ArticleReproductive health2024
Fertility awareness, perceived factors and approaches to improve contraceptive uptake among sexually active adolescent girls in Phalombe, Malawi: a mixed-methods study.
Article in Reproductive health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Trends and socioeconomic inequalities in contraceptive use, skilled birth attendance, and fertility in Malawi (2015-2024).BMC public health · 2026Article
- Classification of knowledge of fertility period among adolescent girls in East Africa from 2012 to 2022: Machine learning algorithm.PLOS digital health · 2026Article
- Knowledge of fertile period and associated factors among adolescent girls and young women in Tanzania: a nationwide survey.Reproductive health · 2025Article
- Demand for and use of modern contraception among young women aged 15-24 years in Malawi: evidence from the Malawi demographic health survey, 2015-2016.Frontiers in reproductive health · 2025Article
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Abstract
backgroundHealthcare practitioners and policymakers in Sub-Saharan Africa face a significant health challenge due to the insufficient fertility awareness and other perceived health outcomes in contraceptive use among adolescent girls. This has resulted in a rise in unplanned pregnancies and other adverse fertility-related health consequences for adolescent girls in Malawi. Consequently, this research examines fertility awareness, perceived factors, and strategies in contraceptive adoption among adolescent girls in Malawi's Phalombe district.
methodsThe study utilized a mixed-methods approach, with the quantitative component employing structured questionnaires administered in person to collect data from school-going adolescent girls in three traditional authorities in Phalombe district, Malawi. The research employed multivariate logistic regression analysis, and its findings were corroborated with qualitative data obtained through focus group discussions involving adolescent girls in the same environment.
resultsThe majority of adolescent females were unaware that their fertile period occurs in the middle of their menstrual cycle, indicating a lack of knowledge regarding their reproductive health. The study examined data from 102 sexually active adolescent females in the quantitative component and 72 adolescent girls in the qualitative component. For the quantitative strand, participants' ages ranged from 13 to 19 years, with a mean age of 16.5 and a standard deviation of 1.5. In the qualitative portion, the study conducted interviews with adolescent females aged between 10 and 19 years, with a median age of 15 years. Services that were not tailored to youth needs served as barriers to contraceptive use. Factors that facilitated contraceptive use included a preference for receiving contraceptives from peers, which was associated with a higher probability of usage (AOR: 4.80, 95% CI 1.31-17.32). Moreover, adolescent females who were identified as Catholic (AOR: 14.01, 95% CI 2.50-78.47) or belonged to other Christian denominations (AOR: 5.85, 95% CI 1.20-28.25) exhibited a greater likelihood of using contraceptives compared to their Muslim counterparts. The focus group discussions suggested making contraceptives available in educational institutions, analogous to the distribution of iron supplements.
conclusionAdolescent girls in the Phalombe district seemingly have low awareness and knowledge of their fertility, which may lead to unintended pregnancies. Adolescent girls are unable to access modern contraceptives, and there is a need for youth-friendly structures when delivering contraceptive services. Additionally, participants indicated that community midwives and health surveillance assistants should provide contraceptives within the communities to reduce distance.
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