Prevalence of contraceptive use and associated factors among youths 15-24 years attending secondary schools in Mbale Municipality, Mbale district

Abstract

Introduction Worldwide, young people make up the greatest proportion of the population. In Uganda, 21% of the population is aged 15-24 years. The proportion of women age 15-19 who have begun childbearing rises rapidly with age, from 3 percent among women age 15 to 22 percent among women age 17 and 54 percent among women age 19. The eastern region of Uganda has a very high teenage pregnancy rate of 28.2% with associated low contraceptive use. Teenage pregnancy is associated with school drops and abortions. The study aimed at determining the prevalence of modern contraceptive use and associated factors among youths attending secondary schools in Mbale municipality, Mbale district Method A cross sectional study in six secondary schools (Nkoma SS, Mbale SS, Bugisu high, Oxford SS, Wanale view and Mbale high school) located in two divisions (Northern and Industrial divisions) within Mbale Municipality, Mbale district. Data were collected from 15th June to 17th July 2017, with self-administered semi structured questionnaire from 2,690 students. Qualitative data from 4 in-depth interviews were collected. Data collected included sexual behaviours, contraceptive use and associated factors. Data entry was conducted in SPSS 10 and analyzed using STATA version 12. Qualitative data were transcribed and analyzed thematically. Results Just over a third (38.1%) of the participants were sexually active, of whom only 60.7% had ever used modern contraceptive method and 26.5% are currently on contraceptives. Among male respondents, the odds of contraceptive use were lowered in the following; absence of health education on family planning by health worker (adjusted OR=0.44; 95% CI(0.30-0.64); p<0.001) and lack of knowledge on girl’s fertility cycle (adjusted OR=0.49;95%CI(0.32-0.77); p=0.002) and while among the female respondents, the odds of contraceptive were lowered by absence of health education on family planning by health worker (adjusted OR=0.36; 95% CI(0.22-0.59); p<0.001), lack of knowledge on girl’s fertility cycle (adjusted OR=0.39 ;95%CI(0.18-0.85); p=0.018) and never aborted (adjusted OR=0.10 ;95%CI(0.02-0.62); p=0.014) Health facilities were the main source of contraceptive methods and male condoms were the commonest method used. Sexual and reproductive health services are not provided in the school; however, knowledge on contraception is acquired during biology lessons. Conclusions and recommendation Over a third of youths attending secondary schools are sexually active, but contraceptive use remains sub-optimal (61%). Lack of knowledge of the girl’s fertility cycle and absence of health education on family planning by health worker are key factors lowering contraceptive use among both boys and girls. Health facilities were the main source of contraceptives, while condoms were the commonest method used. Sexual and reproductive health services are not provided in the schools Through the municipal education and district health officer, health workers should strengthen sexual reproductive health education in secondary schools through school health programs