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Conn Med. 2014 May;78(5):261-72.

Contraceptive use in adolescents in Sub-Saharan Africa: evidence from Demographic and Health Surveys.

Abstract

OBJECTIVE:

Failure to use contraceptives contributes to an unacceptably high rate of undesired pregnancy in Sub-Saharan adolescents with associated maternal and neonatal mortality/morbidity. Evidence-based research is needed to understand contraceptive usage in Sub-Saharan adolescents and to enable appropriate allocation of donor resources.

DESIGN:

Nationally-representative USAID (U.S. Agency for International Development) Demographic and Health Surveys from 18 least developed Sub-Saharan African nations.

POPULATION:

212,819 Sub-Saharan African women (45,054 were 15-19 years old).

METHODS:

The percentages of adolescents using contraception, as well as their preferred contraceptive methods and desired family size, were reported.

MAIN OUTCOME MEASURES:

Contraceptive Use, Neonatal Mortality, Undesired Pregnancy, Pregnancy Terminations.

RESULTS:

Most adolescents (92.4%) surveyed reported no contraceptive use, although 21.6% reported recent sexual activity. A current pregnancy was reported in 6.6% (n = 2,951) of adolescents with 29.9% of these pregnancies being unwanted. Many surveyed adolescents (18.8%) had at least one prior birth. A death of the previous child was reported in 6.6% (n = 560) with half of these deaths (n = 276) occurring within the first month of life. Many adolescents planned to delay childbearing for at least two years (37.1%) or were unsure about future timing (33.3%), and 2.2% reported a history of at least one pregnancy termination. Most adolescents (73.1%) felt it would be a problem if they became pregnant. Adolescents indicated injectable medications and contraceptive pills were the preferred future contraceptives at 39.9% and 31.4% respectively.

CONCLUSIONS:

Sub-Saharan African adolescents report a mismatch between desire for contraception and use; preferred methods are oral and injectable contraceptives.

PMID:
24974559
[PubMed - indexed for MEDLINE]
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