Factors associated with contraception non-use among women aged 15-24 years in migrant communities in Southern Africa in 2018

Abstract

Introduction The non-use of contraceptive among young women aged 15-24 years is a public health concern because of its adverse social and reproductive health outcomes. The extent of contraceptivenon-use as well as the factors associated with their non-use particularly among young women, specifically in high migrant communities need to be investigated further. The aim of this study was to investigate factors associated with contraceptive non-use among young women residing in high migrant communities in Southern Africa.

Methods The study was a secondary data analysis conducted within the larger sexual and reproductive health rights and HIV knows no borders project (SRHR-HIV). The SRHR-HIV project was a longitudinal study which included a cross-sectional baseline survey which was conducted in 2018 to collect data on sexual and reproductive health in 10 high migrant communities in six Southern African countries. In this analysis, the study population was restricted to women aged 15-24 years. Descriptive statistics and multivariable logistic regressions were performed to investigate demographic, social-economic and behavioral factors that are associated with contraceptive non-use. Additional analyses were conducted using multi-level logistic regressions.

Results Of the 1 242 eligible women aged 15-24 years, 588 reported not having used any method of contraception representing a prevalence of 47.3%. Overall, 69% of the women were nonmigrant, international migrants had the lowest proportion with 12% and 19% were internal migrants. Contraceptive non-use was high among international migrants (56%) and lowest for internal migrants (38%). Using multivariable logistic regression, age, religion, and ability to refuse sex were significant factors (p<0.05) associated with contraceptive non-use among young women. Contraceptive non-use decreased with increasing age (aOR 0.75, 95% CI 0.69,0.81), was higher for women unable to refuse sex (aOR 1.39, 95% CI 0.92,2.11). Contraceptive non- use was also higher among women of Catholic (aOR 1.75, 95% CI 0.81,3.77) , Protestant (aOR 2.58, 95% CI 1.18,5.68), Islam (aOR 4.62, 95% CI 1.36,15.73) religions.

Conclusion The findings of this study highlighted the influence of age, religion, and inability to refuse sex as some of the factors associated with contraceptive non-use among young women. These factors were found were found not to differ among migrants. The findings should be considered and reflected in public health policies to address barriers to the use of contraceptives by women aged 15-24 years.