Abstract
BackgroundHigh fertility among young people aged 15-24 years is a public health concern in Uganda. Unwanted pregnancy, unsafe induced abortions and associated high morbidity and mortality among young women may be attributed to low contraceptive use. This study aims at exploring reasons for low contraceptive use among young people.MethodsIn 16 focus group discussions, the views of young people about obstacles and enabling factors to contraceptive use in Mityana and Mubende districts, Uganda were explored. The groups were homogeneously composed by married and unmarried men and women, between the ages of 15-24. The data obtained was analyzed using qualitative content analysis.ResultsYoung men and women described multiple obstacles to contraceptive use. The obstacles were categorized as misconceptions and fears related to contraception, gender power relations, socio-cultural expectations and contradictions, short term planning, and health service barriers. Additionally, young people recounted several enabling factors that included female strategies to overcome obstacles, changing perceptions to contraceptive use, and changing attitude towards a small family size.ConclusionsOur findings suggest changing perceptions and behavior shift towards contraceptive use and a small family size although obstacles still exist. Personalized strategies to young women and men are needed to motivate and assist young people plan their future families, adopt and sustain use of contraceptives. Reducing obstacles and reinforcing enabling factors through education, culturally sensitive behavior change strategies have the potential to enhance contraceptives use. Alternative models of contraceptive service delivery to young people are proposed.
Highlights
High fertility among young people aged 15-24 years is a public health concern in Uganda
There is tremendous need for contraceptive use, especially in areas with high fertility[1]. This is true in Uganda where the persistent high fertility (6.7 children per woman) is contributing to the high maternal morbidity and mortality (435/100,000 live births) as well as the rapidly growing population (3.2%) [2,3,4]
In 2009, 49 percent of the Ugandan population was below 15 years and 20 percent was between the age of 15 and 24[5]
Summary
High fertility among young people aged 15-24 years is a public health concern in Uganda. Unsafe induced abortions and associated high morbidity and mortality among young women may be attributed to low contraceptive use. There is tremendous need for contraceptive use, especially in areas with high fertility[1] This is true in Uganda where the persistent high fertility (6.7 children per woman) is contributing to the high maternal morbidity and mortality (435/100,000 live births) as well as the rapidly growing population (3.2%) [2,3,4]. Young women are exposed to the risk of pregnancy before marriage for a longer period and as a result there is increased need for contraceptive use. Young women between 15-24 years account for nearly half of all maternal deaths due to unsafe induced abortions, which is an indication that contraception is needed [9,10,11]
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