Utilization of modern contraceptive methods among female refugee adolescents at Kyangwali refugee settlement, Kikuube district, south-western Uganda

Abstract

Despite global efforts, inadequate contraceptive provision remains a significant issue, particularly among vulnerable populations such as teenagers, travelers, those residing in slums, and refugees (WHO, 2020). In Uganda, 30.4% of adolescents have unmet family planning needs (UDHS, 2016). Refugees and migrants face various challenges in accessing family planning services, such as language barriers, low education levels, lack of information, cultural and religious taboos, limited income, and personal experiences with contraceptive side effects. This study aims to assess the utilization of modern contraceptives among female refugee adolescents in Kyangwali refugee settlement, identify factors influencing their contraceptive use, determine knowledge and accessibility of contraceptive methods, and determine the proportion of adolescents utilizing these methods. A cross-sectional study design was employed, utilizing structured questionnaires, focus group discussions (FGDs), and key informant interviews (KIIs) for data collection. Data were analyzed using SPSS version 23 and thematic content analysis. Univariate and bivariate methods were utilized, including frequency generation at the univariate level, chi-square tests, and binary logistic regression to test variable associations. The study interviewed 399 sexually active female refugee adolescents (aged 15-19 years). The prevalence of modern contraceptive use (all methods) was 15.3% (95% CI: 11.8-19.0). Condoms (54.1 %) and injectables (31.1 %) were the most preferred methods, with lack of family planning knowledge cited as the primary reason for non-use. Significant associations were found between socio-demographic factors (e.g., age, marital status, education level, and school attendance) and modem contraceptive use. The study reveals a low prevalence of modern contraceptive utilization (15.4%), with injectables being the most known method (35.0%). Barriers to uptake include: side effects, lack of knowledge, myths, misconceptions, inadequate privacy and functionality of adolescent-friendly healthcare facilities. These findings directly relate to the study objectives by highlighting the critical need to assess the factors influencing contraceptive use, examine knowledge, accessibility, and determine the proportion of adolescents utilizing these methods. Urgent measures are needed to improve adolescents' access to high-quality sexual and reproductive healthcare in refugee settings, thereby addressing the identified barriers and enhancing contraceptive uptake among female refugee adolescents in Kyangwali. By focusing on these objectives, the research seeks to highlight the barriers to contraceptive use in this demographic and inform targeted interventions to improve reproductive health outcomes.