Factors Influencing Contraceptive Use among Adolescent Girls Aged 14-19 Years in Homa Bay County, Kenya

Abstract

Adolescents are individuals aged between 10-19 years. This phase is characterized by rapid growth, sexual maturation, and sexual exploration. These behaviors expose sexually active adolescent girls to a greater risk of unintended pregnancies, unsafe abortion, and sexually transmitted infections. This study aimed to assess the factors influencing contraceptive use among adolescent ‘girls in Homa bay county in Kenya with specific objectives assessing the level of awareness, and uptake as well as evaluating the factors affecting the contraceptive services offered to adolescent girls in Homabay County, Kenya.A cross-sectional survey was used to randomly select 385 girls and 32 health facilities in Homabay County, with a response rate of 100%. Data was collected using a semi-structured questionnaire, data entry was done using an excel sheet, and data was analyzed using SPSS 2017. Pearson chi-square and logistic regression were used to test how the main objectives relate to each other. The level of knowledge on contraceptives was 97.6% (P=0.010). The major sources of knowledge on contraceptives were teachers in schools (30%), peers (17.2%), and media. The study further revealed a reduction of knowledge among adolescents on available sexual and reproductive health policies (39.6%). The majority, 70% of the respondents, were in a heterosexual relationship, of which 58.6% preferred male condom use as their contraceptive method, while pills were the least at 0.6%.The majority (57.9%) of the girls did not practice safe sex, exposing them to a greater risk of sexually transmitted infections and unintended pregnancies. The level of contraceptive utilization varied significantly from one sub-county to the other (p < 0.005), with the sub-counties in the Lake Victoria Islands, such as Suba having up to 80% lesser chance of the girls using any form of contraceptives (OR = 0.2; CI: 0.2–0.8). The main barriers were the fear of side effects (51.8%) and self-stigmatization (13.4 %). Healthcare facilities were the primary source of contraceptives (77.1%), although the study noted a lack of youth-friendly services that would favor increased access. The cultural perception of the use of contraceptives among adolescent girls, misinformation, and poor youth-friendly services in health facilities are key drivers to the low uptake of contraceptive services by adolescent girls in Homabay County. Adolescent girls from the island stand a greater risk of non-utilization of contraceptives compared to the girls living on the mainland part of the county. There is a need to enhance the quality of youth-friendly comprehensive sexual health education services in all health facilities, emphasizing risk reduction interventions and sensitization of adolescent girls on the available policies. Mechanisms should be available, specifically to reach the adolescent populations living on the islands