Determinants of Contraceptives Uptake among Adolescents’ Girls Aged 14-19 Years in Homa Bay County

Abstract

Introduction. Adolescents are individuals aged between 10-19 years. This phase is characterised by rapid growth, sexual maturation, and sexual exploration. These behaviours expose sexually active adolescent girls to a greater risk of unintended pregnancies, unsafe abortion, and sexually transmitted infections. This study aimed to assess the determinants of contraceptives uptake among adolescent girls in Homa Bay County in Kenya with specific objectives assessing the level of awareness, uptake as well as evaluating the factors affecting the sexual & reproductive health service provision to adolescent girls in the region. Result: A cross-sectional survey was done targeting 385 girls and 32 health facilities. The response rate was 100%, with the level of knowledge on contraceptives at 97.6%. The main sources of knowledge on contraceptives were from teachers in schools (30%), peers (17.2%) and media. 70% of the respondents were in a heterosexual relationship of which 58.6% preferred male condom use as their contraceptive method of choice, while the use of pills was the least at 0.6%. The majority (57.9%) of the girls did not practice safer sex exposing them to a higher risk of Sexually transmitted infections and unintended pregnancies. Discussions: The level of contraceptive uptake significantly varied from one sub-county to the other (p < 0.005), with the sub-counties in the Islands of Lake Victoria such as Suba sub-counties having up to 80% lesser chance of their girls using any form of contraceptives (OR = 0.2; CI: 0.2–0.8). Major barriers were the fear of side effects (51.8%) and self-stigmatisation (13.4 %). Health facilities were the main source of contraceptives (77.1%); however, the study noted a lack of youth-friendly services that would favour increased access. Further, there was a complete lack of knowledge on adolescent sexual and reproductive health policies and procedures among the girls (39.6%). Conclusion: Misinformation, cultural perception on the use of contraceptives among adolescents, and lack of youth-friendly services in health facilities are key drivers to the underutilisation of contraceptives by adolescent girls in Homabay county. Adolescents from the island stand a higher risk of non-utilisation of contraceptives compared to their mainland counterparts. Recommendations: There is a need for strengthened youth-friendly comprehensive sexual health education and services in all health facilities with more emphasis on risk reduction interventions and sensitisation of young girls on the available policies. Mechanisms should be availed, specifically to reach the “hard to reach” adolescent populations in the islands.