Older Adolescents and Family Planning: Trends in Eastern, Western, and Central Africa

Abstract

Background: Adolescent population globally has reached a historic peak (1.2 billion). More than ever before, adolescents’ sexual and reproductive health is receiving more attention both globally and nationally. Sexual and reproductive health is arguably the core of adolescent public healthcare. Teenage pregnancy and its corresponding negative impacts are still worrisome public health concerns in sub-Saharan Africa. Although most countries in sub-Saharan made family planning commitments for women and girls with target goals for 2020, adolescent fertility rates in this part of Africa are still high. The motivation for this study stems from the claim by Melesse et al. (2020) that Eastern Africa is doing better than West and Central Africa when it comes to modern contraceptive prevalence. Methods: This was an exploratory sequential study. The quantitative phase had two elements. First of all, it included the mining of data using mCPR and DR indicators for older adolescents from the UNFPA and DHS websites for countries in the above three regions. The modern contraceptive prevalence rate indicator was used to rank the countries within each region. For Eastern and Central Africa, the countries with the top, middle and bottom position were selected while in Central Africa, only the top and bottom countries were selected. At the end, eight countries were selected for the next phase of the study. The second quantitative phase included a systematic search of peer-reviewed data on MEDLINE on adolescents and contraceptive access and use published from the chosen eight countries. For the qualitative part, two key informants were recruited and interviewed online per country (making a total of sixteen key informants). Findings: There is a general increase in the trends of mCPR among older adolescents across the three regions. Eastern African countries had more countries with higher mCPR compared to the other regions. There was no specific relationship or correlation between mCPR and DR. Adolescents across the regions still face similar and enormous challenges in accessing and using modern contraception. Other factors such as the impact of the HIV pandemic for a given country, a country’s ability to properly collect and publish disaggregated data and above all, colonial legacy are contributors to the regional trends of mCPR. When it comes the indicators of 19006689 v successful adolescent family planning programmes, factors such as the involvement of adolescents during the design and implementation of interventions, as well as the design of FP interventions to offer other non-SRH related services are key to determining the success of an intervention. Conclusion: Modern contraceptive prevalence count alone is insufficient in telling a country’s or region’s success story on teenage pregnancy prevention. The huge gap between increasing family planning information access and actually family planning use among adolescents could be bridged if greater attention is paid on the lessons learned from country’s that experience the HIV pandemic disproportionately, colonial legacy and its impact on how people view and access the health system, and lastly, the ability of a country to collect and report data.