Research

FACTORS ASSOCIATED WITH CONTRACEPTIVE USE AMONG SEXUALLY ACTIVE ADOLESCENTS IN NORTHERN UGANDA.

TABLE OF CONTENTS

DECLARATION.. ii

APPROVAL. iii

ACKNOWLEGEMENT.. iv

ABSTRACT.. viii

CHAPTER ONE: INTRODUCTION.. 1

1.0            Introduction. 1

1.1            Background of the study. 1

1.2            Problem statement 2

1.3            Purpose of study. 3

1.4            Specific Objectives. 3

1.5            Study Hypotheses. 3

1.6 Scope of the study. 3

1.6            Significance of the study. 3

1.8 Justification of the study. 4

1.9 Conceptual framework. 5

CHAPTER TWO: LITERATURE REVIEW… 6

2.0       Introduction. 6

2.1 Socio-demographic characteristics of adolescents and contraceptive use. 6

2.2 Socio-economic factors associated with contraceptive use among adolescents. 7

2.3 Prevalence of modern contraceptive use among adolescents. 8

CHAPTER THREE: METHODOLOGY.. 10

3.1 Introduction. 10

3.2 Study design. 10

3.3 Area of the study. 10

3.4 Population of the study. 10

3.5 Target population. 10

3.6 Data type and source. 10

3.7 Sample size. 10

3.8 Sampling procedure. 11

3.9 Data collection method. 11

3.10 Data collection instruments. 11

3.11 Study variables. 11

3.12 Data management 11

3.7.2.1             Data storage. 11

3.7.2.2         Data cleaning. 12

3.7.2.3         Data template. 12

3.13 Data analysis. 12

3.13.1At the univariate level: 12

3.13.2 At the bivariate level of analysis, 12

3.13.3 At multi-variate level; A.. 12

CHAPTER FOUR: PRESENTATION OF RESULTS AND DISCUSSION.. 14

4.0 Introduction. 14

4.1 Univariate analysis. 14

4.1.1 Socio-demographic characteristics of the respondents. 14

4.1.2 Socio-economic factors of the respondents. 15

4.1.3 Level of contraceptive use among respondents. 17

4.2 Bivariate analysis. 18

4.3 Discussion of findings. 21

4.3.1 Association between social demographic factors and contraceptive use. 21

4.3.2 Association between social-economic factors and the selected variables. 22

CHAPTER FIVE: SUMMARY, RECOMMENDATIONS AND CONCLUSION.. 23

5.0 Introduction. 23

5.1 Summary of Findings. 23

5.2 Conclusions. 25

5.3 Recommendations. 25

REFERENCES. 26

APPENDIX I: QUESTIONNAIRE.. 32

LIST OF TABLES

Table 4.1 showing Socio-demographic characteristics of the respondents. 14

Table 4.2 showing Socio-economic factors of the respondents. 15

Table 4.3 showing Level of contraceptive use among respondents. 17

Table 4.4: Showing association between social demographic factors and contraceptive use. 18

Table 4.5: Showing association between social-economic factors and the selected variables. 19

CHAPTER ONE: INTRODUCTION

1.0       Introduction

This chapter consists of introduction, background of the study, problem statement, study objectives, research objectives, conceptual framework, and justification of study.

1.1       Background of the study

Adolescents are young people aged 10 to 19. In 2022, over 13 million births occurred among adolescents worldwide. The Demographic and Health Survey collected information on the sexual and reproductive health (SRH) of adolescent girls at the age of 15 (WHO, 2022). Every year, approximately 21 million girls between the ages of 15 and 19 become pregnant in developing countries (You et al, 2015).

Contraception can be modern or traditional. Condoms, pills, implants, intra-uterine devices, and injectables are among the modern contraceptives that are more reliable and effective in preventing unwanted pregnancies. Unreliable traditional contraceptives are withdrawal, periodic abstinence, and herbal mixtures or concoctions. The World Health Organization states that adolescents, like adults, are entitled to SRH rights, such as access to counselling, contraception, and sex education. Access to and use of modern contraceptives among sexually active adolescents has been shown to promote sexual behaviour while also reducing maternal health risks, school dropout, and economic hardship in young girls.  Millions of adolescent girls, particularly in developing countries, lack access to contraception. This has put many adolescent girls at risk of unplanned pregnancy, unsafe abortion, and maternal morbidity and mortality.

Though contraceptive use among adolescent girls varies by country, 14 million (43%) adolescent girls in low- and middle-income countries (LMICs) have an unmet need for modern contraception. Unintended pregnancies account for approximately 49% (10 million) of the 21 million pregnancies that occur among adolescents in LMICs each year; 50% of these pregnancies result in unsafe abortion (Sully, 2020).

Globally, 874 million women worldwide, which equals 77.5% of women of childbearing age, use a modern contraceptive method, up 10 percentage points on 1990 (67%). However, about 15.4% of adolescent women have need for contraceptive but only 10.2% with the highest proportion of users among Latin America and Carribbean (25.3%) and 23.5% in North America and Europe in 2022 (Darroch, 2016).

In 2021, about 12 million births occurred among adolescents in developing countries. Adolescent girls in Africa account for 14% of all babies born in Africa, compared to nine percent globally. While adolescent birth rates have declined in other parts of the world, sub-Saharan Africa (SSA) continues to have the highest (101 births per 1000 adolescent girls, exceeding the world average of 45 births per 1,000 adolescent girls), owing to a high unmet need for contraception among adolescents (Chol & Hlongwana, 2020).

In sub-Saharan Africa, the proportion of contraceptive users among married adolescents was the lowest among all regions at 17.9%. The low contraceptive uptake is responsible for an estimation of 101 birth per 1000 teenage women, (Alo et al., 2020).

In Uganda, the prevalence of modern contraceptive use among females is at 9.4% yet more that 62.3% are sexually active (Sserwanja et al., 2021). According to Reprodutive Health Uganda (2022), barely 30% of married Ugandan women employed contemporary techniques of family planning in 2016.

In Acholi sub region, the rate of contraceptive use among women of reproductive age is yet no known putting policy makers at risk of making wrong policy decisions. The area is characterised by a growing number of women of reproductive age, lack of knowledge about contraceptive hence high birth-rates. According to Kaddaga, (20220, there exist a significant disparity in access to sexual and reproductive health services with Acholi sub region alone accounting for over seven percent of the overall national figures on teenage pregnancies. It is thus necessary to understand the factors associated with contraceptive use among adolescents in Acholi region, Northern Uganda.

1.2       Problem statement

In Uganda, the prevalence of modern contraceptive use among females is at 9.4% yet more that 62.3% are sexually active (Sserwanja et al., 2021). According to Reprodutive Health Uganda (2022), barely 30% of married Ugandan women employed contemporary techniques of family planning in 2016.

