Determinants of contraceptive use among adolescents in rural communities of Zimbabwe: The case of Murombedzi District, Mashonaland West Province.

Abstract

Adolescents face a number of challenges where ASRH issues are concerned. One of these issues is the contraceptive use among adolescents is low. Adolescents in rural areas are prone to a host of factors that hinder their access to contraception compared to their urban counterparts. The study sought to analyse factors that determine contraceptive use in Murombedzi, a rural area located in Zvimba District, Mashonaland West Province. A triangulation of methods was used to collect data as both qualitative and quantitative methods were used. A total of 250 questionnaires were administered to adolescents aged 15-19 years to collect quantitative data. The study conducted 5 FGDs, 6 KIIs and also conducted a desk review to gather qualitative data. Findings showed that there was high sexual activity among adolescents in Murombedzi. Adolescents were engaging in early sexual activity with older sexual partners and having multiple sexual partners. Sexual activity in Murombedzi was largely associated with exchanging sex for monetary gains. This raises concern over the use of contraception as adolescents cannot negotiate for sex with their older partners. The study revealed that although contraceptive use was relatively high in the past 12 months and on the last sexual encounter, it was low on the first sexual encounter. Factors that influenced contraceptive use were not only at individual level but also at interpersonal, organisational, community and national levels. Knowledge of contraception was high, however, adolescents lacked knowledge about condoms offering dual protection and how to use contraception. Adolescents also had negative beliefs and attitudes towards contraception which negatively affected use. These beliefs and attitudes could be attributed to adolescents receiving information about contraception from sources that are not accurate. Policies stipulate that every sexually active person should access contraception. However, there are inconsistencies in the laws which negatively affect contraceptive use. In addition, social and cultural norms are deeply rooted in rural areas and some health workers impose these norms on adolescents thus negatively affecting contraceptive use. The Government needs to align laws that are inconsistent, increase adolescents’ knowledge about contraception and address the issue of health workers denying adolescents contraception so as to increase contraceptive use among adolescents especially as soon as they initiate sexual activity. In addition, efforts need to be made to improve parent-child communication on issues about ASRH. There is need to make religious and community leaders aware of the benefits of adolescents using contraceptives so that they can encourage sexually active adolescents to use them. This is so that adolescents avoid getting infected by STIs, as well as getting teenage pregnancies.