Keywords
reproductive health
barriers
determinants
service accessibility
How to Cite
Abstract
Introduction
The low utilization of family planning services among sexually active adolescents and young women is a pressing public health issue, particularly in the Mweka Health Zone of the Democratic Republic of Congo. Understanding the factors influencing this utilization is crucial for improving access and outcomes.
Purpose
This study aims to identify the determinants associated with the use of family planning services among sexually active adolescents and young women in the Mweka Health Zone.
Methods
This cross-sectional study surveyed 422 randomly selected adolescents and young women using a prospective survey method supported by a closed-ended, self-administered questionnaire.
Results
Key findings indicate that spousal involvement (χ² = 4.175, p = 0.041), interpregnancy spacing (χ² = 16.364, p = 0.000), and health area affiliation (χ² = 12.396, p = 0.030) significantly influenced the use of family planning services. Stigmatization also negatively impacted service utilization (χ² = 5.05, p < 0.05). Additionally, the duration of walking to access services (χ² = 10.987, p = 0.01) and the alignment of contraceptive methods with expressed needs (χ² = 6.132, p < 0.05) were identified as significant factors.
Conclusion
Barriers such as limited spousal support, community stigma, inadequate knowledge, and fear of side effects significantly hinder access to family planning services among sexually active adolescents and young women in the Mweka Health Zone. Addressing these barriers is crucial to enhancing service utilization and improving reproductive health outcomes. Potential interventions include increasing community education to reduce stigma, engaging male partners through targeted awareness programs, and improving access to youth-friendly counselling. These strategies could support informed family planning choices, thereby reducing unintended pregnancies and advancing health equity among young women. Further research and policy initiatives are recommended to tailor family planning services to the needs of this demographic.
References
Akanor, P. Y., Ayanore, M. A., Anaman-Torgbor, J. A., & Tarkang, E. E. (2021). Psychosocial factors influencing contraceptive use among adolescent mothers in the Volta Region of Ghana: Application of the Health Belief Model. African Health Sciences, 21(4), 1849–1859. https://doi.org/10.4314/ahs.v21i4.43
Amoah, E. J., Hinneh, T., & Aklie, R. (2023). Determinants and prevalence of modern contraceptive use among sexually active female youth in the Berekum East Municipality, Ghana. PLOS ONE, 18(6), e0286585. https://doi.org/10.1371/journal.pone.0286585
Avocè, J., Houngnihin, R., & Adisso, L. (2024). Mise en œuvre d'initiatives d'amélioration de la qualité pour améliorer l'utilisation des services de santé adaptés aux adolescents et aux jeunes à Zou, Bénin. Glob Health Sci Pract, 12(Suppl. 2), e2200223. https://doi.org/10.9745/GHSP-D-22-00223
Bhatt, N., Bhatt, B., Neupane, B., Karki, A., Bhatta, T., Thapa, J., Basnet, L. B., & Budhathoki, S. S. (2021). Perceptions of family planning services and its key barriers among adolescents and young people in Eastern Nepal: A qualitative study. PLOS ONE, 16(5), e0252184. https://doi.org/10.1371/journal.pone.0252184
Chamdimba, E., Kabiru, C. W., Ushie, B. A., Munthali, A., Thakwalakwa, C., & Ajayi, A. I. (2023). Naïve, uninformed and sexually abused: Circumstances surrounding adolescent pregnancies in Malawi. Reproductive Health, 20(1), 114. https://doi.org/10.1186/s12978-023-01655-3
Chimatiro, C. S., Mpachika-Mfipa, F., Tshotetsi, L., & Hajison, P. L. (2022). School-going adolescent girls' preferences and views of family planning services in Phalombe district, Malawi: A descriptive, cross-sectional study. PLOS ONE, 17(5), e0267603. https://doi.org/10.1371/journal.pone.0267603
Cleland, J., Conde-Agudelo, A., Peterson, H., Ross, J., & Tsui, A. (2012). Contraception and health. The Lancet, 380(9837), 149-156. https://doi.org/10.1016/S0140-6736(12)60609-6
Dioubaté, N., Manet, H., Bangoura, C., Sidibé, S., Kouyaté, M., Kolie, D., Ayadi, A. M. E., & Delamou, A. (2021). Barriers to contraceptive use among urban adolescents and youth in Conakry, Guinea, in 2019. Frontiers in Global Women's Health, 2, 655929. https://doi.org/10.3389/fgwh.2021.655929
