Influences on contraceptive method choice among adolescents and youth in sub-Saharan Africa

Project Details


Globally, there are nearly 2 billion young people ages 10-24 which represents about one quarter of the world’s population (Das Gupta 2014). Young people often experience key life transitions in school status, living arrangements, employment, marriage and childbearing when in this age range; this is a critical period to ensure that the reproductive needs of young people are met in order to enable them to achieve their full education, economic and social potential (Yinger 2016, Fikree 2017). In recognition of the fundamental right of young people to freely make decisions about their own reproductive health needs, there is increased global focus on improving access to high quality family planning methods (FP2020), including recent commitments by 29 country governments in sub-Saharan Africa.

In 2016, approximately 38 of the 252 million adolescents ages 15-19 living in developing countries were sexually active and did not want a child for the next two years (Darroch 2016). About 15 million of these adolescents use a modern method of family planning (FP) and another 23 million have an unmet need for FP (Darroch 2016). Evidence from multi-country DHS analyses show that show that young people who are using a contraceptive method primarily use traditional methods and condoms (Ross 2015, Radovich 2018). As young women transition from their teen years to early twenties, the method mix broadens further to include more use of pills and injectables as well as some use of long acting reversible contraceptives (LARCs) (IUDs and implants); these changing patterns of contraceptive method use and choice are closely connected to key life transitions such as marriage and childbirth (Ross 2015, Radovich 2018). This suggests that young people, particularly those age 15-19, are not choosing the most effective methods to avoid an unintended pregnancy (Bellizzi 2019, Biddlecom 2018) and to attain their fertility and family planning goals. Preventing unintended pregnancy is essential to improving adolescents’ sexual and reproductive health and their social and economic well-being.

Despite recent global focus on meeting the reproductive health needs of young people, supply, demand and policy related barriers still persist (Biddlecom 2018). Evidence exists to demonstrate the safety, effectiveness, and additional health benefits of contraceptive use, including LARCs, for young people (FP2020), yet gaps exist in terms of how to address the barriers to uptake and use of a range of contraceptive methods including changing policies, addressing provider biases, reaching young people with correct and accurate information on contraception and LARCs to reduce myths and misconceptions, and ensuring young people are protected both from unintended pregnancies and STI/HIV. These barriers must be addressed so that young people are able to meet their full potential which includes being able to access the method of their choice that best suits their lifestyle and life goals.
Effective start/end date27/04/215/02/24

IWETO expertise domain

  • B680-public-health


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