Factors associated with modern contraceptive use among sexually active adolescent girls and young women (15–24): analysis of the Uganda demographic health survey 2016

Abstract

Background: Modern contraceptive use among adolescent girls and young women (AGYW) is crucial for reducing unintended pregnancies, maternal mortality, and unsafe abortions. In Uganda, adolescent fertility and unmet need for contraception remain high despite government efforts to improve access to family planning services. Understanding the factors influencing modern contraceptive use among AGYW is essential for developing targeted interventions. Objective: To determine the prevalence and factors associated with modern contraceptive use among sexually active adolescent girls and young women (15-24 years) in Uganda, using data from the 2016 Uganda Demographic and Health Survey (UDHS). Methods: This study employed a cross-sectional design using secondary data from the 2016 UDHS. 4,534 sexually active AGYW were included in the analysis. The outcome variable was modern contraceptive use, categorized as "Yes" (using a modern contraceptive method) or "No" (not using any modern contraceptive method). Multivariable modified Poisson regression was used to identify factors associated with modern contraceptive use, adjusting for survey design characteristics. Results: The prevalence of modern contraceptive use among AGYW was 32.6%. The age specific modern contraceptive rate (mCPR) was 8.8% for adolescent girls (15-19) and 23.8% for young women (20-24). Key predictors of contraceptive use at multivariable analysis include region, education, wealth, parity, media exposure, recent sexual activity, and number of sexual partners. Conclusion and recommendations: Despite ongoing efforts, modern contraceptive use among AGYW in Uganda remains low. To improve uptake, interventions should target younger adolescents, enhance access to youth-friendly services, and address regional disparities. Increasing digital family planning messaging and integrating reproductive health education into school curricula could further improve contraceptive use among AGYW. Future research should explore the lived experiences of AGYW and the contextual factors influencing their reproductive health decisions.