Mekonnen Alemayehu Gonie, Odo Daniel Bogale, Nigatu Dabere, Amare Nakachew Sewnet, Tizazu Michael Amera
School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.
College of Health Sciences, Arsi University, Asela, Ethiopia.
Contracept Reprod Med. 2022 Sep 1;7(1):16. doi: 10.1186/s40834-022-00183-y.
Various studies have identified different factors that affect adolescent contraceptive uptake in different parts of Ethiopia. However, varying results were reported across primary studies and those results need to be systematically collated to inform policies. Therefore, this systematic review aimed to synthesize the findings of those primary studies to obtain more robust and representative evidence about adolescent contraceptive uptake in Ethiopia.
Five databases (MEDLINE via PubMed, Google Scholar, Scopus, Science Direct and CINAHL) were searched for papers published from January 2000 up to June 2021 in English. We limited our search to start on January 2000 as the health of adolescents have been given more attention after this period and to avoid time-lapsed biases. Seven studies were included in this systematic review. We used the Newcastle-Ottawa Scale and the Mixed Methods Appraisal Tool for quality assessment of the selected studies.
Determinants of adolescent contraceptive utilization were focused on four levels: individual, socio-cultural, healthcare service and knowledge related factors. Individual-related factors that influence adolescents' contraceptive uptake include; being in the age group of 10-15 years, not currently enrolled in school and being from low-income families, while socio-cultural factors include: lack of discussion with family members, arranged marriage, pressure from a partner, harmful traditional practices, discussion with peer groups and sexual partners. Healthcare service-related factors include; lack of information about contraceptives during health facility visits, lack of privacy during service provision and inconvenient service hours at health facilities, and not visiting health facilities, whereas, knowledge related factors include; having knowledge of contraceptive methods and being heard about contraceptives from media. Also, the proportion of adolescent contraceptive uptake ranged from 12 to 79%.
In this systematic, individual, socio-cultural, health-care-related, and knowledge-related characteristics have all been identified as influencing adolescents' contraceptive uptake in Ethiopia. Hence, integrated interventions aimed at overcoming barriers to adolescent contraceptive uptake would be beneficial to improving adolescent contraceptive utilization in Ethiopia.
多项研究已确定了影响埃塞俄比亚不同地区青少年避孕措施采用情况的不同因素。然而，各项初步研究报告的结果各异，需要对这些结果进行系统整理，以为政策提供参考依据。因此，本系统综述旨在综合这些初步研究的结果，以获取关于埃塞俄比亚青少年避孕措施采用情况更有力、更具代表性的证据。
在五个数据库（通过PubMed检索的MEDLINE、谷歌学术、Scopus、科学Direct和CINAHL）中搜索2000年1月至2021年6月期间以英文发表的论文。我们将搜索起始时间限定为2000年1月，因为在此之后青少年健康受到了更多关注，并避免时间推移偏差。本系统综述纳入了七项研究。我们使用纽卡斯尔-渥太华量表和混合方法评估工具对所选研究进行质量评估。
青少年避孕措施使用的决定因素集中在四个层面：个人、社会文化、医疗服务和知识相关因素。影响青少年采用避孕措施的个人相关因素包括：年龄在10至15岁之间、目前未上学以及来自低收入家庭；而社会文化因素包括：与家庭成员缺乏讨论、包办婚姻、来自伴侣的压力、有害的传统习俗、与同龄群体和性伴侣的讨论。医疗服务相关因素包括：在医疗机构就诊时缺乏避孕信息、服务提供过程中缺乏隐私以及医疗机构服务时间不方便，以及未前往医疗机构就诊；而知识相关因素包括：了解避孕方法以及从媒体上听说过避孕药具。此外，青少年避孕措施的采用比例在12%至79%之间。
在本系统综述中发现，个人、社会文化、医疗保健相关和知识相关特征均会影响埃塞俄比亚青少年的避孕措施采用情况。因此，旨在克服青少年避孕措施采用障碍的综合干预措施将有助于提高埃塞俄比亚青少年避孕措施的使用率。
