Kingdom of Cambodia - adolescent contraceptive use
Publication date: 2016
Adolescent contraceptive use DATA FROM THE CAMBODIA DEMOGRAPHIC AND HEALTH SURVEY (CDHS), 2014 K I N G D O M O F C A M B O D I A What can be done to support Cambodian 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 Kingdom of Cambodia, there are 2.9 million adolescents aged 10–19 years – 18.5% of the country’s total population.i Most adolescents live in rural areas, 82.9% of adolescent girls and 83.9% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 7.6, while for adolescent boys it is 7.8.ii Among adolescents who become parents before age 20, the average age at which Cambodian adolescent girls have their first baby is 18.0 years, while the average age at which adolescent boys first become fathers is 18.6.ii Sexual activity and marital status Analysis of data from the CDHSii shows that more than 151 000 Cambodians 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 17.4 years and adolescent boys at 18.1 years. Among unmarried adolescents, 1.9% of adolescent girls report ever having sex and 0.5% are currently sexually active; among adolescent boys, 4.7% report ever having sex, while 2.8% are currently sexually active. Among all Cambodian adolescents, 15.6% of adolescent girls and 3.0% of adolescent boys are in a union. Among these adolescents, the mean age of the first union is 17.3 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: adolescent girls in union, aged 15–19 years (%) Not using Withdrawal Male condom Pill Injectable contraceptives IUD LISTED FROM LEAST EFFECTIVE TO MOST EFFECTIVE In union According to CDHSii analyses, 62.0% of adolescent girls in a union report not wanting a child in the next two years, yet only 34.2% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • health concerns (35.1%) • breastfeeding (25.1%) • not having sex (23.1%) Among all adolescent girls in a union aged 15–19, 70.9% are not using a method of contraception. Injectable contraceptives and pills are the most common modern methods used (8.0% and 7.2% of these adolescent girls, respectively), while 2.2% are using implants, one of the most effective methods. Withdrawal, a traditional method, is used by 8.5% (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 National Institute of Statistics [Cambodia], Directorate General for Health [Cambodia], ICF International. Cambodia Demographic and Health Survey 2014 [Datasets]. KHIR72.DTA and KHMR72.DTA. Rockville (MD): ICF International; 2015 (http://dhsprogram.com/data/dataset/Cambodia_Standard-DHS_2014.cfm?flag=0 accessed 4 November 2016). 70.9 7.2 8.0 8.5 0.7 2.2 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of CDHS 2014ii Adolescents in a union who are using a modern method most often get it from a government facility (61.8%) or a pharmacy (19.5%). Adolescent contraceptive use K I N G D O M O F C A M B O D I A Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 2.9 17.4 for adolescent girls 18.1 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 Cambodian adolescents to prevent unintended pregnancy? Main reasons for not using contraception Report not wanting a child in the next two years In union 62.0% 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 CAMBODIA DEMOGRAPHIC AND HEALTH SURVEY, 2014 COMPILED IN 2016 | UPDATED NOVEMBER 2016 National Institute of Statistics [Cambodia], Directorate General for Health [Cambodia], ICF International. Cambodia Demographic and Health Survey 2014 [Datasets]. KHIR72.DTA and KHMR72.DTA. Rockville (MD): ICF International; 2015 (http://dhsprogram.com/data/dataset/Cambodia_Standard-DHS_2014.cfm?flag=0 accessed 4 November 2016). 18.0 18.6 for adolescent girls for adolescent boys LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use In union 35.1% health concerns 25.1% breastfeeding 23.1% not having sex Method In union Not using 70.9% Withdrawal 8.5% Male condom 0.7% Pill 7.2% Injectable contraceptives 8.0% IUD 2.2% 19.5% from a pharmacy 61.8% 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/16.67
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