Democratic Republic of the Congo - adolescent contraceptive use

Publication date: 2016

Adolescent contraceptive use DATA FROM L’ENQUÊTE DÉMOGRAPHIQUE ET DE SANTÉ (EDS-RDC) EN RÉPUBLIQUE DÉMOCRATIQUE DU CONGO, 2013-14 DEMOCRATIC REPUBLIC OF THE CONGO What can be done to support adolescents from the Democratic Republic of the Congo 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 Congo, there are 16.7 million adolescents aged 10–19 years – 23.4% of the country’s total population.i About half of adolescents live in rural areas, 51.5% of adolescent girls and 49.5% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 7.4, while for adolescent boys it is 8.3.ii Among adolescents who become parents before age 20, the average age at which adolescent girls from the Democratic Republic of the Congo have their first baby is 17.1 years, while the average age at which adolescent boys first become fathers is 18.1.ii Sexual activity and marital status Analysis of data from the EDS-RDCii shows that over 3 million adolescents from the Democratic Republic of the Congo 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, both adolescent girls and boys first have sexual intercourse at age 15.8 years. Among unmarried adolescents, 39.1% of adolescent girls report ever having sex and 24.2% are currently sexually active; among adolescent boys, 45.8% report ever having sex, while 30.9% are currently sexually active. Among all adolescents from the Democratic Republic of the Congo, 21.3% of adolescent girls and 2.0% of adolescent boys are in a union. Among these adolescents, the mean age of the first union is 16.4 years for adolescent girls and 17.7 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 Periodic abstinence Female condom Male condom Pill 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 EDS-RDCii analyses, 68.3% of unmarried, sexually active adolescent girls report not wanting a child in the next two years, yet only 48.1% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • not married (34.8%) • infrequent sex (21.8%) • knows no method (17.0%) Among all unmarried, sexually active adolescent girls aged 15–19, 60.3% are not using a method of contraception. Male condoms are the most common modern method, used by 16.5% of these adolescent girls. Traditional methods, withdrawal or periodic abstinence, are used by 18.7% (see Figure 1). In union According to EDS-RDCii analyses, 61.9% of adolescent girls in a union report not wanting a child in the next two years, yet only 16.2% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • breastfeeding (49.1%) • menses has not returned after giving birth (24.8%) • knows no source (14.5%) Among all adolescent girls in a union aged 15–19, 87.5% are not using a method of contraception. Male condoms are the most common modern method used (3.9% of these adolescent girls). Less than 1% are using one of the following methods: pills, injectable contraceptives, implants, and female sterilization, a permanent method. Withdrawal or periodic abstinence, traditional methods, are used by 6.8% (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 Ministère du Plan et Suivi de la Mise en œuvre de la Révolution de la Modernité (MPSMRM) [DRC], Ministère de la Santé Publique (MSP) [DRC], ICF International. Enquête Démographique et de Santé en République Démocratique du Congo 2013-2014 [Datasets]. CDIR61.DTA and CDMR61.DTA. Rockville (MD): ICF International; 2014 (http://dhsprogram.com/data/dataset/Congo- Democratic-Republic_Standard-DHS_2013.cfm?flag=0, accessed 4 November 2016). Not using Withdrawal Periodic abstinence Male condom Pill Injectable contraceptives Implants Female sterilization LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of EDS-RDC 2013-14ii Source: analysis of EDS-RDC 2013-14ii Unmarried, sexually active adolescents who are using a modern method most often get it from a pharmacy (63.4%) or from friends or parents (16.0%). Adolescents in a union who are using a modern method most often get it from a pharmacy (61.0%) or a government facility (20.6%). 60.32.5 16.2 16.5 0.4 0.5 3.9 2.9 0.20.40.6 3.9 0.1 87.5 Adolescent contraceptive use D E M O C R A T I C R E P U B L I C O F T H E C O N G O Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 16.7 15.8 years for adolescent girls 15.8 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 the Democratic Republic of the Congo 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 68.3% sexually active, unmarried adolescent girls 61.9% adolescent girls in union 63.4% from a pharmacy 61.0% from a pharmacy 16.% from friends or parents 20.6% 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 L’ENQUÊTE DÉMOGRAPHIQUE ET DE SANTÉ EN RÉPUBLIQUE DÉMOCRATIQUE DU CONGO, 2013-14 COMPILED IN 2016 | UPDATED NOVEMBER 2016 Ministère du Plan et Suivi de la Mise en œuvre de la Révolution de la Modernité (MPSMRM) [DRC], Ministère de la Santé Publique (MSP) [DRC], ICF International. Enquête Démographique et de Santé en République Démocratique du Congo 2013-2014 [Datasets]. CDIR61.DTA and CDMR61.DTA. Rockville (MD): ICF International; 2014 (http://dhsprogram.com/data/dataset/Congo-Democratic-Republic_Standard-DHS_2013.cfm?flag=0, accessed 4 November 2016). 17.1 18.1 for adolescent girls for adolescent boys LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Sexually active, unmarried In union 34.8% not married 49.1% breastfeeding 21.8% infrequent sex 24.8% menses has not returned after giving birth 17.0% knows no method 14.5% knows no source Method Sexually active, unmarried In union Not using 60.3% 87.5% Withdrawal 2.5% 2.9% Periodic abstinence 16.2% 3.9% Female condom 0.4% -- Male condom 16.5% 3.9% Pill 0.5% 0.6% Injectable contraceptives -- 0.4% Implants -- 0.2% Female sterilization -- 0.1% 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/16.23

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