Republic of Uganda - adolescent contraceptive use

Publication date: 2016

Adolescent contraceptive use DATA FROM THE UGANDA DEMOGRAPHIC AND HEALTH SURVEY (UDHS), 2011 R E PU B LI C O F U G A N DA What can be done to support Ugandan 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 Uganda, there are nearly 10 million adolescents aged 10–19 years – 24.3% of the country’s total population.i Most adolescents live in rural areas, 81.8% of adolescent girls and 84.6% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 6.8, while for adolescent boys it is 7.6. ii Among adolescents who become parents before age 20, the average age at which Ugandan adolescent girls have their first baby is 16.8 years, while the average age at which adolescent boys first become fathers is 17.9. ii Sexual activity and marital status Analysis of data from the UDHSii shows that more than 1.1 million Ugandans 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 16.1 years and adolescent boys at 16.4 years. Among unmarried adolescents, 31.4% of adolescent girls report ever having sex and 12.9% are currently sexually active; among adolescent boys, 38.8% report ever having sex, while 15.9% are currently sexually active. Among all Ugandan adolescents, 20.0% of adolescent girls and 1.9% of adolescent boys are in a union. Among these adolescents, the mean age of the first union is 16.4 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 Withdrawal Periodic abstinence Male condom Pill Injectable contraceptives IUD 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 UDHSii analyses, 74.0% of unmarried, sexually active adolescent girls report not wanting a child in the next two years, yet only 42.0% 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 (41.8%) • infrequent sex (40.5%) • fear of side-effects or health concerns (29.6%) Among all unmarried, sexually active adolescent girls aged 15–19, 68.8% are not using a method of contraception. Male condoms and injectable contraceptives are the most common modern methods used (17.9% and 6.9% of these adolescent girls, respectively), while IUDs, one of the most effective methods, are used 0.2%. Withdrawal or periodic abstinence, traditional methods, are used by 5.3% of these adolescent girls (see Figure 1). In union According to UDHSii analyses, 44.8% of adolescent girls in a union report not wanting a child in the next two years, yet only 16.0% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • breastfeeding (30.8%) • others are opposed (29.2%) • menses has not returned after giving birth (25.7%) Among all adolescent girls in a union aged 15–19, 86.1% are not using a method of contraception. Injectable contraceptives and male condoms are the most common modern methods used (8.0% and 3.9% of these adolescent girls, respectively). Implants, one of the most effective methods, are used by 0.7%. A small proportion, 0.9%, are relying on a traditional method (withdrawal) (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 Uganda Bureau of Statistics (UBOS), ICF International Inc. Uganda Demographic and Health Survey 2011 [Datasets]. UGIR60.DTA and UGMR60.DTA. Calverton (MD): ICF International; 2012 (http://dhsprogram.com/data/dataset/Uganda_Standard-DHS_2011.cfm?flag=0, accessed 4 November 2016 . Not using Withdrawal Male condom Pill Injectable contraceptives Implants 0.9 0.5 8.0 0.7 3.9 86.1 68.8 4.2 1.1 17.9 0.9 6.9 0.2 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of UDHS 2011ii Source: analysis of UDHS 2011ii Unmarried, sexually active adolescents who are using a modern method most often get it from a private facility (43.5%) or a shop (32.0%). Adolescents in a union who are using a modern method most often get it from a private facility (51.2%) or a government facility (34.1%). Adolescent contraceptive use R E P U B L I C O F U G A N D A Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 10 16.1 years for adolescent girls 16.4 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 Ugandan 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 74.0% sexually active, unmarried adolescent girls 44.8% adolescent girls in union 45.3% from a private facility 51.2% from a private facility 32.0% from a shop 34.1% from a government 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 UGANDA DEMOGRAPHIC AND HEALTH SURVEY, 2011 COMPILED IN 2016 | UPDATED NOVEMBER 2016 Uganda Bureau of Statistics (UBOS), ICF International Inc. Uganda Demographic and Health Survey 2011 [Datasets]. UGIR60.DTA and UGMR60.DTA. Calverton (MD): ICF International; 2012 (http://dhsprogram.com/data/dataset/Uganda_ Standard-DHS_2011.cfm?flag=0, accessed 4 November 2016). 16.8 17.9 for adolescent girls for adolescent boys LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Sexually active, unmarried In union 41.8% not married 30.8% breastfeeding 40.5% infrequent sex 29.2% others are opposed 29.6% fear of side-effects or health concerns 25.7% menses has not returned after giving birth Method Sexually active, unmarried In union Not using 68.8% 86.1% Withdrawal 4.2% 0.9% Periodic abstinence 1.1% -- Male condom 17.9% 3.9% Pill 0.9% 0.5% Injectable contraceptives 6.9% 8.0% Implants -- 0.7% 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/16.46

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