Donatus, L., Nicholas, T., Julius, D. S., & Obinchemti, E. T. (2023). Community perception of the determinants of unmet needs of family planning among married women in Buea Health District, Southwest Region, Cameroon. Pan African Medical Journal, 45, 58. https://doi.org/10.11604/pamj.2023.45.58.33949
Donkoh, I. E., Okyere, J., Seidu, A. A., Ahinkorah, B. O., Aboagye, R. G., & Yaya, S. (2024). Association between knowledge and use of contraceptive among women of reproductive age in sub-Saharan Africa. Health Science Reports, 7(5), e2028. https://doi.org/10.1002/hsr2.2028
Dramé, L., Kolié, D., Sidibé, S., Yombouno, J. F., & Delamou, A. (2024). Facteurs associés à l’utilisation des méthodes contraceptives chez les jeunes filles élèves en milieu rural guinéen [The factors associated with contraceptive use among young female students in rural Guinea]. Santé Publique, 35(6), 129-140. https://doi.org/10.3917/spub.236.0129
Erratum in: BMC Women's Health, 20(1), 212. https://doi.org/10.1186/s12905-020-01076-5
Ganle, J. K., Baatiema, L., Ayamah, P., Ofori, C. A. E., Ameyaw, E. K., Seidu, A. A., & Ankomah, A. (2021). Family planning for urban slums in low- and middle-income countries: A scoping review of interventions/service delivery models and their impact. International Journal for Equity in Health, 20(1), 186. https://doi.org/10.1186/s12939-021-01518-y
Hellwig, F., Saad, G. E., Wendt, A., & Barros, A. J. (2023). Women's marital status and use of family planning services across male- and female-headed households in low- and middle-income countries. Journal of Global Health, 13, 04015. https://doi.org/10.7189/jogh.13.04015
Katoka Fuanda, M. J. (2017). Déterminant de la faible utilisation des méthodes contraceptives modernes chez les femmes en âge de procréer: Cas de la zone de santé de Gombe Matadi. Mémoire de master professionnel, École de Santé Publique de l'UNIKIN, RDC [Determinants of the low use of modern contraceptive methods among women of reproductive age: Case of the Gombe Matadi health zone. Master's thesis, School of Public Health of UNIKIN, DRC] (French).
Kawuki, J., Gatasi, G., Sserwanja, Q., Mukunya, D., & Musaba, M. W. (2022). Utilisation of modern contraceptives by sexually active adolescent girls in Rwanda: A nationwide cross-sectional study. BMC Women's Health, 22(1), 369. https://doi.org/10.1186/s12905-022-01956-y
Mahouli, M.-M. M., Adje, E., Dougnon, V. T., Ahoussinou, C., Gandji, P., et al. (2023). Prévalence et facteurs explicatifs des grossesses non planifiées chez les adolescentes au Bénin [Prevalence and explanatory factors of unplanned pregnancies among adolescents in Benin] (French) HAL (halshs-04235816).
Mosuse, M. A., & Gadeyne, S. (2022). Prevalence and factors associated with unmet need for family planning among women of reproductive age (15-49) in the Democratic Republic of Congo: A multilevel mixed-effects analysis. PLOS ONE, 17(10), e0275869. https://doi.org/10.1371/journal.pone.0275869
Mpunga, D. M., Chenge, F. M., Mambu, T. N., Akilimali, P. Z., Mapatano, M. A., & Wembodinga, G. U. (2022). Determinants of the use of contraceptive methods by adolescents in the Democratic Republic of the Congo: Results of a cross-sectional survey. BMC Women’s Health, 22(1), 478. https://doi.org/10.1186/s12905-022-02084-3
Prata, N., Fraser, A., Huchko, M. J., Gipson, J. D., Withers, M., Lewis, S., Ciaraldi, E. J., & Upadhyay, U. D. (2017). Women's empowerment and family planning: A review of the literature. Journal of Biosocial Science, 49(6), 713-743. https://doi.org/10.1017/S0021932016000663
Sidibé, S., Traoré, M., & Bah, A. (2020). Fréquence des grossesses en milieu scolaire et profil des adolescentes concernées à Conakry, Guinée. Santé Publique, 32(5-6), 571-582. https://doi.org/10.3917/spub.205.0571
Utomo, B., Sucahya, P. K., Romadlona, N. A., Robertson, A. S., Aryanty, R. I., & Magnani, R. J. (2021). The impact of family planning on maternal mortality in Indonesia: What future contribution can be expected? Population Health Metrics, 19(1), 2. https://doi.org/10.1186/s12963
Yadav, K., Agarwal, M., Shukla, M., Singh, J. V., & Singh, V. K. (2020). Unmet need for family planning services among young married women (15-24 years) living in urban slums of India. BMC Women's Health, 20(1), 187. https://doi.org/10.1186/s12905-020-01010-9
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