According to Kaddaga, (20220, there exist a significant disparity in access to sexual and reproductive health services with Northern Uganda alone accounting for over seven percent of the overall national figures on teenage pregnancies. The frequency of these inequalities represents an alarming failure of our collective efforts to safeguard young Ugandans, with damaging consequences for both individuals and society at large. The government has undertaken steps to enhance contraceptive use among women of reproductive age like free condom distribution, radio talk shows and many others but contraceptive use has remained low in some areas of the country most the rural areas. It is thus necessary to understand the factors associated with contraceptive use among adolescents in Acholi sub-region, Northern Uganda.

1.3       Purpose of study

To understand the factors associated with contraceptive use among adolescents in Northern Uganda.

1.4       Specific Objectives

The study was guided by the following objectives;

• To examine the demographic factors associated with contraceptive use among adolescents in Northern Uganda.
• To assess the socio-economic factors associated with contraceptives among adolescents in Acholi sub-region, Northern Uganda.
• To understand the association between enabling factors and contraceptive use among adolescents in Northern Uganda.

1.5       Study Hypotheses 

1. Socio-demographic factors are significantly associated with contraceptive use among adolescents in Northern Uganda.

• Socio-economic factors are significantly associated with contraceptives among adolescents in Northern Uganda.
• There is a significant association between enabling factors and contraceptive use among adolescents in Northern Uganda.

1.6 Scope of the study

The study was carried out in Acholi-sub Region in Northern Uganda exploring the factors associated with contraceptive use among adolescents.

UDHS data 2016 was utilized for this study.

1.6       Significance of the study

The Uganda National Health Policy focus has been on strengthening health systems in line with increasing contraceptive use among sexual active adolescent through health education and increasing accessibility to various contraceptive methods. Thus, this study will help in conducting the study will aid in understanding the factors associated with non – use of contraceptives thereby set grounds for formulating policies/laws aimed at fostering the use of contraceptives. The study results will act as a guide for implementation of programs promoting contraceptive use in areas it has not been done. The study will be used as a guide by future researchers as they carry out research on other countries. In addition, further studies will develop their literature on this based on the information that will be generated in the study.

1.8 Justification of the study

Many teenagers conceive annually as a result of failure to use contraceptives which is associated with maternal and neonatal complications. The use of contraceptives can be improved if the demographic and socio – economic factors associated with uptake are well known. Related variables like accessibility and acceptability to contraceptives can be addressed in consideration to the demographic profile of the sexually active adolescents. Therefore, conducting this study in Northern Uganda will act as a yardstick for formulation of evidenced based programs aimed at improving contraceptive uptake among sexually active adolescents in the region.

1.9 Conceptual framework

The conceptual frame work above presents the variables that were involved in the study i.e. dependent variable and independent variables. The dependent variable of the study was contraceptive use among sexually active adolescents. The independent variables was demographic factors, socio – economic factors and enabling factors.

CHAPTER TWO: LITERATURE REVIEW

2.0       Introduction

This chapter consists of the literature review of previous published studies on factors associated with contraceptive use among sexually active adolescents which has been obtained from journals and text books.

2.1 Contraceptive use

Despite efforts towards making access and use of contraceptive services a basic reproductive right for all women, many countries still face high rates of unintended and unwanted pregnancies (Greek, 2019). In sub-Saharan Africa alone, about 14 million unintended (unwanted or mistimed) pregnancies occur every year; and adolescent girls and young women 15–24 years old are the most vulnerable group (WHO, 2019). The reasons behind this situation include the high prevalence (about 70%) of sexually active young women with low utilization of effective contraceptive methods (less than 10%) (WHO, 2019).

Additionally, unmarried sexually active adolescents are likely to have a high unmet need for contraception, which increases their risk of unintended pregnancies (Mishell, 2018). In low/middle-income countries, nearly half (49%) of pregnancies are unintended among adolescent girls of 15–19 years old. (Greek, 2019). Adolescence is viewed as the starting point in the continuum of care for reproductive, maternal, neonatal and child health; and is a phase when poor access and utilisation of contraception are likely to result in poor health outcomes across the continuum of care. Early and unintended pregnancies result in increased risks of maternal mortality and morbidity, premature births, low birth weight, unsafe abortions and social consequences such as stigmatisation, school drop-out and poverty (Chengen, 2019).

In Benin, although the use of modern contraceptives has been slowly increasing since 2006, it is still relatively low. The modern contraceptive prevalence among all women reached 12% in 2018 compared with 6% in 2006 (Africa, centre for Health Statistics, 2020). At the same time, almost half (48%) of all adolescent girls age 15–19 are sexually active, and one in five girls has already had a child or is pregnant. According to WHO,(2019), only 5.4% of women ages 15–24 were using modern contraceptive methods in 2017. Recent data showed a total fertility rate of 5.7 among all women of reproductive ages 15–49 years old, and the modern contraceptive prevalence rate was estimated at 12%. Of all pregnancies in the country, 19% were unintended, and in 2017, both the maternal mortality ratio and infant mortality rate remained high at 397 per 100 000 live births, and 30 per 1000 live births, respectively, (UNICEF, 2022, WHO, 2021).

Existing studies on the use of modern contraceptive methods in Benin largely reported on women of reproductive age as a whole, rather than focusing on specific age groups. MacQuarrie (2022) suggested that young women should be studied separately, as they do not have the same needs for or access to contraception as adult women.

2.2 Demographic characteristics of adolescents and contraceptive use

Population-based studies are important, as they are often used as a source of data on determinants of health and as a source of information on people’s health status (Ezzati, et al, 2019). As such, these surveys should adequately reflect the target population for the relevant indicators. A problem with population-based studies is that participation is voluntary, thus people can choose not to participate. Non-participation can reduce the precision of estimates, and more seriously may introduce selection bias if both the exposure and the outcome under investigation affect the probability of participation, and may reduce the generalizability of the results (Jousilahti, 2019).

The presence of selection bias cannot usually be inferred from the study data alone; participation studies are therefore necessary to identify any underrepresented subgroups (Lash & Rothman, 2021).  Knowledge of the characteristics of non-participants may help to improve recruitment procedures and representativeness, leading to more accurate assumptions and conclusions in population-based studies, i.e., estimations of prevalence and incidence, and associations between exposures and outcomes.

Sociodemographic characteristics refer to a combination of social and demographic factors, including socioeconomic status (SES), which is often measured by an individual’s educational attainment, occupation, and income Mackenbach, 2019). Individuals with low SES have been reported to have poorer health status and to be less likely to participate in health surveys compared with individuals with high SES (Greek, 2021). Men, people who are unmarried, and those with low education or low income are also less likely to participate, according to previous studies (Greek, 2019). The association between participation and age or belonging to an ethnic minority (Palaba, 2019) is inconsistent in the literature.

