Determinants of modern contraception use among youths (15 – 24 years); case study: Bumanya sub-county in Kaliro district, Eastern Uganda

Abstract

1.Introduction: It is estimated that over 14 million adolescents give birth in a yearglobally. These pregnancies and births pose a serious public health challenge. The situation is worse in low and middle-income countries where the use of modern contraceptives by adolescents is constrained due to structural, demographic, social factors and ignorance. Contextual understanding of factors that influence use of modern contraceptives by adolescents is essential since these may vary considerably. The general study objective was: To explore the determinants of modern contraception use among the youths (15-24 years) in Bumanya Sub County, Kaliro District. Methodology This was an analytical cross-sectional study using quantitative data collection methods.The study was carried among 338youths aged 15 – 24 years. Systematic sampling was applied to select households were study participants were accessed. A semi-structured questionnairewas used to collect the data. Data wasentered intoEPI-Info computer statistical package and exported to Stata Version 14 for analysis. Three levels of data analysis: univariate analysis, bivariate analysis, and multivariable analysis were carried out. Findings Majority (128/318) of the respondents were in the 21-24 age group with overall mean age of 19.7 years and standard deviation (SD) of 2.74 years. There was high level of awareness of modern contraception (92.2%) though close to a half (48.4%) reported to have used traditional methods to prevent pregnancy. Close to a half (44.4%) of the respondents reported to have got the information from mass media and only 24.6% and 10.2% got the information from health workers. Majority (53.8%) mentioned that their religions approved contraception though to the majority (50.6%), peers influenced their choice of contraception.The majority (52.2%) travelled 0.5-2km distance to the health facility. More than three quarters (80.4%) of the respondents rated health workers’ attitudes to be fair. After adjustment, only age showed strong statistical significance though other factors showed borderline association. The proportion of those who utilised modern contraceptives attenuated from 95% to 22% higher among those aged 18-20 compared to those who were aged 15-17 [APR: 1.22; 95%CI: 1.03-1.45; P=0.02] and from 1.4 times to 20% higher among those who were aged 21-24 [APR: 1.20; 95%CI: 1.02-1.42; P=0.03]. The proportion of those who had ever used contraceptives was 16% higher among those who had tested for HIV in the past 12 months [CPR: 1.16; 95%CI: 1.00-1.33; P=0.03] compared to those who did not. Compared to Christians, the proportion of those who had ever used contraception was 3% more among Muslims [APR: 1.20; 95%CI: 1.00-1.07, P=0.05]. The proportion of those who had ever used contraceptives was 9% higher among those who were married [CPR: 1.09; 95%CI: 1.00-1.19; P<0.001] compared to those who were single. Conclusion: The study showed key determinants of modern contraception were: being aged 18 years and above: being a Muslim: being married and having had HIV tests 12 months prior to the study.