Adigwe Faith ChukwudunmbiNgwira Abraham2025-02-042025-02-042025-02-04https://dspace.ughe.org/handle/123456789/91Background: Globally, Sub-Saharan Africa holds the highest adolescent fertility rate with severe consequences to both mother and child. In Neno district, Malawi, despite the free availability of family planning services in all 14 health facilities, the uptake of these services by adolescents aged 15-19 remains remarkably low at 10%. Despite the availability of various research on similar topics, the research gap in surveying a rural setting like the Neno district and including the experiences of male adolescents and other vital stakeholders, recognizing the intersectionality of adolescents' family planning issues, still needs to be filled. Objective: To explore the barriers, facilitators, and preferences for the uptake of family planning methods among adolescents aged 15-19 in the Neno district by July 2024. Methods: This was a phenomenological qualitative study. Purposive sampling was used to enroll 23 participants who included both female and male adolescents aged 15-19 who had used family planning methods in the past 6 months, the parents/guardians of such adolescents, healthcare workers and Youth Community Based Distribution Agents (YCBDA) who attend to such adolescents, religious and traditional leaders. In-depth interviews and focus group discussions were carried out in Chichewa and English after obtaining informed consent. The interviews were recorded, transcribed, and translated into English where applicable. This was followed by an open reading and then a codebook development using Dedoose (9.2.12). Thematic analysis was then used to organize the codes into categories and then themes. Results: A total of 23 transcripts were obtained. The study results highlighted the perspectives of the participants on adolescent’s low uptake of family planning methods in the district. The study identified 4 themes based on the socio-ecological model used, which were, “socio cultural environment, informational gaps, and health facility environment contributed to low uptake of family planning methods among adolescents”, “adolescent FP method uptake was significantly promoted by individual and external factors”, “adolescent specific choices included their FP methods, source of information and desired interventions”, and “adolescent's individual and socio-economic challenges arising from unsafe sex practices was a shared understanding”. Conclusion: The study identified a complex interplay of individual, interpersonal, community and health facility level barriers and facilitators to the uptake of family planning methods among adolescents aged 15-19 in Neno district. Socio-cultural environment, informational gaps, and health facility environment were reported as barriers while adolescent family Planning method uptake was significantly promoted by individual and external factors. Building up on the current efforts by PIH Malawi to improve the uptake of family Planning methods, an intersectional approach in adolescent family planning programming is needed to address the highlighted barriers and adopt the preferences of the adolescents. It is also important to prioritize interventions that promote dual protection, community involvement and social behavioral changeenMalawiSouth Eastern AfricaFamily PlanningFamily Planning MethodsAdolescentstext::thesis