Factors Influencing Modern Contraceptive Use among Adolescents in Nepal

Abstract

In Nepal, contraceptive use among married adolescents is low and has remained nearly stagnant since 2006, while little information is available about contraceptive use among unmarried adolescents. Nepal is committed to improve sexual and reproductive health rights among all the adolescents. Promoting modern contraceptive use especially among married adolescents is one of the key approaches in practice, to prevent HIV or sexual transmitted infections, avoid unintended pregnancy and sub-sequent unsafe abortion. In spite of these efforts, modern contraceptive use among married adolescents is not increasing. In this study, we aimed to review the prevalence and trends as well as factors influencing modern contraceptive use among both married and unmarried adolescents in Nepal. A review of existing published and unpublished articles, documents, and reports were conducted. An adapted and modified socio-ecological model was used to explore the factors influencing contraceptive use. Contraceptive use is persistently low among adolescents. Various interrelated factors like socio-cultural norms and traditions, lack of comprehensive knowledge on contraceptive methods among adolescents, inadequate adolescent friendly Services and health workers not having the competencies to work with adolescents, are the major influential factors that limit adolescents to seek and use contraceptive services and information. A multilevel approach is required to address the interrelated factors and to create an enabling environment in which adolescent are fully informed and equipped to make use of contraceptives and related services. For this to happen, Government and NGOs working on sexual and reproductive health rights have to work towards translating the existing policies into practice. Involving adolescents, their families and communities; equipping teachers to provide comprehensive sex education within school and sex education programme for out of school and enhancing the competencies of health workers to provide adolescent friendly services – all in line with the written policy - is urgently needed.

Patterns, trends, and factors associated with contraceptive use among adolescent girls in Zambia (1996 to 2014): a multilevel analysis

“…Adolescent girls aged 19 years were more likely to be using contraceptives at the time of the survey compared to 15-year-olds. This finding is consistent with those from other studies [8,29]. This could be attributed to older female adolescents being more mature and knowledgeable about contraception and the importance of contraceptive use, unlike younger female adolescents.…”

“…In recent surveys, adolescent girls who were separated, widowed, or divorced were also more likely to be using contraceptives compared to those who had never married. The findings are in line with those from other studies [10,29,30]. One study found that adolescent girls who were married or living with a man were significantly more likely to use contraception compared to those who were not married or living together with a partner [10].…”

Adolescent Sexual and Reproductive Health Care Service Availability and delivery in Public Health Facilities of Plateau State Nigeria

“…This scenario was also reported in the studies conducted in Tanzania and Nepal where lack of quali ed staff affected the utilization of SRH services. 30,33,34,35 Achieving a meaningful reduction in adolescent sexual and reproductive health challenges faced by the country will require an urgent intervention in the area of training of health care providers which should be backed with a standard management guideline and procedure that should be available in all the health care facilities Although it is argued that the health system component is not the only aspect affecting the sexual and reproductive health of adolescents, the lack of such structure contributes to the poor sexual and reproductive health challenges of adolescents in Nigeria.…”

Contraceptive Use among Senior Secondary School Students in Abakaliki Metropolis, Ebonyi State, Nigeria

“…The low uptake of contraception services has been linked to many factors in developing countries including religious misperceptions and negative social norms around premarital sex and pregnancy [9,10]. Other factors include non-availability of modern contraception services [11][12][13], and poor knowledge and access to youth-friendly sexual reproductive health services from health workers and teachers [14]. Contraceptive use and continuation over sustained periods of time is an important issue for young people.…”