Sexual behaviour, reproductive health and contraceptive use among adolescents and young adults in Mbale District, Uganda

Abstract

Results from a survey of adolescents and young adults in Mbale District in Uganda are presented. First sexual experience among female and male respondents occurs at quite an early age, 15 years for males and 16 years for females. Most respondents claimed to have received information on reproductive health. The accuracy of these self-assessments was rather poor as a relatively small proportion of the respondents could identify the safe period in a woman's menstrual cycle. The incidence of adolescent pregnancy is generally high and slightly higher in rural than in urban areas. A relatively large proportion of pregnancies occur out of wedlock. The respondents' contraceptive knowledge was quite good but many still engaged in unprotected sexual relations. The most commonly used methods were the condom and the pill. The main reasons given for non-use were lack of knowledge about contraceptives, beliefs that they were not safe, and their non-availability. This calls for improvements in family planning education and in accessibility of contraceptives.

PIP: A 3-phase adolescent fertility survey was carried out in Uganda starting in 1988. This report presents data from household and individual questionnaires collected in Mbale District for the third phase in August 1990. 1357 adolescent and young adult respondents (15-24 years old) comprised the sample (146 urban males, 330 urban females, 356 rural males, and 525 rural females). Information was solicited on education, religion, employment, marital status, age at first intercourse, frequency of intercourse, number of partners, pregnancy, abortions, and childbearing, sexually transmitted disease experience and knowledge, and contraceptive knowledge and use. It was found that most of these young people were sexually active, and many initiated sexual activity before age 15 years. Most reported having received information about reproductive health, but few could identify the safe period in a woman's menstrual cycle. There were contradictions between behavior and attitudes, with many more young people reporting that they engaged in sexual behavior than reporting that they approved of premarital sex. Whereas levels of contraceptive knowledge were quite high, actual usage was very low. The condom, oral contraceptives, and rhythm method were most often used, but many respondents stated that they lacked enough knowledge to use contraceptive, they believed contraceptives were not safe, or contraceptives were not accessible to them. It is recommended that more educational programs be devised to counter the factors which will encourage high fertility in this population.