Contraception determinants in youths of Sierra Leone are largely behavioral

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Sexual initiation occurs early in Sierra Leone. This study aims to analyze the determinants of condom and/or contraceptive use among a representative sample of young persons (10 to 24 years) in Sierra Leone.

Methods

This is a secondary analysis of data from a study conducted to monitor the implementation of a UNFPA package of interventions directed to improve SRH in young people of Sierra Leone. This assessment was conducted in 2016 at the end of the Ebola outbreak. In consequence, determinants linked to healthy lifestyle behaviors and UNFPA interventions were explored in addition to the usual determinants: socio demographic and sexual lifestyle. This study is a household quantitative survey with open ended questions used to illustrate and complete the analysis.

Results

A total of 1409 young people were interviewed: of these, 216 boys and 381 girls were sexually active. Those who were pregnant or wished for pregnancy were excluded, leaving 194 boys and 268 girls for the analysis of determinants. The proportion of young people using neither condom nor other contraception at their last sexual intercourse in the whole sample was 40.5% and there was no statistically significant difference between boys and girls (42.3 vs 39.2; P = 0.504). Determinants were assessed and, after multivariable analysis, results differed between boys and girls and showed the importance of behavioral aspects. Four determinants were common to boys and girls: literacy, distance, negotiation capacity and hand washing. However, the distance factor for girls was to the health facility and for boys it was to school. Three more determinants remained in the boy’s model: sleeping under a bednet, number of sexual partners and knowledge of contraceptive methods. Opinions about condoms and contraception revealed important barriers; opposition to contraceptive use was the main reason for non-use for both boys and girls, while lack of access was an important reason for boys.

Conclusion

There is a need to reach out to the 40% of young people who are sexually active and neither pregnant nor with pregnancy desire, and are not using condom or contraception.

Related collections

Most cited references 16

Record: found
Abstract: found
Article: found

Is Open Access

Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review

Ibrahim Yakubu, Waliu Salisu (2018)

Background Adolescent pregnancy has been persistently high in sub-Saharan Africa. The objective of this review is to identify factors influencing adolescent pregnancies in sub-Saharan Africa in order to design appropriate intervention program. Methods A search in MEDLINE, Scopus, Web of science, and Google Scholar databases with the following keywords: determinants, factors, reasons, sociocultural factors, adolescent pregnancy, unintended pregnancies, and sub- Saharan Africa. Qualitative and cross-sectional studies intended to assess factors influencing adolescent pregnancies as the primary outcome variable in sub- Saharan Africa were included. Our search was limited to, articles published from the year 2000 to 2017 in English. Twenty-four (24) original articles met the inclusion criteria. Results The study identified Sociocultural, environmental and Economic factors (Peer influence, unwanted sexual advances from adult males, coercive sexual relations, unequal gender power relations, poverty, religion, early marriage, lack of parental counseling and guidance, parental neglect, absence of affordable or free education, lack of comprehensive sexuality education, non-use of contraceptives, male’s responsibility to buy condoms, early sexual debut and inappropriate forms of recreation). Individual factors (excessive use of alcohol, substance abuse, educational status, low self-esteem, and inability to resist sexual temptation, curiosity, and cell phone usage). Health service-related factors (cost of contraceptives, Inadequate and unskilled health workers, long waiting time and lack of privacy at clinics, lack of comprehensive sexuality education, misconceptions about contraceptives, and non-friendly adolescent reproductive services,) as influencing adolescent pregnancies in Sub-Saharan Africa Conclusion High levels of adolescent pregnancies in Sub-Saharan Africa is attributable to multiple factors. Our study, however, categorized these factors into three major themes; sociocultural and economic, individual, and health service related factors as influencing adolescent pregnancies. Community sensitization, comprehensive sexuality education and ensuring girls enroll and stay in schools could reduce adolescent pregnancy rates. Also, provision of adolescent-friendly health services in schools and healthcare centers and initiating adolescent empowerment programs could have a positive impact.

0 comments Cited 143 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Is Open Access

Maternal mortality in adolescents compared with women of other ages: evidence from 144 countries.

Andrea Nove, Zoe Matthews, Sarah Neal … (2014)

Adolescents are often noted to have an increased risk of death during pregnancy or childbirth compared with older women, but the existing evidence is inconsistent and in many cases contradictory. We aimed to quantify the risk of maternal death in adolescents by estimating maternal mortality ratios for women aged 15-19 years by country, region, and worldwide, and to compare these ratios with those for women in other 5-year age groups.

0 comments Cited 121 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Reproductive, maternal, newborn, and child health: key messages from Disease Control Priorities 3rd Edition.

