Contraception among adolescents in Bangladesh

Abstract

Data from the 1989 Bangladesh Fertility Survey were used to investigate the contraceptive behavior of married adolescents (age range: 10-19 years) in comparison with that of married adults. Marriage occurs at an early age in Bangladesh and is almost universal. Thus, adolescent fertility contributes substantially to overall fertility. The 11,906 women interviewed included 1922 (16.1%) adolescents. Knowledge of family planning (FP) was almost universal among both groups, with specific knowledge about methods slightly lower among adolescents. Ever use of a method was reported by 26.3% of the adolescents and 48.4% of the adults. The contraceptive prevalence rate was 15.3% among adolescents (10.7% modern and 4.6% traditional methods) and 34.4% for adults (10.5% female sterilization, 9.9% oral contraceptives, and 6.4% traditional methods). Little difference was found in the attitudes towards contraceptives of adults and adolescents. 83% of adolescents and 58% of adults indicated an intention to use a method in the future. When attitudes about family size were indecisive, contraceptive usage was very low. Logistic regression analysis revealed that increased education is the most important factor having a positive effect on the contraceptive use rate for adolescents, followed by participating in family decision-making, frequency of visits by FP workers, region of residence, husband's occupation, and availability of electricity in the household. The policy implication of these findings are that as women's status improves with increased opportunities for education and employment, they will find ways to meet their contraceptive needs. Also, the popularity of traditional methods could be exploited by program managers, since traditional methods can be effective if taught properly and used consistently. Adolescents need to become aware of the negative consequences of early marriage, early pregnancy, and large family size, they need information on the availability of FP methods and their use-effectiveness, they need improved reproductive health care services which are readily available, and they would benefit from programs designed to overcome the resistance of older family members and husbands to FP.