Factors associated with the uptake of long-acting reversible contraceptives among adolescents accessing family planning services in Lusaka, Zambia

Abstract

Long-acting reversible contraceptives (LARC) provide effective contraception for an extended period, are user independent, safe and therefore important in preventing teenage pregnancy. However, the uptake of this contraceptive method remains relatively low among adolescents. Family planning clinics provide an opportunity to counsel and provide LARC to adolescents. This study was therefore conducted to explore the factors that influence the uptake of LARC among adolescents accessing family planning services at selected health facilities in Lusaka, Zambia. An unmatched case control study was conducted at selected facilities in Lusaka between May and November, 2018 and convenient sampling was used. Exit interviews using a structured questionnaire were conducted on 75 adolescents who had chosen LARC (as cases) and 75 adolescents who had chosen others contraception methods (as controls). The mean age of participants was 17.73 years (SD ± 1.83). A total number of 89(59%) had previously used contraceptives and the most commonly used contraceptives were male condoms at 78%. Out of these, only 12(13%) had previously used LARC. It was found that those participants who had used injectable contraceptives previously were about 93% less likely to accept LARC methods (AOR 0.72; 95% CI 0.006-0.870). It was also found that those who had knowledge about LARC methods were more than 90% less likely to choose the LARC method (AOR 0.077; 95% CI 0.008-0.697). Other predictors of LARC method use were myths like LARC methods being painful. When backward logistic regression model was performed, it was found that those participants who felt that LARC methods dislodged in the body were more than 80% less likely to accept LARC methods (AOR 0.183; 0.040-0.839). Socio-demographic factors were found not to be significantly with LARC uptake. Knowledge on LARC methods and sexual activity positively affect the utilisation of LARC among adolescents. Previous use of Injectable contraception and myths and misconception surrounding LARC methods negatively impact on LARC utilisation. Socio-demographic characteristics and provider-based factors have no significant association with LARC uptake among adolescents. Key words: adolescents, Long-acting reversible contraceptive, family planning.