Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa.
Department of Epidemiology & Biostatistics, School of Public Health, University of Zambia, Lusaka 10101, Zambia.
Int J Environ Res Public Health. 2023 Feb 17;20(4):3614. doi: 10.3390/ijerph20043614.
Low contraceptive use in sub-Saharan Africa, and Zambia specifically, negates the potential benefits of contraception in preventing unwanted and early pregnancies. This study aimed to explore and understand the motivators and influencers of adolescent girls' contraceptive decision making. Using thematic analysis, we analysed qualitative data from seven focus group discussions and three key informant interviews with adolescent girls aged 15 to 19 years in four Zambian districts. The data were managed and organised using NVivo version 12 pro (QSR International). Fear of pregnancy, fear of diseases, fear of having more children, and spacing of children (especially among married adolescents) were key motivators for adolescents' contraceptive use. Friends and peers motivated them to use contraceptives while fear of side effects and fear of infertility drove non-use. Peer pressure and fear of mocking by their friends were important deterrents to contraceptive use. Parents, peers and friends, family members, partners, churches, and religious groups influenced adolescent girls' contraceptive decisions. Mixed messages from these influencers, with some in favour and others against contraceptives, make adolescents' decisions to use contraceptives complex. Therefore, interventions targeting increased contraceptive use should be all-inclusive, incorporating multiple influencers, including at institutional and policy levels, to empower adolescents and give them autonomy to make contraceptive decisions.
撒哈拉以南非洲，尤其是赞比亚，避孕药具使用率低，这使得避孕药具在预防意外怀孕和早孕方面的潜在益处化为泡影。本研究旨在探索和了解少女避孕药具使用决策的动机和影响因素。我们采用主题分析方法，对来自赞比亚四个地区的 15 至 19 岁的 7 个焦点小组讨论和 3 个关键知情人访谈的定性数据进行了分析。使用 NVivo 版本 12 pro（QSR International）对数据进行管理和组织。对怀孕、疾病、生育更多孩子的恐惧以及（尤其是已婚青少年中的）孩子间隔是少女使用避孕药具的主要动机。朋友和同龄人促使她们使用避孕药具，而对副作用和不孕的恐惧则导致她们不使用。同龄人的压力和对被嘲笑的恐惧是避孕药具使用的重要障碍。父母、同伴和朋友、家庭成员、伴侣、教会和宗教团体影响少女的避孕药具决策。来自这些影响者的信息相互矛盾，一些人赞成，另一些人反对避孕药具，这使得少女使用避孕药具的决定变得复杂。因此，针对提高避孕药具使用率的干预措施应该是全面的，包括多个影响者，包括在机构和政策层面，以使青少年获得授权并自主做出避孕药具决策。
