THE DEMAND AND SUPPLY BARRIERS TO ADOLESCENTS’ ACCESS AND UTILIZATION OF FAMILY PLANNING (FP) SERVICES IN THE NORTHERN REGION OF MALAWI
Background: The government of Malawi has been committed to providing a comprehensive and integrated Sexual and Reproductive Health (SRH) package at all levels since 1997. However, adolescents continue to face many health problems like gender inequality, unplanned pregnancies, unsafe abortion, and sexually transmitted infections (STI’s). Most interventions have been unable to effectively address adolescents’ unmet needs and access and utilization of FP services among adolescents remain low. This study investigates the supply and demand barriers to adolescent access and utilization of family planning (FP) services in northern Malawi, one of the areas most affected by preventable SRH problems. Identifying these barriers may assist in planning efforts to increase unmet needs. Methods: This desk-based study used Queen Margaret University (QMU) electronic library resources to search and identify peer-reviewed articles published between 1994 and 2019 in key databases like PubMed, Medline, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Online resources like government and various organizational portals were also utilized to obtain grey literature on the concept of adolescent’s access and utilization of FP services. A total of 368 articles were identified and screened after which 30 articles were selected for this study. Findings: The study findings show high coverage and awareness of FP services in northern Malawi. However, awareness is partial in that it mainly relates to contraceptives instead of general sexual reproductive health (SRH) services. Several issues relating to supply and demand-side health determinants like religious and cultural constraints, childbearing preferences, gender and power relations, misconceptions and fear of modern contraceptives significantly influence adolescents’ access and utilization of FP services. Conclusion: To ensure continued and increased access and utilization of FP services by adolescents, it is crucial for policymakers, program planners and implementers to mobilize community support by developing culturally contextualized sexual health interventions. Community acceptance is crucial to both seeking and engaging with health services. The acceptability of FP services not only depend on health providers ability to understand the religious, cultural, historical and social fabric of the people they serve but may also require a thoughtful level of interaction that ensures that those who perceive the need for FP services will continue to use them.