Intention and decision making regarding contraception acceptance among tertiary school adolescents in Blantyre District, Malawi
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Date
2012-08-01
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Abstract
There is low contraceptive use reported in most of sub-Saharan Africa including Malawi despite adolescents indulging themselves in risky sexual and reproductive health behaviours such as unprotected sexual activities. This study explored intentions and decision making regarding contraceptive acceptance among tertiary school sexually active adolescents in Blantyre district in the southern region of Malawi. A qualitative basic interpretive design was used for the study involving 18-19 year old male and female adolescents. A purposive sampling was used and a total of 23 (13 female and 10 male) adolescents participated in the study. Data was collected through in-depth interviews using a semi-structured interview guide. Descriptive statistics were computed for demographic data while the qualitative data was analysed by manifest content analysis using verbatim transcription from which categorises and themes were created. Five themes emerged from the data, which included contraceptives information; contraceptive knowledge; attitude towards contraceptive use; consistency in contraceptive use and motivating factors for contraceptive use. Some respondents had positive attitudes towards contraceptive use which were developed from knowledge on the benefits of contraceptives hence avert the negative consequences of sex. Adolescents reported that they had self efficacy to use condoms. They also admitted to have perceived behaviour control in terms of time, opportunity and resources to use condoms. While most adolescents in this study were using less effective contraceptive methods, other respondents were not using any contraceptive at all. Use of condoms, withdrawal and calendar methods were well-accepted as compared to the other methods such as the pill, Norplant and injectable contraceptives. Contraceptives that require a health facility consultation were unpopular to the adolescents. Lack of adequate and accurate information was found to be a major hindrance to contraceptive use among the respondents. Information gaps were identified in other contraceptive methods except the condom which was found to be the most widely discussed and used among the adolescents. Religious, cultural and societal beliefs of the respondents held negative attitudes on premarital sex and consequently the use of contraceptives among adolescents. Despite adolescents adopting this negative attitude towards sex, they still indulged in sexual relationships. Rampant misinformation jeopardised the knowledge respondents had consequently hindered contraceptive use as respondents developed negative attitudes towards contraceptives. Respondents lacked details on contraceptives as well as how they are properly used. There is need for the health educators, teachers, parents and others to reach out to the adolescents with accurate information about sex and contraceptives. Civic education should emphasise the positive aspects of contraceptives to the public in general and particularly adolescents in order to increase their awareness, which can affect the intention to use, and the actual use of contraceptives. Adolescents need to be assisted to have goals in life which can help them focus on their future hence delay pregnancy beyond adolescence.