2.3 Socio-economic factors associated with contraceptive use among adolescents 

It has also been hypothesized that there is a positive correlation between contraceptive use and level of education (Feyisetan 2000). Other things being equal the higher the level of education the higher contraceptive use is expected to be. Although both the wives’ and husbands’ education is important there appears to be a consensus that the former is more important than the latter.

Use of family planning is higher in urban than rural areas. Urban-rural difference in the adoption of contraception is the highest in SSA, where the rate is more than twice as high as among urban than among rural in all surveyed countries (Curtis and Katherine, 2021).

The observed place of residence variation, in the practice of contraception, may be attributed to differences in the availability of social services. Such as, education information about method and access to family planning and health care services which are among the important ones.

Religious affiliation also affects contraceptive use (Gyimah et al. 2008). Religions differ in their stand on fertility regulation and among the major world religions, Catholicism and Islam are widely regarded as pronatalist in their ideology. However, the relationship between religion and contraceptive use is much more complex than expected. In one study conducted in India, it was discovered that even though the average number of children born to a Muslim or Christian couple is higher than that born to a Hindu couple, the acceptance of sterilization to limit family size was greater among Muslims and Christians than Hindus (Ullah and Chakraborty 2019). A study of contraceptive use in Bangladesh found that Muslim women here were less likely to use contraception than Hindu women (Ullah and Chakraborty 2022). The strength of one’s religiosity or degree of one’s adherence to the norms of a given religion may exert an influence on ones’ mode of life including reproductive behaviour. Furthermore, studies in developing countries reveal that social, cultural and religious unacceptability of contraception frequently emerged as an obstacle to use contraception (Oni and McCarthy, 2022).

The work status of women has also been linked to knowledge and use of contraceptives. Women who work outside the home have higher rate of use than women who do not work outside home (housewives) (Robey et al.2022). Working women, particularly, those who earn cash incomes are assumed to have greater control over household decisions and increased awareness of the world outside home. Consequently, they have more control over reproductive decisions (Hialemariam  et al. 2021). Some studies also add that paid work also provides alternative satisfactions for women, which may complete with bearing and rearing children and may promote contraceptive use.

CHAPTER THREE: METHODOLOGY

3.1 Introduction

This chapter explains the various methods and procedures through which my research was carried out. It presents the study design, target population, area of study, data type and sources of data, data collection method, variable selection, data management, data analysis, ethical considerations and limitations of the study

3.2 Study design

The study was a cross-section study design approach. The study design was used because it studied the snap short of the characteristics of adolescents within a short period of time at a single moment/encounter. The design enabled the research determine the relationship between the factors and contraceptive use.

3.3 Area of the study

The study was conducted in Northern Uganda.

3.4 Population of the study

The study involved sexually active adolescents.

3.5 Target population

The target population comprised of female adolescents between the age of 15-19 years of age in northern Uganda.  Region.

3.6 Data type and source

The study involved secondary data. The UDHS 2016 was used as the major source of data. The 2016 Uganda Demographic and Health Survey (UDHS) was implemented by the Uganda Bureau of Statistics (UBOS). Data collection took place from 20 June to 16 December 2016. ICF provided technical assistance through The DHS Program, which is funded by the United States Agency for International Development (USAID) and offers financial support and technical assistance for population and health surveys in countries worldwide. Other agencies and organisations that facilitated the successful implementation of the survey through technical or financial support were the Government of Uganda, the United Nations Children’s Fund (UNICEF), and the United Nations Population Fund (UNFPA). Only Data collected in Northern Uganda was utilized

3.7 Study variables

Dependent variable: Contraceptive use (Yes and No).

Independent variables: These was demographic factors i.e age, marital status, education level, religion and marital status, as socio – economic factors such as wealth index and employment status.

Enabling factors included access to the health facility, availability of health personnel and the price of the contraceptives.

3.8 Data analysis.

Data analysis was conducted using statistical package for social sciences (SPSS) version 20 at univariate, bivariate and multivariate levels.

At the univariate level: It involved analysing one variable at a time. Frequency distributions were run to show the number of observations in each category and find out the variable characteristics.

3 At the bivariate level of analysis, The chi-square using a cross was used because the data is categorical in order to find out if there is an association between the two categorical variables.

Chi square test statistics was also used to test for significance and independence between the dependent and each of the independent variables, variables at 5%. A high significance value below 5% indicated a relationship between two variables.

At multi-variate level; A binary logistic regression because my dependent variable is categorized into only two categories (using contraceptives and not using contraceptives). This was used to determine the degree of relationship significance within the dependent variable and independent variables.

The model is illustrated as follows;

The model permits the computation of a regression coefficient bi for each independent variable Xi. Where;

Variable (Contraceptive use)

=    probability of using contraceptive use being influenced by                                                  demographic and socio – economic factors.

= is the probability of not using contraceptives.

= independent variable

=    constant (y-intersect)

= regression coefficient of the variable.

The interpretation of the results was based on probabilities (B), significance and the p- value. For OR which is the positive = the likelihood of contraceptive utilization for that particular variable relative to the reference category is high. OR which is negative= the likelihood of contraceptive is lower for that particular variable relative to reference category. p<0.05, the result is statistically significant, otherwise not.

3.9 Limitations

3.10 Ethical considerations 

Data from UDHS was requested from Uganda bureau of statistics. The data set was sent via email and used for analysis.

The researcher respected confidentiality and privacy of individuals represented in the data. Even anonymized data can sometimes be re-identified, so researchers should be cautious about how they use and present the data.

CHAPTER FOUR: PRESENTATION OF RESULTS AND DISCUSSION

4.0 Introduction

This chapter presents results and discussion of findings in line with the objectives of the study which included; to examine the socio-demographic factors associated with contraceptive use among adolescents in Acholi sub-region, Northern Uganda, to assess the socio-economic factors associated with contraceptives among adolescents in Acholi sub-region, Northern Uganda and to understand the association between enabling factors and contraceptive use among adolescents in Acholi region, Northern Uganda.

4.1 Univariate analysis

Univariate analysis is a statistical method that focuses on analyzing one variable at a time to summarize, describe, and understand its properties. Univariate analysis is a straightforward but powerful tool for summarizing data and gaining initial insights, forming the basis for more advanced statistical methods and data-driven decision-making.

4.1.1 Demographics characteristics of respondents

This section presents the demographic characteristics of respondents.

