Democratic Republic of Sao Tome and Principe - adolescent contraceptive use

Publication date: 2016

Adolescent contraceptive use DATA FROM O INQUÉRITO DEMOGRÁFICO E SANITÁRIO, SÃO TOMÉ E PRÍNCIPE (IDS STP), 2008-09 DEMOCRATIC REPUBLIC OF SÃO TOMÉ AND PRÍNCIPE What can be done to support adolescents of São Tomé and Príncipe to prevent unintended pregnancy? Plan for how, when and where different groups of sexually active adolescents (married and unmarried, boys and girls, rural and urban) use and do not use contraception. Learn the reasons why adolescents are not using contraception, and develop policies and programmes to better address their needs. Understand that adolescents may get contraception from a variety of sources and ensure that each of these sources can provide high quality services for adolescents. COMPILED IN 2016 | UPDATED NOVEMBER 2016 Adolescent population: who are they? In the Democratic Republic of São Tomé and Príncipe, there are 44 000 adolescents aged 10–19 years – 21.7% of the country’s total population.i The majority of adolescents live in urban areas, 66.8% of adolescent girls and 64.2% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 6.8, while for adolescent boys it is 8.2.ii Among adolescents who become parents before age 20, the average age at which adolescent girls have their first baby is 17.2 years, while the average age at which adolescent boys first become fathers is 18.5.ii Sexual activity and marital status Analysis of data from the IDS STPii shows that over 7 600 adolescents of the Democratic Republic of São Tomé and Príncipe aged 15–19 are currently sexually active – they are either unmarried and have had sex in the last three months or they are in a union (i.e. married or living together). On average, among adolescents who had sex before age 20, adolescent girls first have sexual intercourse at age 16.7 years and adolescent boys at 16.3 years. Among unmarried adolescents, 32.3% of adolescent girls report ever having sex and 22.0% are currently sexually active; among adolescent boys, 47.2% report ever having sex, while 33.6% are currently sexually active. Among all adolescents of the Democratic Republic of São Tomé and Príncipe, 19.9% of adolescent girls and 0.7% of adolescent boys are in a union. Among these adolescents, the mean age of the first union is 16.9 years for adolescent girls and 18.1 for adolescent boys. Contraceptive use and non-use among adolescent girls FIGURE 1. Use and non-use of contraception: unmarried sexually active adolescent girls, aged 15–19 years (%) Not using Withdrawal Male condom Pill Injectable contraceptives FIGURE 2. Use and non-use of contraception: adolescent girls in union, aged 15–19 years (%) LISTED FROM LEAST EFFECTIVE TO MOST EFFECTIVE LISTED FROM LEAST EFFECTIVE TO MOST EFFECTIVE Unmarried, sexually active According to IDS STPii analyses, 68.7% of unmarried, sexually active adolescent girls report not wanting a child in the next two years, and 49.2% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • fear of side-effects or health concerns or interferes with body's processes (40.0%) • infrequent sex (38.1%) • knows no method (8.2%) Among all unmarried, sexually active adolescent girls aged 15–19, 53.6% are not using a method of contraception. Male condoms are the most common modern method used (43.6% of these adolescent girls) and 2.0% are using pills. Implants, which are among the most effective methods, are used by 0.3%. Withdrawal, a traditional method, is used by 0.5% of these adolescent girls (see Figure 1). In union According to IDS STPii analyses, 80.7% of adolescent girls in a union report not wanting a child in the next two years, yet only 27.0% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • fear of side-effects or health concerns or interferes with body's processes (20.0%) • breastfeeding (14.5%) • infrequent sex (12.6%) Among all adolescent girls in a union aged 15–19, 77.8% are not using a method of contraception. Pills and male condoms are the most common modern methods used (11.2% and 6.6% of these adolescent girls, respectively). Injectable contraceptives and lactational amenorrhea (LAM) are