Republic of Kenya - adolescent contraceptive use
Publication date: 2016
Adolescent contraceptive use DATA FROM THE KENYA DEMOGRAPHIC AND HEALTH SURVEY (KDHS), 2014 R E P U B L I C O F K E N YA What can be done to support Kenyan 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 Kenya, there are 10.5 million adolescents aged 10–19 years – 22.5% of the country’s total population.i Just over three quarters of adolescents live in rural areas, 77.0% of adolescent girls and 79.3% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 9.4, while for adolescent boys it is 9.3.ii Among adolescents who become parents before age 20, the average age at which Kenyan adolescent girls have their first baby is 17.4 years, while the average age at which adolescent boys first become fathers is 18.1.ii Sexual activity and marital status Analysis of data from the KDHSii shows that over 1.5 million Kenyans 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 15.5 years. Among unmarried adolescents, 28.7% of adolescent girls report ever having sex and 4.9% are currently sexually active; among adolescent boys, 40.0% report ever having sex, while 17.0% are currently sexually active. Among all Kenyan adolescents, 11.9% of adolescent girls and 1.0% of adolescent boys are in a union. Among these adolescents, the mean age of the first union is 16.9 years for adolescent girls and 17.8 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 Pill Injectible contraceptives 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 KDHSii analyses, 86.4% of unmarried, sexually active adolescent girls report not wanting a child in the next two years, yet only 42.9% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • not married (47.4%) • infrequent sex (35.2%) • fear of side-effects or health concerns (12.8%) Among all unmarried, sexually active adolescent girls aged 15–19, 59.3% are not using a method of contraception. Male condoms and injectable contraceptives are the most common modern methods used (21.3% and 11.8% of these adolescent girls, respectively), while implants, which are considered to be one of the most effective methods, are used by 3.4%. Periodic abstinence, a traditional method, is used by 3.4% (see Figure 1). In union According to KDHSii analyses, 66.0% of adolescent girls in a union report not wanting a child in the next two years, and 46.5% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • breastfeeding (17.1%) • menses has not returned after giving birth (15.8%) • fear of side effects or health concerns (13.9%) Among all adolescent girls in a union aged 15–19, 59.8% are not using a method of contraception. Injectable contraceptives are the most common modern method used (27.1% of these adolescent girls), followed by male condoms (2.1%) and pills (1.9%). A small proportion, 5.6%, are using a most effective method, implants or IUDs. Traditional methods (abstinence or withdrawal) are used by 3.3% of these adolescent girls (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 Kenya National Bureau of Statistics (KNBS), ICF International. Kenya Demographic and Health Survey 2014 [Datasets]. KEIR70.DTA and KEMR70.DTA. Calverton (MD): ICF International; 2015 (http://dhsprogram.com/data/dataset/Kenya_Standard-DHS_2014.cfm?flag=0, accessed 4 November 2016). Not using Periodic abstinence Withdrawal Male Condom Pill Injectable contraceptives Implants IUD 5.4 0.2 1.9 2.1 1.3 2.0 27.1 59.8 59.3 3.4 21.3 0.5 11.8 3.4 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of KDHS 2014ii Source: analysis of KDHS 2014ii Unmarried, sexually active adolescents who are using a modern method most often get it from a shop (23.5%) or a pharmacy (21.8%). Adolescents in a union who are using a modern method most often get it from a government facility (69.0%) or a private facility (21.6%). Adolescent contraceptive use R E P U B L I C O F K E N Y A Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 10.5 16.3 years for adolescent girls 15.5 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 Kenyan 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 86.4% sexually active, unmarried adolescent girls 66.0% adolescent girls in union 23.5% from a shop 69.0% from a government facility 21.8% from a pharmacy 21.6% 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 THE KENYA DEMOGRAPHIC AND HEALTH SURVEY, 2014 COMPILED IN 2016 | UPDATED NOVEMBER 2016 Kenya National Bureau of Statistics (KNBS), ICF International. Kenya Demographic and Health Survey 2014 [Datasets]. KEIR70.DTA and KEMR70.DTA. Calverton (MD): ICF International; 2015 (http://dhsprogram.com/data/ dataset/Kenya_Standard-DHS_2014.cfm?flag=0, accessed 4 November 2016). 17.4 18.1 for adolescent girls for adolescent boys LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Sexually active, unmarried In union 47.4% not married 17.1% breastfeeding 35.2% infrequent sex 15.8% menses has not returned after giving birth 12.8% fear of side-effects or health concerns 13.9% fear of side-effects or health concerns Method Sexually active, unmarried In union Not using 59.3% 59.8% Periodic abstinence 3.4% 2.0% Withdrawal -- 1.3% Male Condom 21.3% 2.1% Pill 0.5% 1.9% Injectable contraceptives 11.8% 27.1% Implants 3.4% 5.4% IUD -- 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/16.29
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