Factors associated with use of modern contraceptives among female adolescents 15-19 years in Rubaga Division slums of Kampala- Uganda: A cross sectional study

Abstract

Introduction: Avertable pregnancies and maternal deaths continue to occur predominantly in Sub-Saharan Africa where use of the effective modern contraceptive methods is still low due to a number of barriers. Female adolescents, particularly those in slums are some of the marginalized groups due to their low income, high unemployment and illiteracy levels. Objective: To assess level and associated factors of modern contraceptive use among female adolescents, 15-19 years old in Rubaga division slums Kampala Uganda. Methods: This was a descriptive cross sectional study design, employing both qualitative and quantitative data collection methods. Data was collected between May and June 2018. Multistage simple random sampling was employed of parishes, villages and respondents in the slums of Rubaga division and 14 out of 69 villages were sampled. Purposive sampling was engaged to recruit respondents for the qualitative study, while convenience sampling was engaged to recruit 300 eligible respondents for the quantitative study since a sampling frame could not be obtained. Results: Nearly three quarters (72.7%) were nulliparous; Three quarters (75.7%), were single or separated, and only 24.3% were in consensual union. Current modern contraceptive use was relatively high (88.3%) and the most used method was the male condom (76.5%). Factors associated with current modern contraceptive use among female adolescents 15-19 years, at multivariable analysis were; knowledge of source of methods (p=0.015) AdjPR. (95% CI) – 1.03(1.006-1.062), Religion – catholics p-value 0.018 Adj. PR(95% CI) – 1.04(1.006-1.066), and moslems –p value 0.048, Adj. PR(95% CI) -1.02(1.00-1.038), perceived distance to service point; p-value -0.028, Adj. PR(95% CI) -1.07(1.01-1.13), perceived confidentiality; p-value 0.028, Adj. PR(95% CI) 1.2(1.01-1.195), and perceived health worker attitude; p-value 0.033 Adj. PR(95% CI) -0.96(1.007-1.176) Identified barriers at thematic content analysis were; misconceptions, stigma and fears, gender power relations, health system barriers and lack of adolescent friendly services. Motivators to modern contraceptive use were; individual initiatives to overcome obstacles, set goals to be achieved and favorable method related factors. xiv Conclusion: Current modern contraceptive use was suboptimal with short term methods (mainly the male condom), being the most known and used method. Factors associated with use were mainly individual perceptions and motivators and barriers were cost effective factors if addressed by mainly creating adolescent friendly health services