used by (2.7% and 0.9%, respectively) (see Figure 2). i Urban and rural population by age and sex, 1980–2015 [online database]. New York (USA): United Nations Department of Economic and Social Affairs, Population Division; 2014 (https://esa. un.org/unpd/popdev/urpas/urpas2014.aspx, accessed 4 November 2016). ii Instituto Nacional de Estatística (INE) [São Tomé e Príncipe], Ministério da Saúde [São Tomé e Príncipe], ICF International. Inquérito Demográfico e Sanitário, São Tomé e Príncipe, IDS STP, 2008-2009 [Datasets]. STIR50.DTA and STMR50.DTA. Calverton (MD): ICF International; 2010 (http://dhsprogram.com/data/dataset/Sao- Tome-and-Principe_Standard-DHS_2008.cfm?flag=0, accessed 4 November 2016). Not using Male condom Pill Injectable contraceptives Lactational amenorrhea (LAM) 2.7 0.9 6.6 11.2 77.8 53.6 43.6 2.0 0.3 0.5 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of IDS STP 2008-09ii Source: analysis of IDS STP 2008-09ii Unmarried, sexually active adolescents who are using a modern method most often get it from a shop (48.9%) or a government facility (41.5%). Adolescents in a union who are using a modern method get it from a government facility (100.0%). Adolescent contraceptive use D E M O C R A T I C R E P U B L I C O F S Ã O T O M É A N D P R Í N C I P E Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 0.4 16.7 years for adolescent girls 16.3 years for adolescent boys Among adolescents who had sex before age 20, the average age at first sex is Among adolescents who become parents before age 20, the average age at first birth is What can be done to support adolescents of São Tomé and Príncipe to prevent unintended pregnancy? Main reasons for not using contraception Report not wanting a child in the next two years Sexually active, unmarried In union 68.7% sexually active, unmarried adolescent girls 80.7% adolescent girls in union 48.9% from a shop 100.0% from a government facility 41.5% from a government facility Understand that adolescents may get modern contraception from a variety of sources. Learn the reasons why adolescents are not using contraception. Plan for how, when, and where different groups of adolescents use or don’t use contraception. ANALYSIS OF O INQUÉRITO DEMOGRÁFICO E SANITÁRIO, SÃO TOMÉ E PRÍNCIPE, 2008-09 COMPILED IN 2016 | UPDATED NOVEMBER 2016 Instituto Nacional de Estatística (INE) [São Tomé e Príncipe], Ministério da Saúde [São Tomé e Príncipe], ICF International. Inquérito Demográfico e Sanitário, São Tomé e Príncipe, IDS STP, 2008-2009 [Datasets]. STIR50.DTA and STMR50.DTA. Calverton (MD): ICF International; 2010 (http://dhsprogram.com/data/dataset/Sao-Tome-and-Principe_Standard-DHS_2008.cfm?flag=0, accessed 4 November 2016). 17.2 18.5 for adolescent girls for adolescent boys LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Sexually active, unmarried In union 40.0% fear of side-effects or health concerns or interferes with body’s processes 20.0% fear of side-effects or health concerns or interferes with body’s processes 38.1% infrequent sex 14.5% breastfeeding 8.2% knows no method 12.6% infrequent sex Method Sexually active, unmarried In union Not using 53.6% 77.8% Withdrawal 0.5% -- Male condom 43.6% 6.6% Pill 2.0% 11.2% Injectable contraceptives 0.3% 2.7% Lactational amenorrhea (LAM) -- 0.9% REASONS FOR NON-USE: Not married Not having sex Infrequent sex Menses has not returned after birth Breastfeeding Fatalistic (up to god) She is opposed Husband/partner is opposed Religious prohibition Knows no method Knows no source Fear of side effects/health concerns Inconvenient to use Others opposed Lack of access/too far SOURCE OF METHOD: Government facility Private facility Pharmacy Shop Friends or parents Other Community Health Worker Icon Directory METHODS: Not using Withdrawal Periodic abstinence Rhythm/calendar Female condom Male condom Standard days/cycle beads Pill Injectable contraceptives Lactational amenorrhea (LAM) Implants IUD Male sterilization Female sterilization © WHO 2016. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence WHO/RHR/16.40

View the publication

You are currently offline. Some pages or content may fail to load.