Robert E Black, Carol Levin, Neff Walker … (2016)

As part of Disease Control Priorities 3rd Edition, the World Bank will publish a volume on Reproductive, Maternal, Newborn, and Child Health that identifies essential cost-effective health interventions that can be scaled up to reduce maternal, newborn, and child deaths, and stillbirths. This Review summarises the volume's key findings and estimates the effect and cost of expanded implementation of these interventions. Recognising that a continuum of care from the adolescent girl, woman, or mother to child is needed, the volume includes details of preventive and therapeutic health interventions in integrated packages: Maternal and Newborn Health and Child Health (along with folic acid supplementation, a key reproductive health intervention). Scaling up all interventions in these packages from coverage in 2015 to hypothetically immediately achieve 90% coverage would avert 149 000 maternal deaths, 849 000 stillbirths, 1 498 000 neonatal deaths, and 1 515 000 additional child deaths. In alternative calculations that consider only the effects of reducing the number of pregnancies by provision of contraceptive services as part of a Reproductive Health package, meeting 90% of the unmet need for contraception would reduce global births by almost 28 million and consequently avert deaths that could have occurred at 2015 rates of fertility and mortality. Thus, 67 000 maternal deaths, 440 000 neonatal deaths, 473 000 child deaths, and 564 000 stillbirths could be averted from avoided pregnancies. Particularly effective interventions in the Maternal and Newborn Health and Child Health packages would be management of labour and delivery, care of preterm births, and treatment of serious infectious diseases and acute malnutrition. Nearly all of these essential interventions can be delivered by health workers in the community or in primary health centres, which can increase population access to needed services. The annual incremental cost of immediately scaling up these essential interventions would be US$6·2 billion in low-income countries, $12·4 billion in lower-middle-income countries, and $8·0 billion in upper-middle-income countries. With the additional funding, greater focus on high-effect integrated interventions and innovations in service delivery, such as task shifting to other groups of health workers and supply and demand incentives, can help rectify major gaps in accessibility and quality of care. In recent decades, reduction of avoidable maternal and child deaths has been a global priority. With continued priority and expansion of essential reproductive, maternal, newborn, and child health interventions to high coverage, equity, and quality, as well as interventions to address underlying problems such as women's low status in society and violence against women, these deaths and substantial morbidity can be largely eliminated in another generation.

0 comments Cited 95 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Aline Labat:

ORCID: http://orcid.org/0000-0001-9746-5178

+322 555 4073 , aline.labat@ulb.ac.be

Marta Medina: Marta.Medina@hera.eu

Mohammed Elhassein: elhassein@unfpa.org

Afrina Karim: afrina_karim@yahoo.com

Mohammad B. Jalloh: jallohbai@gmail.com

Michèle Dramaix: miwilmet@ulb.ac.be

Wei-Hong Zhang: zhang.wei.hong@ulb.ac.be

Sophie Alexander: sophie.alexander@ulb.ac.be

Kim E. Dickson: dickson@unfpa.org

Journal

Journal ID (nlm-ta): Reprod Health

Journal ID (iso-abbrev): Reprod Health

Title: Reproductive Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1742-4755

Publication date (Electronic): 19 April 2018

Publication date PMC-release: 19 April 2018

Publication date Collection: 2018

Volume: 15

Electronic Location Identifier: 66

Affiliations

[1 ]ISNI 0000 0001 2348 0746, GRID grid.4989.c, Université Libre de Bruxelles, Ecole de Santé Publique, Research Center: Policies and Health Systems - International Health, ; 808, Route de Lennik, 1070 Brussels, Belgium

[2 ]hera, Right to Health and Development, Reet, Belgium

[3 ]FOCUS 1000, NGO, Freetown, Sierra Leone

[4 ]UNFPA, Freetown, Sierra Leone

Author information

Aline Labat http://orcid.org/0000-0001-9746-5178

Article

Publisher ID: 504

DOI: 10.1186/s12978-018-0504-9

PMC ID: 5907724

PubMed ID: 29673404

SO-VID: 3faa127e-0680-4c63-9ccc-9dfaea8d557f

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 2 August 2017

Date accepted : 4 April 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100000278, Department for International Development;

Award ID: GB-1-202721

Custom metadata

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: adolescent,youth,behavior,condoms,contraception,determinants,gender,health promotion,sierra leone

Data availability:

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: adolescent, youth, behavior, condoms, contraception, determinants, gender, health promotion, sierra leone

Contraception determinants in youths of Sierra Leone are largely behavioral

Read this article at

Abstract

Background

Methods

Results

Conclusion

Related collections

Behavioral Public Administration

Most cited references 16

Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review

Maternal mortality in adolescents compared with women of other ages: evidence from 144 countries.

Reproductive, maternal, newborn, and child health: key messages from Disease Control Priorities 3rd Edition.

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 321

Cited by 6

Most referenced authors 186