Islamic Republic of Pakistan - adolescent contraceptive use

Publication date: 2016

Adolescent contraceptive use DATA FROM THE PAKISTAN DEMOGRAPHIC AND HEALTH SURVEY (PDHS), 2012-13 ISLAMIC REPUBLIC OF PAKISTAN What can be done to support married Pakistani adolescents to prevent unintended pregnancy? Plan for how, when and where different groups of sexually active adolescents (boys and girls, rural and urban) use and do not use contraception. Learn the reasons why married adolescents are not using contraception, and develop policies and programmes to better address their needs. Understand that married adolescents may get contraception from a variety of sources and ensure that each of these sources can provide high quality services for adolescents. Adolescent population: who are they? In the Islamic Republic of Pakistan, there over 39.6 million adolescents aged 10–19 years – 21.1% of the country’s total population.i The majority of adolescents live in rural areas, 60.6% of adolescent girls and 61.2% of adolescent boys.i By age 19, the mean number of years of schooling attended by married adolescent girls is 3.3, while for married adolescent boys it is 6.5.ii Among married adolescents who become parents before age 20, the average age at which Pakistani adolescent girls have their first baby is 17.6 years, while the average age at which adolescent boys first become fathers is 18.2.ii Sexual activity and marital status According to data from the PDHSii, on average, among married adolescents who had sex before age 20, adolescent girls first have sexual intercourse at age 17.4 years. Among married adolescents, the mean age of the first marriage is 17.4 years for adolescent girls and 17.8 for adolescent boys. 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 National Institute of Population Studies (NIPS) [Pakistan], ICF International. Pakistan Demographic and Health Survey 2012-13 [Datasets]. PKIR61.DTA and PKMR61.DTA. Calverton (MD): ICF International; 2013 (http://dhsprogram.com/data/dataset/Pakistan_Standard-DHS_2012.cfm?flag=0, accessed 4 November 2016). Contraceptive use and non-use among adolescent girls FIGURE 1. Use and non-use of contraception: married adolescent girls, aged 15–19 years (%) LISTED FROM LEAST EFFECTIVE TO MOST EFFECTIVE Married According to PDHSii analyses, 26.9% of married adolescent girls report not wanting a child in the next two years, and 19.3% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • up to God or fatalistic (37.6%) • breastfeeding (35.0%) • menses has not returned after giving birth (31.5%) Among all married adolescent girls aged 15–19, 89.7% are not using a method of contraception. Male condoms and injectable contraceptives are the most common modern methods used (3.4% and 1.1% of these adolescent girls, respectively). IUDs, one of the most effective methods, are used by 0.8% of these adolescent girls. Traditional methods (withdrawal or periodic abstinence) are used by 3.6% (see Figure 1). Source: analysis of PDHS 2012-13ii Married adolescents who are using a modern method most often get it from a government facility (56.2%) or a private facility (19.3%). Not using Withdrawal Periodic abstinence Male condom Pill Injectable contraceptives Lactational amenorrhea (LAM) IUD 89.7 0.8 0.61.10.5 0.2 3.4 3.4 COMPILED IN 2016 | UPDATED NOVEMBER 2016 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Adolescent contraceptive use I S L A M I C R E P U B L I C O F P A K I S T A N Use and non-use of contraception married adolescent girls, aged 15-19 million adolescents ages 10-19 39.6 17.4 years for adolescent girls Among married adolescents who had sex before age 20, the average age at first sex is Among married adolescents who become parents before age 20, the average age at first birth is What can be done to support married Pakistani adolescents to prevent unintended pregnancy? Main reasons for not using contraception Report not wanting a child in the next two years Married 26.9% married adolescent girls 19.3% from a private facility Understand that married adolescents may get modern contraception from a variety of sources. Learn the reasons why married adolescents are not using contraception. Plan for how, when, and where different groups of adolescents use or don’t use contraception. DATA FROM THE PAKISTAN DEMOGRAPHIC AND HEALTH SURVEY, 2012-13 COMPILED IN 2016 | UPDATED NOVEMBER 2016 National Institute of Population Studies (NIPS) [Pakistan], ICF International. Pakistan Demographic and Health Survey 2012-13 [Datasets]. PKIR61.DTA and PKMR61.DTA. Calverton (MD): ICF International; 2013 (http://dhsprogram. com/data/dataset/Pakistan_Standard-DHS_2012.cfm?flag=0, accessed 4 November 2016). 18.217.6 for adolescent boysfor adolescent girls LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Married 37.6% up to God or fatalistic 35.0% breastfeeding 31.5% menses has not returned after giving birth Method Married Not using 89.7% Withdrawal 3.4% Periodic abstinence 0.2% Male condom 3.4% Pill 0.5% Injectable contraceptives 1.1% Lactational amenorrhea (LAM) 0.6% IUD 0.8% 56.2% 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 Spermicide © WHO 2016. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence WHO/RHR/16.71 LU_WHO_Template_Text_En-EMRO-Pakistan LU_WHO_Template_Infographic_En_EMRO_Pakistan

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