Contraceptive use among in and out of school adolescents in rural Southwest Uganda

Abstract

Objective: To compare the level of contraceptive use among in and out of school rural Ugandan adolescents. Design: Cross sectional survey. Setting: Mbarara district. Subjects: Five hundred in-school and 220 out of school adolescents aged 15-19 years. Main outcome measure: Contraceptive use. Results: Contraceptive prevalence was 171 (23.8%), with 99 (19.8%) among in-school and 72 (32.7%) in out of school (OR=0.8, 95% CI=0.5-1.3). Of the 286 who had had sexual intercourse, 171 (59.8%) were current users with 99 (57.9%) in-school and 72 (42.1%) out of school. The predominant method was the male condom with 80 (56.7%) in-school and 61 (43.3%) out-of-school (p=0.3). Sixty-five (67%) of in-school aged 18- 19 used contraceptives compared to those less than 18 years (OR=0.4, 95% CI=0.2- 0.8). The out of school who were urban residents 51(75%) were more likely to use contraceptives (OR=0.3, 95% CI=0.1-0.6). Outdo school with secondary education 37(84.1%) were more likely to use contraceptives (OR=0.2, 95% CI=0.1-0.5). Cost was a barrier for contraceptive use among in-school users 37(77.1%) (OR=2.6, 95% CI=1.7- 5.4). Stigma surrounding their sexual activity was a barrier to out-of school 25 (58.1%) (OR=0.4, 95% CI=0.2-0.8). Conclusion: Contraceptive use among rural sexually active adolescents is low although the prevalence is higher in out-of school. Reorientation of contraceptive services to make them more accessible through strengthening of school health programme and establishment of out-of school adolescent health programme are urgently needed