Contraceptive use among adolescent and young women in North and South Kivu, Democratic Republic of the Congo: A cross-sectional population-based survey

Abstract

Background Adolescent girls in humanitarian settings are especially vulnerable as their support systems are often disrupted. More than 20 years of violence in the Democratic Republic of the Congo (DRC) has weakened the health system, resulting in poor sexual and reproductive health (SRH) outcomes for women. Little evidence on adolescent contraceptive use in humanitarian settings is available. CARE, International Rescue Committee (IRC), and Save the Children, in collaboration with the Reproductive Health Access, Information and Services in Emergencies (RAISE) Initiative, Columbia University, have supported the Ministry of Health (MOH) since 2011 to provide good quality contraceptive services in public health facilities in conflict-affected North and South Kivu. In this study, we analyzed contraceptive use among sexually active young women aged 15-24 in the health zones served by the partners' programs. Methods and findings The partners conducted cross-sectional population-based surveys in program areas of North and South Kivu using two-stage cluster sampling in six health zones in July-August 2016 and 2017. Twenty-five clusters were selected in each health zone, 22 households in each cluster, and one woman of reproductive age (15-49 years) was randomly selected in each household. This manuscript presents results from a secondary data analysis for 1,022 women aged 15-24 who reported ever having sex: 326 adolescents (15-19 years) and 696 young women (20-24 years), 31.7% (95% confidence interval [CI] 29.5-34.1), of whom were displaced at least once in the previous five years. Contraceptive knowledge was high, with over 90% of both groups able to name at least one modern contraceptive method.

What Influences Modern Contraceptive Utilisation Among Single Mothers in Nigeria? Evidence from Pooled Cross-Sectional Surveys

“…This study investigated the factors in uencing modern contraceptive utilisation among single mothers. The study differs from existing studies that focused on other segments of childbearing women such as adolescents [21][22][23], never married women [24][25][26] and women of advanced reproductive age [27][28][29][30] by focusing on single mothers. This group of women has received little attention in family planning programming in Nigeria.…”

“…Existing studies in Nigeria and elsewhere have examined the associated factors of modern contraceptive utilisation among different segments of women such as adolescents and young people [21][22][23], never married women [24][25][26], women of advanced reproductive age [27][28][29][30]. Other studies have focused the general population of childbearing women [31][32][33][34].…”

Prevalence and Determinants of Covert Contraceptive Use in Kenya: a Cross-Sectional Study

“…The independent variables were selected based on a review of the literature on FP and the availability of the variables in the dataset. They included the county of residence (Nairobi, Bungoma, Kericho, Kiambu, Kili , Kitui, Nandi, Nyamira, Siaya, Kakamega and West Pokot), residence (rural/urban) [20,21], age in years (15-19, 20-34 and 35-49) [21], education levels (no formal, primary, secondary and tertiary) [21][22][23], wealth quintiles (poorest, poorer, middle, richer, richest) [20], parity (0, 1, 2-3 and 4+) [23], desire for more children (yes/no/infertile) [24], and age at sexual debut in years [25].…”

Strengthening Health Systems in Humanitarian Settings: Multi-Stakeholder Insights on Contraception and Postabortion Care Programs in the Democratic Republic of Congo and Somalia

“…The program underwent periodic monitoring and evaluation reviews, including client satisfaction surveys, register reviews, and scienti c studies, which were presented at international venues, published in peer-reviewed journals, or both [12][13][14][15][16][17]. Results from these studies showed the overall feasibility of FP and PAC programs in mostly protracted crisis humanitarian settings (with an acute phase due to the Ebola outbreak in the DRC), a high level of acceptability by clients above 90% [14], and the shift from the harmful practice of dilatation and curettage to manual vacuum aspiration or medication use for the provision of PAC [12].…”