Modern contraceptive use among female refugee adolescents in northern Uganda: prevalence and associated factors.


Journal

Reproductive health
ISSN: 1742-4755
Titre abrégé: Reprod Health
Pays: England
ID NLM: 101224380

Informations de publication

Date de publication:
20 May 2020
Historique:
received: 20 02 2020
accepted: 11 05 2020
entrez: 22 5 2020
pubmed: 22 5 2020
medline: 16 3 2021
Statut: epublish

Résumé

Adolescent pregnancies are persistently high among refugees. The pregnancies have been attributed to low contraceptive use in this population. The aim of this study was to determine the prevalence and factors associated with modern contraceptive use among female refugee adolescents in northern Uganda. This was a cross sectional study using both descriptive and analytical techniques. The study was carried out in Palabek refugee settlement in Northern Uganda from May to July 2019. A total of 839 refugee adolescents who were sexually active or in-union were consecutively enrolled. Interviewer administered questionnaires were used for data collection. Modern contraceptive prevalence was 8.7% (95% CI: 7.0 to 10.8). The injectable was the most commonly used modern contraceptive method [42.5% (95% CI: 31.5 to 54.3)], and most of the participants had used the contraceptives for 6 months or less (59.7%). Reasons for not using modern contraceptives included fear of side effects (39.3%), partner prohibition (16.4%), and the desire to become pregnant (7.0%). Participants who were married (OR = 0.11, 95% CI: 0.04 to 0.35, p < 0.001), cohabiting (OR = 0.43, 95% CI: 0.20 to 0.93, p = 0.032) or having an older partner (OR = 0.93, 95% CI: 0.86 to 0.99, p = 0.046) were less likely to use modern contraceptives. Modern contraceptive use among female refugee adolescents was very low, and few reported a desire to become pregnant, leaving them vulnerable to unplanned pregnancies. Least likely to use modern contraceptives were participants who were married/cohabiting and those having older partners implying a gender power imbalance in fertility decision making. There is an urgent need for innovations to address the gender and power imbalances within relationships, which could shape fertility decision-making and increase modern contraceptive use among refugee adolescents.

Sections du résumé

BACKGROUND BACKGROUND
Adolescent pregnancies are persistently high among refugees. The pregnancies have been attributed to low contraceptive use in this population. The aim of this study was to determine the prevalence and factors associated with modern contraceptive use among female refugee adolescents in northern Uganda.
METHODS METHODS
This was a cross sectional study using both descriptive and analytical techniques. The study was carried out in Palabek refugee settlement in Northern Uganda from May to July 2019. A total of 839 refugee adolescents who were sexually active or in-union were consecutively enrolled. Interviewer administered questionnaires were used for data collection.
RESULTS RESULTS
Modern contraceptive prevalence was 8.7% (95% CI: 7.0 to 10.8). The injectable was the most commonly used modern contraceptive method [42.5% (95% CI: 31.5 to 54.3)], and most of the participants had used the contraceptives for 6 months or less (59.7%). Reasons for not using modern contraceptives included fear of side effects (39.3%), partner prohibition (16.4%), and the desire to become pregnant (7.0%). Participants who were married (OR = 0.11, 95% CI: 0.04 to 0.35, p < 0.001), cohabiting (OR = 0.43, 95% CI: 0.20 to 0.93, p = 0.032) or having an older partner (OR = 0.93, 95% CI: 0.86 to 0.99, p = 0.046) were less likely to use modern contraceptives.
CONCLUSION CONCLUSIONS
Modern contraceptive use among female refugee adolescents was very low, and few reported a desire to become pregnant, leaving them vulnerable to unplanned pregnancies. Least likely to use modern contraceptives were participants who were married/cohabiting and those having older partners implying a gender power imbalance in fertility decision making. There is an urgent need for innovations to address the gender and power imbalances within relationships, which could shape fertility decision-making and increase modern contraceptive use among refugee adolescents.

Identifiants

pubmed: 32434523
doi: 10.1186/s12978-020-00921-y
pii: 10.1186/s12978-020-00921-y
pmc: PMC7238518
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

67

Subventions

Organisme : Swedish International Development Agency
ID : 51180060

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Auteurs

Ritah Bakesiima (R)

Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. esmie.ritah@gmail.com.
Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden. esmie.ritah@gmail.com.

Amanda Cleeve (A)

Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.

Elin Larsson (E)

Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

James K Tumwine (JK)

Department of Paediatrics and Child health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.

Grace Ndeezi (G)

Department of Paediatrics and Child health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.

Kristina Gemzell Danielsson (KG)

Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.

Rose Chalo Nabirye (RC)

Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.

Jolly Beyeza Kashesya (JB)

Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.

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