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Published in: Reproductive Health 1/2021

Open Access 01-12-2021 | Research

Factors influencing contraceptive decision making and use among young adolescents in urban Lilongwe, Malawi: a qualitative study

Authors: Gift Mtawali Dombola, Wanangwa Chimwaza Manda, Effie Chipeta

Published in: Reproductive Health | Issue 1/2021

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Abstract

Background

The prevalence of teenage pregnancies in Malawi is 29%. About 25% of those are married while 30% are unmarried adolescents (15–19 years old) who use contraceptives. Data on contraceptive use has focused on older adolescents (15–19 years old) leaving out the young adolescents (10–14 years old). This study assessed factors that influence contraceptive decision-making and use among young adolescents aged 10–14 years.

Methods

This was a qualitative study that used the Theory of Reasoned Action (TRA) model to understand the processes that influence contraceptive decision-making among young adolescents (10–14 years old) in urban Lilongwe. The study was conducted in six youth health-friendly service centers and 12 youth clubs. Two focus group discussions and 26 in-depth interviews were conducted among sexually active in and out of school young adolescents and key informants. The results are organized into themes identified during the analysis.

Results

Results showed that contraceptive decision-making is influenced by social factors (individual, interpersonal, society) and adolescents’ perceptions regarding hormonal contraceptives. There is also a disconnect between Education and Adolescent Sexual and Reproductive Health policies.

