Barriers to contraceptive use among adolescents in two semi-rural Nicaraguan communities
-
J.J. Parker
,
Cindy B. Veldhuis
Abstract
Objective
To identify barriers to contraceptive use among adolescents in two neighboring semi-rural communities in Nicaragua.
Methods
We recruited and surveyed a convenience sample of 287 adolescents, ages 15–19 years old, in July and August, 2013 about barriers to contraceptive use. We compared adolescents by gender, sexually active status (sexual intercourse in the previous year) and frequency of contraceptive use.
Results
More than 40% (43.5%) of the adolescents surveyed reported that they had ever had sexual intercourse. The likelihood of ever having had sexual intercourse differed based on gender, relationship status, sexual activity of peers, and the presence of a father in the home. Contraceptive use was low and female adolescents were more likely than their male counterparts to report never or rarely using contraceptives (46.5% vs. 21.4%, p < 0.007). Contraceptive use for females was positively associated with discussing contraception with a healthcare professional (HCP) [adjusted odds ratio (AOR) 13.32; 95% confidence interval (CI) 1.35–139.98] and a family member (AOR 4.64; 95% CI 1.09–19.72). Reasons for non-use also varied significantly by gender. Low rates of contraceptive use in these two semi-rural Nicaraguan communities appear to be primarily related to gender norms, social stigma, and poor communication about family planning.
Conclusions
Interventions that focus on promoting gender equality and encouraging adolescent communication with HCPs, schools, families, and partners are imperative to combating adolescent pregnancy in Nicaragua and countries worldwide.
Acknowledgments
This work was supported by the University of Illinois at Chicago Center for Global Health and the University of Illinois at Chicago College of Medicine. We thank the University of Illinois Center for Global Health for supporting this project with a travel grant for airfare to Nicaragua. We would like to thank Dr. William Parker for his suggestions to the statistical analysis of this project. We are grateful to Cindy Stoffel and Ailea Stites for their helpful comments on earlier drafts of this article. We would like to thank the individuals of the community advisory board, Manna Project International and University of South Florida College of Medicine for their advice and assistance with this project. Finally, and perhaps most importantly, the authors would like to express their gratitude to the young men and women of Cedro Galán and Chiquilistagua, Nicaragua who participated in this study.
Authors’ contributions
Design: Parker, Haider, Veldhuis
Planning: Parker, Haider, Veldhuis
Conduct: Parker
Data Analysis: Parker, Haider, Veldhuis
Manuscript Writing: Parker, Haider, Veldhuis, Hughes
Conflict of interest: The authors have no conflicts of interest in this study.
References
[1] World Health Organization. Adolescent Pregnancy; Issues in Adolescent Health and Development. Available at: http://apps.who.int/iris/bitstream/10665/42903/1/9241591455_eng.pdf. Accessed 2 Feb 2012.Search in Google Scholar
[2] WHO | Adolescent pregnancy. Available at: http://www.who.int/mediacentre/factsheets/fs364/en. Accessed 1 Dec 2017.Search in Google Scholar
[3] State of World Population 2013 | UNFPA – United Nations Population Fund. Available at: http://www.unfpa.org/publications/state-world-population-2013. Accessed 11 Nov 2016.Search in Google Scholar
[4] Buvinic M. The costs of adolescent childbearing: evidence from Chile, Barbados, Guatemala, and Mexico. Stud Fam Plann. 1998;29:201–9.10.2307/172159Search in Google Scholar
[5] The Global Programme to Enhance Reproductive Health Commodity Security, Annual Report. Available at: http://www.unfpa.org/sites/default/files/pub-pdf/UNFPA%20GPRHCS%20Annual%20Report%202012_web%20final.pdf. Accessed 1 Dec 2017.Search in Google Scholar
[6] Blandón L, Carballo Palma L, Wulf D, Remez L, Prada E, Drescher J. Early childbearing in Nicaragua: a continuing challenge. Issues Brief (Alan Guttmacher Inst). 2006;3:1–24.Search in Google Scholar
