Research
1.1 Background of the Study
Adolescents, defined as individuals aged 10 to 19, represent a critical demographic in sexual and reproductive health (SRH). In 2022, over 13 million births occurred among adolescents globally, highlighting the importance of addressing SRH needs. Data from the Demographic and Health Survey collected insights into the SRH of adolescent girls starting at age 15 (WHO, 2022). Each year, approximately 21 million girls aged 15–19 in developing countries become pregnant (You et al., 2015).
Contraceptive methods can be classified as modern or traditional. Modern methods, such as condoms, pills, implants, intrauterine devices, and injectables, are reliable and effective in preventing unwanted pregnancies. Conversely, traditional methods like withdrawal, periodic abstinence, and herbal remedies are less reliable. The World Health Organization affirms that adolescents, like adults, have a right to SRH services, including access to contraception, counselling, and sex education. Evidence suggests that the use of modern contraceptives among sexually active adolescents can promote safer sexual behaviours and reduce maternal health risks, school dropouts, and economic hardships for young girls.
Despite this, millions of adolescents, particularly in developing countries, lack access to contraception, placing them at risk of unplanned pregnancies, unsafe abortions, and maternal health complications. The unmet need for modern contraceptives among adolescents is significant, with 14 million (43%) in low- and middle-income countries (LMICs) affected annually. Approximately 49% of the 21 million pregnancies in LMICs each year are unintended, and 50% of these result in unsafe abortions (Sully, 2020).
Globally, contraceptive use among women of childbearing age has risen, with 77.5% of women using modern methods in 2022, compared to 67% in 1990. However, only 15.4% of adolescent women require contraceptives, and just 10.2% use them. The highest proportions of users are in Latin America and the Caribbean (25.3%) and North America and Europe (23.5%) (Darroch, 2016).
In sub-Saharan Africa (SSA), adolescent birth rates remain alarmingly high, at 101 births per 1,000 girls compared to the global average of 45 births per 1,000. This is primarily due to unmet contraceptive needs among adolescents (Chol & Hlongwana, 2020). SSA also records the lowest contraceptive use among married adolescents, at 17.9% (Alo et al., 2020).
In Uganda, the prevalence of modern contraceptive use among women is 9.4%, despite 62.3% of females being sexually active (Sserwanja et al., 2021). Furthermore, in 2016, only 30% of married women used modern family planning methods (Reproductive Health Uganda, 2022). The Acholi sub-region in Northern Uganda demonstrates limited contraceptive use among women of reproductive age, contributing to high birth rates and significant teenage pregnancy rates, accounting for 7% of national figures. Understanding the factors influencing contraceptive use among adolescents in Acholi is crucial for informed policy-making.
1.2 Problem Statement
Modern contraceptive use in Uganda is low, with only 9.4% of females adopting these methods, despite 62.3% being sexually active (Sserwanja et al., 2021). In Northern Uganda, the disparity in access to SRH services contributes to high rates of teenage pregnancies, with the region accounting for 7% of national teenage pregnancy figures (Kaddaga, 2022).
Although the government has introduced initiatives such as free condom distribution and awareness campaigns, contraceptive uptake remains inadequate, particularly in rural areas. Understanding the determinants of contraceptive use among adolescents in the Acholi sub-region is essential for addressing these gaps and improving outcomes.
1.3 Purpose of the Study
To explore the factors influencing contraceptive use among adolescents in Northern Uganda.
1.4 Specific Objectives
The study seeks to:
- Examine the demographic factors associated with contraceptive use among adolescents in Northern Uganda.
- Assess the socio-economic factors influencing contraceptive use in the Acholi sub-region.
- Analyze the relationship between enabling factors and contraceptive use among adolescents in Northern Uganda.
1.5 Study Hypotheses
- Socio-demographic factors significantly influence contraceptive use among adolescents in Northern Uganda.
- Socio-economic factors significantly influence contraceptive use in the Acholi sub-region.
- Enabling factors are significantly associated with contraceptive use among adolescents in Northern Uganda.
1.6 Scope of the Study
The study focuses on the Acholi sub-region of Northern Uganda, utilizing data from the 2016 Uganda Demographic and Health Survey (UDHS) to investigate factors influencing contraceptive use among adolescents.
1.7 Significance of the Study
This research aligns with Uganda’s National Health Policy, which emphasizes strengthening health systems to increase contraceptive use among sexually active adolescents. The findings will provide evidence for policy development, improve SRH program implementation, and serve as a reference for future research on contraceptive use in similar contexts.
1.8 Justification of the Study
High rates of teenage pregnancies in Northern Uganda, stemming from low contraceptive use, result in maternal and neonatal health complications. Understanding demographic and socio-economic factors influencing contraceptive uptake will guide the development of evidence-based interventions to enhance contraceptive access and usage among adolescents in the region.
