Association between Contraceptive Awareness and Use, and Teenage Pregnancy among Prime Gravidas Delivering at Mbarara Hospital Regional Referral, Uganda

Abstract

Introduction: The promotion of family planning, so that women can avoid unwanted pregnancy, is central to the World Health Organisation work on improving maternal health. This requires that women have access to safe and effective methods of fertility control. It is estimated that 90% of abortion-related and 20% of pregnancyrelated morbidity and mortality, along with 32% of maternal deaths, could be prevented by use of effective contraception. In sub-Saharan Africa, it is estimated that 14 million unintended pregnancies occur every year, with almost half occurring among women aged 15–24 years. The objective of this study was to determine the impact of contraceptive awareness and use on teenage pregnancy among primigravidas at Mbarara Regional Referral Hospital, Southwestern Uganda. Methods: The study was conducted on postnatal ward at Mbarara Regional Referral Hospital between October and December 2015 using case control design by consecutively sampling 100 primiparas who delivered during the study period at gestation age ≥28 WOA Results: The total number of respondents was 100 where by 30 mothers were below 20 years and 70 above 20 years. The age range was 15- 35 years and the most frequent age was 20 years. Majority of teenage mothers were either married or cohabiting (85%), unemployed (57%), never used contraceptive (93%), lacked knowledge of long term contraception (71%) and emergency contraception (84%). Lack of Knowledge of contraceptives, long term contraception and Emergency contraception was found to be strongly associated with likelihood of teenage pregnancy [OR (95%CI) and p values: 7.992(2.533- 25.222) <0.0001, 6.838(1.891-24.730) 0.001, 0.105(0.013-0.837) 0.012] respectively. Other factors associated with teenage pregnancy included rural residence [OR (95%CI) 2.382 (1.022-5.556) p value 0.043], Education Below secondary level [OR (95%CI): 5.167(2.116-12.617) p value<0.0001] and being unemployed [OR (95%CI): 9.374(2.595-33.859) p value <0.000]. Conclusion: Majority of teenage mothers delivering at Mbarara Regional Referral Hospital lack knowledge about contraception, long term contraceptives and emergency contraception. This knowledge gap is associated with low use of contraception and hence of teenage pregnancy