| Issue/Objective |
The non-utilization of modern contraceptives among sexually active Adolescent Girls and Young Women (AGYW) in Uganda threatens the likelihood of achieving SDG 3.7 and 5.6 targets. With only five years left, SDGs achieving universal access to sexual reproductive health and rights hangs in the balance. If urgent measures are not taken, Uganda risks missing this crucial milestone, which could lead to increased unintended pregnancies, higher maternal and neonatal mortality rates, and hinder progress towards national and global reproductive health goals. The study investigated the prevalence and determinants of non-utilization of modern contraceptives among sexually active adolescent girls and young women in the Busoga sub-region, Eastern Uganda |
| Methodology/Approach |
This cross-sectional study was conducted in the Busoga sub-region, Eastern Uganda, on 490 sexually active young women aged 10-24 who were randomly selected using a multi-stage sampling technique. The study included only Adolescent girls and young women who had had sexual intercourse in the last 12 months. Data was collected using Kobo Collect in October 2024. The outcome variable was non-utilization of modern contraceptives derived from the question, "Have you ever used any modern contraceptive to prevent or delay getting pregnant?". Data was downloaded into Microsoft Excel 2019, cleaned, and exported to STATA version 17 for statistical analysis. The data was analysed at a univariate level to describe the characteristics of AGYW, while modified poison regression was utilized at bivariate and multivariable levels to determine the factors influencing contraceptive non-utilization. The factors significant at the bivariate level at p<0.2 were considered for the multivariable model. Model building was done using stepwise elimination, and a final model with a lower Akaike information criterion (AIC) was considered the best fit. Unadjusted and adjusted prevalence ratios with 95% confidence intervals were used to explain the associated factors of non-use of modern contraceptives. |
| Results |
Out of the 490 Adolescent Girls and Young Women, 318 (64.9%) had sexual intercourse in the last six months. More than half (56.9%) of 279/490 had used modern contraceptives, while 211 had never used modern contraceptives (43.1%). The mean age was 19.3 years (SD) = 6.7) with the distribution of 10-14 years (12%), 15-19 years (53.9) and 20-24 years (34.1%). Three per cent of participants had no formal education, 62% had primary education, and 34% had attained at least secondary education. Regarding marital status, 66.3% were single, 29.8% were married/cohabiting, and 3.9% were divorced or separated. The majority of AGYW (85.5%) had no confidence in discussing modern contraceptives with their peers or older people. Regarding partner discussion, 78% of participants do not discuss with their partners about contraceptive use. Over half (57.6%) of the participants had visited a health facility in the last 12 months, 57.8% knew contraceptive service points, 55.5% perceived the health facilities had privacy, and health workers kept their information confidential. The majority (87.3%) had interacted with community health workers, while 79.2% of participants knew about modern contraceptives.
Among the 490 randomly selected AGYW, 43.1% (211/490) were not using modern contraceptives. The prevalence of non-utilization was significantly associated with a lack of confidence in discussing contraceptives with peers (APR=1.331; 95% CI: 1.056-1.667), limited partner discussions about contraception (APR=1.373; 95% CI: 1.023-1.845), and perceived inaccessibility of contraceptive services (APR=1.386; 95% CI: 1.021-1.845), marital status(APR=0.631; 95% CI: 0.475-0.838), interaction with. Community health worker (APR=0.623; 95% CI: 0.401-0.967).
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| Discussion/Conclusion |
The findings underscore the urgency of achieving universal access to sexual and reproductive health-care services and rights and highlight the need for youth-friendly interventions that enhance confidence in discussing and using contraceptives, strengthen partner communication, and improve access to services. |
| Presenters and affiliations |
Godfrey Tumwizere Makerere University School of public Health |
