Modern contraceptive use among teenage mothers aged 13-19 years in Kamuli District Uganda

Abstract

Background: In Uganda, almost a quarter (24%) of women have given birth by the age of 19, making it the highest teenage pregnancy rate in East Africa. Teenage mothers often face adverse outcomes such as school dropout, social stigmatization, forced marriage, pregnancy complications, and even death. Contraceptive use among teenage mothers is essential to prevent repeat unintended pregnancies for those who are unmarried and to enable appropriate child spacing for those who are married. This study aimed to determine the prevalence and factors associated with modern contraceptive use among teenage mothers in Kamuli district so as to suggest recommendations aimed at preventing teenage pregnancy in the district. Methods: This was a cross-sectional study that utilized quantitative and qualitative data collection techniques. Quantitative data was collected among 286 teenage mothers in three randomly selected sub-counties using a semi-structured questionnaire uploaded to the Kobo Collect. Qualitative data was collected among 20 purposively selected key informants, including community health workers, health facility in charges, local and religious leaders. Quantitative data was cleaned in Microsoft Excel and transferred to STATA version 15 for analysis. Univariate analysis was carried out to describe the data, while the bivariable and multivariable analyses were conducted using modified poison regression. Qualitative data was transcribed verbatim, coded and analysed using manual thematic analysis. Quantitative findings were presented using tables, while qualitative findings were presented using themes and quotes. Results: This study found that out of 286 teenage mothers included in this study, 45% (129/286) were using modern contraceptive. The factors that were associated with modern contraceptive use included: being separated (APR=1.68; 95% CI: 1.22-2.30), being a Muslim (APR= 0.69; 95% CI: 0.48-0.99), finding it difficult to access family planning (APR=0.61; 95% CI: 0.38 0.98), contraceptive services being affordable (APR=1.90; 95% CI: 1.24-2.89), and the culture accepting use of contraceptives (APR=1.83; 95% CI: 1.11-3.01). From the qualitative findings, strategies to scale up modern contraceptive use among teenage mothers included enhancing service accessibility and affordability, community education, improving healthcare worker attitudes, supporting village health teams, and encouraging parental involvement. Conclusion: The prevalence of modern contraceptive use among teenage mothers in Kamuli district was 45%. Factors associated with modern contraceptive use included marital status, religion, accessibility, affordability, and cultural acceptance. To increase contraceptive use, targeted strategies are needed to improve service accessibility and affordability, enhance community education, and foster supportive attitudes among healthcare workers.