The use of condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries

Abstract

Background: Adolescents in sub-Saharan Africa still face sexual and reproductive health challenges. Contraceptives have been used to address these challenges. Despite efforts at national and global levels, contraceptive uptake among young people in Africa remains a challenge due to personal, societal, and health systems-based barriers. We estimated the prevalence and correlates of condom use and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African (SSA) countries. Methods: We conducted a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from nine SSA countries. We included a sample of 27,504 school-going adolescents 11 years and younger and 18 years and older. We employed meta-analysis using a random-effects model to estimate the total prevalence of the use of condoms, other birth control methods other than a condom and any birth control method at last sexual intercourse. We conducted complex sample descriptive and logistic regression analyses to determine the characteristics and determinants of not using condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries, respectively. Results: More than half [n = 4430, 53.8% (43.9–63.8)], two-fifth [n = 3242, 39.5% (33.2–45.9) and two-thirds of adolescents [n = 4838, 65.6% (57.5–73.7)] of sexually active in school adolescents across the nine sub-Saharan African countries used condom, other birth control methods and any form birth control method during their last sexual intercourse, respectively. The non-use of condoms at last sex was associated with being younger (less than 16 years) [AOR = 1.48;95%CI: 1.12–1.94], early sexual debut [AOR = 1.81(1.47–2.22)], having two or more sexual partners [AOR = 1.30(1.06–1.58)] and no/minimal parental support [AOR = 1.54(1.17–2.03)]. The non-use of other birth control methods at last sex was associated with being male [AOR = 1.37 (1.09–1.73)], early sexual debut [AOR = 1.83(1.48–2.27) and having no parental support [AOR = 1.64(1.34–2.00)]. Conclusion: Contraceptive need among sexually active school adolescents in the nine sub-Saharan African countries is high. Such a need calls for the development of country-specific and or the review of existing school-based sexual health education and youth-friendly sexual and reproductive health interventions that target risky adolescents and promote adolescent-parent effective communication, connectedness and support.