Skip to main content
Top
Published in: Reproductive Health 1/2019

Open Access 01-12-2019 | Contraception | Research

Contraception in adolescence: the influence of parity and marital status on contraceptive use in 73 low-and middle-income countries

Authors: Carolina de Vargas Nunes Coll, Fernanda Ewerling, Franciele Hellwig, Aluísio Jardim Dornellas de Barros

Published in: Reproductive Health | Issue 1/2019

Login to get access

Abstract

Background

There is still a large gap in relation to effectively meet the contraceptive needs and family planning goals of adolescents. Our aim was to describe how having a partner and children impact on contraceptive behavior of sexually active female adolescents from low and middle-income countries (LMICs).

Methods

Analyses were based on the most recent Demographic and Health Surveys and Multiple Indicator Surveys carried out since 2005 in 73 LMICs with available data for sexually active women aged 15–19 years. Modern contraceptive prevalence and demand for family planning satisfied with modern methods of contraception (mDFPS) were estimated among three subgroups of adolescents considering their parity and marital status- not married, married without children, and married with children – at national and regional levels.

Results

Female adolescents who were married with no children presented the lowest median modern contraceptive prevalence in all world regions, ranging from 2.9% in West & Central Africa to 29.0% in Latin America & Caribbean. Regarding mDFPS, the lowest coverage for married adolescents without children was found in West & Central Africa (12.6%), whereas Latin America & Caribbean presented the highest (50.4%). In East Asia & Pacific, not married adolescents were the group with the lowest mDFPS (17.1%). In 12 countries, mDFPS was below 10% among married adolescents without children: Angola, Chad, Congo, Congo DR, Guinea, Mozambique, Niger, Nigeria, and Senegal in Africa, Philippines and Timor-Leste in Asia and Guyana in Latin America & Caribbean.

