Perceptions and Barriers to Contraceptive Use Among Adolescents: a Case Study of Nairobi
Abstract
Contraceptive use among teenagers is low worldwide and in the Kenyan context, little is known
about factors that underlie the low use of contraceptives among adolescents aged 15-19 years.
Similarly, little is known and documented about the perceptions of the adolescents regarding
access and use of contraceptives. To. develop more responsive interventions, it is important to.
understand adolescents' perceptions and the barriers that contribute to. low contraceptive use
among young people. In Kenya, the focus of the studies has been on whether adolescents are
sexually active, information and knowledge of contraceptives, assessment of clinic based family
planning services and contraceptive use among high school students. Most studies have been
conducted using secondary data without linking information from the adolescents with that of
their parents and their teachers; this limits the level of exploring the perceptions. The goal of this
study was to. identify perceptions and barriers that affect contraceptive use among female and
male adolescents in Nairobi, Kenya, to. guide policy and programmes. This was achieved using
several metho.ds of data collection: adolescents' respondent interviews, focus group discussions
and in-depth interviews with parents of adolescents and teachers of schools attended by those
adolescents, The study used a household systematic random sampling design using Kenya
Demographic and Health Survey enumeration clusters of 2009 and projections from the 1999
population census for adolescents aged 15-19 years in 8 administrative divisions in Nairobi.
The statistical metho.ds used were bivariate and logistic regression analysis. The bivariate
analyses show that socio-cultural, socio-demographic, knowledge, perception and barrier factors
are associated with contraceptive use. However, socio-economic factors, free services and
privacy of services at the clinic were found to. have a weak association with contraceptive use.
Among socio-demographic factors, contraceptive use increased by age while more males used
contraceptives. More ever married ad0'1espents used contraceptives, Significant socio-cultural
factors were living arrangement and ~mo.re adolescents living with their spouses used
contraceptives, More adolescents not attending school and adolescents living in Dagoretti
Division used contraceptives. Contraceptive use increased with the level of knowledge of
pregnancy prevention methods, knowledge qf how to. use contraceptives and knowledge of how
a contraceptive method works in the prevention of pregnancy and HIV/AIDS. However,
knowledge of the risks of unprotected sex was not consistent with use and adolescents with
moderate and low knowledge used contraceptives more than those with high knowledge,
Results of the multivariate regression analyses showed that perception and barriers modify
background factors on contraceptive use. The effects of background factors on contraceptive use
diminished when perceptions and barriers were introduced into. one model, The test of
significance of the overall regression model showed that, partner communication had the
strongest significant effect on contraceptive use. Other significant factors in the model were:
knowledge of how to. use contraceptives, opinion of adolescents to. use contraceptives, ability to.
get contraceptives for self if adolescents wanted to, marital status and school attendance. Results
of regression analysis showed that barriers were no.t significant in the influence of contraceptive
use among adolescents. The study supported the hypothesis that sexual partner communication is
associated with contraceptive "use among adolescents, The study also. proved that knowledge of
how to. use a contraceptive method and marital status are associated with higher levels of
contraceptive use.
Citation
PhDPublisher
University of Nairobi