Factors Associated with use of Modern Contraceptives amongst Sexually Active Adolescent Girls Aged 15-19 in Homa Bay Town Sub-County, Kenya
DOI:
https://doi.org/10.47941/ijhmnp.2276Keywords:
Utilization, Modern Contraceptives, Sexually Active, Adolescent Girls, Health ServicesAbstract
Background: Modern contraception is the use of birth control methods to determine the number of children in a family. Worldwide, more than 16 million adolescent girls give birth every year and an additional 5 million have abortions in which sub-Saharan Africa accounts for 50% of these births. Low or no utilization of modern contraceptives among the adolescents, has led to increased cases of unplanned pregnancies, which stands at 80% as per birth and death registration records nationally.
Methodology: A cross-sectional mixed study design was used; involving 385 girls aged 15-19 years selected through systematic random sampling. For quantitative data, the study employed a structured/semi-structured questionnaire, while for qualitative data; purposive sampling was used to identify key informants. Descriptive and inferential statistics were used to analyze quantitative data with STATA v14, while qualitative data was analyzed using NVivo and thematic analysis.
Findings: Study revealed that one-third 118 (30.7%) of the respondents were aged 17 years. The majority 370 (96.1%) of the respondents were single, with 346 (89.9%) attending public schools. It was further established that while 68.5% of the respondents were knowledgeable about modern contraceptives only 37.2% were using them. Married adolescent girls had higher odds of using modern contraceptives than unmarried girls (a OR=19.88, p <0.001). The cultural and religious practices of the community were also significant predictors of contraceptive use; individuals with rigid cultural and religious beliefs were less likely to use contraceptives (a OR=9.1, p<0.001). Additionally, the level of knowledge was significantly related to contraceptive usage (a OR=11.6, p<0.001).
Unique Contribution to Theory, Practice and Policy: From the research findings, it can be deduced that socio-economic, cultural, and demographic variables significantly impact the utilization of modern contraceptives among adolescent girls. The study's implications are valuable because they suggest that if access to accurate information were improved, cultural and religious barriers were eliminated, and economic opportunities for adolescent girls were provided, the uptake of modern contraceptives could increase, leading to a decrease in teenage pregnancies and related risks.
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References
Abdulahi, M., Kakaire, O., & Namusoke, F. (2020). Determinants of modern contraceptive use among married Somali women living in Kampala; a cross-sectional survey. Reproductive Health, 17, 1-9.
Adedini et al. (2019). In S. A. Adedini, Trends, patterns and determinants of long-acting reversible methods of contraception among women in sub-Saharan Africa. Africa Journal.
Adelekan, A. I., Oladimeji, A. B., & Ayotunde, A. (2019). Influence of religious beliefs on contraceptive use among adolescents in Nigeria. Journal of Adolescent Health, 64(4), 487-494.
Adongo, P. B., Phillips, J. F., & Aglago, E. K. (2014). The role of cultural and religious beliefs on contraceptive use in Ghana. African Journal of Reproductive Health, 18(2), 25-34.
Ahinkorah B.O, Hagan J.E Jr, Seidu A.A, (2021). Linking Female Adolescents' Knowledge, Attitudes and Use of Contraceptives to Adolescent Pregnancy in Ghana: A Baseline Data for Developing Sexuality Education Programmes. Healthcare (Basel).9(3):272.
Akintola, O., Tayo, E. O., & Akinleye, K. (2021). Religious teachings and contraceptive use among Nigerian adolescents. BMC Public Health, 21(1), 1268.
Akinyi, J., Owino, E., & Otieno, M. (2021). Gender dynamics and contraceptive use among adolescent girls in rural Kenya. Journal of Adolescent Health, 68(2), 321-328.
Alemayehu, M., Belachew, T., & Tilahun, T. (2018). Factors associated with utilization of long acting and permanent contraceptive methods among married women of reproductive age in Mekelle town, Tigray region, north Ethiopia. BMC pregnancy and childbirth, 12, 1-9.
Ali, M., Ahmed, M., Ibrahim, S., & Ochieng, C. (2021). Community-based information campaigns and their impact on contraceptive use among adolescents in Kenya. International Journal of Reproductive Medicine, 2021, Article ID 8916123. doi:10.1155/2021/8916123.
