Utilization Status and Perceived Barriers Towards Long-Acting Reversible Contraceptives Among Female Youth College Students in Northern Ethiopia: A Mixed-Methods Study

Abstract

Mulu Eyasu Weldekiros,1 Mulugeta Tamire,2 Adugnaw Berhane,2 Zenawi Hagos Gufue,3 Ferehiwot Hailemariam Tesfa1 1Health Education and Promotion Unit, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2Health Education and Promotion Unit, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, EthiopiaCorrespondence: Mulu Eyasu Weldekiros, Health Education and Promotion Unit, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia, Email [email protected]: In Ethiopia, teenage sexual activity, unintended pregnancy, and unsafe abortions among youth college students have become the most prevalent public health problems. Contraceptive misuse, low use, and a high unmet need for long-acting reversible contraceptives are attributed to the high rate of unintended pregnancy.Objective: To assess the utilization status of long-acting reversible contraceptives and to explore the perceived barriers among youth female college students in Mekelle City, Northern Ethiopia, in 2019.Methods: An institutional-based, concurrent, mixed cross-sectional study with quantitative and qualitative components was conducted among four private and two public colleges in Mekelle City from March 1 to April 30, 2019. A total of 580 female youth college students were included in the quantitative study, and six in-depth and four key informant interviews were conducted for the qualitative study. The quantitative data were analyzed using descriptive statistics, frequency, and percentages. The chi-square test was done to assess the crude association between the outcome variable and independent categorical variables. A p-value of < 0.05 was considered a statistically significant difference. In addition, ATLAS.ti qualitative software version 7.5 was used to code and analyze the qualitative data.Results: With a 93.8% response rate, 544 female youth college students participated, and 177 (32.5%) were sexually active. Seventy-five (42.3%) of students had a history of pregnancy, and of these, 85% of the pregnancies were unplanned. The utilization of long-acting reversible contraceptives among sexually active college students was 7.3%. Qualitatively, the following themes emerged as perceived barriers to the utilization of long-acting reversible contraceptives: knowledge barriers, fear of side effects, misperceptions, health providers’ approach, discrimination, and poor confidentiality.Conclusion: This study revealed low utilization of long-acting reversible contraceptives among college students. The findings indicate that college students are at high risk of unintended pregnancy, unsafe abortion, and complications.Keywords: long-acting reversible contraceptives, youths, college students, utilization status, Mekelle

Keywords

• long-acting reversible contraceptives
• youths
• college students
• utilization status
• mekelle