4.1.2 Age category of respondents

Source: Primary Data

Findings in the indicates that adolescents Aged 15-19; Representing 23.1% of the sample, this age group is the largest among all categories. As the primary focus group for this study, their high representation offers significant insights into adolescent contraceptive use patterns and challenges. Adolescents in this age range are more likely to face barriers to accessing contraceptive services due to social and cultural norms, education level, and availability of youth-friendly health services. This group also has implications for public health initiatives, given their unique needs and the critical role contraceptive use plays in reducing unintended pregnancies and associated health risks. This group constitutes 20.4% of the respondents, making it the second-largest age cohort. Although technically outside the adolescent age range, this group’s contraceptive behavior can provide comparative insights, particularly as they transition from adolescence to adulthood. It is common for contraceptive use to increase with age and autonomy, but this may vary based on education level, marital status, and sociocultural expectations. Including this group helps to understand whether factors such as employment or relationship stability impact contraceptive choices, with a representation of 16.3%, this age group reflects early adulthood, where individuals may have different contraceptive needs compared to adolescents. Understanding how contraceptive use evolves from adolescence into later years can highlight the shifts in factors influencing usage, such as marital status, childbearing intentions, and economic independence. The remaining age groups (30-49 years) make up a cumulative 40.2% of the respondents, divided as follows: 30-34 (14.0%), 35-39 (11.0%), 40-44 (8.8%), and 45-49 (6.4%). Although not the primary focus of adolescent-centered contraceptive studies, these groups can provide a context for understanding how factors associated with contraceptive use change over time, including shifts in fertility preferences and different life stages. Observing contraceptive use patterns among these older age groups can also inform programs aimed at reducing unintended pregnancies and reproductive health issues beyond adolescence. The cumulative percentages indicate that by age 24, 43.5% of the sample has been accounted for. This emphasizes that nearly half of the respondents are within the adolescent and early young adult stages, underscoring the need to address contraceptive access and education tailored to this younger population. Additionally, with the inclusion of older respondents, the cumulative percentages show the study’s relevance to broader age groups, potentially informing intergenerational contraceptive use patterns and preferences. The distribution of ages, heavily skewed towards younger individuals (15-24), aligns well with the study’s objective to analyze adolescent contraceptive use. This demographic composition will allow for robust comparisons between adolescents and older cohorts, which may reveal unique age-specific challenges and facilitators of contraceptive use. Such insights are crucial in formulating targeted interventions that cater to the unique needs of sexually active adolescents in Northern Uganda.

Findings on type of place of residence

Source: primary data

This indicates that a minority (23.7%) of the sexually active adolescents in this study reside in urban areas. This lower percentage may reflect the overall population distribution in Northern Uganda, where rural populations are often larger than urban ones. The majority (76.3%) of adolescents included in the study live in rural areas. This reflects the larger rural demographic typical of Northern Uganda. Rural residency may also influence contraceptive use due to factors such as limited access to health facilities, cultural norms, lower education levels, and possibly fewer awareness programs compared to urban settings.

Findings on education level of respondents

Source: Primary Data

This category represents 11.2% of the respondents (2,071 individuals). While this is a minority, it indicates a portion of the population with limited literacy and numeracy skills. Lack of formal education can hinder opportunities for employment, limit access to information, and reduce engagement in civic activities. Reducing this figure may be a priority for policymakers, aiming to improve basic education access for all age groups, a majority, 58.9% (10,893 individuals), have attained primary-level education. This high proportion suggests that primary education is accessible and completed by most people in the population. However, it also implies that many individuals do not advance beyond primary school, which can restrict them to low-skill jobs. Policies aimed at retaining students beyond primary school and supporting progression to higher levels of education may benefit this group and strengthen the overall workforce, about 22.8% of the respondents (4,213 individuals) have completed secondary education. This level often allows for more job opportunities than primary education alone, and those with secondary education may have a higher likelihood of engaging in semi-skilled occupations. Nonetheless, the relatively lower percentage, compared to primary education, may reflect economic or social barriers that prevent further educational attainment. Only 7.2% (1,329 individuals) of the respondents have achieved higher education. This small proportion may indicate limited access to tertiary institutions, financial constraints, or fewer incentives to pursue further education. Individuals with higher education tend to have better employment prospects, higher income potential, and more opportunities in specialized fields. Increasing access to and affordability of higher education can be a significant driver of socioeconomic advancement, the data suggests a pyramidal structure in educational attainment, with the largest proportion in primary education and a sharp decline as educational levels increase. This pattern highlights potential barriers to education progression, such as economic challenges, limited access to quality education, and perhaps a lack of government support for secondary and higher education. These findings can be useful for policymakers, educational institutions, and NGOs focused on education reform, as they indicate where efforts may be needed to promote further educational advancement and improve opportunities for all segments of the population.

Time spent at school

Source of drinking water

The cumulative percentage shows a clear increase in educational attainment up to 7 years, peaking at 100% cumulative by that level. This progressive rise suggests most respondents achieved around 6 to 7 years of schooling, reflecting either the primary or early secondary education level as the common threshold. Education levels of 1 to 3 years’ account for 6.9%, 13.0%, and 12.2% of respondents respectively, with cumulative percentages reaching 9.8%, 24.4%, and 38.1%. This reflects a substantial segment of respondents who had at least begun formal education but did not progress to higher levels. The data highlights a concentration of respondents around 4–7 years of education, likely reflective of primary and early secondary school achievements. This pattern suggests access to basic education but potential limitations in further advancement, possibly due to socioeconomic, geographic, or policy-related factors affecting access to higher education levels. Understanding these constraints would be essential for designing programs to enhance educational access and progression.

Findings on the source of drinking water

Source: Primary Data

This is the most common source, with nearly 40% of people depending on it. Boreholes and tube wells are generally considered safer, as they typically draw water from underground, away from surface contaminants. This high reliance indicates that groundwater sources play a crucial role in the water supply system. Protected springs are the second most used source, likely favored for their accessibility and relative safety from contamination, making them a significant water source for rural or semi-urban areas. River, Dam, Lake, Ponds, Stream, Canal, Irrigation Channel (8.7%): Surface water sources such as rivers and lakes account for nearly 9% of drinking water supply. While abundant, these sources can pose contamination risks, especially in areas without adequate sanitation infrastructure.