Ansha, M.G., Bosho, C.J. & Jaleta, F.T. (2015). Reproductive Health Services Utilization among adolescents in Anchar Dstrict, East Ethiopia. J Family & Reprod Health.
Apanga, P. A, & Adam, M. A. (2019). Factors influencing the uptake of family planning services in the Talensi District, Ghana. The Pan African Medical Journal.
APHRC. (2020). EVALUATION OF THE IN THEIR HANDS (ITH) PROGRAM IN KENYA. Nairobi: Africa Pupolation and Health Research Center.
Blackstone, E. H., Suri, R. M., Rajeswaran, J., Babaliaros, V., Douglas, P. S., Fearon, W. F., ... & Svensson, L. G. (2017). Why people don't use family planning: how different methods of enquiry elicit different responses. J Fam Plann Reprod Health Care, 43(1), 44-49. doi: 10.1136/jfprhc-2014-101117
Bulto, T. S. (2018). Use of contraceptive use among adolescents in Ethiopia. BMC Reproductive Health, 40(1), 18
Chao, L., Selvaraj, S., & Zewdie, S. (2022). Socio-economic determinants of contraceptive use among adolescents in Ethiopia. BMC Reproductive Health, 19(1), 78. https://doi.org/10.1186/s12978-022-01346-5.
Chege, M., Muthoni, A., & Mwangi, E. (2022). Misinformation and its impact on contraceptive use among adolescents in Kenya. Reproductive Health, 19(1), 47.
Chinwe, N., Nwaubani, I., & Okafor, I. (2022). The role of community information in contraceptive uptake among Nigerian adolescents. African Health Sciences, 22(2), 621-630. doi:10.4314/ahs. v22i2.14.
Chola, C., Mallikarjuna, P., Muaad, A. Y., Bibal Benifa, J. V., Hanumanthappa, J., & Al-antari, M. A. (2020). The state of hormonal contraception today: established and emerging noncontraceptive health benefits. Am J Obstet Gynecol, 205(4 Suppl), S4-8. doi:10.1016/j.ajog.2011.06.056Collins,
Corey J, Schwandt H, Boulware A, Herrera A, Hudler E, Imbabazi C, King I, Linus J, Manzi I, Merrit M, et al. (2022): Family planning demand generation in Rwanda: Government efforts at the national and community level impact interpersonal communication and family norms.
de Mouzon, J., Godeau, D., & Boissin, C. (2020). Contraceptive use among adolescents and young adults in Europe: Trends and challenges. European Journal of Contraception and Reproductive Health Care, 25(2), 101-110.
Ezeh, A., Emina, J., Langer, A., Kegeles, S., & Njogu, M. (2023). The impact of comprehensive sex education on contraceptive use among adolescents in Nigeria. BMC Public Health, 23(1), 112. doi:10.1186/s12889-023-1559-8.
Gebremedhin, S., Assefa, T., & Lerebo, W. (2018). Factors associated with modern contraceptive use among sexually active adolescents in Ethiopia: A multilevel analysis. PLOS ONE, 13(8), e0201507.
Gichuki, C. N., Ochieng, M. A., & Wanjiru, D. (2023). Contraceptive use among adolescents in Kenya: The role of socio-economic factors. International Journal of Public Health, 68(1), 123-134. https://doi.org/10.1007/s00038-022-01890-w.
Govender, D., Naidoo, S., & Taylor, M. (2019). Prevalence and risk factors of repeat pregnancy among South African adolescent females. African Journal of Reproductive Health, 23(1), 73-87.
Gueye, A., Sy, K., Toure, M., & Diouf, I. (2021). Knowledge about contraceptive methods and usage among adolescents: A global perspective. Journal of Global Health, 11, 04008. doi:10.7189/jogh.11.04008.
Habyarimana F, Ramroop S. (2018): Spatial analysis of socio-economic and demographic factors associated with contraceptive use among women of childbearing age in Rwanda. Int. J Environ Res Public Health.
