Contraceptive use among sexually active female adolescents in Ethiopia: trends and determinants from national demographic and health surveys

Abstract

Background

Sexual and reproductive health and right of adolescents is a global priority as the reproductive choices made by them have a massive impact on their health, wellbeing, education, and economy. Teenage pregnancy is a public health issue and a demographic challenge in Ethiopia. Increasing access to contraceptive services for sexually active adolescents will prevent pregnancies and related complications. However, little is known about the trends in contraceptive use and its determinants among adolescent girls in Ethiopia. Therefore, this study was designed to examine the trends and factors associated with contraceptive use among sexually active girls aged 15–19 years in Ethiopia by using Ethiopian demographic and health survey data.

Methods

Four Ethiopian demographic and health survey data were used to examine trends of contraceptive methods use. To identify factors associated with contraceptive use, the 2016 Ethiopian demographic and health survey data were used. The data was downloaded from the demographic and health survey program database and extracted for sexually active adolescent girls. Data were weighted for analysis and analyzed using SPSS version 21. Descriptive analysis was used to describe the independent variables of the study. A multivariable logistic regression model was used to identify factors associated with contraceptive use and adjusted odds ratios with 95% confidence interval were presented for significant variables. Variables with a p-value less than 0.05 were considered as significantly associated with contraceptive use.

Results

Contraceptive method use had increased significantly from 6.9% in 2000 to 39.6% in 2016 among sexually active adolescent girls in Ethiopia. The odds of contraceptive use were lower among female adolescents who had no formal education (AOR 0.044; 95% CI 0.008–0.231) and attended primary education (AOR 0.101; 95% CI 0.024–0.414). But the odds were higher among adolescents from a wealthy background (AOR 3.662; 95% CI 1.353–9.913) and those who have visited health facilities and were informed about family planning (AOR 3.115; 95% CI 1.385–7.007).

Conclusion

There is an increment in the trend of contraceptive use among sexually active female adolescents in Ethiopia between 2000 and 2016. Significant variations in the use of modern contraception by wealth status, educational level and visited a health facility, and being informed about family planning were observed. Improving the economic and educational status of young women, and provision of information may help in improving contraceptive use in Ethiopia.

Plain English summary

Adolescent contributes up to 16 per cent of the world’s population. Sexual and reproductive health and right of these populations is a global priority. Teenage pregnancy is a public health issue and a demographic challenge in Ethiopia. A contraceptive method is best for sexually active adolescents to prevent pregnancies and its related complications.

Data for this study are from the four Ethiopian Demographic and Health Surveys [EDHS] conducted in 2000, 2005, 2011, and 2016. Data for sexually active adolescent girls were extracted from the data set.

The trend of contraceptive use among adolescents is increasing from time to time. However, more than three-fifth of the sexually active female adolescents are still not using any type of contraception. There were significant variations in the use of modern contraception by background characteristics of the respondents. In all four rounds of the EDHS, modern contraceptive use was common among adolescents in 18–19 years, who attended secondary and above educational level, lived in urban areas, and was from wealthy family groups.