Modern contraceptive use among young women aged 15–24 years in selected municipalities of Western Nepal: results from a cross-sectional survey in 2019

Abstract

ObjectiveTo estimate the modern contraceptive prevalence rate (mCPR) and its predictors among young women aged 15–24 years.DesignCross-sectional analysis of Adolescent Youth Project baseline survey.Setting29 municipalities within Lumbini Province and Sudurpaschim Province in Western Nepal.Participants683 young women aged 15–24 years who were living in the catchment area of the selected 30 private OK network health facilities at the study sites from November to December 2019 and who provided informed consent or assent.Outcome measuremCPR among young women aged 15–24 years.ResultsThe mean age of the respondents was 19 years, 61.7% never had sex and 63.9% were unmarried. The mCPR was 11.9% (95% CI 9.5 to 14.8). Of those who reported using a modern method of contraception, injectables (37.9%) were the most common, followed by male condom (35.9%) and implants (8.8%). Majority (86.4%) of the respondents reported currently not using any method of contraception. In the binary logistic regression analysis, the odds of contraceptive use were higher among women aged 20–24 years (adjusted OR (AOR)=5.50, 95% CI 2.94 to 10.29) and those of Janajati caste/ethnicity (AOR=2.08, 95% CI 1.16 to 3.71), while the odds were lower among women who faced high level of barriers (individual, family/societal, service provider and health facility barriers) to contraceptive use (AOR=0.36, 95% CI 0.14 to 0.98).ConclusionsThe mCPR among young women aged 15–24 years was low but similar to the national level. Sexual and reproductive health programmes aiming to improve the mCPR in this population of young women should consider the reported level of sexual activity. Reaching young women to improve their knowledge and self-efficacy for contraception is critical to ensure they can access contraception when needed. The focus should be on reaching not just young women but also key influencers and service providers and making health facilities adolescent-friendly to reduce barriers to contraceptive uptake and to realise self-efficacy.

Spatial variations and multi-level determinants of modern contraceptive utilization among young women (15–24 years) in Ethiopia: spatial and multi-level analysis of mini-EDHS 2019

“…The possible justification for this is that married women had high likelihood to be pregnant and as a result, they usually prefer to use contraceptives to space births [ 36 ]. On the other hand, our study noted a higher prevalence of modern contraceptive use among young women compared to few studies in Zambia [ 37 ], Guinea [ 38 ], Western Nepal [ 19 ], Uganda [ 39 ]. The higher prevalence of modern contraceptive use in our study could be due to the survey year where our study is most recent and may be related availability of expanded services recently and could also be the countries difference in the investments of family planning initiatives by the non-governmental and governmental organizations.…”

“…The Ethiopian mini-DHS 2019 report has also indicated a lower modern contraceptive utilization rate among the young women [ 9 ]. Hence, to achieve the HSTP-II national target of reaching 50% contraceptive prevalence rate (CPR) by 2024/25 [ 23 ], it is imperative to meet the needs of the young women, characterized by high fertility age group, key productive population segment, but high unmet need for contraceptives and highly vulnerable in someway [ 9 , 19 ]. Therefore, the present study aimed at exploring the spatial distribution and the multi-level determinants of modern contraceptive use among young women in Ethiopia using the most recent national survey, mini- EDHS 2019 data.…”

“…Different literatures have identified a number of individual and community level factors that could positively or negatively affect the use of modern contraceptive methods among women of reproductive age. These factors include maternal age, educational status, wealth index, marital status, births in the last three years, women autonomy, partner/husband influence, knowledge on contraceptives, religion, region, and place of residence, media exposure, number of desired children, and family size [10][11][12][13][14][15][16][17][18][19][20][21][22].…”

Utilisation of modern contraceptives by sexually active adolescent girls in Rwanda: a nationwide cross-sectional study

“…Contraceptive use among adolescents was very low (17.4%), similar to Mali (17.1%) [ 28 ], but higher than Uganda (9.4%) [ 6 ], Benin (8.5%) [ 29 ], Nigeria (14.8%) [ 30 ], Nepal (11.9%) [ 31 ] and Zambia (12%) [ 32 ], according to previous studies. Nonetheless, the Government of Rwanda has put considerable efforts in family planing and reducing unwanted pregnancies as part of its 2030 Family Planing country commitment agenda.…”

Utilisation of modern contraceptives by sexually active adolescent girls in Rwanda: a nationwide cross-sectional study

“…Compared to the rst analysis of only sexually active adolescents, sensitivity analysis results clearly indicate that modern contraceptive use increases with age, a signi cant trend noted in age groups of 17, 18 and 19 years (Table 4). [29], Nigeria (14.8%) [30], and Nepal (11.9%) [31], according to previous studies. This low uptake could be a result of various factors, including a lack of awareness and limited sex education in schools and households, poor access to services, misconceptions regarding contraceptive effects on reproduction, and negative cultural implications [32,33].…”