Abstract
BackgroundThe prevalence of teenage pregnancies in Malawi is 29%. About 25% of those are married while 30% are unmarried adolescents (15–19 years old) who use contraceptives. Data on contraceptive use has focused on older adolescents (15–19 years old) leaving out the young adolescents (10–14 years old). This study assessed factors that influence contraceptive decision-making and use among young adolescents aged 10–14 years.MethodsThis was a qualitative study that used the Theory of Reasoned Action (TRA) model to understand the processes that influence contraceptive decision-making among young adolescents (10–14 years old) in urban Lilongwe. The study was conducted in six youth health-friendly service centers and 12 youth clubs. Two focus group discussions and 26 in-depth interviews were conducted among sexually active in and out of school young adolescents and key informants. The results are organized into themes identified during the analysis.ResultsResults showed that contraceptive decision-making is influenced by social factors (individual, interpersonal, society) and adolescents’ perceptions regarding hormonal contraceptives. There is also a disconnect between Education and Adolescent Sexual and Reproductive Health policies.ConclusionThe findings suggest that interventions that scale up contraceptive use need male and female involvement in decision making. Addressing myths around contraceptives, and harmonization of Education and Sexual and Reproductive Health policies in the country would motivate adolescents to use contraceptives.
Highlights
The prevalence of teenage pregnancies in Malawi is 29%
The study was conducted in 6 youth healthfriendly services clinics and 12 youth clubs where adolescents access contraceptives
The study was conducted in six Youth Friendly Health Service (YFHS) centers and 12 Youth Clubs (YCs) because these centers provide contraceptives where adolescents and youth aged 10–24 years can access them with minimal challenges
Summary
The prevalence of teenage pregnancies in Malawi is 29%. About 25% of those are married while 30% are unmarried adolescents (15–19 years old) who use contraceptives. One of the developing countries in sub-Saharan Africa, 40% of the total population are adolescents aged below 15 years [3]. Some of the factors that contribute to these problems include early sexual debut and early maturity where 17–31% of girls aged 12–14 years in some parts of Africa including Malawi experience menstruation [4]. The rapid growth of technology where adolescents spend more time on social network sites interacting with friends who have become the main source of information [5]8 Along the way, they engage in intimate relationships that lead to risky sexual behaviors such as unprotected sexual intercourse [5–7]. Sexual debut in this study is defined as having sex before or at the age of 14 that contributes to early marriages, sexually transmitted infections including cervical cancer in young adolescent girls [7]. 7% of adolescent girls aged 15–19 years old get pregnant before 15 years of age[3]
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