Abstract:
BACKGROUND :
Low uptake of family planning services by adolescent girls remains a public health concern.
An estimated 120 out of every 1,000 girls aged 15 to 19 years are having unplanned pregnancies in the sub-Saharan region. Between January and June 2020, the Phalombe District
of Malawi reported 3,030 adolescent pregnancies. At this stage, most Malawian schools
were closed due to the COVID-19 pandemic. The high rate of adolescent pregnancies
prompted the Ministry of Health to provide emergency contraceptives to reduce the number
of unplanned pregnancies among adolescents. The provision of emergency contraceptives
would be effective if girls were willing and able to access these family planning services. We
thus explored the views of school-going adolescent girls regarding their preferences for
modern family planning methods including emergency contraceptives in Phalombe, Malawi.
METHODS :
This was a cross-sectional, descriptive study, where quantitative data were collected using
a structured questionnaire. Participants included randomly sampled school-going adolescent girls from eight purposively selected secondary schools and eight randomly selected
primary schools. All the schools were sampled from three purposively selected Traditional
Authorities namely Nkhulambe, Jenala and Nkhumba which had reported high numbers of
adolescent pregnancies. We analyzed the GeoPoints for schools and health facilities using
ArcGIS, while adolescent girls’ views were analyzed using STATA.
RESULTS :
Participants included 388 adolescent girls, ranging in age from 10 to 19 years (median age =
15.5 years, SD = 1.9 years). Participants were hesitant to use contraceptives because they
were afraid of being stigmatized and embarrassed, had to travel long distances to reach the service center, knew little about modern family planning and were afraid of medical
complications.
CONCLUSION :
The uptake of family planning services by adolescent girls can be improved by bringing
healthcare services closer to schools and homes. Family planning services should employ
health workers who are non-judgmental and who are able to remove the stigma associated
with family planning. Health workers should at any given opportunity, address the misconceptions and beliefs that adolescents have towards contraceptives. Community sensitization and health talks should be done to improve adolescent girls’ understanding of family
planning services.
