Contraceptive use by adolescents in Internally Displaced Persons’ (IDPs) camps in Pader District, Northern Uganda
Kabarangira, Janex Mabel
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Background; Sexual and reproductive health of adolescents is central to the general health of the population. Knowledge of contraceptives and contraceptive use are important indictors of sexual health among adolescents and young people in general. Pader district situated in Northern Uganda experienced a 20-year old intractable conflict that resulted in the displacement of over 415,000 people into internally displaced persons (IDP) camps. A total of 166,160 (40%) of the displaced were young people. Adolescents are highly vulnerable to risky behaviours including unprotected sex, relatively low use of contraceptives resulting into unplanned pregnancy, early marriages, and a high rate of teenage pregnancy in the country. Objectives; To estimate the prevalence of contraceptive use among sexually active adolescents living in IDP camps. Factors that affect contraceptive use among adolescents living in internally displaced persons’ camps of Pader district were also assessed. Methods; This was a cross-sectional study that used both quantitative and qualitative techniques to collect data. The study population comprised adolescents (males and females), aged 15-19 years living in 20 randomly selected IDP camps in Pader district. The number of adolescents included in the study was calculated based on proportional representation of adolescents in each of the selected camps. Random sampling was used to select counties, sub-counties, camps, zones, households and the calculated number of adolescents from the camps that participated in the study after consent and /or assent. A total of 384 adolescents randomly selected participated in the study; however, analysis was for 378 respondents. Qualitative data was collected using 8 Focus Group Discussions (FGD) and 10 Key Informant Interviews (KII). Statistical analysis was performed to determine level of use of contraceptives and those factors that affect use among these adolescents. Results; Overall, the prevalence of contraceptive use was 16.7% (63/378). When disaggregated by sex, the rate was 11.5% amongst females and 29.6% amongst males. Factors that significantly influenced use of contraceptives by adolescents were prior knowledge of contraceptives [OR 9.33(95% CI 1.26 – 69.15)], partner discussion about contraception [OR 9.92(95%CI 4.96 – 19.85)], and level of education [OR 11.36 (95% CI 3.65 – 35.71)]. Reasons why adolescents do not use contraceptives include perceived myths about and fear of side effects from contraceptives. Conclusions; Contraceptive prevalence rate in the study settings was low. Sexually active adolescents in IDP camps were not using contraceptives as was anticipated. Prior knowledge of contraceptives, and frequent partner discussions among sexually active adolescents promoted use of contraceptives. Economic benefits of contraception were more appreciated by adolescents than health benefits. Recommendations; All adolescents, both males and females, need continuous education on the importance of use of contraceptives and the associated side effects in order to reduce the risk of unintended teenage pregnancy. Social mobilization and a promotion strategy for contraceptive use by adolescents in IDP situation should include health benefits in addition to the economic gains of contraception. Policy makers and implementers should understand the reproductive needs of adolescents in conflict situations and design appropriate and focused programs accordingly. Hence, the need to do more operational research on adolescent reproductive health needs in conflict situations.