Bwambale Mulekya Francis, Moyer Cheryl A, Bukuluki Paul, van den Borne Bart
Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), University of Maastricht, Maastricht, Netherlands.
Global Reach, Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI, United States.
Front Reprod Health. 2022 Jul 29;4:869118. doi: 10.3389/frph.2022.869118. eCollection 2022.
This paper aims to describe and assess social demographic factors associated with childbearing decision-making, fertility and contraceptive intentions among street adolescents and youth in Kampala, Uganda while considering rural-urban migration as an explanatory factor.
A cross-sectional survey of 513 adolescents and youth aged 12-24 years self-identifying as street adolescents and youth were interviewed with a structured questionnaire in 2019. Street adolescents and youth who migrated from other rural districts to Kampala were compared with those from the city. Logistic regression was performed to assess associations between the independent factors and personal childbearing decision-making, fertility and contraceptive intentions.
Overall, 80.31% of the street adolescents and youth had a rural-urban migration experience. Fifty six percent (56.32%) of the street adolescents and youth made personal childbearing decisions, 94.15% expressed intentions to have children in the future and 42.88% expressed intentions to use contraceptives in the future. Intentions to use contraceptives were significantly higher among males (58.75%) than females (20.00%), and higher among migrants (65.91%) compared to non-migrants (34.09%). Contraceptive intentions were positively associated with self-perceived permanent residential status (aOR = 10.26, 2.70-39.08), intra-urban mobility (aOR = 4.99, 95%CI 1.50-6.59) and intentions to migrate to other towns within the country (aOR = 5.33, 95%CI 1.59-17.80). Being married (aOR = 0.13, 95%CI 0.02-0.85), a large shelter population size (aOR = 0.13, 95%CI 0.03-0.63) and having repeat migrations between the city and home district (aOR = 0.23, 95%CI 0.05-0.94), including migration-associated challenges reduced the odds of street youth's personal childbearing decision-making, while belonging to a social support group increased the odds of childbearing decision-making. We found no significant association between social demographic characteristics and fertility intentions.
Factors that influenced personal childbearing decision-making and contraceptive intentions among street adolescents and youth in Kampala operate mainly at the interpersonal and community levels, with marital status, shelter population size, rural-urban migration and its associated challenges associated with childbearing decision-making. Interventions to promote childbearing decision-making and contraceptive use among street adolescents and youth should take into consideration their migration and intra-urban mobility patterns.
本文旨在描述和评估与乌干达坎帕拉街头青少年和青年的生育决策、生育意愿和避孕意愿相关的社会人口因素，同时将城乡迁移作为一个解释因素。
2019年，对513名年龄在12 - 24岁、自我认定为街头青少年和青年的人群进行了横断面调查，采用结构化问卷进行访谈。将从其他农村地区迁移到坎帕拉的街头青少年和青年与来自城市的进行比较。进行逻辑回归以评估独立因素与个人生育决策、生育意愿和避孕意愿之间的关联。
总体而言，80.31%的街头青少年和青年有城乡迁移经历。56.32%的街头青少年和青年做出了个人生育决策，94.15%表示未来有生育意愿，42.88%表示未来有使用避孕措施的意愿。男性（58.75%）使用避孕措施的意愿显著高于女性（20.00%），移民（65.91%）高于非移民（34.09%）。避孕意愿与自我感知的永久居住状态（调整后比值比[aOR]=10.26，95%置信区间[CI]2.70 - 39.08）、市内流动（aOR = 4.99，95%CI 1.50 - 6.59）以及迁移到该国其他城镇的意愿（aOR = 5.33，95%CI 1.59 - 17.80）呈正相关。已婚（aOR = 0.13，95%CI 0.02 - 0.85）、避难所人口规模大（aOR = 0.13，95%CI 0.03 - 0.63）以及在城市和家乡地区之间反复迁移（aOR = 0.23，95%CI 0.05 - 0.94），包括与迁移相关的挑战，降低了街头青年个人生育决策的可能性，而属于社会支持群体则增加了生育决策的可能性。我们发现社会人口特征与生育意愿之间没有显著关联。
影响坎帕拉街头青少年和青年个人生育决策和避孕意愿的因素主要在人际和社区层面起作用，婚姻状况、避难所人口规模、城乡迁移及其与生育决策相关的挑战有关。促进街头青少年和青年生育决策和避孕使用的干预措施应考虑他们的迁移和市内流动模式。