This source is widely accessible, commonly found in public spaces. While convenient, issues such as water quality and reliability depend on the location’s infrastructure, affecting communities’ ease of access to safe drinking water. Unprotected wells, accounting for a significant 7.3%, are vulnerable to contaminants from runoff and other surface activities. Households relying on such sources may face higher health risks, particularly in densely populated or agricultural areas.  Though similar to unprotected wells in design, these wells have measures to reduce contamination risks. Their usage highlights efforts to improve water safety, though their prevalence is slightly lower than unprotected wells, Various forms of piped water (directly into the dwelling, yard, or to a neighbor) account for a combined 12.8%, signifying some urban and peri-urban areas’ access to municipal water systems. This access level, while relatively low, represents a more structured water supply where available. Other Sources (Rainwater, Tanker Truck, Bicycle with Jerrycans, Bottled Water, Sachet Water): Combined, these account for a small percentage of water supply. While minor in distribution, they serve as alternative sources in areas where standard water systems may not be available or reliable, A notable portion of the population (3.5%) is not officially recognized as permanent residents, suggesting a need for policies that address water supply for all individuals, regardless of residency status.

Findings on sex of household head

Source: Primary Data

The data shows that 66.7% of household heads are male, while 33.3% are female. This male dominance in household leadership may reflect cultural norms where men are typically seen as the primary decision-makers within households. In Northern Uganda, like many other regions, such traditional structures may influence adolescents’ access to information and resources on reproductive health, including contraceptives.

Female-headed households, constituting about one-third of the sample, could represent single mothers, widows, or other family dynamics where women are the primary providers. Female heads might have different perspectives on reproductive health and possibly be more open to discussing contraceptives with their children, especially daughters, than male-headed households. Male household heads might influence restrictive norms around discussing sexual health and contraceptive access, which could limit adolescents’ awareness or access to contraceptives. Male heads may also prioritize conservative views on adolescent sexuality, seeing contraceptive use as a taboo.

In contrast, female household heads might be more supportive of contraceptive use, potentially due to firsthand experience with the challenges of unplanned pregnancies. Female heads could be more receptive to educating adolescents on the benefits of contraception, especially in avoiding early pregnancies that may lead to socioeconomic hardships.

Findings on age of house hold head

Source: Primary Data

The findings in the study indicates that; with a sample size of 18,506 household heads, this provides a robust representation of households in Northern Uganda. A large sample size strengthens the reliability of any statistical analyses conducted and helps ensure that findings are generalizable within this population. The age of household heads in this dataset ranges from 15 to 98 years. This wide age range suggests that household heads in the sample come from diverse age groups, which could impact attitudes, knowledge, and practices related to adolescent contraceptive use. Younger household heads may relate more to adolescent needs and challenges, while older household heads may have different perspectives based on traditional views. The mean age of approximately 41 years suggests that most household heads are relatively young to middle-aged. This is relevant because attitudes toward contraceptive use among adolescents may vary based on the age of the household head. Younger household heads may be more open to contraceptive use among adolescents, while older ones might adhere to traditional norms or be less informed about modern contraceptive practices. This indicates a moderate variation in the age of household heads. A higher standard deviation might suggest a wide range of perspectives regarding adolescent contraceptive use, while a lower standard deviation would imply a more homogenous group, which could affect how they influence adolescent decisions about contraception.

Findings on if the youths shared toilet facilities

Source: Primary Data

The majority of respondents indicated they did not share toilet facilities, representing 54% of all responses and 58.2% among valid responses. This finding suggests a large portion of youth may have access to private or exclusive-use sanitation facilities, which can have positive implications for privacy and hygiene, a significant portion of youth reported sharing toilet facilities. This group accounts for 35.2% of all responses and 38% of the valid responses. Shared toilet facilities, often found in densely populated or low-income areas, can present hygiene challenges due to increased usage and lower cleanliness levels. This data indicates that many young people still rely on communal sanitation facilities, which might indicate a need for improved sanitation infrastructure in certain areas.

Findings on if the youth has been forced to have sex by anyone other than husband/partner in last 12 months

Source: Primary Data

The findings suggest that the reported occurrence of forced sex outside marital or partnership contexts among the youth is low within this dataset. However, it is essential to consider the implications of the high proportion (97.5%) of non-responses or missing data. This large percentage may indicate various factors, including reluctance to disclose sensitive information, fear of stigma, or limitations in the data collection methodology, While the available responses show that 2.3% of the respondents have not faced this experience, and 0.2% have, the overwhelming system-coded responses underscore the difficulty in assessing the full extent of forced sexual experiences among youth.

Ever forced to perform sexual acts

Source: Primary Data

The findings indicated that 5% of the respondents indicated that they had been forced to perform unwanted sexual acts, while 94.1% indicated that they have not been forced.

Findings on the location of source for water

Source: Primary Data

The dataset suggests that most individuals obtain water from sources located outside of their immediate dwelling or yard, which could reflect infrastructural challenges, economic conditions, or the structure of water provision services in the area. The data highlights a critical dependence on community-based or external water sources, with potential impacts on daily life and public health. Reducing reliance on distant sources and increasing access to water within or near the home could be beneficial goals for improving living conditions.

Findings on the respondents in civil marriage

Source: Primary Data

An overwhelming 18,418 respondents (99.5%) indicated that they were not in civil marriages. This significant majority suggests that civil marriage may not be the predominant form of marriage or formal partnership among the respondents in this particular population. Only 88 respondents (0.5%) reported being in civil marriages. This could imply a small segment of the population sees specific benefits to civil marriage, such as legal protections or property rights, but the limited uptake suggests these benefits are either underutilized or undervalued by the larger community.

Findings the respondents who have been married by customary

Source: Primary Data

With only a quarter of the respondents (25.7%) married by customary means, it suggests that customary marriages are less common than other forms of marriage (e.g., civil or religious marriages) within this sample. This could reflect broader social trends, cultural shifts, or legal preferences among the population surveyed. Customary marriages often involve traditional or cultural practices that may vary significantly by region, ethnicity, or religious affiliation. The lower frequency of customary marriages may indicate a preference for civil or religious marriages, possibly due to modernization, urbanization, or legal considerations in certain communities.

Findings on if the respondents had religious marriage

Source: primary data

The majority of respondents, 92.5% (17,125 individuals), reported not having a religious marriage. This suggests that non-religious marriages are significantly more common in the sample population. The high frequency of non-religious marriages may reflect cultural, legal, or personal preferences that influence marriage choices in this group. Additionally, this trend could indicate shifting attitudes towards marriage ceremonies or the importance of religious elements in formalizing unions only 7.5% (1,381 respondents) indicated that they had a religious marriage. This smaller proportion suggests that religious ceremonies are relatively rare among the sampled population. Factors such as religious affiliation, social norms, or economic conditions could be influencing the lower prevalence of religious marriages. The low percentage might also suggest that religious institutions play a less central role in the formalization of marriages within this group or that civil or customary marriages are preferred alternatives, the data shows a clear preference for non-religious marriages, possibly highlighting evolving perspectives on marriage practices within the population. Further qualitative research could provide deeper insights into the motivations and perceptions behind these choices.

