Andrew Kondaine Makwinja1,2,3, Zione Mchikaya Maida4, Alinane Linda Nyondo-Mipando5. 1. Department of Health Systems and Policy, College of Medicine, School of Public Health and Family Medicine, University of Malawi, Chichiri, Private Bag 360, Blantyre, Malawi. andrewmakwinja@gamil.com. 2. College of Medicine, African Centre of Excellence in Public Health and Herbal Medicine (ACEPHEM), University of Malawi, Blantyre, Malawi. andrewmakwinja@gamil.com. 3. Medecins Sans Frontieres-Belgium Malawi Mission, Blantyre, Malawi. andrewmakwinja@gamil.com. 4. Ministry of Health, Nsanje District Hospital, Nsanje, Malawi. 5. Department of Health Systems and Policy, College of Medicine, School of Public Health and Family Medicine, University of Malawi, Chichiri, Private Bag 360, Blantyre, Malawi.
Abstract
BACKGROUND: Despite documented benefits of contraceptives, uptake among young people aged 20-24 years is high compared to adolescents aged 15-19 years in Malawi. As the world's population of 15-19-year-olds continues to grow the need to meet the increasing demand for contraceptive services and information that address adolescent-specific needs cannot be underestimated. To inform Sexual and Reproductive health services for the youth, we explored strategies for optimizing uptake of contraceptives among this age group. METHODS: An exploratory qualitative cross-sectional study was conducted at Nsanje District Hospital and Nyamadzere Community Day Secondary School guided by Social-Ecological Framework to understand strategies that may optimize the uptake of contraceptives among adolescents aged 15-19. Nsanje district was purposively selected based on the reason that it is the second district in Malawi with the highest rate of adolescent childbearing of girls aged 15-19 years. We conducted a Focus Group Discussion (FGD) with 9 traditional leaders, 11 Key Informant Interviews (KIIs) with health workers, 20 In-depth Interviews (IDIs) with 12 adolescents, 4 teachers, and 4 parents. All data were digitally recorded, transcribed verbatim into English. The data was analyzed and managed using deductive thematic analysis guided by Social-Ecological Framework. RESULTS: Adolescents suggested accessing contraceptives from local drug stores, pharmacies and hospitals at a health system level and through Youth Centres, clubs, and corners at a Community level. There is a need to ensure a continuous supply of various kinds of contraceptives and the presence of youth-friendly health care workers in the specified areas. CONCLUSION: There is no one way of delivering contraceptives to adolescents. Multiple avenues existent at the health facility and community could be leveraged to optimize delivery and uptake of contraceptives in a manner that is not intimidating to an adolescent while involving key stakeholders.
BACKGROUND: Despite documented benefits of contraceptives, uptake among young people aged 20-24 years is high compared to adolescents aged 15-19 years in Malawi. As the world's population of 15-19-year-olds continues to grow the need to meet the increasing demand for contraceptive services and information that address adolescent-specific needs cannot be underestimated. To inform Sexual and Reproductive health services for the youth, we explored strategies for optimizing uptake of contraceptives among this age group. METHODS: An exploratory qualitative cross-sectional study was conducted at Nsanje District Hospital and Nyamadzere Community Day Secondary School guided by Social-Ecological Framework to understand strategies that may optimize the uptake of contraceptives among adolescents aged 15-19. Nsanje district was purposively selected based on the reason that it is the second district in Malawi with the highest rate of adolescent childbearing of girls aged 15-19 years. We conducted a Focus Group Discussion (FGD) with 9 traditional leaders, 11 Key Informant Interviews (KIIs) with health workers, 20 In-depth Interviews (IDIs) with 12 adolescents, 4 teachers, and 4 parents. All data were digitally recorded, transcribed verbatim into English. The data was analyzed and managed using deductive thematic analysis guided by Social-Ecological Framework. RESULTS: Adolescents suggested accessing contraceptives from local drug stores, pharmacies and hospitals at a health system level and through Youth Centres, clubs, and corners at a Community level. There is a need to ensure a continuous supply of various kinds of contraceptives and the presence of youth-friendly health care workers in the specified areas. CONCLUSION: There is no one way of delivering contraceptives to adolescents. Multiple avenues existent at the health facility and community could be leveraged to optimize delivery and uptake of contraceptives in a manner that is not intimidating to an adolescent while involving key stakeholders.