Islam et al. (2020). In M. F. Islam, Exploring factors influencing the use of modern contraceptives among adolescents in rural Bangladesh (pp. 20(1), 1-10.). BMC Public Health.
Iyanda, A. E., Adeleke, R., Lu, Y., Osayomi, T., Adaralegbe, A., Lasode, M., ... & Osundina, A. M. (2020). Sexual Initiation and Contraceptive use among female adolescents (2020). Journal of infection and public health, 13(10), 1438-1445.
Izugbara, C. O., Wekesah, F. M., Tilahun T., A.-A., J., , & Tsala Dimbuene, Z. T. (2018). Family Planning in East Africa. In A. P. (APHRC), Trends and Dynamics (p. 44). Nairobi - Kenya: APHRC.
James, D. (2020). The Social and Economic Benefits of Women’s Ability To Determine Whether and When to Have Children (pp. 25-40). Routledge.
Jansen, H., Ngcobo, M., & Madlala, S. (2021). The impact of marital status on contraceptive use among adolescents in South Africa. Journal of Adolescent Health, 69(3), 345-352. https://doi.org/10.1016/j.jadohealth.2021.05.015.
Kaba, G., Tadesse, A., & Chanie, A. (2021). Cultural and religious determinants of contraceptive use among adolescents in Ethiopia. Ethiopian Journal of Health Sciences, 31(1), 89-98.
Kawuki J, Kamara K, Sserwanja Q (2022). Prevalence of risk factors for human immunodeficiency virus among women of reproductive age and contraceptive use in Sierra Leone, International Journal of health Studies, 10(2), 25.
Kelčíková, S., Mazúchová, L., & Kaisová, L. (2017). Examining the determinants of intimate. Kenya Demographic and Health Survey (2014), Kenya National Bureau of Statistics & ICF. African Journal of Reproductive Health, 17(3), 40-54.
KDHS. (2022). Kenya Demographic and Health Survey. Nairobi: Kenya National Bureau of Statistics. (KNBS).
Khundi et al. (2024). In M. M. Khundi, Unravelling Factors Influencing Demand for Modern Contraception and Evaluating Coverage Progress since 2015 in Ethiopia, Kenya, and Nigeria. Africa.
Kinaro, J., Mbwele, B., & Mutua, M. (2017). The role of social networks in influencing contraceptive use among adolescents in Kenya. African Journal of Reproductive Health, 21(3), 72-83.
Kiwanuka, A., Mugisha, J., & Babirye, J. N. (2022). Contraceptive use among adolescents in Uganda: The effect of marital status. Reproductive Health, 19(1), 45. https://doi.org/10.1186/s12978-022-01478-2.
KNBS. (2019). Kenya Population and Housing Census. NAIROBI: KENYA NATIONAL BUREAU OF STATISTICS.
NSDCC. (2022). HIV Situation in Kenya, National Syndemic Diseases Control Council. Kenya: https://nsdcc.go.ke/hiv-situation-in-kenya/.
Kokila, V., & Sampathlakshmi, N. (2021). Trends in contraceptive prevalence in sub-Saharan Africa. International Journal of Management (IJM), 12(1).
Kumar, R., Gupta, R., Sharma, S., & Singh, P. (2022). The association between contraceptive knowledge and usage among adolescents in India. Sexual Health, 19(2), 123-130. doi:10.1071/SH21112.
Kyilleh, J. M., Tabong, P. T. N., & Konlaan, B. B. (2018). Adolescents’ reproductive health knowledge, choices and factors affecting reproductive health choices: a qualitative study in the West Gonja District in Northern region, Ghana. BMC international health and human rights, 18(1), 1-12.
Laura L. Lunani, Andrew Abaasa, and Gloria Omosa- Manyonyi (2019): Prevalence and factors associated with contraceptive use among kenyan women aged 15–49 years.
Leta, T., Dagnachew, A., & Belayneh, S. (2023). The impact of peer educators on contraceptive use among Ethiopian adolescents. Ethiopian Journal of Health Sciences, 33(1), 75-84. doi:10.4314/ejhs. v33i1.9.