[7] Trends in Contraceptive Use Worldwide 2015. United Nations. Economics and Social Affairs. Available at: http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf. Accessed 11 Nov 2016.Search in Google Scholar
[8] Lion KC, Prata N, Stewart C. Adolescent childbearing in Nicaragua: a quantitative assessment of associated factors. Int Perspect Sex Reprod Health. 2009;35:91–6.10.1363/3509109Search in Google Scholar
[9] Decat P, De Meyer S, Jaruseviciene L, Orozco M, Ibarra M, Segura Z, et al. Sexual onset and contraceptive use among adolescents from poor neighbourhoods in Managua, Nicaragua. Eur J Contracept Reprod Health Care. 2015;20:88–100.10.3109/13625187.2014.955846Search in Google Scholar
[10] World Abortion Policy 2011. United Nations. Available at: http://www.un.org/esa/population/publications/2011abortion/2011wallchart.pdf. Accessed 15 April 2015.Search in Google Scholar
[11] Córdova Pozo K, Chandra-Mouli V, Decat P, Nelson E, De Meyer S, Jaruseviciene L, et al. Improving adolescent sexual and reproductive health in Latin America: reflections from an International Congress. Reprod Health. 2015;12:11.10.1186/1742-4755-12-11Search in Google Scholar
[12] Instituto Nacional De Información De Desarrollo. Managua en cifras. Available at: http://www.inide.gob.ni/censos2005/CifrasMun/Managua/Managua.pdf. Accessed 1 Dec 2017.Search in Google Scholar
[13] Mmari K, Sabherwal S. A review of risk and protective factors for adolescent sexual and reproductive health in developing countries: an update. J Adolesc Health Off Publ Soc Adolesc Med. 2013;53:562–72.10.1016/j.jadohealth.2013.07.018Search in Google Scholar
[14] Oliveira-Campos M, Giatti L, Malta D, Barreto SM. Contextual factors associated with sexual behavior among Brazilian adolescents. Ann Epidemiol. 2013;23:629–35.10.1016/j.annepidem.2013.03.009Search in Google Scholar
[15] WHO | Risk and protective factors affecting adolescent reproductive health in developing countries. Available at: http://www.who.int/maternal_child_adolescent/documents/9241592273/en. Accessed 13 March 2017.Search in Google Scholar
[16] Okereke CI. Unmet reproductive health needs and health-seeking behaviour of adolescents in Owerri, Nigeria. Afr J Reprod Health. 2010;14:43–54.Search in Google Scholar
[17] Magnani RJ, Seiber EE, Gutierrez EZ, Vereau D. Correlates of sexual activity and condom use among secondary-school students in urban Peru. Stud Fam Plann. 2001;32:53–66.10.1111/j.1728-4465.2001.00053.xSearch in Google Scholar
[18] Unger JB, Molina GB, Teran L. Perceived consequences of teenage childbearing among adolescent girls in an urban sample. J Adolesc Health Off Publ Soc Adolesc Med. 2000;26:205–12.10.1016/S1054-139X(99)00067-1Search in Google Scholar
[19] Berglund S, Liljestrand J, De María Marín F, Salgado N, Zelaya E. The background of adolescent pregnancies in Nicaragua: a qualitative approach. Soc Sci Med. 1997;44:1–12.10.1016/S0277-9536(96)00084-6Search in Google Scholar
[20] Manji A, Peña R, Dubrow R. Sex, condoms, gender roles, and HIV transmission knowledge among adolescents in León, Nicaragua: implications for HIV prevention. AIDS Care. 2007;19:989–95.10.1080/09540120701244935Search in Google Scholar PubMed
[21] Gutierrez J-P, Bertozzi SM, Conde-Glez CJ, Sanchez-Aleman MA. Risk behaviors of 15-21 year olds in Mexico lead to a high prevalence of sexually transmitted infections: results of a survey in disadvantaged urban areas. BMC Public Health. 2006;6:49.10.1186/1471-2458-6-49Search in Google Scholar
[22] Morris JL, Rushwan H. Adolescent sexual and reproductive health: the global challenges. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2015;131(Suppl 1):S40–2.10.1016/j.ijgo.2015.02.006Search in Google Scholar
[23] Jacobson L, Richardson G, Parry-Langdon N, Donovan C. How do teenagers and primary healthcare providers view each other? An overview of key themes. Br J Gen Pract. 2001;51:811–6.Search in Google Scholar
[24] Marston C, King E. Factors that shape young people’s sexual behaviour: a systematic review. Lancet Lond Engl. 2006;368:1581–6.10.1016/S0140-6736(06)69662-1Search in Google Scholar
