Abstract
BackgroundDespite international support for increasing access to contraceptives among adolescents, gaps in use still exist worldwide. Past research has identified barriers to use across all levels of the socioecological model including restrictive policies, a lack of youth friendly services, and knowledge gaps. This study was conducted to further identify influences on contraceptive use among adolescent girls in Nigeria in hopes of guiding future policies and programs.MethodsIn 2018, 12 focus group discussions (FGD) were conducted in three cities in Nigeria with young women ages 15–24 with the objective of determining what and who influence adolescents’ contraceptive seeking behaviors. A vignette structure was used to identify perceptions on injunctive and descriptive community norms that influence adolescent contraceptive behaviors. The FGDs were conducted by members of the University of Ibadan Centre for Population and Reproductive Health (CPRH) and analyzed by a researcher at the University of North Carolina-Chapel Hill’s Carolina Population Center using a thematic analysis approach.ResultsParticipants identified community level resistance to sex and contraceptive use among unmarried adolescents though also acknowledged that these adolescent behaviors are still occurring despite established norms. Concerns about side effects and the preservation of fertility were frequently attached to contraceptive use and pointed to as a reason for community resistance to contraceptive use among this population. Participants saw peers, parents and partners as influencers on a girl’s decision to seek a method, though each were believed to play a different role in that decision.ConclusionThe findings show that that despite barriers created by established injunctive norms, young women with a supportive social network can access contraceptive methods despite these barriers. By harnessing the influence of peers, partners and parents, the Nigerian family planning efforts can strive to improve the health and well-being of young people.
Highlights
A pregnancy is a life altering event, among adolescents as it is a significant reason why young girls globally drop out of school and fall into poverty [1, 2]
This study identifies known barriers across the socioecological model, a resistance to sex and contraceptive use among unmarried adolescents
The focus group discussions (FGD) all began with discussions around the inherent relationships between sex and contraceptive use, and how support for both behaviors was restricted by the character’s age and marital status
Summary
A pregnancy is a life altering event, among adolescents as it is a significant reason why young girls globally drop out of school and fall into poverty [1, 2]. Despite the recognition of adolescent contraceptive needs, there are still large gaps in contraceptive use within adolescent populations. An important indicator of this gap is the unmet need for family planning, which is usually measured as the percent of fecund, sexually active women who want to limit or delay childbearing (beyond 2 years), but are not using a contraceptive method [8]. Achieving universal contraceptive method coverage for sexually-active adolescents who desire to use a method would lower the number of unplanned pregnancies by an estimated 63% per year, greatly lowering the burden of negative outcomes among this population [3]. Despite international support for increasing access to contraceptives among adolescents, gaps in use still exist worldwide. This study was conducted to further identify influences on contraceptive use among adolescent girls in Nigeria in hopes of guiding future policies and programs
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