Findings if the respondents have experienced fistula

Source: Primary Data

The data gathered indicates that a substantial majority of respondents, specifically 98.7%, reported they had not experienced fistula, while only 1.3% indicated they had experienced it. This distribution reflects that fistula, though present, is a relatively rare experience among the surveyed population, In many communities, increased access to skilled birth attendants, maternal healthcare facilities, and antenatal care services has likely played a role in reducing the risk of obstetric complications like fistula.

Public Health Initiatives: Health campaigns that focus on raising awareness of maternal health and on preventing obstetric complications could be contributing to lower prevalence rates. Educating women on early warning signs of pregnancy complications may also help reduce cases. Fistula occurrence often correlates with socioeconomic factors, particularly in regions with limited access to healthcare and high rates of poverty. The fact that only a small percentage of respondents reported having experienced fistula could suggest that many respondents had access to necessary healthcare services or lived in areas where obstetric care was more accessible.

However, the 1.3% who reported experiencing fistula still represent a significant public health concern. Even with low prevalence rates, fistula has severe impacts on affected individuals, including social stigma, physical health complications, and mental health issues. The data suggests that public health programs should continue to address and improve maternal healthcare services, particularly in high-risk areas, to further reduce the incidence of fistula and provide support for those affected.

Findings if the respondents has ever been circumcised

Source: Primary Data

Out of the 18,506 total respondents, 10,247 answered the question on circumcision status, while 8,259 did not (represented as “System” data). Among those who answered, 10,155 respondents (54.9% of the total sample) stated that they had not been circumcised, while 92 respondents (0.5% of the total) reported being circumcised.

Findings on if the respondents are aware of health insurance

Source: Primary Data

The findings reveal a significant disparity in the awareness of health insurance among respondents. Of the 18,506 respondents surveyed, a substantial 77.7% (14,382 individuals) indicated that they were not aware of health insurance. In contrast, only 22.3% (4,124 individuals) reported awareness of health insurance. This high rate of unawareness suggests potential barriers to information dissemination or understanding regarding health insurance within the population. Several factors could contribute to this gap, Awareness of health insurance often correlates with educational attainment. Populations with limited access to formal education may lack exposure to complex concepts like health insurance, which could explain the low awareness levels in some demographics. Individuals in lower-income brackets might have less exposure to health insurance options or perceive it as inaccessible or unaffordable, contributing to low awareness.

4.2 Bivariate analysis

• To examine the demographic factors associated with contraceptive use among adolescents in Northern Uganda.

Correlation analysis between education attainment and contraceptive use and intention

Source: Primary Data

In this study, the Pearson correlation analysis reveals an inverse relationship between educational attainment and contraceptive use and intention, with a correlation coefficient of -0.125. This statistically significant correlation (p < 0.01) suggests a mild but meaningful trend: as educational attainment increases, the likelihood of contraceptive use and intention decreases slightly within the sample of 18,506 individuals. The negative correlation (-0.125) between educational attainment and contraceptive use and intention could imply that individuals with higher levels of education may be less inclined toward contraceptive use or intentions. This might seem counterintuitive since higher education often correlates with greater health awareness. However, in certain contexts, highly educated individuals may have greater access to comprehensive family planning information, leading them to make different choices about contraception based on long-term goals or family planning preferences.

Implications of the Significant Negative Correlation The statistically significant correlation at the 0.01 level indicates that, although small, the relationship is consistent enough to merit attention. Factors underlying this association could include varying societal, cultural, and personal values related to family planning and education. Additionally, education may indirectly influence contraceptive choices through improved economic opportunities, delayed marriage, or enhanced knowledge about alternative family planning options.

The inverse relationship observed may reflect broader socio-economic and cultural factors unique to the population studied, which includes 18,506 individuals. Cultural or religious norms that may discourage contraceptive use might also intersect with education, shaping contraceptive intentions differently than in other populations. It’s also essential to consider potential confounding factors not captured in this analysis, such as marital status, income level, or access to healthcare services.

Correlation analysis between religion and contraceptive use

Source: Primary Data

The correlation coefficient of 0.013 indicates that changes in contraceptive use and intention are not strongly associated with changes in religious affiliation. In practical terms, this means that the degree of religious commitment or the particular religion a person identifies with has minimal predictive power regarding their contraceptive practices or intentions.

The p-value of 0.068 suggests that while there is a relationship, it does not reach conventional levels of statistical significance. This therefore indicates that it is an indicative of a trend, but not one robust enough to assert a definitive relationship. The results might suggest that factors other than religion are more influential in shaping contraceptive use and intention.

Given the weak correlation, it appears that religious beliefs may not be a strong determinant in contraceptive use and intentions. This could imply that other socio-economic, educational, or cultural factors play a more significant role in influencing individuals’ decisions regarding contraceptives.

Findings on the relationship between contraceptive use and intention and sex of the house hold head

The correlation coefficient between contraceptive use and intention and the sex of the household head is 0.099. This indicates a positive relationship, albeit a weak one, suggesting that as one variable increases, the other tends to increase as well. The significance level (p-value) associated with this correlation is 0.000, which is less than the conventional alpha level of 0.01. This indicates that the correlation is statistically significant, meaning there is a very low probability that this correlation is due to random chance. The correlation of 0.099 suggests that there is a slight tendency for households headed by males or females to show higher or lower contraceptive use and intention. However, the weak nature of the correlation indicates that other factors likely play a more significant role in determining contraceptive use and intention. Understanding the relationship between the sex of the household head and contraceptive use and intention can have important implications for public health initiatives. For instance, programs that aim to increase contraceptive use may need to consider the dynamics of household leadership, as the head of the household may influence decision-making regarding family planning.

Findings on the age of respondent at 1st birth and contraceptive use and intention

A correlation coefficient of 0.046 indicates that while there is a statistically significant relationship, it is weak. This suggests that contraceptive use and intention are only slightly related to the age at which respondents have their first child. This may imply that factors influencing contraceptive use and intention do not strongly depend on when individuals have their first child. Given the weak correlation, it is essential to explore other factors that might influence both contraceptive use and the age of first birth. These could include education, socio-economic status, cultural norms, access to healthcare, and personal beliefs about family planning. Programs aimed at increasing contraceptive use may need to address these factors more comprehensively.

The weak correlation points to the need for further research to understand the underlying reasons for this relationship. It may also be beneficial to explore other demographic variables (e.g., education level, marital status, income) that might have a stronger impact on both contraceptive use and age at first birth. In conclusion, while there is a statistically significant but weak correlation between contraceptive use and intention and the age of respondents at their first birth, the practical implications of this relationship are limited. Additional qualitative and quantitative research could help elucidate the factors that more substantially impact contraceptive behaviors and reproductive timing. This understanding could lead to more effective interventions aimed at improving reproductive health outcomes.

