Republic of Chad - adolescent contraceptive use

Publication date: 2016

Adolescent contraceptive use DATA FROM L’ENQUÊTE DÉMOGRAPHIQUE ET DE SANTÉ ET À INDICATEURS MULTIPLES AU TCHAD (EDST-MICS), 2014-15 R E PU B LI C O F C H A D What can be done to support Chadian 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 Republic of Chad, there are 3.3 million adolescents aged 10–19 years – 25.0% of the country’s total population.i Three quarters of adolescents live in rural areas, 75.5% of adolescent girls and 74.6% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 4.5, while for adolescent boys it is 6.8.ii Among adolescents who become parents before age 20, the average age at which Chadian adolescent girls have their first baby is 16.2 years, while the average age at which adolescent boys first become fathers is 18.0.ii Sexual activity and marital status Analysis of data from the EDST-MICSii, over 450 000 Chadians 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 15.3 years and adolescent boys at 16.7 years. Among unmarried adolescents, 15.9% of adolescent girls report ever having sex and 9.6% are currently sexually active; among adolescent boys, 20.5% report ever having sex, while 12.7% are currently sexually active. Among all Chadian adolescents, 38.3% of adolescent girls and 3.2% of adolescent boys are in a union. Among these adolescents, the mean age of the first union is 16.7 years for adolescent girls and 17.6 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 Periodic abstinence Male condom Implants 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 EDST-MICSii analyses, 41.8% of unmarried, sexually active adolescent girls report not wanting a child in the next two years, yet only 39.4% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • infrequent sex (34.3%) • not married (28.0%) • knows no source (10.2%) Among all unmarried, sexually active adolescent girls aged 15–19, 84.8% are not using a method of contraception. Male condoms are the most common modern method used (13.6% of these adolescent girls), while implants, which are considered to be one of the most effective methods, are used by 0.7%. Only a small proportion (0.5%) are using periodic abstinence, a traditional method (see Figure 1). In union According to EDS-MICSTii analyses, 29.4% of adolescent girls in a union report not wanting a child in the next two years, yet only 5.8% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • breastfeeding (68.5%) • menses has not returned after giving birth (21.3%) • knows no method (12.1%) Among all adolescent girls in a union aged 15–19, nearly all (97.1%) are not using a method of contraception. Among the small proportion of users, 1% or fewer are using one of the following modern methods: implants, lactational amenorrhea (LAM), injectable contraceptives, pills, and male condoms. Only 0.7% are using periodic abstinence, a traditional method (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 Institut National de la Statistique, des Études Économiques et Démographiques (INSEED) [Tchad], Ministère de la Santé Publique (MSP) [Tchad], ICF International. Enquête Démographique et de Santé et à Indicateurs Multiples (EDST-MICS 2014-2015) [Datasets]. TDIR70.DTA and TDMR70.DTA. Rockville (MD): ICF International; 2015 (http://dhsprogram.com/data/dataset/Chad_Standard-DHS_2014.cfm?flag=0, accessed 4 November 2016). Not using Periodic abstinence Male condom Pill Injectable contraceptives Lactational amenorrhea (LAM) Implants 0.7 0.2 0.3 0.7 0.9 0.2 97.1 84.8 13.6 0.5 0.7 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of EDST-MICS 2014-15ii Source: analysis of EDST-MICSii Unmarried, sexually active adolescents who are using a modern method most often get it from a shop (54.2%) or a private facility (9.3%). Adolescents in a union who are using a modern method most often get it from a government facility (66.4%) or a private facility (15.5%). Adolescent contraceptive use R E P U B L I C O F C H A D Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 3.3 15.3 years for adolescent girls 16.7 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 Chadian adolescents 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 41.8% sexually active, unmarried adolescent girls 29.4% adolescent girls in union 54.2% from a shop 66.4% from a government facility 9.3% from a private facility 15.5% from a private 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 ET À INDICATEURS MULTIPLES AU TCHAD, 2014-15 COMPILED IN 2016 | UPDATED NOVEMBER 2016 Institut National de la Statistique, des Études Économiques et Démographiques (INSEED) [Tchad], Ministère de la Santé Publique (MSP) [Tchad], ICF International. Enquête Démographique et de Santé et à Indicateurs Multiples (EDST-MICS 2014-2015) [Datasets]. TDIR70.DTA and TDMR70.DTA. Rockville (MD): ICF International; 2015 (http://dhsprogram.com/data/dataset/Chad_Standard-DHS_2014.cfm?flag=0, accessed 4 November 2016). 16.2 18.0 for adolescent girls for adolescent boys LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Sexually active, unmarried In union 34.3% infrequent sex 68.5% breastfeeding 28.0% not married 21.3% menses has not returned after giving birth 10.2% knows no source 12.1% knows no method Method Sexually active, unmarried In union Not using 84.8% 97.1% Periodic abstinence 0.5% 0.7% Male condom 13.6% 0.2% Pill -- 0.3% Injectable contraceptives -- 0.7% Lactational amenorrhea (LAM) -- 0.9% Implants 0.7% 0.2% 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/16.19

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