Adherence to modern contraceptives among female refugee adolescents in northern Uganda: A prospective single cohort study
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Date
2022
Journal Title
Journal ISSN
Volume Title
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A prospective single cohort study
Abstract
Background: Contraceptive adherence is the current and consistent use of a contraceptive method as prescribed by a health worker or family planning provider so as to prevent pregnancy. Globally, adherence is lowest among adolescents. This has greatly contributed to the high burden of adolescent pregnancies. Adherence and reasons for discontinuation among refugee adolescents are poorly understood. The aim of this study was to determine the rates and predictors of adherence to modern contraceptives among female refugee adolescents in northern Uganda. Methods: A prospective single cohort study, nested into a randomised controlled trial (RCT) assessing the effect of peer counselling on acceptance of modern contraceptives. The RCT was conducted among female refugee adolescents in Palabek refugee settlement, northern Uganda. The study involved 272 new
starters of modern contraceptives who were followed up for six months from May 2019 to January 2020. The outcome was measured at one, three and six months after receiving a contraceptive method. Data was analysed using STATA version 14.0.
Results: Adherence rates were low and reduced over time. By the end of the six months, only 44% of the participants were using a contraceptive method. The commonest reasons for non-adherence were side effects and partner prohibition. Participants using long acting reversible contraceptives (LARC) were more likely to adhere compared to those who were using short acting reversible contraceptives (SARC) (OR: 3.37, 95% CI: 1.914-5.937, p=<0.001). There was no difference in adherence between participants who received peer counselling and those who received routine counselling. Conclusion: Adherence to modern contraceptives was low, leaving adolescents at risk of unintended pregnancies. Participants using LARC were more likely to adhere than those using SARC. Interventions addressing fear of side effects and partner prohibition should be studied and implemented to enable adherence to modern contraceptives
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Keywords
Contraceptive adherence, contraceptive discontinuation, adolescents
Citation
Bakesiima, R., Gemzell-Danielsson, K., Beyeza-Kashesya, J., Ayebare, E., Cleeve, A., Larsson, E. C., & Nabirye, R. C. (2022). Adherence to modern contraceptives among female refugee adolescents in northern Uganda: A prospective single cohort study.https://doi.org/10.21203/rs.3.rs-1314823/v1