Findings on the correlation between contraceptive use and intention and education in single years

The correlation coefficient (r = -0.136) suggests a weak negative relationship between the two variables: contraceptive use and education (measured in single years). This means that as education increases, contraceptive use tends to decrease, although the relationship is not very strong. The significance level (p < 0.01) indicates that the correlation is statistically significant. This means that the likelihood of this correlation occurring by chance is very low, suggesting that there is likely a genuine relationship between education and contraceptive use, A negative correlation between education and contraceptive use could imply that individuals with higher education levels may have lower rates of contraceptive use. This could seem counterintuitive, as higher education is often associated with increased awareness of reproductive health and access to contraceptive methods, further research is warranted to explore the underlying causes of this relationship. Qualitative studies could provide deeper insights into the attitudes and beliefs about contraception among different educational groups, the statistically significant negative correlation between contraceptive use and education in single years highlights the need for a nuanced understanding of how education influences reproductive health behaviors. It underscores the importance of culturally sensitive education and targeted public health strategies to promote informed contraceptive use, particularly among populations with varying educational levels.

Findings on the contraceptive use and intention and place of delivery

Source: Primary Data

The correlation coefficient between contraceptive use and intention and the place of delivery is -0.004. The significance level (p-value) is 0.692, which is well above the common alpha level of 0.05. This suggests that the correlation is not statistically significant. In practical terms, it indicates that there is no meaningful relationship between contraceptive use/intention and the place of delivery in this dataset. A Pearson correlation of -0.004 suggests that as contraceptive use and intention increase, there is a negligible decrease in the likelihood of choosing a certain place of delivery (or vice versa). However, given the correlation is very close to zero, it implies that this relationship is virtually non-existent.

Findings on the relationship between civil marriage on contraceptive use and intention

The Pearson correlation coefficient between contraceptive use/intention and the type of marriage (civil) is -0.018. This value indicates a very weak negative correlation.

The negative sign suggests that as one variable increases, the other tends to decrease slightly; however, the correlation is so weak that it may not hold practical significance. The significance level (p-value) is reported as 0.016. Since this value is less than the standard alpha level of 0.05, we can conclude that the correlation is statistically significant. This means there is evidence to suggest a relationship exists between the two variables, although the strength of this relationship is weak.

Finding on the relationship between customary marriage on contraceptive use and intention

Customary marriages are often rooted in traditional practices and beliefs, which may influence attitudes towards family planning and contraceptive use. In many cultures where customary marriages prevail, there may be a greater emphasis on larger family sizes or traditional roles that prioritize childbearing over the use of contraceptives.  The negative correlation might reflect issues related to access to contraceptive methods or a lack of education about family planning within communities that predominantly practice customary marriages. If individuals in these settings have limited access to information about contraceptive options or face barriers to accessing these methods, it could contribute to the observed relationship, while there is a correlation between the type of marriage and contraceptive use/intention, it’s important to note that correlation does not imply causation. The intention to use contraceptives may exist among individuals in customary marriages, but various factors—including partner influence, community norms, and socio-economic conditions—can affect actual usage. These findings highlight the need for tailored family planning programs that consider the cultural context of customary marriages. Community-based interventions that engage local leaders and address traditional beliefs about family size and contraceptive use may enhance the effectiveness of family planning initiatives.

Finding on the relationship between contraceptive use and intention and type of marriage: religious

The value of -0.070 indicates a weak negative correlation between contraceptive use and intention and the type of marriage (religious). This means that as one variable increases, the other tends to decrease slightly, but the relationship is not strong.

The p-value associated with the correlation is 0.000, which is less than the conventional alpha level of 0.01. This indicates that the correlation is statistically significant. Therefore, we can confidently say that there is a relationship between the two variables, even though the strength of this relationship is weak. The negative sign of the correlation suggests that higher levels of contraceptive use and intention may be associated with lower levels of religious marriage type, or vice versa. This could imply that individuals in more religious marriage settings may be less likely to use contraception or have intentions to use it. This finding can be explored within the framework of cultural and religious beliefs about contraception. Many religious groups advocate against contraceptive use, viewing it as contrary to their values. As such, individuals in these marriages might prioritize religious teachings over personal or practical considerations related to contraceptive use.

Findings if the respondent ever been circumcised correlates with contraceptive use and intention

A Pearson correlation of .056 indicates a very weak positive relationship between circumcision status and contraceptive use and intention. While the correlation is statistically significant (p = .000), the effect size is minimal, meaning that circumcision status has only a slight association with contraceptive use and intention. The p-value is below the 0.01 threshold, indicating that this result is unlikely to be due to chance alone. Thus, there is sufficient evidence to conclude a weak association between circumcision and contraceptive use and intention, while circumcision status appears to be slightly associated with contraceptive behavior or intention, the strength of this relationship is very weak. This finding may suggest that other factors beyond circumcision status play a more prominent role in influencing contraceptive behaviors and intentions, such as cultural beliefs, education level, socioeconomic status, or access to healthcare.

Finding on the relationship between number of sex partners, excluding spouse, in last 12 months and contraceptive use and intention

Source: Primary Data

The negative correlation (-0.036) suggests a very slight inverse relationship between contraceptive use intention and the number of non-spousal sexual partners. While statistically significant due to the large sample size, the correlation’s low absolute value indicates a weak association. In practical terms, this result suggests that individuals reporting a higher number of non-spousal sexual partners in the past year are very slightly less likely to express intention or use contraceptives, but this trend is minimal. The statistical significance at the 0.01 level implies that the observed relationship is unlikely to be due to random chance alone. However, given the extremely weak correlation, the practical significance of this relationship may be limited. This suggests that while contraceptive use and sexual partner count are connected at a statistical level, they do not strongly predict each other in real-world contexts.

• To assess the socio-economic factors associated with contraceptives among adolescents in Acholi sub-region, Northern Uganda.
• To understand the association between enabling factors and contraceptive use among adolescents in Northern Uganda.

4.3 Multivariate analysis

Analysis of variables between contraceptive use and intervention on demographic factors

The output table provided is from an ANOVA (Analysis of Variance) test in a regression model, where the dependent variable is “contraceptive use and intention.” The independent variables (predictors) are the sex of the household head, religion, highest year of education, age in 5-year groups, and highest educational level. This value represents the sum of squares due to the regression, which indicates the portion of the total variability in contraceptive use and intention explained by the predictor variables. This is the sum of squares for the residual or error, representing the unexplained variability in contraceptive use and intention. This is the total sum of squares, representing the overall variability in the dependent variable. It’s the sum of the Regression and Residual sums of squares. The degrees of freedom for the regression is 5, corresponding to the five predictor variables. The degrees of freedom for the residual indicates the sample size minus the number of predictors minus one (total sample size – predictors – 1). The total degrees of freedom is equal to the total sample size minus 1.

