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

Abstract

Background Modern contraceptive use has been shown to influence population growth, protect women’s health and rights, as well as prevent sexually transmitted infections (STIs) for barrier contraceptive methods such as condoms. The present study aimed at assessing the level of utilization and factors associated with modern contraceptive use among sexually active adolescent girls in Rwanda. Methods We used secondary data from the Rwanda Demographic and Health Survey (RDHS) 2020 data of 539 sexually active adolescent girls (aged 15 to 19 years). Multistage stratified sampling was used to select study participants. We conducted multivariable logistic regression to assess the association between various socio-demographics and modern contraceptive use using SPSS version 25. Modern contraception included the use of products or medical procedures that interfere with reproduction from acts of sexual intercourse. Results Of the 539 sexually active girls, only 94 (17.4%, 95% CI: 13.8–20.1) were using modern contraceptives. Implants (69.1%) and male condoms (12.8%) were the most used options. Modern contraceptive use was positively associated with older age (AOR = 10.28, 95% CI: 1.34–78.70), higher educational level (AOR = 6.98, 95% CI: 1.08–45.07), history of having a sexually transmitted infection (AOR = 8.27, 95% CI: 2.54–26.99), working status (AOR = 1.72, 95% CI: 1.03–2.88) and being from a female-headed household (AOR = 1.96, 95% CI: 1.12–3.43). However, not being in a union (AOR = 0.18, 95% CI: 0.10–0.35) and region (AOR = 0.28, 95% CI: 0.10–0.80) had negative associations. Conclusions To promote utilisation of modern contraceptives, family planning campaigns need to place more emphasis on the younger, unmarried adolescents, as well as those with lower educational levels. Consideration of household and regional dynamics is also highlighted.

What are the sources of contraceptives for married and unmarried adolescents: Health services or friends? Analysis of 59 low- and middle-income countries

“…It is a taboo covering up complex couples' dynamics and a decision-making process that can lead unmarried adolescents to risky sexual behavior (33). In a context of increasing rates of unwanted adolescent pregnancies and HIV infection, there is evidence that being unmarried is the more common reason for nonuse of contraceptives among unmarried sexually active Rwandan adolescents (30,32). Regarding the inequalities in the source of method by women's age, our findings are consistent with previous studies that identified an overall lower share of the public sector among adolescents and young adults than among older women (19).…”

“…Most of these results, however, consider only married women (3,8,(27)(28)(29). Although the government has launched youthfriendly policies, premarital sex is uncommon in the country (30)(31)(32)(33). It is a taboo covering up complex couples' dynamics and a decision-making process that can lead unmarried adolescents to risky sexual behavior (33).…”

Association between exposure to family planning messages on different mass media channels and the utilization of modern contraceptives among young women in Sierra Leone: insights from the 2019 Sierra Leone Demographic Health Survey

“…Correct and consistent use of the available modern contraceptives enables couples to realize the desired birth intervals, ideal family size, and control fertility [2]. Beyond control of fertility, use of modern contraceptives has got several non-contraceptive benefits such as contributing to poverty reduction, increasing gender equity, preventing the spread of HIV (barrier methods), reducing unwanted teenage pregnancies, and lowering infant deaths but also contributes to the progress towards achieving the sustainable development goals (SDGs) [3][4][5].…”

Prevalence of discontinuation of contraceptives due to failure among women aged 14 to 49 years in Uganda: a nation wide cross-sectional survey

“…We included possible determinants of contraceptive use and discontinuation based on the available literature [ 7 , 27 , 30 , 31 ]. Twenty-one (21) variables were considered and grouped as follows.…”

“…Improving access to family planning (FP) services is fundamental to achieving the Sustainable Development Goals (SDGs) because it is strongly related with women's and children's health, poverty reduction, education, gender equality, and human rights [1]. Access to family planning contributes up to a 44% reduction in maternal deaths [2], as most unplanned pregnancies and abortions occur in women who were either not using contraception or not using it consistently [3][4][5][6].Greater access to contraception and more consistent use are crucial in reducing unplanned pregnancies and abortions [7,8].…”