A cross-country qualitative study on contraceptive method mix: contraceptive decision making among youth

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Ouma, L
Bozkurt, B.
Chanley, J.
Power, C.
Kakonge, R.
Adeyemi, O.C.
Kudekallu, R.J.
Madsen, E.L.
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BMC/ Springer Nature
Background Youth ages 15 to 24, who comprise a large portion of sub-Saharan Africa, face a higher burden of unmet contraceptive needs than adults. Despite increased international and national commitments to improving young people’s access to contraception, significant barriers impede their access to a full range of methods. To further explore these barriers among youth in Kenya, Nigeria, and Uganda, we conducted a qualitative study to capture the challenges that affect contraceptive method decision-making and complicate youth access to the full method mix. Methods To understand factors that impact young people’s contraceptive decision-making process across all three countries, we conducted a total of 35 focus group discussions with 171 youth ages 15 to 24 and 130 in-depth interviews with key stakeholders working in youth family planning. Questionnaires aligned with the High Impact Practices in Family Planning’s elements of adolescent-friendly contraceptive services. Data were coded with MAXQDA and analyzed using a framework for contraceptive decision-making to identify relevant patterns and themes. Results In all three countries, youth reported that condoms are the most commonly sought contraceptive method because they are easiest to access and because youth have limited knowledge of other methods. Youth from diverse settings shared uncertainty and concern about the safety and side effects of many methods other than condoms, complicating their ability to take full advantage of other available methods. While most youth in Kenya, Nigeria, and Uganda reported at least moderate confidence in obtaining the information needed to help choose a method, and only a few youths reported that they are completely unable to access contraceptives, other barriers still present a major deterrent for youth, including cost, inconvenient facility hours and long wait times, and stigma from family, community members, and providers. Conclusions Young people’s ability to fully exercise their method choice remains limited despite the availability of services, leading them to take the path of least resistance. Program implementers and policymakers should consider the diverse and often interconnected barriers that youth face in attempting to enjoy the benefits of a full spectrum of contraceptive methods and design multi-level interventions to mitigate such barriers.
Scholarly articles
Youth-friendly services , contraceptive access , unmet contraceptive need , modern contraceptive methods , Qualitative study , Research Subject Categories::PHARMACY
Ouma L., Bozkurt B., Chanley J., Power C., Kakonge R., Adeyemi O.C., Kudekallu R.J., Madsen E.L. (2021). A cross-country qualitative study on contraceptive method mix: contraceptive decision-making among youth. Reprod Health 18, 105 (2021). https://doi.org/10.1186/s12978-021-01160-5