This is calculated by dividing the regression sum of squares by its degrees of freedom (702.008 / 5). Calculated as the residual sum of squares divided by its degrees of freedom (20374.024 / 16429). The F-statistic tests the overall significance of the model, comparing the explained variance to the unexplained variance. The F-value here (113.216) is relatively high, which suggests that the model explains a significant amount of variance in contraceptive use and intention relative to the error. The p-value is less than 0.001, indicating strong evidence that the model as a whole is statistically significant. Therefore, we reject the null hypothesis that none of the predictors explain the variability in contraceptive use and intention. This means that at least one of the predictor variables contributes significantly to explaining the variability in the dependent variable. The ANOVA table indicates that the model significantly explains variability in contraceptive use and intention, with the predictors collectively contributing to the model’s explanatory power. The high F-statistic and the extremely low p-value suggest that these variables, such as sex of the household head, religion, age, and education, have a meaningful impact on the outcome variable. Further analysis could delve into the individual contributions of each predictor to understand their specific effects.

Coefficients of variables of the relationship between contraceptive use and intervention on demographic factors

The intercept B=3.108B = 3.108B=3.108 represents the predicted value of contraceptive use and intention when all predictor variables are zero. This high t-value (62.283) and a significant p-value (.000) indicate the intercept is significantly different from zero. This coefficient suggests that for each additional 5-year increase in age, contraceptive use and intention decrease by 0.075 units on the original scale, assuming other variables remain constant. This value indicates a moderate negative impact on contraceptive use and intention relative to other predictors, with a significant impact (p = .000). Age has a significant negative association with contraceptive use and intention. Each unit increase in educational level correlates with a 0.241-unit decrease in contraceptive use and intention, assuming other variables are held constant. This moderate negative beta suggests that higher educational levels are linked with a decrease in contraceptive use and intention, with strong statistical significance (p = .000). Higher educational attainment is associated with decreased contraceptive use and intention. Each additional year of education corresponds to a decrease of 0.052 units in contraceptive use and intention. This small but significant standardized coefficient (p = .000) implies a slight negative impact of education years on contraceptive use. Each additional year of education slightly reduces contraceptive use and intention. Religion has a near-zero coefficient, suggesting almost no effect on contraceptive use and intention, with a very small and non-significant effect (p = .285), religion does not appear to have a meaningful association with contraceptive use and intention.

CHAPTER FIVE: SUMMARY, RECOMMENDATIONS AND CONCLUSION

5.0 Introduction

This chapter presents a summary of the findings, conclusions, and recommendations based on the study objectives which included; to examine the socio-demographic factors associated with contraceptive use among adolescents in Acholi sub-region, Northern Uganda, to assess the socio-economic factors associated with contraceptives among adolescents in Acholi sub-region, Northern Uganda and to understand the association between enabling factors and contraceptive use among adolescents in Acholi region, Northern Uganda.

5.1 Summary of Findings

5.2 Conclusions

5.3 Recommendations

Based on the findings regarding the association between socio-demographic and socio-economic factors and contraceptive use among adolescents in Northern Uganda, the following recommendations are proposed:

Enhance Education and Awareness: Implement comprehensive sex education programs in schools and communities that address reproductive health, contraceptive options, and responsible sexual behavior. Tailor these programs to the specific needs and cultural contexts of adolescents.

Improve Access to Contraceptive Services: Increase the availability of youth-friendly health services that provide confidential and affordable contraceptive options. Ensure that these services are accessible in both urban and rural areas.

Community Engagement and Advocacy: Engage community leaders and stakeholders in advocacy efforts to shift cultural attitudes toward contraception. Promote open discussions about reproductive health in community forums to reduce stigma and increase acceptance.

Strengthen Economic Support Programs: Develop and implement socio-economic programs aimed at improving the financial stability of families. Programs that provide vocational training or financial literacy can empower adolescents to make informed choices about their reproductive health.

Parental and Guardian Involvement: Encourage initiatives that promote communication between adolescents and their parents or guardians about sexual health. Workshops or information sessions can equip parents with the knowledge to discuss these topics with their children effectively.

By addressing these recommendations, stakeholders can create a supportive framework that enhances contraceptive use among adolescents in Northern Uganda, ultimately contributing to improved reproductive health outcomes and empowerment for young people in the region.

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APPENDIX I: QUESTIONNAIRE

Topic:

FACTORS ASSOCIATED WITH CONTRACEPTIVE USE AMONG SEXUALLY ACTIVE ADOLESCENTS IN ACHOLI REGION, NORTHERN UGANDA.

Instructions

Do not put your name on this questionnaire.

Tick the correct answer provided OR fill in the space provided.

Thank you.

Section A: Demographic Characteristics 

1. Sex
2. Male
3. Female
4. What is your age bracket in years?
5. 16-24
6. 25-36
7. Any other (specify) …………………
8. Religion
9. Protestant
10. Catholic
11. Muslim
12. Any other (specify) …………………
13. Highest education level
14. Certificate
15. Diploma
16. Bachelor’s degree
17. Any other (specify) …………………
18. What is your Marital Status?
19. Single
20. Married

Section B: Social Demographic Factors Affecting Contraceptive Use   

When did you first here about contraceptive?

1. 1 month back
2. 6 months back
3. One year back
4. Can’t remember

From the first day you heard about contraceptive, what was the source?

1. Friend
2. Social media
3. Health facility
4. Radio

To what extent do your peers influence your intention to use the contraceptives?

1. Low extent
2. Moderate extent
3. High extent

Kindly comment on the price of the contraceptive that you have ever used.

1. Affordable
2. Very expensive

Do you think the price of contraceptives would influence your intention to utile them?

1. Yes
2. No

Kindly comment on the distance from your home up to the heath facility?

1. Half a kilometre
2. 1-5 kilometres
3. 5 +kilometres

Do you think the distance between your home and the health facility determine your utilisation of the contraceptives?

1. Yes
2. No

Section C: Level of contraceptive use

Have you ever used contraceptives before?

1. Yes
2. No

Are you familiar with different types of birth control methods?

1. Yes
2. No

Have you ever used contraception to prevent pregnancy?

1. Yes
2. No

Are you currently using any form of contraception?”

1. Yes
2. No

If yes, which type of contraceptive?

1. Daily or monthly Pill
2. IUD
3. Contraceptive Injection
4. Contraceptive Implant
5. Condoms

THE END

THANK YOU FOR YOUR COOPERATION