Conclusion

The findings suggest that interventions that scale up contraceptive use need male and female involvement in decision making. Addressing myths around contraceptives, and harmonization of Education and Sexual and Reproductive Health policies in the country would motivate adolescents to use contraceptives.
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Literature
2.
go back to reference Hofferth SL HC. The effects of programs and policies on adolescent pregnancy and childbearing—risking the future—NCBI bookshelf. In: Risking the future: adolescent sexuality, pregnancy, and childbearing, Volume II: Working Papers and Statistical Appendices. Washington DC: National Academy of Sciences; 1987. Hofferth SL HC. The effects of programs and policies on adolescent pregnancy and childbearing—risking the future—NCBI bookshelf. In: Risking the future: adolescent sexuality, pregnancy, and childbearing, Volume II: Working Papers and Statistical Appendices. Washington DC: National Academy of Sciences; 1987.
4.
go back to reference Bankole A, et al. Sexual behavior, knowledge and information sources of very young adolescents in four sub-Saharan African Countries. NIH Public Access. 2008;11(3):28–43. Bankole A, et al. Sexual behavior, knowledge and information sources of very young adolescents in four sub-Saharan African Countries. NIH Public Access. 2008;11(3):28–43.
6.
go back to reference Pettifor BA, Brien KO, Miller C, Miller WC. Early coital debut and associated HIV risk factors among young women and men in South Africa. Peer Rev Res. 2009;35(2):74–82. Pettifor BA, Brien KO, Miller C, Miller WC. Early coital debut and associated HIV risk factors among young women and men in South Africa. Peer Rev Res. 2009;35(2):74–82.
7.
go back to reference Peltzer K, Pengpid S. Early sexual debut and associated factors among in-school adolescents in six Caribbean countries. West Indian Med J. 2015;64(4):1–356. Peltzer K, Pengpid S. Early sexual debut and associated factors among in-school adolescents in six Caribbean countries. West Indian Med J. 2015;64(4):1–356.
8.
go back to reference Peltzer K. Early sexual debut and associated factors among in-school adolescents in eight African countries. Acta Paediatr Int J Paediatr. 2010;99(8):1242–7.CrossRef Peltzer K. Early sexual debut and associated factors among in-school adolescents in eight African countries. Acta Paediatr Int J Paediatr. 2010;99(8):1242–7.CrossRef
9.
go back to reference Joyce CB, Martinez GM and Division of vital statistics. National Health Statistics Reports, Number 104, June 22, 2017. Michingan; 2017. Joyce CB, Martinez GM and Division of vital statistics. National Health Statistics Reports, Number 104, June 22, 2017. Michingan; 2017.
10.
go back to reference WHO. Family planning_Contraception WHO. 2018. WHO. Family planning_Contraception WHO. 2018.
12.
go back to reference Tebeu PM, Fomulu JN, Khaddaj S, De BL, Delvaux T, Rochat CH. Risk factors for obstetric fistula : a clinical review. Int Urogynecol. 2012;23:387–94.CrossRef Tebeu PM, Fomulu JN, Khaddaj S, De BL, Delvaux T, Rochat CH. Risk factors for obstetric fistula : a clinical review. Int Urogynecol. 2012;23:387–94.CrossRef
13.
14.
go back to reference Chalasani S, Kelly CA, Mensch BS, Soler-hampejsek E. Adolescent pregnancy and education trajectories in Malawi. Comp Educ Rev. 2013;51(3):281–305. Chalasani S, Kelly CA, Mensch BS, Soler-hampejsek E. Adolescent pregnancy and education trajectories in Malawi. Comp Educ Rev. 2013;51(3):281–305.
15.
go back to reference Muula AS. Trends in contraceptive knowledge and use among adolescent married women in Malawi. Croat Med J. 2008;49(4):561–3.CrossRef Muula AS. Trends in contraceptive knowledge and use among adolescent married women in Malawi. Croat Med J. 2008;49(4):561–3.CrossRef
16.
go back to reference FP2020. Accelerating progress: strategy for 2016–2020. In: Executive sammary. United Nations; 2016. p. 6. FP2020. Accelerating progress: strategy for 2016–2020. In: Executive sammary. United Nations; 2016. p. 6.
18.
go back to reference Ajzen I. Theory of reasoned action and theory of planned behavior. Organ Behav Hum Decis Process. 1975;50(2):179–211. Ajzen I. Theory of reasoned action and theory of planned behavior. Organ Behav Hum Decis Process. 1975;50(2):179–211.
20.
go back to reference Charles P, Linda VDL, Ciel W. Contraceptive decision-making background and outcomes of contraceptive methods. Rutgers WPF; 2011. Charles P, Linda VDL, Ciel W. Contraceptive decision-making background and outcomes of contraceptive methods. Rutgers WPF; 2011.
21.
go back to reference Daley AM. What influences adolescents’ contraceptive decision-making? A meta-ethnography. J Pediatr Nurs. 2014;29(6):614–32.CrossRef Daley AM. What influences adolescents’ contraceptive decision-making? A meta-ethnography. J Pediatr Nurs. 2014;29(6):614–32.CrossRef
22.
go back to reference COGOMA. List of NGOs working in Lilongwe. Lilongwe; 2018. COGOMA. List of NGOs working in Lilongwe. Lilongwe; 2018.
23.
go back to reference Mardi A, Ebadi A, Shahbazi S, EsmaelzadeSaeieh S, Behboodi MZ. Factors influencing the use of contraceptives through the lens of teenage women: a qualitative study in Iran. BMC Public Health. 2018;18(1):1–8.CrossRef Mardi A, Ebadi A, Shahbazi S, EsmaelzadeSaeieh S, Behboodi MZ. Factors influencing the use of contraceptives through the lens of teenage women: a qualitative study in Iran. BMC Public Health. 2018;18(1):1–8.CrossRef
24.
go back to reference Funds UNP. Marrying too young. New York; 2012. 1–76 p. Funds UNP. Marrying too young. New York; 2012. 1–76 p.
26.
go back to reference Wang T. The effects of school-based condom availability programs (CAPs) on condom acquisition, use and sexual behavior: a systematic review. AIDS Behav. 2018;22(1):308–20.CrossRef Wang T. The effects of school-based condom availability programs (CAPs) on condom acquisition, use and sexual behavior: a systematic review. AIDS Behav. 2018;22(1):308–20.CrossRef
27.
go back to reference McNicholas C, DO, Peipert JF. NIH public access. Curr Opin Obstet Gynaecol. 2014;24(5):293–8. McNicholas C, DO, Peipert JF. NIH public access. Curr Opin Obstet Gynaecol. 2014;24(5):293–8.
31.
go back to reference Harris A. Factors that influence contraceptive-making in African American women an intergenerational perspective. Boston College; 2008. Harris A. Factors that influence contraceptive-making in African American women an intergenerational perspective. Boston College; 2008.
32.
go back to reference Cheung E, Free C. Factors influencing young women’s decision making regarding hormonal contraceptives : a qualitative study. 2005;71:426–31. Cheung E, Free C. Factors influencing young women’s decision making regarding hormonal contraceptives : a qualitative study. 2005;71:426–31.
33.
go back to reference Klampe M. Relationship factors affect decisions about contraceptive use among young adults, study finds Oregon State University; 2018. Klampe M. Relationship factors affect decisions about contraceptive use among young adults, study finds Oregon State University; 2018.
35.
go back to reference Hofferth SL, Hayes CD. Contraceptive decision-making among adolescents—risking the future—NCBI Bookshelf. In: Hayes SLH and CD, editor. Risking the future adolescent sexuality, pregnancy, and childbearing, Volume II: Working Papers and Statistical Appendices. Washington DC: National Academy of Sciences; 1987. Hofferth SL, Hayes CD. Contraceptive decision-making among adolescents—risking the future—NCBI Bookshelf. In: Hayes SLH and CD, editor. Risking the future adolescent sexuality, pregnancy, and childbearing, Volume II: Working Papers and Statistical Appendices. Washington DC: National Academy of Sciences; 1987.
36.
go back to reference Anchorage L, No TA. The framework of guidelines for research in the social sciences and humanities in Malawi. Lilongwe: National Commission for Science and Technology; 2011. p. 23. Anchorage L, No TA. The framework of guidelines for research in the social sciences and humanities in Malawi. Lilongwe: National Commission for Science and Technology; 2011. p. 23.
Metadata
Title
Factors influencing contraceptive decision making and use among young adolescents in urban Lilongwe, Malawi: a qualitative study
Authors
Gift Mtawali Dombola
Wanangwa Chimwaza Manda
Effie Chipeta
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2021
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-021-01259-9

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