Abstract:
Background: Adolescence is a period between childhood and adulthood when young people undergo major physical, emotional and social development, with significant impact on their sexual and reproductive health, it cutters the age between 10 to 19 years. Some of them fail to overcome the challenges of this important stage and eventually miss the opportunity to realise their full potential in life. About 13% of women and 7% men have been reported to have had sex at age 15 or below. There is inadequate knowledge and use of modern family planning methods. Currently the rate of contraceptive use among in school adolescents is not known. Objectives: To determine the magnitude of use of modern family planning methods and associated determinants among secondary school Adolescents in Ilala Municipality. Methods: This was a cross sectional study design among secondary school Adolescents in Ilala Municipality of Dar es Salaam. Structured Questionnaire was used to collect data from the adolescents and a check list for assessment of health facilities youth friendliness was used. Random samples of 273 adolescents and 8 health facilities were included.
Results: The overall mean age of the participants was 16 years with male significantly older then females (mean age 17.3 versus 16.6, p<0.001). Of those interviewed, 72(26.4%) reported to have had sex and only 15.8% of them reported to have used a modern contraceptive method. Appropriate knowledge about danger period for pregnancy was expressed by 42(15.4%) of adolescents. Poor access to family planning method was reported to be due to lack of awareness about their reproductive rights and afraid of meeting the elderly/older providers A total of 112(41.0%) adolescents reported to have not discussed any topic about adolescent reproductive health with parents/caregivers and only 15.4% of adolescents had appropriate knowledge about danger period for pregnancy. Determinants of family planning use were having a mother, being aware of family planning methods, being knowledgeable on issues related to reproductive health social influence particularly use of FP by friends and discussing reproductive health issues with parents. A total of 263(96.3%) said there is a need
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to guide heads of schools on how to implement the reproductive health policy. and a need to have policy statement regarding access to Adolescents reproductive health services Conclusion: Use of family planning methods is still low among in school adolescents being influenced by poor access to services, lack of knowledge about pregnancy timing, fear for unfriendly health service providers and low parental communication on reproductive related issues. Family planning use was found to be influenced by family factors such as mother alive, parental discussion, peer influence and knowledge. Intervention measure should address parental, peer pressures as well as increasing awareness and knowledge about family planning. Youth friendly clinics have an important role in the provision of reproductive heath services to adolescents. Hence School reproductive health policy review is called for