Conclusions

In most countries, modern contraceptive prevalence and mDFPS were particularly low among married female adolescents without children, which should be considered a priority group for intervention. The findings suggest that social norms regarding marriage and fertility expectations and other cultural barriers have a role at least as relevant as contraceptive availability. All these aspects need to be considered in the design of family planning strategies to effectively increase modern contraceptive use among adolescents everywhere, particularly in conservative contexts.
Appendix
Available only for authorised users
Literature
1.
go back to reference Chandra-Mouli V, Parameshwar PS, Parry M, et al. A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it. Reprod Health. 2017;14(1):85.PubMedPubMedCentralCrossRef Chandra-Mouli V, Parameshwar PS, Parry M, et al. A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it. Reprod Health. 2017;14(1):85.PubMedPubMedCentralCrossRef
2.
go back to reference Nations U. Transforming our world: the 2030 agenda for sustainable development (resolution adopted by the general Assembly-70/1). New Yourk: United Nations, 2015. Nations U. Transforming our world: the 2030 agenda for sustainable development (resolution adopted by the general Assembly-70/1). New Yourk: United Nations, 2015.
3.
go back to reference WHO. Global Accelerated Action for the Health of Adolescents (AA-HA!): guidance to support country implementation. Geneva: World Health Organization; 2017. WHO. Global Accelerated Action for the Health of Adolescents (AA-HA!): guidance to support country implementation. Geneva: World Health Organization; 2017.
4.
go back to reference Cahill N, Sonneveldt E, Stover J, et al. Modern contraceptive use, unmet need, and demand satisfied among women of reproductive age who are married or in a union in the focus countries of the Family Planning 2020 initiative: a systematic analysis using the Family Planning Estimation Tool. Lancet. 2018;391:870–82. Cahill N, Sonneveldt E, Stover J, et al. Modern contraceptive use, unmet need, and demand satisfied among women of reproductive age who are married or in a union in the focus countries of the Family Planning 2020 initiative: a systematic analysis using the Family Planning Estimation Tool. Lancet. 2018;391:870–82.
5.
go back to reference MacQuarrie K. Unmet need for family planning among young women: levels and trends. . Rockville, Maryland. In: USA: ICF international; 2014. MacQuarrie K. Unmet need for family planning among young women: levels and trends. . Rockville, Maryland. In: USA: ICF international; 2014.
6.
go back to reference Dennis ML, Radovich E, Wong KLM, et al. Pathways to increased coverage: an analysis of time trends in contraceptive need and use among adolescents and young women in Kenya, Rwanda, Tanzania, and Uganda. Reprod Health. 2017;14(1):130.PubMedPubMedCentralCrossRef Dennis ML, Radovich E, Wong KLM, et al. Pathways to increased coverage: an analysis of time trends in contraceptive need and use among adolescents and young women in Kenya, Rwanda, Tanzania, and Uganda. Reprod Health. 2017;14(1):130.PubMedPubMedCentralCrossRef
7.
go back to reference Ewerling FA-Ohoo, Victora CG, Raj A, Coll CVN, Hellwig F, Barros AJD. Demand for family planning satisfied with modern methods among sexually active women in low- and middle-income countries: who is lagging behind? Reprod Health. 2018;15(1). Ewerling FA-Ohoo, Victora CG, Raj A, Coll CVN, Hellwig F, Barros AJD. Demand for family planning satisfied with modern methods among sexually active women in low- and middle-income countries: who is lagging behind? Reprod Health. 2018;15(1).
8.
go back to reference Chandra-Mouli V, Camacho AV, Michaud PA. WHO guidelines on preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries. J Adolesc Health. 2013;52(5):517–22. Chandra-Mouli V, Camacho AV, Michaud PA. WHO guidelines on preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries. J Adolesc Health. 2013;52(5):517–22.
9.
go back to reference Hoggart L, Phillips J. Teenage pregnancies that end in abortion: what can they tell us about contraceptive risk-taking? J. Fam. Plann. Reprod. Health Care. 2011;37(2):97–102.PubMedCrossRef Hoggart L, Phillips J. Teenage pregnancies that end in abortion: what can they tell us about contraceptive risk-taking? J. Fam. Plann. Reprod. Health Care. 2011;37(2):97–102.PubMedCrossRef
10.
go back to reference Chandra-Mouli V, McCarraher DR, Phillips SJ, Williamson NE, Hainsworth G. Contraception for adolescents in low and middle income countries: needs, barriers, and access. Reprod Health. 2014;11(1):1.PubMedPubMedCentralCrossRef Chandra-Mouli V, McCarraher DR, Phillips SJ, Williamson NE, Hainsworth G. Contraception for adolescents in low and middle income countries: needs, barriers, and access. Reprod Health. 2014;11(1):1.PubMedPubMedCentralCrossRef
11.
go back to reference Adams MK, Salazar E, Lundgren R. Tell them you are planning for the future: gender norms and family planning among adolescents in northern Uganda. Int J Gynaecol Obstet. 2013;123(Suppl 1):e7–10.PubMedCrossRef Adams MK, Salazar E, Lundgren R. Tell them you are planning for the future: gender norms and family planning among adolescents in northern Uganda. Int J Gynaecol Obstet. 2013;123(Suppl 1):e7–10.PubMedCrossRef
