Prevalence and factors associated with modern contraceptive use among female adolescents aged 15-19 years in Kenya

Abstract

Adolescent sexual and reproductive health (ASRH) contributes to the global burden of sexual ill health, with unmet needs persisting worldwide. Kenya's government reaffirms its commitment to increasing the contraceptive prevalence among adolescents aged 15-19 to 55% by 2025 from the current 10%. Only 43.8% of married and 36.9% of sexually active unmarried adolescents (15-19) used any method of contraception as of 2022 in Kenya. The objectives were; to determine the demographic and social characteristics (Age, education, marital status, parity, economic status), and prevalence of modern contraceptive use among female adolescents and to identify associated factors. The study utilized secondary data from Kenya's 2021 Performance Monitoring for Action (PMA) survey. The data extraction process focused on identifying and filtering female adolescents aged 15-19 who met specific inclusion criteria: sexually active, married or unmarried, and present during the survey period. After applying these criteria, the final weighted sample consisted of 344 respondents. Descriptive analyses were conducted to calculate the mean values and proportions for the relevant variables. Bivariate analysis was carried out to determine the association between outcome (modern contraceptive use) and exposure variables. All variables with a p-value>0.2 at the bivariate level were subjected to a multivariable binary logistic regression model. Stepwise backward elimination unconditional logistic regression was used to develop the final model. All variables with p-values >0.05 at a multivariable level were regarded as independently associated with modern contraceptives. According to the results of the 344 sexually active girls, 169 were using modern contraceptives, giving a prevalence of 49.1% (95% CI: 43.8- 54.4). The mean age was 17.8 years (SD+/-1.7), with the age group 18-19 years contributing 64.8% of the respondents, with a prevalence of 57.4%. Those who reported being married or staying with a partner as if married had 46.3% using modern contraceptives, while those with secondary and higher education had 51.9% using modern contraceptives. The odds of modern contraceptive use were 2.0 times higher among those adolescents aged 18-19 years (AOR 2.0, 95% CI, 1.21-3.45, p<0.005) compared to adolescents aged 15- 17 years. Those who reported having one child had 2.2 odds of using modern contraceptives compared to those who had never had a child before (AOR 2.2, 95% CI, 1.17-4.24, p<0.05). Other factors that were independently associated with modern contraceptive use include household wealth quantiles (AOR 4.9 CI 95%, 2.08-11.29, p<0.05) and the perception that the community’s view a few adolescents using modern contraceptives were promiscuous (AOR 0.4. 95% CI, 0.2-0.78, p<0.05). In conclusion Age, education, and economic resources have a positive impact on modern contraceptive use, while community perceptions have a negative influence. These factors are key in shaping the contraceptive behavior of adolescents in Kenya. Recommending this a targeted comprehensive approach encompassing education on sexual reproductive health, awareness-raising, and community engagement is paramount in empowering adolescents to make informed decisions about their reproductive health