Republic of Colombia - adolescent contraceptive use

Publication date: 2016

Adolescent contraceptive use DATA FROM LA ENCUESTA NACIONAL DE DEMOGRAFÍA Y SALUD DE COLOMBIA (ENDSC), 2010 RE PU B LI C O F CO LO M B IA What can be done to support Colombian 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 Colombia, there are 8.8 million adolescents aged 10–19 years – 17.8% of the country’s total population.i The majority of adolescents live in urban areas, 73.7% of adolescent girls and 72.5% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 10.2.ii Among adolescents who become mothers before age 20, the average age at which Colombian adolescent girls have their first baby is 17.1 years.ii Sexual activity and marital status Analysis of data from the ENDSCii shows that more than 940 000 Colombian adolescent girls, 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 adolescent girls who had sex before age 20, they first have sexual intercourse at age 16.2 years. Among unmarried adolescents, 42.0% of adolescent girls report ever having sex and 30.0% are currently sexually active. Among all Colombian adolescent girls, 13.7% are in a union. Among these adolescent girls, the mean age of the first union is 16.6 years. 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 (%) 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 ENDSCii analyses, 93.0% of unmarried, sexually active adolescent girls report not wanting a child in the next two years, and 66.1% of them are currently using a method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • infrequent sex (50.4%) • not having sex (20.4%) • not married (16.5%) Among all unmarried, sexually active adolescent girls aged 15–19, 35.6% are not using a method of contraception. Male condoms and injectable contraceptives are the most common modern methods used (27.3% and 13.9% of these adolescent girls, respectively). IUDs and implants, which are among the most effective methods, are used by 2.4% and 6.3% respectively. Female sterilization and male sterilization, permanent methods, are used by 0.2% and 0.1%, respectively. Traditional methods, withdrawal or periodic abstinence, are used by 5.6% (see Figure 1). In union According to ENDSCii analyses, 76.4% of adolescent girls in a union report not wanting a child in the next two years and 66.6% of them are currently using a method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • menses has not returned after giving birth (16.5%) • breastfeeding (13.2%) • infrequent sex (12.3%) Among all adolescent girls in a union aged 15–19, 39.5% are not using a method of contraception. Injectable contraceptives and pills are the most common modern methods used (23.5% and 10.0% of these adolescent girls, respectively), while 7.5% are using implants and 4.2% are using IUDs. Female sterilization, a permanent method, is used by 1.5% of these adolescent girls. Traditional methods, withdrawal or periodic abstinence, are used by 5.2% (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 Asociación Probienestar de la Familia Colombiana (Profamilia), ICF International. La Encuesta Nacional de Demografía y Salud de Colombia 2010 [Datasets]. COIR61.DTA and COMR61.DTA. Calverton (MD): ICF International; 2011 (http://dhsprogram.com/data/dataset/Colombia_Standard-DHS_2010.cfm?flag=0, accessed 4 November 2016). Not using Withdrawal Periodic abstinence Male condom Pill Injectable contraceptives Lactational amenorrhea (LAM) Implants IUD Female sterilization LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of ENDSC 2010ii Source: analysis of ENDSC 2010ii Unmarried, sexually active adolescents who are using a modern method most often get it from a pharmacy (56.5%) or a government facility (27.9%). Adolescents in a union who are using a modern method most often get it from a government facility (58.5%) or a pharmacy (31.0%). Not using Withdrawal Periodic abstinence Male condom Pill Injectable contraceptives Implants IUD Male sterilization Female sterilization 35.6 4.8 0.827.3 8.5 6.3 2.4 0.1 0.2 13.9 23.5 0.2 4.8 0.47.8 7.5 4.2 1.5 10.0 39.5 Adolescent contraceptive use R E P U B L I C O F C O L O M B I A Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 8.8 16.2 years for adolescent girls 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 Colombian 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 93.0% sexually active, unmarried adolescent girls 76.4% adolescent girls in union 56.5% from a pharmacy 58.5% from a government facility 27.9% from a government facility 31.0% from a pharmacy 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 LA ENCUESTA NACIONAL DE DEMOGRAFÍA Y SALUD DE COLOMBIA, 2010 COMPILED IN 2016 | UPDATED NOVEMBER 2016 Asociación Probienestar de la Familia Colombiana (Profamilia), ICF International. La Encuesta Nacional de Demografía y Salud de Colombia 2010 [Datasets]. COIR61.DTA and COMR61.DTA. Calverton (MD): ICF International; 2011 (http://dhsprogram.com/data/dataset/Colombia_Standard-DHS_2010.cfm?flag=0, accessed 4 November 2016). 17.1 for adolescent girls LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Sexually active, unmarried In union 50.4% infrequent sex 16.5% menses has not returned after giving birth 20.4% not having sex 13.2% breastfeeding 16.5% not married 12.3% infrequent sex Method Sexually active, unmarried In union Not using 35.6% 39.5% Withdrawal 4.8% 4.8% Periodic abstinence 0.8% 0.4% Male condom 27.3% 7.8% Pill 8.5% 10.0% Injectable contraceptives 13.9% 23.5% Lactational amenorrhea (LAM) -- 0.2% Implants 6.3% 7.5% IUD 2.4% 4.2% Male sterilization 0.1% -- Female sterilization 0.2% 1.5% 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/16.55

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