Modern contraceptives among female refugee adolescents | OAJC

Introduction

Adolescent pregnancy remains a global burden with an estimated birth rate of 44 births per 1,000 girls aged 15 to 19 years.¹ In low-resource settings, approximately 770,000 girls under 15 years of age and about 12 million aged 15 to 19 years give birth annually,² and an additional 3 million girls aged 15 to 19 years undergo unsafe abortions annually.³ Sub-Saharan Africa has the highest rates of adolescent pregnancy and child birth globally at 99.4 births per 1000 women.⁴ In Uganda, adolescent births account for 14% of all births,⁵ the majority of which are unintended.⁶ However, the rates are mentioned to be higher among the refugee adolescents than among the nationals.^7–9 This is so because of the insecurity and poverty faced by refugee adolescents, which leave them vulnerable to sexual exploitation, abuse, rape, transactional sex, and early or forced marriages.

Sustainable Development Goals (SDGs)

• SDG 3: Good Health and Well-being
• SDG 4: Quality Education
• SDG 5: Gender Equality
• SDG 10: Reduced Inequalities
• SDG 16: Peace, Justice, and Strong Institutions

Methods

Study Design

This was a prospective single-cohort study, nested in a randomised controlled trial (RCT) which was aimed at assessing the effect of peer counselling, compared to routine contraceptive counselling on acceptance of modern contraceptives among female refugee adolescents.¹⁴ The current study aimed at assessing adherence to modern contraceptives among female refugee adolescents who were new starters of modern contraceptives from the RCT. The RCT was carried out among 588 female refugee adolescents aged 15 to 19 years, who were not using any contraceptives at the time of the RCT. The participants were randomised to either peer contraceptive counselling (the intervention), or routine contraceptive counselling provided at the health facilities (the control). After receiving their allocated counselling, they were assessed for contraceptive acceptance. All those who accepted to use contraceptives received their preferred method, and these are what we regarded as “new starters”. All new starters who consented to participate and were eligible were included in the current study.

Study Setting

Palabek refugee settlement was established in April 2017 and is one of the newest refugee settlements in Uganda. It is situated at the border of Uganda and South Sudan. It hosts close to 55,000 refugees from South Sudan, 85% of whom are women and children.²³ Palabek refugee settlement is burdened with adolescent pregnancy among girls aged 17 to 19 years with a prevalence of over 50%,⁷ and the settlement has four health centres which provide contraceptive services free of charge. The family planning services provided include contraceptive counselling, provision of condoms (both male and female), oral contraceptives, injectables, and insertion and removal of implants and intra-uterine devices (IUDs).

Study Participants

A total of 272 female refugee adolescents aged 15 to 19 years who were new starters of reversible modern contracept

SDGs, Targets, and Indicators

Explanation

1. The issues discussed in the article are directly connected to SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities). These goals address the need for universal access to sexual and reproductive health services, including family planning, and the empowerment and inclusion of all individuals, regardless of their age, gender, or status.

2. The specific target identified based on the article’s content is Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.

3. The article mentions the indicator “adherence to modern contraceptives among female refugee adolescents” as a measure of progress towards the identified targets. The study conducted in northern Uganda aimed to determine the rates and predictors of adherence to modern contraceptives among female refugee adolescents.

4. Table:

| SDGs | Targets | Indicators |
|——|———|————|
| SDG 3: Good Health and Well-being | 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs | Adherence to modern contraceptives among female refugee adolescents |
| SDG 5: Gender Equality | 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Program of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences | Adherence to modern contraceptives among female refugee adolescents |
| SDG 10: Reduced Inequalities | 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status | Adherence to modern contraceptives among female refugee adolescents |

These findings highlight the importance of addressing adolescent pregnancy and improving access to sexual and reproductive health services for female refugee adolescents. By focusing on these issues, progress can be made towards achieving the SDGs related to health, gender equality, and reduced inequalities.

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Source: dovepress.com