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      Contraceptive use among sexually active female adolescents in Ethiopia: trends and determinants from national demographic and health surveys

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          Abstract

          Background

          Sexual and reproductive health and right of adolescents is a global priority as the reproductive choices made by them have a massive impact on their health, wellbeing, education, and economy. Teenage pregnancy is a public health issue and a demographic challenge in Ethiopia. Increasing access to contraceptive services for sexually active adolescents will prevent pregnancies and related complications. However, little is known about the trends in contraceptive use and its determinants among adolescent girls in Ethiopia. Therefore, this study was designed to examine the trends and factors associated with contraceptive use among sexually active girls aged 15–19 years in Ethiopia by using Ethiopian demographic and health survey data.

          Methods

          Four Ethiopian demographic and health survey data were used to examine trends of contraceptive methods use. To identify factors associated with contraceptive use, the 2016 Ethiopian demographic and health survey data were used. The data was downloaded from the demographic and health survey program database and extracted for sexually active adolescent girls. Data were weighted for analysis and analyzed using SPSS version 21. Descriptive analysis was used to describe the independent variables of the study. A multivariable logistic regression model was used to identify factors associated with contraceptive use and adjusted odds ratios with 95% confidence interval were presented for significant variables. Variables with a p-value less than 0.05 were considered as significantly associated with contraceptive use.

          Results

          Contraceptive method use had increased significantly from 6.9% in 2000 to 39.6% in 2016 among sexually active adolescent girls in Ethiopia. The odds of contraceptive use were lower among female adolescents who had no formal education (AOR 0.044; 95% CI 0.008–0.231) and attended primary education (AOR 0.101; 95% CI 0.024–0.414). But the odds were higher among adolescents from a wealthy background (AOR 3.662; 95% CI 1.353–9.913) and those who have visited health facilities and were informed about family planning (AOR 3.115; 95% CI 1.385–7.007).

          Conclusion

          There is an increment in the trend of contraceptive use among sexually active female adolescents in Ethiopia between 2000 and 2016. Significant variations in the use of modern contraception by wealth status, educational level and visited a health facility, and being informed about family planning were observed. Improving the economic and educational status of young women, and provision of information may help in improving contraceptive use in Ethiopia.

          Plain English summary

          Adolescent contributes up to 16 per cent of the world’s population. Sexual and reproductive health and right of these populations is a global priority. Teenage pregnancy is a public health issue and a demographic challenge in Ethiopia. A contraceptive method is best for sexually active adolescents to prevent pregnancies and its related complications.

          Data for this study are from the four Ethiopian Demographic and Health Surveys [EDHS] conducted in 2000, 2005, 2011, and 2016. Data for sexually active adolescent girls were extracted from the data set.

          The trend of contraceptive use among adolescents is increasing from time to time. However, more than three-fifth of the sexually active female adolescents are still not using any type of contraception. There were significant variations in the use of modern contraception by background characteristics of the respondents. In all four rounds of the EDHS, modern contraceptive use was common among adolescents in 18–19 years, who attended secondary and above educational level, lived in urban areas, and was from wealthy family groups.

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          Most cited references29

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          Our future: a Lancet commission on adolescent health and wellbeing

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            Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher– Lancet Commission

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              Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study.

              To investigate the risk of adverse pregnancy outcomes among adolescents in 29 countries. Secondary analysis using facility-based cross-sectional data of the World Health Organization Multicountry Survey on Maternal and Newborn Health. Twenty-nine countries in Africa, Latin America, Asia and the Middle East. Women admitted for delivery in 359 health facilities during 2-4 months between 2010 and 2011. Multilevel logistic regression models were used to estimate the association between young maternal age and adverse pregnancy outcomes. Risk of adverse pregnancy outcomes among adolescent mothers. A total of 124 446 mothers aged ≤24 years and their infants were analysed. Compared with mothers aged 20-24 years, adolescent mothers aged 10-19 years had higher risks of eclampsia, puerperal endometritis, systemic infections, low birthweight, preterm delivery and severe neonatal conditions. The increased risk of intra-hospital early neonatal death among infants born to adolescent mothers was reduced and statistically insignificant after adjustment for gestational age and birthweight, in addition to maternal characteristics, mode of delivery and congenital malformation. The coverage of prophylactic uterotonics, prophylactic antibiotics for caesarean section and antenatal corticosteroids for preterm delivery at 26-34 weeks was significantly lower among adolescent mothers. Adolescent pregnancy was associated with higher risks of adverse pregnancy outcomes. Pregnancy prevention strategies and the improvement of healthcare interventions are crucial to reduce adverse pregnancy outcomes among adolescent women in low- and middle-income countries. © 2014 RCOG The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.
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                Author and article information

                Contributors
                alemikebede@gmail.com
                Journal
                Reprod Health
                Reprod Health
                Reproductive Health
                BioMed Central (London )
                1742-4755
                25 May 2021
                25 May 2021
                2021
                : 18
                : 104
                Affiliations
                [1 ]GRID grid.411903.e, ISNI 0000 0001 2034 9160, Population and Family Health Department, Faculty of Public Health, , Institute of Health Science, Jimma University, ; Jimma, Ethiopia
                [2 ]GRID grid.411903.e, ISNI 0000 0001 2034 9160, School of Nursing and Midwifery, Faculty of Health Sciences, , Institute of Health Science, Jimma University, ; Jimma, Ethiopia
                [3 ]GRID grid.411903.e, ISNI 0000 0001 2034 9160, Department of Epidemiology Faculty of Public Health, , Institute of Health, Jimma University, ; Jimma, Ethiopia
                Article
                1161
                10.1186/s12978-021-01161-4
                8146240
                34034741
                3c0a14f1-ac36-4e2c-9f57-ae3545af54d4
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 12 June 2020
                : 16 May 2021
                Categories
                Research
                Custom metadata
                © The Author(s) 2021

                Obstetrics & Gynecology
                adolescent,contraception,family planning,sexual and reproductive health and right,utilization,ethiopia

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