Republic of Zimbabwe - adolescent contraceptive use

Publication date: 2016

Adolescent contraceptive use DATA FROM THE ZIMBABWE DEMOGRAPHIC AND HEALTH SURVEY (ZDHS), 2015 REPUBLIC OF ZIMBABWE What can be done to support Zimbabwean 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 DECEMBER 2016 Adolescent population: who are they? In Republic of Zimbabwe, there are 3.4 million adolescents aged 10–19 years – 22.7% of the country’s total population.i About three quarters of adolescents live in rural areas, 71.1% of adolescent girls and 75.1% of adolescent boys.i By age 19, the mean number of years of schooling attended by both adolescent girls and adolescent boys is 9.7. ii Among adolescents who become parents before age 20, the average age at which Zimbabwean adolescent girls have their first baby is 17.5 years, while the average age at which adolescent boys first become fathers is 18.4. ii Sexual activity and marital status Analysis of data from the ZDHSii shows that more than 395 000 Zimbabweans 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, both adolescent girls and adolescent boys first have sexual intercourse at age 16.9 years. Among unmarried adolescents, 16.8% of adolescent girls report ever having sex and 6.5% are currently sexually active; among adolescent boys, 26.5% report ever having sex, while 12.0% are currently sexually active. Among all Zimbabwean adolescents, 19.6% of adolescent girls and 0.9% 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 18.4 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 Female condom Male condom Pill Injectable 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 ZDHSii analyses, 66.3% of unmarried, sexually active adolescent girls report not wanting a child in the next two years, and 39.9% 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 (31.9%) • not married (31.1%) • not having sex (26.4%) Among all unmarried, sexually active adolescent girls aged 15–19, 66.8% are not using a method of contraception. Male condoms are the most common modern methods used (16.4%) and implants, one of the most effective methods, are used by 5.8% of these adolescent girls. Injectable contraceptives are used by 5.6% and pills are used by 4.8% (see Figure 1). In union According to ZDHSii analyses, 59.1% of adolescent girls in a union report not wanting a child in the next two years, and 63.1% of them are currently using a method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • not having sex (43.5%) • infrequent sex (37.8%) • breastfeeding (21.9%) Among all adolescent girls in a union aged 15–19, 54.2% are not using a method of contraception. Pills are the most common modern method used (31.7% of these adolescent girls), while 8.1% are using injectable contraceptives. Implants and IUDs, among the most effective methods, are used by 3.6% and 0.1%, respectively (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 Zimbabwe National Statistics Agency (ZIMSTAT), ICF International. Zimbabwe Demographic and Health Survey 2015 [Datasets]. ZWIR70.DTA and ZWMR70.DTA. Calverton (MD): ICF International Inc.; 2016 (https://dhsprogram.com/data/dataset/Zimbabwe_Standard-DHS_2015.cfm?flag=1 accessed 13 December 2016). Not using Withdrawal Male condom Pill Injectable contraceptives Implants IUD 31.7 0.1 54.2 8.1 3.6 0.9 1.5 66.80.6 4.8 16.4 5.6 5.8 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of ZDHS 2015ii Source: analysis of ZDHS 2015ii Unmarried, sexually active adolescents who are using a modern method most often get it from a government facility (50.2%) or a market (21.9%). Adolescents in a union who are using a modern method most often get it from a government facility (84.7%) or a pharmacy (9.0%). Adolescent contraceptive use R E P U B L I C O F Z I M B A B W E Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 3.4 16.9 years for adolescent girls 16.9 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 Zimbabwean 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 66.3% sexually active, unmarried adolescent girls 59.1% adolescent girls in union 84.7% from a government facility 9.0% 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 THE ZIMBABWE DEMOGRAPHIC AND HEALTH SURVEY, 2015 COMPILED IN 2016 | UPDATED DECEMBER 2016 Zimbabwe National Statistics Agency (ZIMSTAT), ICF International. Zimbabwe Demographic and Health Survey 2015 [Datasets]. ZWIR70.DTA and ZWMR70.DTA. Calverton (MD): ICF International Inc.; 2016 (https://dhsprogram.com/data/dataset/Zimbabwe_Standard-DHS_2015.cfm?flag=1 accessed 13 December 2016). 17.5 18.4 for adolescent girls for adolescent boys LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Sexually active, unmarried In union 31.9% infrequent sex 43.5% not having sex 31.1% not married 37.8% infrequent sex 26.4% not having sex 21.9% breastfeeding Method Sexually active, unmarried In union Not using 66.8% 54.2% Withdrawal -- 0.9% Female condom 0.6% -- Male condom 16.4% 1.5% Pill 4.8% 31.7% Injectable contraceptives 5.6% 8.1% Implants 5.8% 3.6% IUD -- 0.1% 50.2% from a government facility 21.9% from a market 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/16.48 LU_WHO_Template_Text_En-AFRO-Zimbabwe LU_WHO_Template_Infographic_En_AFRO_Zimbabwe

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