Abstract
In sub-Saharan Africa, about 80% of young women either use a traditional method or do not use any form of contraception at all. The objectives of this review were to ascertain the barriers and motivators of contraceptive use among young people in Sub-Saharan Africa. We conducted electronic literature searches in PubMed, EMBASE, Ebsco/PsycINFO and Scopus. We identified a total of 4,457 publications and initially screened 2626 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A total of 13 qualitative studies were retained for the final analysis based on the Joanna Briggs criteria for assessing qualitative studies. The systematic review is registered on PROSPERO with identifier CRD42018081877. Supportive social networks, respect for privacy and confidentiality, ready availability, affordability and accessibility of contraceptives, as well as the desire to prevent unintended pregnancy and sexually transmitted infections were the motivators of contraceptive use among young people in sub-Saharan Africa. Despite these motivators, myriad of personal, societal, and health systems-based barriers including myths and misconceptions, known side effects of contraceptives, prohibitive social norms, and negative attitude of health professionals were the major barriers to contraceptive use among young people. Sub-Saharan African countries with widespread barriers to contraceptive use among young people may not be able to achieve the Sustainable Development Goal 3.8 target of achieving health for all by the year 2030. Interventions intended to improve contraceptive use need to be intersectoral and multi-layered, and designed to carefully integrate the personal, cultural, organizational and political dimensions of contraception.
Highlights
Pregnancy and childbirth among young women remain major public health concerns worldwide [1]
Supportive social networks, respect for privacy and confidentiality, ready availability, affordability and accessibility of contraceptives, as well as the desire to prevent unintended pregnancy and sexually transmitted infections were the motivators of contraceptive use among young people in sub-Saharan Africa
Myriad of personal, societal, and health systems-based barriers including myths and misconceptions, known side effects of contraceptives, prohibitive social norms, and negative attitude of health professionals were the major barriers to contraceptive use among young people
Summary
Pregnancy and childbirth among young women remain major public health concerns worldwide [1]. Optimal contraceptive use alone has the capacity of reducing the burden of unintended pregnancies and abortions by one third [3, 4]. High levels of contraceptive failure or discontinuation are accrued predominantly to the use of traditional methods (coitus interruptus [withdrawal method], lactational amenorrhea method, calendar/rhythm method, cervical mucus method, and abstinence), and increase the overall burden of unintended pregnancies and abortions in SSA [4]. The contraceptive challenges and their resultant morbidities and mortalities occur at the backdrop that SSA countries have signed up to meeting the Sustainable Development Goal (SDG) 3.8 target of achieving health for all by the year 2030 [5, 6]. Achieving health for all, implies that the countries have to, among other things increase the level of contraceptive use among their populace especially young people.
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