Federal Democratic Republic of Nepal - adolescent contraceptive use
Publication date: 2016
Adolescent contraceptive use DATA FROM THE NEPAL DEMOGRAPHIC AND HEALTH SURVEY (NDHS), 2011 F E D E R A L D E M O C R AT I C R E P U B L I C O F N E P A L What can be done to support Nepalese adolescents 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 Federal Democratic Republic of Nepal, there are 6.6 million adolescents aged 10–19 years – 23.2% of the country’s total population.i Most adolescents live in rural areas, 83.4% of adolescent girls and 81.6% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 7.1, while for adolescent boys it is 8.7.ii Among adolescents who become parents before age 20, the average age at which Nepalese adolescent girls have their first baby is 17.3 years, while the average age at which adolescent boys first become fathers is 18.3.ii Sexual activity and marital status Analysis of data from the NDHSii shows that nearly 684 000 Nepalese 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 16.4 years and adolescent boys at 17.1 years. Among unmarried adolescents, 0.8% of adolescent girls report ever having sex and 0.3% are currently sexually active; among adolescent boys, 14.9% report ever having sex, while 7.0% are currently sexually active. Among all Nepalese adolescents, 28.8% of adolescent girls and 6.9% 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 17.6 for adolescent boys. Contraceptive use and non-use among adolescent girls LISTED FROM LEAST EFFECTIVE TO MOST EFFECTIVE In union According to NDHSii analyses, 53.4% of adolescent girls in a union report not wanting a child in the next two years, yet only 22.7% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • menses has not returned after giving birth (19.8%) • breastfeeding (7.5%) • infrequent sex (7.1%) Among all adolescent girls in a union aged 15–19, 82.4% are not using a method of contraception. Male condoms and injectable contraceptives are the most common modern methods used (6.5% and 4.9% of these adolescent girls, respectively), while 3.0% are using pills. Traditional methods, withdrawal or periodic abstinence, are used by 3.1% of these adolescent girls (see Figure 1). 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 Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International. Nepal Demographic and Health Survey 2011 [Datasets]. NPIR60.DTA and NPMR60.DTA. Calverton (MD): ICF International; 2012 (http://dhsprogram.com/data/dataset/Nepal_Standard-DHS_2011.cfm?flag=0, accessed 4 November 2016). Not using Withdrawal Periodic abstinence Male condom Pill Injectable contraceptives 2.2 0.9 4.9 3.0 6.5 82.4 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of NDHS 2011ii Adolescents in a union who are using a modern method most often get it from a government facility (51.4%) or a pharmacy (36.4%). FIGURE 1. Use and non-use of contraception: adolescent girls in union, aged 15–19 years (%) Adolescent contraceptive use F E D E R A L D E M O C R A T I C R E P U B L I C O F N E P A L Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 6.6 16.4 years for adolescent girls 17.1 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 Nepalese adolescents to prevent unintended pregnancy? Main reasons for not using contraception Report not wanting a child in the next two years In union 53.4% adolescent girls in union 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 THE NEPAL DEMOGRAPHIC AND HEALTH SURVEY, 2011 COMPILED IN 2016 | UPDATED NOVEMBER 2016 Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International. Nepal Demographic and Health Survey 2011 [Datasets]. NPIR60.DTA and NPMR60.DTA. Calverton (MD): ICF International; 2012 (http://dhsprogram.com/ data/dataset/Nepal_Standard-DHS_2011.cfm?flag=0, accessed 4 November 2016). 18.317.3 for adolescent boysfor adolescent girls LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use In union 19.8% menses has not returned after giving birth 7.5% breastfeeding 7.1% infrequent sex Method In union Not using 82.4% Withdrawal 2.2% Periodic abstinence 0.9% Male condom 6.5% Pill 3.0% Injectable contraceptives 4.9% 36.4% from a pharmacy 51.4% from a government facility 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/16.64
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