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Factors influencing accessibility to contraceptive services among adolescent girls (10-19 years) in Mahama camp, Rwanda.
Date Issued
2022-09
Author(s)
Linda Mwale
University of Global Health Equity
Aloysius Chidiebere Ugwu
University of Global Health Equity
Annet Mwizerwa
University of Global Health Equity
Abstract
Background:
Access to contraceptives by adolescents has become a global health concern. According to WHO, 12 million adolescents aged 15-19 years give birth each year, mainly in low and middle income countries with at least 10 million of these pregnancies unintended. Despite FP2020’s commitment to provide 120 million women and girls an opportunity to use life-changing modern contraceptives by the end of 2020, 23 million adolescents still have an unmet need for contraceptives. In Mahama refugee camp, there has been observed an increase in teenage pregnancy despite the presence of various campaigns aimed at reducing these pregnancies. There are no studies that explored the lived experiences of adolescent refugee girls in Mahama camp, highlighting barriers and enabling factors influencing their accessibility to contraceptive services. Such a study is vital for informing interventions aimed at reducing teenage pregnancies in the camp. This study adopts the social cognitive theory, highlighting the environment, behavioral, and cognitive determinants influencing adolescent access to contraceptive services. This study aimed at exploring community-level factors influencing the accessibility of contraceptive services among adolescent girls aged (10-19 years) in Mahama camp and proffer recommendations by August 2022.
Methods:
This was a qualitative study to explore lived experiences of adolescent refugee girls, and sexual and reproductive health service providers to inform interventions to curb teenage pregnancy and promote the sexual and reproductive health of adolescent girls in the camp. With informed consent
from parents or guardians and ascents adolescents under age 18, 25 in-depth interviews were conducted with adolescent girls and service providers using a semi-structured interview guide. Interviews were conducted and recorded in Kinyarwanda, and further transcribed and translated into English. The
transcripts were read in detail followed by the development of a codebook. The coding of transcripts was done using Dedoose software version 9.0.54 and emerging themes were identified and categorized.
Results:
The results showed that the enablers for contraceptive use among adolescent refugee girls were majorly environmental determinants and these were influenced by cost of service, sufficient support from service providers, frequent community awareness campaigns, location and setting of service centers, as well as knowledge on contraception. The main barriers to accessibility of contraceptive use by adolescent refugee girls were based on environmental and behavioral
determinants. These barriers were influenced by cultural and religious norms, fear, and misconceptions about contraception. Out-of-stock of contraception, paucity of funds to provide services, and as well as the shortage of service providers also contributed to the barriers faced by adolescents in accessing
contraceptives. The study recommended intensifying awareness on the availability of contraceptives in the camp, having sufficient health care workers to provide SRH services and more youth centers that would offer services to adolescents.
Conclusion:
The findings suggest the need for a joint effort by all stakeholders to ensure that
contraceptives are constantly available at the service points while amplifying community awareness
programmes where the community is educated on the need for contraceptive use among adolescent
refugee girls. Increasing the number of health care workers would also improve access to
contraceptives to these girls. The study findings also recommend that there should be revision and
amendment of laws that pose age-based restriction for adolescents to access contraceptives.
Access to contraceptives by adolescents has become a global health concern. According to WHO, 12 million adolescents aged 15-19 years give birth each year, mainly in low and middle income countries with at least 10 million of these pregnancies unintended. Despite FP2020’s commitment to provide 120 million women and girls an opportunity to use life-changing modern contraceptives by the end of 2020, 23 million adolescents still have an unmet need for contraceptives. In Mahama refugee camp, there has been observed an increase in teenage pregnancy despite the presence of various campaigns aimed at reducing these pregnancies. There are no studies that explored the lived experiences of adolescent refugee girls in Mahama camp, highlighting barriers and enabling factors influencing their accessibility to contraceptive services. Such a study is vital for informing interventions aimed at reducing teenage pregnancies in the camp. This study adopts the social cognitive theory, highlighting the environment, behavioral, and cognitive determinants influencing adolescent access to contraceptive services. This study aimed at exploring community-level factors influencing the accessibility of contraceptive services among adolescent girls aged (10-19 years) in Mahama camp and proffer recommendations by August 2022.
Methods:
This was a qualitative study to explore lived experiences of adolescent refugee girls, and sexual and reproductive health service providers to inform interventions to curb teenage pregnancy and promote the sexual and reproductive health of adolescent girls in the camp. With informed consent
from parents or guardians and ascents adolescents under age 18, 25 in-depth interviews were conducted with adolescent girls and service providers using a semi-structured interview guide. Interviews were conducted and recorded in Kinyarwanda, and further transcribed and translated into English. The
transcripts were read in detail followed by the development of a codebook. The coding of transcripts was done using Dedoose software version 9.0.54 and emerging themes were identified and categorized.
Results:
The results showed that the enablers for contraceptive use among adolescent refugee girls were majorly environmental determinants and these were influenced by cost of service, sufficient support from service providers, frequent community awareness campaigns, location and setting of service centers, as well as knowledge on contraception. The main barriers to accessibility of contraceptive use by adolescent refugee girls were based on environmental and behavioral
determinants. These barriers were influenced by cultural and religious norms, fear, and misconceptions about contraception. Out-of-stock of contraception, paucity of funds to provide services, and as well as the shortage of service providers also contributed to the barriers faced by adolescents in accessing
contraceptives. The study recommended intensifying awareness on the availability of contraceptives in the camp, having sufficient health care workers to provide SRH services and more youth centers that would offer services to adolescents.
Conclusion:
The findings suggest the need for a joint effort by all stakeholders to ensure that
contraceptives are constantly available at the service points while amplifying community awareness
programmes where the community is educated on the need for contraceptive use among adolescent
refugee girls. Increasing the number of health care workers would also improve access to
contraceptives to these girls. The study findings also recommend that there should be revision and
amendment of laws that pose age-based restriction for adolescents to access contraceptives.
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