12.
go back to reference Pandey A, Singh KK. Contraceptive use before first pregnancy by women in India (2005-2006): determinants and differentials. BMC Public Health. 2015;15:1316.PubMedPubMedCentralCrossRef Pandey A, Singh KK. Contraceptive use before first pregnancy by women in India (2005-2006): determinants and differentials. BMC Public Health. 2015;15:1316.PubMedPubMedCentralCrossRef
13.
go back to reference UNFPA. Girlhood, not motherhood: preventing adolescent pregnancy. New York: United Nations Population Fund; 2015. UNFPA. Girlhood, not motherhood: preventing adolescent pregnancy. New York: United Nations Population Fund; 2015.
14.
go back to reference UNFPA. Marrying too young end child marriage. New York, USA, 2012. UNFPA. Marrying too young end child marriage. New York, USA, 2012.
16.
go back to reference Bradley SE, Casterline JB. Understanding unmet need: history, theory, and measurement. Stud Fam Plan. 2014;45(2):123–50. Bradley SE, Casterline JB. Understanding unmet need: history, theory, and measurement. Stud Fam Plan. 2014;45(2):123–50.
17.
go back to reference Barros AJ, Boerma T, Hosseinpoor AR, Restrepo-Mendez MC, Wong KL, Victora CG. Estimating family planning coverage from contraceptive prevalence using national household surveys. Glob Health Action. 2015;8:29735.PubMedCrossRef Barros AJ, Boerma T, Hosseinpoor AR, Restrepo-Mendez MC, Wong KL, Victora CG. Estimating family planning coverage from contraceptive prevalence using national household surveys. Glob Health Action. 2015;8:29735.PubMedCrossRef
18.
go back to reference Sedekia Y, Nathan R, Church K, et al. Delaying first birth: an analysis of household survey data from rural southern Tanzania. BMC Public Health. 2017;17(1):134.PubMedPubMedCentralCrossRef Sedekia Y, Nathan R, Church K, et al. Delaying first birth: an analysis of household survey data from rural southern Tanzania. BMC Public Health. 2017;17(1):134.PubMedPubMedCentralCrossRef
19.
go back to reference Edmeades J, Pande R, Macquarrie K, Falle T, Malhotra A. Two sons and a daughter: sex composition and women's reproductive behaviour in Madhya Pradesh, India. J Biosoc Sci. 2012;44(6):749–64.PubMedCrossRef Edmeades J, Pande R, Macquarrie K, Falle T, Malhotra A. Two sons and a daughter: sex composition and women's reproductive behaviour in Madhya Pradesh, India. J Biosoc Sci. 2012;44(6):749–64.PubMedCrossRef
20.
go back to reference Ngome E, Odimegwu C. The social context of adolescent women's use of modern contraceptives in Zimbabwe: a multilevel analysis. Reprod Health. 2014;11:64.PubMedPubMedCentralCrossRef Ngome E, Odimegwu C. The social context of adolescent women's use of modern contraceptives in Zimbabwe: a multilevel analysis. Reprod Health. 2014;11:64.PubMedPubMedCentralCrossRef
21.
go back to reference Ochako R, Mbondo M, Aloo S, et al. Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study. BMC Public Health. 2015;15:118.PubMedPubMedCentralCrossRef Ochako R, Mbondo M, Aloo S, et al. Barriers to modern contraceptive methods uptake among young women in Kenya: a qualitative study. BMC Public Health. 2015;15:118.PubMedPubMedCentralCrossRef
22.
go back to reference Dynes M, Stephenson R, Rubardt M, Bartel D. The influence of perceptions of community norms on current contraceptive use among men and women in Ethiopia and Kenya. Health & place. 2012;18(4):766–73.CrossRef Dynes M, Stephenson R, Rubardt M, Bartel D. The influence of perceptions of community norms on current contraceptive use among men and women in Ethiopia and Kenya. Health & place. 2012;18(4):766–73.CrossRef
23.
go back to reference Kane S, Kok M, Rial M, et al. Social norms and family planning decisions in South Sudan. BMC Public Health. 2016;16:1183.  Kane S, Kok M, Rial M, et al. Social norms and family planning decisions in South Sudan. BMC Public Health. 2016;16:1183.
24.
go back to reference Sedekia Y, Jones C, Nathan R, Schellenberg J, Marchant T. Using contraceptives to delay first birth: a qualitative study of individual, community and health provider perceptions in southern Tanzania. BMC Public Health. 2017;17(1):768.PubMedPubMedCentralCrossRef Sedekia Y, Jones C, Nathan R, Schellenberg J, Marchant T. Using contraceptives to delay first birth: a qualitative study of individual, community and health provider perceptions in southern Tanzania. BMC Public Health. 2017;17(1):768.PubMedPubMedCentralCrossRef
25.
go back to reference McClendon KA, McDougal L, Ayyaluru S, et al. Intersections of girl child marriage and family planning beliefs and use: qualitative findings from Ethiopia and India. Cult Health Sex. 2017:1–16. McClendon KA, McDougal L, Ayyaluru S, et al. Intersections of girl child marriage and family planning beliefs and use: qualitative findings from Ethiopia and India. Cult Health Sex. 2017:1–16.
26.
go back to reference Corroon M, Speizer IS, Fotso JC, et al. The role of gender empowerment on reproductive health outcomes in urban Nigeria. Matern Child Health J. 2014;18(1):307–15.PubMedPubMedCentralCrossRef Corroon M, Speizer IS, Fotso JC, et al. The role of gender empowerment on reproductive health outcomes in urban Nigeria. Matern Child Health J. 2014;18(1):307–15.PubMedPubMedCentralCrossRef
