Republic of Haiti - adolescent contraceptive use

Publication date: 2016

Adolescent contraceptive use DATA FROM L’ENQUÊTE MORTALITÉ, MORBIDITÉ ET UTILISATION DES SERVICES, HAÏTI (EMMUS), 2012 R E P U B L I C O F H A Ï T I What can be done to support Haitian 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 HaÏti, there are 2.3 million adolescents aged 10–19 years – 21.5% of the country’s total population.i The majority of adolescents live in urban areas, 62.5% of adolescent girls and 57.8% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 7.5, while for adolescent boys it is 6.9.ii Among adolescents who become parents before age 20, the average age at which Haitian adolescent girls have their first baby is 17.4 years, while the average age at which adolescent boys first become fathers is 18.0.ii Sexual activity and marital status Analysis of the data from the EMMUSii shows that 460 000 Haitians 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 16.3 years and adolescent boys at 14.7 years. Among unmarried adolescents, 41.3% of adolescent girls report ever having sex and 28.0% are currently sexually active; among adolescent boys, 63.1% report ever having sex, while 40.7% are currently sexually active. Among all Haitian adolescents, 12.1% of adolescent girls and 1.5% of adolescent boys are in a union. Among these adolescents, the mean age of the first union is 17.0 years for adolescent girls and 17.7 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 Withdrawal Periodic abstinence Male condom Injectable contraceptives Lactational amenorrhea (LAM) Implants Male sterilization 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 EMMUSii analyses, 90.4% unmarried, sexually active adolescent girls report not wanting a child in the next two years, yet only 30.2% of them are currently using any method to prevent pregnancy. The main reasons these adolescent girls report for not using a contraceptive method include: • infrequent sex (41.1%) • not married (29.3%) • fear of side-effects or health concerns (26.1%) Among all unmarried, sexually active adolescent girls aged 15–19, 72.1% are not using a method of contraception. Male condoms are the most common modern method used (23.9% of these adolescent girls). Implants, which are considered to be among the most effective methods, are used by 0.1% while male sterilization, a permanent method of contraception, is used by 0.4%. A small proportion, 1.3%, is using traditional methods (withdrawal or periodic abstinence) (see Figure 1). In union According to EMMUSii analyses, 88.2% of adolescent girls in a union report not wanting a child in the next two years, yet only 31.8% of them are currently using any method to prevent pregnancy. The main reasons these adolescent girls report for not using a contraceptive method include: • fear of side-effects or health concerns (26.3%) • menses has not returned after giving birth (24.0%) • breastfeeding (20.5%) Among all adolescent girls in a union aged 15–19, 74.4% are not using a method of contraception. Injectable contraceptives and male condoms are the most common modern method used (15.5% and 5.4% of these adolescent girls, respectively). Implants are used by 0.7%. Traditional methods (withdrawal or abstinence) are used by 1.6% (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 Ministère de la Santé Publique et de la Population (MSSP) [Haiti], Institut Haïtien de l’Enfance (IHE) [Haiti], ICF International. Enquête Mortalité, Morbidité et Utilisation des Services, Haïti, 2012 [Datasets]. HTIR61.DTA and HTMR61.DTA. Calverton (MD): ICF International; 2013 (http://dhsprogram.com/data/dataset/Haiti_Standard-DHS_2012.cfm?flag=0, accessed 4 November 2016). Not using Withdrawal Periodic abstinence Male condom Pill Injectable contraceptives Lactational amenorrhea (LAM) Male sterilization 0.7 0.9 5.4 2.2 15.5 0.70.3 74.4 72.1 0.8 0.5 1.9 0.1 0.1 0.4 23.9 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of EMMUS 2012ii Source: analysis of EMMUS 2012ii Unmarried, sexually active adolescents who are using a modern method most often get it from a shop (16.2%) or other (19.8%). Adolescents in a union who are using a modern method most often get it from a government facility (43.9%) or a private facility (40.1%). Adolescent contraceptive use R E P U B L I C O F H A Ï T I Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 2.3 16.3 years for adolescent girls 14.7 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 Haitian 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 90.4% sexually active, unmarried adolescent girls 88.2% adolescent girls in union 16.2% from a shop 43.9% from a government facility 19.8% other 40.1% 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 MORTALITÉ, MORBIDITÉ ET UTILISATION DES SERVICES, HAÏTI, 2012 COMPILED IN 2016 | UPDATED NOVEMBER 2016 Ministère de la Santé Publique et de la Population (MSSP) [Haiti], Institut Haïtien de l’Enfance (IHE) [Haiti], ICF International. Enquête Mortalité, Morbidité et Utilisation des Services, Haïti, 2012 [Datasets]. HTIR61.DTA and HTMR61.DTA. Calverton (MD): ICF International; 2013 (http://dhsprogram.com/data/dataset/Haiti_Standard-DHS_2012.cfm?flag=0, accessed 4 November 2016). 17.4 18.0 for adolescent girls for adolescent boys LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Sexually active, unmarried In union 41.1% infrequent sex 26.3% fear of side- effects or health concerns 29.3% not married 24.0% menses has not returned after giving birth 26.1% fear of side- effects or health concerns 20.5% breastfeeding Method Sexually active, unmarried In union Not using 72.1% 74.4% Withdrawal 0.8% 0.7% Periodic abstinence 0.5% 0.9% Male condom 23.9% 5.4% Pill -- 2.2% Injectable contraceptives 1.9% 15.5% Lactational amenorrhea (LAM) 0.1% 0.3% Implants 0.1% -- Male sterilization 0.4% 0.7% 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/16.58

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