Effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda: A randomised controlled trial.
Adolescent
Contraception
/ methods
Contraception Behavior
/ psychology
Contraceptive Agents
/ therapeutic use
Contraceptive Devices, Female
/ statistics & numerical data
Fear
/ psychology
Female
Health Knowledge, Attitudes, Practice
Humans
Peer Group
Pregnancy
Pregnancy in Adolescence
/ psychology
Pregnancy, Unplanned
/ psychology
Refugees
Sex Counseling
/ methods
Uganda
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
26
03
2021
accepted:
03
08
2021
entrez:
2
9
2021
pubmed:
3
9
2021
medline:
17
11
2021
Statut:
epublish
Résumé
The unmet need for contraceptives among refugee adolescents is high globally, leaving girls vulnerable to unintended pregnancies. Lack of knowledge and fear of side effects are the most reported reasons for non-use of contraceptives amongst refugee adolescents. Peer counselling, the use of trained adolescents to offer contraceptive counselling to fellow peers, has showed effectiveness in increasing use of contraceptives in non-refugee adolescent resarch. To determine the effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda. A randomised controlled trial carried out in Palabek refugee settlement in northern Uganda, May to July 2019. Adolescents were included if they were sexually active or in any form of union, wanted to delay child bearing, and were not using any contraceptives. A total of 588 consenting adolescents were randomised to either peer counselling or routine counselling, the standard of care. Adolescents who received peer counselling were more likely to accept a contraceptive method compared to those who received routine counselling (PR: 1·24, 95% CI: 1·03 to 1·50, p = 0·023). Adolescents whose partners had attained up to tertiary education were more likely to accept a method than those whose partners had secondary or less education (PR: 1·45, 95% CI: 1·02 to 2·06, p = 0·037). In both groups, the most frequently accepted methods were the injectable and implant, with the commonest reasons for non-acceptance of contraception being fear of side effects and partner prohibition. Our data indicates that peer counselling has a positive effect on same day acceptance of modern contraceptives and should therefore be considered in future efforts to prevent adolescent pregnancies in refugee settings. Future peer counselling interventions should focus on how to effectively address adolescents' fear of side effects and partner prohibition, as these factors continue to impede decision making for contraceptive uptake.
Sections du résumé
BACKGROUND
The unmet need for contraceptives among refugee adolescents is high globally, leaving girls vulnerable to unintended pregnancies. Lack of knowledge and fear of side effects are the most reported reasons for non-use of contraceptives amongst refugee adolescents. Peer counselling, the use of trained adolescents to offer contraceptive counselling to fellow peers, has showed effectiveness in increasing use of contraceptives in non-refugee adolescent resarch.
OBJECTIVE
To determine the effect of peer counselling on acceptance of modern contraceptives among female refugee adolescents in northern Uganda.
METHODS
A randomised controlled trial carried out in Palabek refugee settlement in northern Uganda, May to July 2019. Adolescents were included if they were sexually active or in any form of union, wanted to delay child bearing, and were not using any contraceptives. A total of 588 consenting adolescents were randomised to either peer counselling or routine counselling, the standard of care.
RESULTS
Adolescents who received peer counselling were more likely to accept a contraceptive method compared to those who received routine counselling (PR: 1·24, 95% CI: 1·03 to 1·50, p = 0·023). Adolescents whose partners had attained up to tertiary education were more likely to accept a method than those whose partners had secondary or less education (PR: 1·45, 95% CI: 1·02 to 2·06, p = 0·037). In both groups, the most frequently accepted methods were the injectable and implant, with the commonest reasons for non-acceptance of contraception being fear of side effects and partner prohibition.
CONCLUSION
Our data indicates that peer counselling has a positive effect on same day acceptance of modern contraceptives and should therefore be considered in future efforts to prevent adolescent pregnancies in refugee settings. Future peer counselling interventions should focus on how to effectively address adolescents' fear of side effects and partner prohibition, as these factors continue to impede decision making for contraceptive uptake.
Identifiants
pubmed: 34473750
doi: 10.1371/journal.pone.0256479
pii: PONE-D-21-09788
pmc: PMC8412258
doi:
Substances chimiques
Contraceptive Agents
0
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0256479Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Int Perspect Sex Reprod Health. 2009 Dec;35(4):176-85
pubmed: 20123651
Reprod Health. 2020 May 20;17(1):67
pubmed: 32434523
Eur J Contracept Reprod Health Care. 2009 Apr;14(2):144-52
pubmed: 19340710
PLoS Med. 2008 Nov 25;5(11):e224; discussion e224
pubmed: 19067478
BMC Womens Health. 2020 Aug 26;20(1):185
pubmed: 32847569
Reprod Health. 2020 Jul 29;17(1):115
pubmed: 32727500
Open Access Maced J Med Sci. 2019 Mar 14;7(5):760-766
pubmed: 30962834
PLoS Med. 2020 Mar 31;17(3):e1003086
pubmed: 32231356
Curr Dir Psychol Sci. 2013 Apr;22(2):114-120
pubmed: 25544805
PLoS One. 2020 Jul 20;15(7):e0236316
pubmed: 32687519
BMJ Sex Reprod Health. 2020 Oct;46(4):254-269
pubmed: 31826883
Front Psychol. 2019 Aug 29;10:1915
pubmed: 31555164
Health Care Women Int. 2014;35(7-9):845-58
pubmed: 24750172
PLoS One. 2018 Sep 26;13(9):e0204327
pubmed: 30256821
Eur J Contracept Reprod Health Care. 2016 Oct;21(5):380-7
pubmed: 27499054
Int J Epidemiol. 1999 Apr;28(2):319-26
pubmed: 10342698
Sex Reprod Health Matters. 2019 Dec;27(1):1681091
pubmed: 31738122
Evid Based Spine Care J. 2012 Feb;3(1):9-12
pubmed: 23236300
PLoS One. 2019 Jun 13;14(6):e0218259
pubmed: 31194833
Ethiop J Health Sci. 2016 Sep;26(5):439-448
pubmed: 28446849
Reprod Health. 2019 Feb 21;16(1):21
pubmed: 30791914
Int J Environ Res Public Health. 2018 Feb 03;15(2):
pubmed: 29401677
Sci Rep. 2019 Feb 20;9(1):2365
pubmed: 30787379