Masese, L., Kimani, M., & Karanja, S. (2020). Sources of contraceptive knowledge and its effect on use among Kenyan adolescents. Journal of Adolescent Health, 66(3), 457-463.
Mbaru, K., & Nzioka, C. (2021). Myths and misconceptions about contraceptives: A barrier to their uptake in Kenya. African Journal of Reproductive Health, 25(1), 89-100.
Mbuthia, G., Wanzala, P., Ngugi, C., & Nyamogoba, H. D. N. (2019). Patterns of risky sexual behavior and associated factors among undergraduates in the Coastal region of Kenya. African Journal of Health Sciences, 32(3), 16-26.
Mekonnen, G., Worku, A., & Berhane, Y. (2022). Influence of knowledge about contraceptive methods on usage rates among Ethiopian adolescents. Reproductive Health, 19(1), 101. doi:10.1186/s12978-022-01456-0.
Mkhize, N., Naidoo, R., & Sibiya, M. (2022). The impact of religious and cultural beliefs on contraceptive use among adolescents in South Africa. Journal of Adolescent Health, 71(2), 161-168.
Moore, B., Jones, E., & Meador, J. (2018). Teenage Pregnancy Rates: A Multiple Regression Analysis of Teen Pregnancy Rates and the Correlates for Texas Counties in the Year Mutumba, M., Wekulo, P., & Moen, L. (2018). Gendered barriers to contraceptive use among adolescents in rural Kenya. Global Public Health, 13(7), 1024-1036.
Musyimi, C. W., Mutiso, V. N., Nyamai, D. N., Ebuenyi, I., & Ndetei, D. M. (2020). Suicidal behavior risks during adolescent pregnancy in a low-resource setting: A qualitative study. PLoS one, 15(7), e0236269. Nairobi, Kenya & Rockville, MD, USA.
Mutumba, M., Wekulo, P., & Moen, L. (2018). Gendered barriers to contraceptive use among adolescents in rural Kenya. Global Public Health, 13(7), 1024-1036.
Mwesigwa, R., Nampijja, M., & Kisaakye, P. (2023). Access to contraceptive information and use among married adolescents in Tanzania. Journal of Family Planning and Reproductive Health Care, 49(2), 137-144. https://doi.org/10.1136/jfprhc-2022-2068.
Nakirijja, D. S., Xuili, X and Mark, I. K. (2020). Socio-economic Determinants of Access to and Utilization of Contraception among Rural Women in Uganda. Advanced Journal of Social Science, https://www.researchgate.net/publication/330493668_.
Nsubuga, F. W., & Rautenbach, H. (2016). Ending Child Marriage in Africa: A Multi-Disciplinary Perspective. International Journal of Climate Change Strategies and Management, 10(5), 752-771.
Ntabaye, M., Chirwa, T., & Katakwe, P. (2023). The role of marital status and access to contraceptive information among adolescents in Kenya. Journal of Adolescent Health, 71(2), 239-246.
Nyewie, G., Guzzo, K. B., & Hayford, S. R. (2024). Adolescent reproductive and contraceptive knowledge and attitudes and adult contraceptive behavior. Maternal and child health journal, 22(1), 32-40
Nyovani, M., Were, V., & Kabiru, C. (2020). Knowledge and use of contraceptives among adolescents in Nairobi: A mixed-methods study. BMC Public Health, 20(1), 567.
Obwoya, J. G., Wulifan, J. K., & Kalolo, A. (2018). Factors influencing contraceptives use among women in the Juba City of South Sudan. International Journal of Population Research, 2018(1), 6381842.
Ogundipe, O., Adebayo, B., Olusola, A., & Emmanuel, O. (2022). Peer education and contraceptive use among adolescents in South Africa. Journal of Adolescent Health, 71(4), 423-430. doi: 10.1016/j.jadohealth.2022.05.012.
Okigbo, C., Speizer, I., & Crosby, R. (2019). Influence of social norms on contraceptive use among young women in Kenya. Journal of Reproductive Health, 16(1), 87.
Olayinka, A. O., Suleiman, B. S., & Oladipo, O. (2021). Barriers to contraceptive use among unmarried adolescents in Nigeria. African Journal of Reproductive Health, 25(4), 24-33. https://doi.org/10.29063/ajrh2021/v25i4.3.
