Delivery and promotion strategies for optimising uptake of contraceptives among adolescents aged 15-19 years in Nsanje district, Malawi
Despite documented benefits of contraceptives, uptake among adolescents aged 20-24 years is high compared to age group 15-19 years in Malawi. As the world’s population of 15-19 year olds continues to grow the need to meet increasing demand for contraceptive services and information that address adol...
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| Format: | Thesis |
| Language: | English |
| Published: |
Kamuzu University of Health Sciences
2022
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| Online Access: | http://nkhokwe.kuhes.ac.mw/handle/20.500.12845/623 |
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Add Tag | Summary: | Despite documented benefits of contraceptives, uptake among adolescents aged 20-24 years is high compared to age group 15-19 years in Malawi. As the world’s population of 15-19 year olds continues to grow the need to meet increasing demand for contraceptive services and information that address adolescent specific needs cannot be underestimated. To inform Sexual and Reproductive health services for the youth, we explored strategies that may optimize uptake of contraceptives among this age group.
The objective of this study explored strategies for optimizing uptake of contraceptives among adolescents aged 15-19 years old. An exploratory qualitative cross-sectional study guided by Social Ecological Framework to understand strategies that may optimize uptake of contraceptives among adolescents age 15-19 years was conducted from September to October 2019 at Nsanje District Hospital and Nyamadzere Community Day Secondary School in Nsanje district, Malawi. Nsanje district was purposively selected based on the reason that it is second district in Malawi with highest rate of adolescent childbearing of girls aged 15-19 years. We conducted a Focus Group Discussion (FGD) with 9
traditional leaders, 11 Key Informant Interviews (KIIs) with health workers, 20 In-depth
Interviews (IDIs) with 12 adolescents and 4 teachers and 4 parents. All data were digitally
recorded, transcribed verbatim into English. The data was analyzed and managed using deductive thematic analysis guided by Social Ecological Framework. Individual, community and interpersonal level strategies with subcategories Physical spaces and
Promotional strategies as well as organizational level strategies were identified. Individual level strategies: Physical spaces (local drug store, peers, and community health workers), Promotional strategies (Leaflets, flyers, Short Message Service, Placards, mass media). Community and interpersonal level strategies: Physical spaces (Youth Centred Services: youth corners, clubs and centers); Community promotion strategies (Use of community leaders, Counselling and guidance in schools and homes, Information, Education and Communication, Awareness campaigns and peer education). Organizational strategies include aspects of design and service delivery, society laws and policies (resource availability, introduction of bylaws and penalties by traditional leaders, provide adolescent health services separate from adults, mandatory teaching of contraceptive topics in schools, contraceptive health education by school health nurses in schools). This study suggests that enabling environment to deliver and promote use of contraceptives among
adolescents aged 15-19 years need to have various people and places as deliverers of
contraceptives such as local private drug stores, adolescent centered units in hospitals, community health workers and peers enforced by policies such as mandatory teaching of contraceptives in schools by school health nurses and bylaws and penalties for teen pregnancy by traditional leaders. This provides a strong argument for collaboration and involvement of different people and institutions at community, organization and policy level to strengthen strategies for optimizing delivery and promotion of contraceptives among adolescents aged 15-19 years. Leveraging of available structures, resources and services that target adolescents within and out of school will accelerate uptake of contraceptives among adolescents |
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