Framing Contraceptive Use Motivations Among Adolescents and Young Adults Living in Informal Settlements in Kira Municipality, Wakiso District, Uganda

Abstract

Introduction: The use of contraceptives among adolescents and young adults is one of the most cost-effective strategies to address many sexual and reproductive health (SRH) challenges, including unintended pregnancies, early marriages, and sexually transmitted infections. Despite a high burden of SRH challenges, uptake and unmet needs of modern contraceptives remain low in Uganda, especially among adolescents and young adults in informal settlement settings. This study aimed to explore the motivations of adolescents and young people to use modern contraceptives (or not).Methods: We analysed qualitative data from eight focus group discussions with 88 adolescents and young people aged 18–24 years residing in informal settlements of urban communities in Kira Municipality of Wakiso district, Uganda.Results: Motivations for use (or not) of modern contraceptives were framed by two interrelated constructs, sources of information on contraception and the unacceptable use of contraceptives among adolescents widespread in the community. These two, in turn, formed the scope of knowledge upon which adolescents and young people based their decision on whether or not to access and use modern contraceptives.Conclusion: To be more effective, sexual and reproductive health programs and interventions that aim to motivate the use of modern contraceptives among adolescents and young people in informal settings should be more comprehensive and focused on alleviating individual, health systems, social, religious factors that reinforce negative health-seeking behaviours towards contraceptive use. In addition, there is a need to support adolescents and young people with socio-economic empowering strategies that equip them with sufficient resources to choose contraceptives of their choice.

Perspectives on DMPA-SC for self-injection among adolescents with unmet need for contraception in Malawi

“…However, never-married adolescents appeared more likely than their married counterparts to face challenges in accessing that information and care from HSAs/facilities, where fear of being seen by other women at service delivery sites (linked to the stigma around pre-marital sex) was considered a strong barrier in most cases. These challenges echo many of those found to pose barriers to adolescents accessing contraceptive care in other contexts (24,34) and are not specific to DMPA-SC or selfinjection. Indeed, some analyses have found that never-married women are more likely to use easier-to-access methods such as condoms over methods that require interaction with healthcare workers, such as injectables (35), likely due to these sorts of access and stigma barriers.…”

Determinants of Contraceptive Use at The First Sexual Intercourse among Unmarried Adolescents in Indonesia: 2017 IDHS Analysis

“…Hence, they are expected to have a great influence one another in terms of the use of modern contraception. Schools also share information about contraceptives, as well as places in which peers interact and share information about contraception (Mulubwa et al, 2021). Obtaining information about contraception from teachers is less favorable because the explanation from them is considered incomplete and not exhaustive (Munakampe et al, 2018).…”

“…Obtaining information about contraception from teachers is less favorable because the explanation from them is considered incomplete and not exhaustive (Munakampe et al, 2018). Health workers are admitted as a source of information expert, but sometimes, health workers own a negative perspective of contraceptive use among adolescents, which makes them feel uncomfortable in applying contraceptives (Mulubwa et al, 2021). The existence of regulations refusing adolescent contraceptive services because they are not married can also be an obstacle to contraceptive use (Oppong et al, 2021).…”

Motivators and Influencers of Adolescent Girls’ Decision Making Regarding Contraceptive Use in Four Districts of Zambia

“…Older women encouraged contraceptive use, recommending different methods, depending on whether the girl is married or not [ 53 ]. Adolescents whose family members were more positive and had a liberal attitude and encouraged contraceptive use found it easier to use contraceptives [ 54 ]. However, family members can also discourage the use of contraceptives through the disapproval of their use [ 27 ], especially amidst perceived effects on future fertility [ 41 ].…”