[25] Jaruseviciene L, Orozco M, Ibarra M, Ossio FC, Vega B, Auquilla N, et al. Primary healthcare providers’ views on improving sexual and reproductive healthcare for adolescents in Bolivia, Ecuador, and Nicaragua. Glob Health Action. 2013;6:20444.10.3402/gha.v6i0.20444Search in Google Scholar PubMed PubMed Central
©2019 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Review
- Confronting the impact of teen pregnancy in Mississippi: the need for after-school programs
- Original Articles
- Needs assessment for gender sensitive reproductive health services for adolescents
- Knowledge of emergency management of avulsed tooth among intern dental students: a questionnaire based study
- Factors associated with time between using a drug and injection initiation among people who inject drugs in Kermanshah, Iran
- Environmental perceptions and its associations with physical fitness and body composition in adolescents: longitudinal results from the LabMed Physical Activity Study
- Health promoting behaviors of staff in a university of medical sciences in southeast of Iran
- Investigating adolescents’ sweetened beverage consumption and Western fast food restaurant visits in China, 2006–2011
- An examination of eating disorder education and experience in a 1-month adolescent medicine rotation: what is sufficient to foster adequate self-efficacy?
- Tobacco use: the main predictor of illicit substances use among young adolescents in Sousse, Tunisia
- Integrated training (practicing, peer clinical training and OSCE assessment): a ladder to promote learning and training
- One-year changes in physical activity and sedentary behavior among adolescents: the Croatian Physical Activity in Adolescence Longitudinal Study (CRO-PALS)
- Feasibility and acceptability of the Bod Pod procedure and changes in body composition from admission to discharge in adolescents hospitalized with eating disorders
- Barriers to contraceptive use among adolescents in two semi-rural Nicaraguan communities
- The association between school bullying victimization and substance use among adolescents in Malawi: the mediating effect of loneliness
- Assessment of dietary habits and nutritional status among adolescent girls in a rural area of Puducherry: a community-based cross-sectional study
Articles in the same Issue
- Review
- Confronting the impact of teen pregnancy in Mississippi: the need for after-school programs
- Original Articles
- Needs assessment for gender sensitive reproductive health services for adolescents
- Knowledge of emergency management of avulsed tooth among intern dental students: a questionnaire based study
- Factors associated with time between using a drug and injection initiation among people who inject drugs in Kermanshah, Iran
- Environmental perceptions and its associations with physical fitness and body composition in adolescents: longitudinal results from the LabMed Physical Activity Study
- Health promoting behaviors of staff in a university of medical sciences in southeast of Iran
- Investigating adolescents’ sweetened beverage consumption and Western fast food restaurant visits in China, 2006–2011
- An examination of eating disorder education and experience in a 1-month adolescent medicine rotation: what is sufficient to foster adequate self-efficacy?
- Tobacco use: the main predictor of illicit substances use among young adolescents in Sousse, Tunisia
- Integrated training (practicing, peer clinical training and OSCE assessment): a ladder to promote learning and training
- One-year changes in physical activity and sedentary behavior among adolescents: the Croatian Physical Activity in Adolescence Longitudinal Study (CRO-PALS)
- Feasibility and acceptability of the Bod Pod procedure and changes in body composition from admission to discharge in adolescents hospitalized with eating disorders
- Barriers to contraceptive use among adolescents in two semi-rural Nicaraguan communities
- The association between school bullying victimization and substance use among adolescents in Malawi: the mediating effect of loneliness
- Assessment of dietary habits and nutritional status among adolescent girls in a rural area of Puducherry: a community-based cross-sectional study
