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  • Title: Long-acting reversible contraceptives use among adolescent girls and young women in high fertility countries in sub-Saharan Africa.
    Author: Sambah F, Aboagye RG, Seidu AA, Tengan CL, Salihu T, Ahinkorah BO.
    Journal: Reprod Health; 2022 Nov 16; 19(1):209. PubMed ID: 36384976.
    Abstract:
    BACKGROUND: Given the instrumental role long-acting reversible contraceptives (LARCs) play in reducing unintended pregnancies, there is a need to understand the factors that predict their use among adolescent girls and young women in high fertility countries. Our study examined the prevalence and predictors of LARCs use among adolescent girls and young women in high fertility countries in sub-Saharan Africa. MATERIALS AND METHODS: We pooled data from the women's files of the most recent Demographic and Health Surveys (DHS) from 2010 to 2020 of the top ten high fertility countries in sub-Saharan Africa, which are part of the DHS programme. The total sample was 5854 sexually active adolescent girls and young women aged 15-24 who were using modern contraceptives at the time of the survey. Descriptive and multilevel logistic regression models were used in the analyses. The results were presented using percentages and adjusted odds ratio (AOR) with their respective 95% confidence intervals (CIs). RESULTS: At the descriptive level, the overall prevalence of LARCs utilisation was 17.6% in the ten countries, with the lowest of 1.7% in Angola and the highest of 55.8% in Mali. Adolescent girls and young women who were married had a lower likelihood of LARCs utilisation than those who were never married [AOR = 0.63, 95% CI = 0.45, 0.88]. Adolescent girls and young women who wanted no more children had higher odds of LARCs use compared to those who wanted more children [AOR = 1.56, 95% CI = 1.09, 2.26]. Adolescent girls and young women with one to three births [AOR = 6.42, 95% CI = 4.27, 9.67], and those with four or more births [AOR = 7.02, 95% CI = 3.88, 12.67] were more likely to use LARCs compared to those who had no children. Countries in sub-Saharan Africa with lower probability of utilizing LARCs were Angola, Niger and Mozambique, whereas adolescent girls and young women in Mali had higher probability of utilizing LARCs. CONCLUSION: Our findings suggest that LARCs utilisation among adolescent girls and young women is low in high fertility countries in sub-Saharan Africa. To reduce the rates of unplanned pregnancies and induced abortions, it is imperative that adolescent girls and young women in sub-Saharan Africa are educated on the advantages of utilising LARCs. Additionally, governments, policymakers, and stakeholders in sub-Saharan Africa should raise awareness by executing health promotion measures to enhance the demand for LARCs among adolescent girls and young women. Achieving these would not only prevent unplanned pregnancies and induced abortions, but also help meet the United Nation's health and well being for all as enshrined in Sustainable Development Goals 3 and 5. The use of long-acting reversible contraceptives can contribute to the reduction of unintended pregnancies. Hence, knowledge of the prevalence and predictors of long-acting reversible contraceptives use among adolescent girls and young women in high fertility countries in sub-Saharan Africa is important in public health. Our study examined the predictors of long-acting reversible contraceptives among adolescent girls and young women in ten high fertility countries in sub-Saharan Africa. A sample of 5854 sexually active adolescent girls and young women were included in the study.The overall prevalence of long-acting reversible contraceptives utilisation was 17.6% in the ten countries, with the lowest of 1.7% in Angola and the highest of 55.8% in Mali. Adolescent girls and young women who were married had a lower likelihood of using long-acting reversible contraceptives than those who were never married. Adolescent girls and young women who wanted no more children had higher odds of long-acting reversible contraceptive use compared to those who wanted more children. Adolescent girls and young women with one to three births, and those with four or more births were more likely to use long-acting reversible contraceptives than those who had no child. To reduce the rates of unplanned pregnancies and induced abortions, there is the need to educate adolescent girls and young women on the advantages of utilising long-acting reversible contraceptives. Additionally, governments, policymakers, and stakeholders in sub-Saharan Africa should raise awareness by executing health promotion measures to enhance the demand for long-acting reversible contraceptives among adolescent girls and young women.
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