Abstract
BackgroundContraceptive use among adolescent girls is low in many sub-Saharan African countries including Kenya. Attitude and perspectives about contraception of community members including adolescent girls themselves may be likely to limit contraceptive use among adolescent girls. This study was conducted to explore and compare adults’/parents’ and adolescent girls’ narratives and perspectives about contraception in Narok and Homa Bay counties, Kenya.MethodsQualitative data from 45 in-depth-interviews conducted with purposively selected consenting adolescent girls aged 15–19 was used. Additionally, twelve focus group discussions were held with 86 consenting adults conveniently recruited from the two counties. All discussions were conducted in the local language and audio recorded following consent of the study participants. Female moderators were engaged throughout the study making it appropriate for the study to solicit feedback from the targeted respondents.ResultsFindings highlighted adults’ perceptions on adolescents’ sexuality and the presence of stringent conceptions about the side-effects of contraception in the study communities. Some participants underscored the need for open contraceptive talk between parents and their adolescent girls. Four main themes emerged from the discussions; (i) Perceptions about adolescents’ sexuality and risk prevention, (ii) Conceptions about contraception among nulligravida adolescents: fear of infertility, malformation and sexual libertinism, (iii) Post-pregnancy contraceptive considerations and (iv) Thinking differently: divergent views regarding contraceptives and parent/adolescent discussion.ConclusionsOur findings suggest the need for increased attention towards adolescents and their caregivers particularly in demystifying contraceptive misconceptions. Programmatic responses and models which include the provision of comprehensive sexuality education and increased access to and utilization of SRH information, products and services through a well-informed approach need to be well executed. Programmatic efforts like SRH community education should further seek to enhance the capacity of parents to discuss sexuality with their adolescents.
Highlights
Contraceptive use among adolescent girls is low in many sub-Saharan African countries including Kenya
Studies have documented several factors associated with this low use of contraceptives among sexually active adolescent girls including; adolescent girls’ poor contraceptive knowledge, myths and misconceptions associated with modern contraceptives and judgmental tendencies of adults towards adolescents’ sexual and reproductive health (SRH) services on access to modern family planning methods
Using data from in-depth interviews conducted with 45 adolescent girls aged 15–19 and 12 focus group discussions held with 86 adults, we established that contraceptive behaviors among adolescent girls entail a balance between adults’ perceptions towards adolescents’ sexuality and perceived effectiveness of modern contraceptives
Summary
Contraceptive use among adolescent girls is low in many sub-Saharan African countries including Kenya. Approximately 16 million girls aged 15–19 years and two million girls below the age of 15 become pregnant every year, with the poorest regions of the world estimated to have four times higher prevalence of adolescent pregnancies compared to their counterparts in the higher income regions [1]. Whilst the 2014 KDHS established that the median age at first sexual intercourse among women in Kenya was 18 years [2], county-level variations exist with counties like Migori, Homa Bay and Samburu having a median of 15.5, 15.7 and 15.7 years respectively [2]. The resultant effect of early sexual debut coupled with low contraceptive prevalence rates is poor SRH outcomes, including early child births; most of which are either mistimed or unintended [7,8,9]. A nationally, representative cross-sectional study on abortion complication severity and associated factors in Kenya established a high abortion complication fatality rate; adolescents aged between 12 and 19 years constituted approximately 34% of patients presenting for post-abortion care in Kenya with almost half, 47% being unmarried [11]
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