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

Abstract

Background: Despite high levels of pregnancy and childbearing among adolescents in Africa, contraceptive use remains low. Examining variations in contraceptive use among adolescent girls is vital for informing programs to improve contraceptive utilisation among this segment of the population. This study aimed to examine the patterns, trends, and factors associated with contraceptive use among adolescents in Zambia over the period 1996-2014. Methods: The study involved an analysis of data from 1996, 2001/2, 2007 and 2013/14 Zambia Demographic and Health Surveys focusing on adolescent girls aged 15-19 years. Analysis entailed descriptive statistics and estimation of multilevel logistic regression models examining variations in contraceptive use among adolescent girls over time. Estimates with p-values less than 0.05 were considered statistically significant. Results: Results showed that contraceptive use remains low and ranged from 7.6% in 1996 to 10.9% in 2013/14, reflecting a change of 3.3 percentage points over 18 years. Over the 18 years, contraceptive use was significantly associated with age, level of education, and marital status. Older adolescent girls and those with higher levels of education were significantly more likely to use contraception compared to younger ones and those with lower levels of education. Although initially significant (AOR 0.556, 95% CI 0.317, 0.974 in 1996), rural-urban differences disappeared between 2001/2 and 2007 but re-emerged in 2013/14 (AOR 0.654, 95% CI 0.499, 0.859). Across all survey years, adolescents who were married or living with a partner were significantly more likely to use contraceptives compared to those who were not married. Conclusions: The findings suggest the need for targeted interventions to improve contraceptive use among sexually active adolescent girls in the country in general, and those who are disadvantaged in particular.

Rural-urban Correlates of Modern Contraceptives Utilization Among Adolescents in Zambia: a National Cross-sectional Survey

“…These health complications are the second leading cause of mortality among adolescents [2]. Furthermore, babies born to adolescent mothers are at an increased risk of higher perinatal mortality and low birth weight [2,3]. Despite the adverse effects of adolescent pregnancies and births, contraceptive use among adolescents in Africa is low [2,4,5].…”

“…Furthermore, babies born to adolescent mothers are at an increased risk of higher perinatal mortality and low birth weight [2,3]. Despite the adverse effects of adolescent pregnancies and births, contraceptive use among adolescents in Africa is low [2,4,5]. In addition to the negative health outcomes, adolescent childbirths and STIs have been associated with adverse socio-economic consequences such as; poverty, school dropout and subsequent lower educational attainment which affects their personal development [1,6].…”

“…Due to the heterogeneous nature of the sub-Saharan region, sub-regional variations exist in contraceptive use among young women [9]. Despite the various interventions and policies to promote modern contraceptives utilization among young women in Sub-Saharan Africa, the utilization rate has remained low [2,10,11]. This could partly be attributed to generic interventions and policies that are not adapted to local settings [10].…”

“…Zambia's adolescent contraceptive use is low despite high universal knowledge of at least one modern contraceptive method [2]. Information on the predictors of the rural-urban differentials in uptake of modern contraceptive utilization among female adolescents is relevant since policies, programs, and interventions that are necessary to improve modern contraceptive uptake may differ in rural and urban areas.…”

“…Information on the predictors of the rural-urban differentials in uptake of modern contraceptive utilization among female adolescents is relevant since policies, programs, and interventions that are necessary to improve modern contraceptive uptake may differ in rural and urban areas. Although disparities in the rates of utilization of contraceptives between urban and rural adolescents have been documented [2,12], information on factors responsible for these differences has not been adequately explained. It is important to further understand these factors when stratifying by rural-urban place of residence among adolescents.…”