Abstract
BackgroundUnintended pregnancies lead to unsafe abortions, which are a leading cause of preventable maternal mortality among young women in Uganda. There is a discrepancy between the desire to prevent pregnancy and actual contraceptive use. Health care providers' perspectives on factors influencing contraceptive use and service provision to young people aged 15-24 in two rural districts in Uganda were explored.MethodsSemi-structured questionnaires were used for face- to-face interviews with 102 providers of contraceptive service at public, private not-for-profit, and private for-profit health facilities in two rural districts in Uganda. Descriptive and inferential statistics were used in the analysis of data.ResultsProviders identified service delivery, provider-focused, structural, and client-specific factors that influence contraceptive use among young people. Contraceptive use and provision to young people were constrained by sporadic contraceptive stocks, poor service organization, and the limited number of trained personnel, high costs, and unfriendly service. Most providers were not competent enough to provide long-acting methods. There were significant differences in providers' self-rated competence by facility type; private for-profit providers' competence was limited for most contraceptives. Providers had misconceptions about contraceptives, they had negative attitudes towards the provision of contraceptives to young people, and they imposed non-evidence-based age restrictions and consent requirements. Thus, most providers were not prepared or were hesitant to give young people contraceptives. Short-acting methods were, however, considered acceptable for young married women and those with children.ConclusionProvider, client, and health system factors restricted contraceptive provision and use for young people. Their contraceptive use prospects are dependent on provider behavior and health system improvements.
Highlights
Unintended pregnancies lead to unsafe abortions, which are a leading cause of preventable maternal mortality among young women in Uganda
Unintended pregnancies have been linked to unsafe abortions that constitute nearly one third of maternal deaths among young people in Uganda [8,9]
The median years of experience related to family planning service was six (Table 1)
Summary
Unintended pregnancies lead to unsafe abortions, which are a leading cause of preventable maternal mortality among young women in Uganda. Health care providers’ perspectives on factors influencing contraceptive use and service provision to young people aged 15-24 in two rural districts in Uganda were explored. High fertility is associated with preventable maternal and infant morbidity and mortality in low-resource settings with weak health care infrastructure [1]. Research indicates that contraceptive use alone could reduce maternal deaths associated with unwanted pregnancies by 40 percent [2]. Contraceptive use in sub-Saharan Africa is low at only 21 percent, mainly as a result of inaccessibility to fertility regulation methods [3,4]. Unintended pregnancies have been linked to unsafe abortions that constitute nearly one third of maternal deaths among young people in Uganda [8,9]
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