27.
go back to reference Bogale B, Wondafrash M, Tilahun T, Girma E. Married women's decision making power on modern contraceptive use in urban and rural southern Ethiopia. BMC Public Health. 2011;11:342.PubMedPubMedCentralCrossRef Bogale B, Wondafrash M, Tilahun T, Girma E. Married women's decision making power on modern contraceptive use in urban and rural southern Ethiopia. BMC Public Health. 2011;11:342.PubMedPubMedCentralCrossRef
28.
go back to reference Raj A, Saggurti N, Lawrence D, Balaiah D, Silverman JG. Association between adolescent marriage and marital violence among young adult women in India. Int J Gynaecol Obstet. 2010;110(1):35–9.PubMedPubMedCentralCrossRef Raj A, Saggurti N, Lawrence D, Balaiah D, Silverman JG. Association between adolescent marriage and marital violence among young adult women in India. Int J Gynaecol Obstet. 2010;110(1):35–9.PubMedPubMedCentralCrossRef
29.
go back to reference Henry EG, Lehnertz NB, Alam A, et al. Sociocultural factors perpetuating the practices of early marriage and childbirth in Sylhet District, Bangladesh. Int Health. 2015;7(3):212–7.PubMedCrossRef Henry EG, Lehnertz NB, Alam A, et al. Sociocultural factors perpetuating the practices of early marriage and childbirth in Sylhet District, Bangladesh. Int Health. 2015;7(3):212–7.PubMedCrossRef
30.
go back to reference Raj A, Saggurti N, Balaiah D, Silverman JG. Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: a cross-sectional, observational study. Lancet. 2009;373(9678):1883–9.PubMedPubMedCentralCrossRef Raj A, Saggurti N, Balaiah D, Silverman JG. Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: a cross-sectional, observational study. Lancet. 2009;373(9678):1883–9.PubMedPubMedCentralCrossRef
31.
go back to reference Sarkar A, Chandra-Mouli V, Jain K, Behera J, Mishra SK, Mehra S. Community based reproductive health interventions for young married couples in resource-constrained settings: a systematic review. BMC Public Health. 2015;15:1037.PubMedPubMedCentralCrossRef Sarkar A, Chandra-Mouli V, Jain K, Behera J, Mishra SK, Mehra S. Community based reproductive health interventions for young married couples in resource-constrained settings: a systematic review. BMC Public Health. 2015;15:1037.PubMedPubMedCentralCrossRef
32.
go back to reference Hindin MJ, Kalamar AM, Thompson TA, Upadhyay UD. Interventions to prevent unintended and repeat pregnancy among young people in low- and middle-income countries: a systematic review of the published and gray literature. J Adolesc Health. 2016;59(3 Suppl):S8–S15.PubMedCrossRef Hindin MJ, Kalamar AM, Thompson TA, Upadhyay UD. Interventions to prevent unintended and repeat pregnancy among young people in low- and middle-income countries: a systematic review of the published and gray literature. J Adolesc Health. 2016;59(3 Suppl):S8–S15.PubMedCrossRef
33.
go back to reference Subramanian L, Simon C, Daniel EE. Increasing contraceptive use among young married couples in Bihar, India: evidence from a decade of implementation of the PRACHAR project. Glob Health Sci Pract. 2018;6(2):328–42.PubMedCentralCrossRef Subramanian L, Simon C, Daniel EE. Increasing contraceptive use among young married couples in Bihar, India: evidence from a decade of implementation of the PRACHAR project. Glob Health Sci Pract. 2018;6(2):328–42.PubMedCentralCrossRef
34.
go back to reference Sánchez-Páez DA, Ortega JA. Adolescent contraceptive use and its effects on fertility. Demogr Res. 2018;38(45):1359–88.CrossRef Sánchez-Páez DA, Ortega JA. Adolescent contraceptive use and its effects on fertility. Demogr Res. 2018;38(45):1359–88.CrossRef
35.
go back to reference Sedgh G, Ashford L, Hussain R. Unmet need for contraception in developing countries: examining Women’s reasons for not using a method. New York: Guttmacher Institute; 2016. Sedgh G, Ashford L, Hussain R. Unmet need for contraception in developing countries: examining Women’s reasons for not using a method. New York: Guttmacher Institute; 2016.
36.
go back to reference Alkema L, Kantorova V, Menozzi C, Biddlecom A. National, regional, and global rates and trends in contraceptive prevalence and unmet need for family planning between 1990 and 2015: a systematic and comprehensive analysis. Lancet. 2013;381(9878):1642–52.PubMedCrossRef Alkema L, Kantorova V, Menozzi C, Biddlecom A. National, regional, and global rates and trends in contraceptive prevalence and unmet need for family planning between 1990 and 2015: a systematic and comprehensive analysis. Lancet. 2013;381(9878):1642–52.PubMedCrossRef
Metadata
Title
Contraception in adolescence: the influence of parity and marital status on contraceptive use in 73 low-and middle-income countries
Authors
Carolina de Vargas Nunes Coll
Fernanda Ewerling
Franciele Hellwig
Aluísio Jardim Dornellas de Barros
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Contraception
Published in
Reproductive Health / Issue 1/2019
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-019-0686-9

Other articles of this Issue 1/2019

Reproductive Health 1/2019 Go to the issue