Oluwaseun, O. M., Opeyemi, A. Y., & Oluwaseun, A. A. (2016). Barriers to contraceptive use among adolescents in sub-Saharan Africa: A review. African Journal of Reproductive Health, 20(3), 85-95.
Onasoga O.A, Afolayan J.A, Asamabiriowei T.F, Jibril UN, Imam A.A (2016). Adolescents' Knowledge, Attitude and Utilization of Emergency Contraceptive Pills in Nigeria's Niger Delta Region. Int J MCH AIDS.5(1):53-60.
Ontiri, S., Gathari, N., Kabue, M., Regien, B., Jelle, S., & Ouma, C. (2019). Long-Acting Reversible Contraception Uptake and Associated Factors among Women of Reproductive Age in Rural Kenya, International Journal for Env research and public health. https://pubmed.ncbi.nlm.nih.gov/31052372/
Osei, D., Aikins, M., & Boateng, K. (2022). Contraceptive use among adolescents in Ghana: Influence of marital status and access to information. African Journal of Reproductive Health, 26(1), 63-72. https://doi.org/10.29063/ajrh2022/v26i1.7.
Osei, D., Aikins, M., & Boateng, K. (2023). Contraceptive use among adolescents in Ghana: The influence of religious norms. African Journal of Reproductive Health, 27(1), 55-63.
Paquette, D., Bell, C., Roy, M., Whitmore, L., Currie, A., Archibald, C., ... & Pennock, J. (2020). Do women requesting only contraception find attendance at an integrated sexual health clinic more stigmatizing than attendance at a family planning-only clinic? Int J Womens Health, 5, 57-64.
Rono, P., Mbutu, K., & Ondimu, J. (2021). Perceived barriers to contraceptive use among adolescents in Homa Bay County, Kenya. Reproductive Health Journal, 18(1), 92.
Sanchez-Paez, D.A. & Ortega, J.A. (2018). Adolescent Contraceptive Use and its Use on Fertility; Demographic Research Scientific and Cultural Organization: Paris, France.
Shikuku, J., Njeri, K., & Wambui, M. (2022). Cultural norms and contraceptive practices among adolescents in rural Kenya. Reproductive Health, 19(1), 18.
Smith, A. J. B., Harney, K. F., Singh, T., & Hurwitz, A. G. (2017). Provider and health system factors associated with usage of long-acting reversible contraception in adolescents. Journal of Pediatric and Adolescent Gynecology, 30(6), 609-614.
Smith, C., Edwards, P., & Free, C. (2018). Assessing the validity and reliability of self-report data on contraception use in the Mobile Technology for Improved Family Planning (MOTIF) randomised controlled trial. Reproductive health, 15(1), 1-5.
Solanke, B. L. (2017). Factors influencing contraceptive use and non-use among women of advanced reproductive age in Nigeria. Journal of Health, Population and nutrition, 36, 1-14.
Sserwanja Q, Musaba MW, Mukunya D. (2021): Prevalence and factors associated with modern contraceptives utilization among female adolescents in Uganda.
UNESCO (2017): Early and unintended pregnancy & the education sector: Evidence Review.
UNFPA. (2023). Reducing Poverty and Achieving the Millennium DevelopmentGoals: Arguments for Investing in Reproductive Health and Rights. NEWYORK: UNFPA.
WHO. (2017). Family planning Contraception: Fact sheet. Kenya Population, Geneva.
WHO. (2018). The Sexual and Reproductive Health of Younger Adolescents: Research Issues in Developing Countries. GENEVA: WHO.
WHO. (2023). Family Planning and Contraceptive Methods. Kenya: https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception.
Wirsiy, F. S., & Yeika, E. V. (2019). Contraceptive Uptake among Adolescent Girls Attending Family Planning Units in Four Health Facilities in Cameroon. Journal of Womens Health and Development, 2(2), 48-57.
Ziblim et al. (2022). In A. M. Ziblim, The impact of modern contraceptive use on adolescent reproductive health in Northern Ghana (pp. Reproductive Health, 19(1), 45-55). Ghana.
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