innovative, participatory and
implemented within the context of local cultural norms.
Description
Doctoral Degree. University of KwaZulu-Natal, Durban.