dc.description.abstract | Use of contraceptives is one of the pillars of preventing unintended pregnancies
amongst adolescent girls globally. The risk of mistimed and unwanted pregnancy is high
among adolescents as compared to older women. Adolescent pregnancy is identified as one of
the reasons for unsafe abortions, mother and child morbidity as well as mortality and even girls
dropping out of school. Regardless, effective contraceptive use among adolescents in low and
middle income countries remains low and poorly documented. The study assessed the adoption
of contraceptives and unintended pregnancies amongst adolescent girls in Nyando Sub-county.
The study objectives were: to establish how socio-demographic factors influence adoption of
contraceptives amongst adolescent girls; to determine how contraceptive methods applied
prevent unintended pregnancies amongst adolescent girls; to investigate how culture influences
adoption of contraceptives amongst adolescent girls; and to determine how access to
contraceptives influences adoption of contraceptives amongst adolescent girls in Nyando sub-
County. The Health Belief Model (HBM) was applied to understand adolescent contraceptive
use. A cross-sectional design and assisted questionnaires were used to collect data. The study
targeted adolescent girls (10-19 years) visiting maternal health and child welfare clinics within
Nyando Sub-County. Cluster sampling was used where two out of the five wards within
Nyando Sub-County were randomly selected to act as the main cluster. All health facilities
offering reproductive health services were considered as the next set of clusters where all
eligible participants were nominated and consented until 400 respondents were attained. The
data was analyzed using excel and IBM SPSS version 20 program and presented in the form
of frequency tables, with mean, median and standard deviation and p-values indicated as
applicable. All ethical considerations were observed throughout the conduct of the study, with
the study being reviewed and approved by the institutional ethics review committee of
Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH IERC) and the National
Commission for Science, Technology and Innovation (NACOSTI). From the study findings,
the mean age of respondents was 16 years. From the study findings, a majority (86.3%) of the
respondents were already sexually active by age 15. Only 17% of the respondents were
married, with all respondents having attained some basic education. The study found out that
the majority of adolescent girls got information about contraceptives through their friends. The
majority of adolescents also started using any form of contraceptive either after sexual debut
or delivery or following an abortion. The study area is predominantly Christian, and this did
not have a negative influence on adoption of contraceptives by adolescents. Despite the
acknowledged availability of contraceptive methods, and reported use by the majority of
respondents upon sexual debut, the majority of respondents had either visited the health facility
for antenatal care or child welfare clinic, meaning the contraceptive methods applied (majorly
male condoms) did not effectively prevent occurrence of unintended pregnancies in the subcounty.
Myths and fear of side effects, real or perceived, were reported to negatively influence
adoption of contraceptive use by adolescents. Lack of knowledge about how contraceptives
work was also documented as a key challenge to adoption of contraceptives amongst
adolescents. The study recommends that social relationships should be tapped and players
empowered in order to share accurate contraceptive information. This is informed by the fact
that the majority of respondents were influenced and introduced to contraceptives by friends
and mothers, yet at the same time parental disapproval was cited as an impediment to adoption
of contraceptives. Evaluating the role of social media is also recommended. | en_US |